Laughter is the best medicine

Anyone who has read doctor-turned-comedian Adam Kay’s best-selling ‘This Is Going to Hurt’ about his experiences on the obstetrics wards will be aware that medicine provides rich pickings for humour and satire.

But Kay is not the first person to draw on medical experiences to amuse his audiences. For as long as modern medicine has existed, medics and patients have been finding the humour in their experiences, helping to inform on attitudes and experiences from that time.

One such example is this excerpt from the October 1869 magazine, Punch. Written by Francis Cowley Burnand, a nineteenth century comic writer and playwright whose popular column ‘Happy Thoughts’ describes the difficulties and distractions of everyday life.

In this excerpt, Burnand turns his attentions to the doctor’s waiting room, in a scenario that will be very familiar to anyone who has ever made an appointment to see their General Practitioner. The narrator’s attempts to catch the doctor’s eye and jump to the front of the queue are ultimately dashed and he is forced to wait his turn like everyone else. The incident ends in embarrassment when he misplaces the doctor’s fee inside the lining of his coat.

The gentle observational humour illustrated in this column gives insight into the type of medical treatment available to the upper classes, while also demonstrating how little doctor’s waiting rooms have changed in the last 150 years.

The working relationship between doctors and nurses is also very neatly satirised in the following engraving from 1891. The Doctor asks the Nurse: “How is the patient this morning?” To which she replies, “Well – he has been wandering a good deal in his mind. Early this morning I heard him say ‘What an old woman that doctor is!’ – and I think that was about the last really rational remark he made.”‘

This comedic interchange about a delirious patient could just have easily occurred on one of today’s NHS medical wards.

As well as providing entertainment, humour and satire have also been used to highlight public health and social issues. In the following satirical cartoon from an 1893 issue off Punch, ‘Mr Punch’ remonstrates with a policeman about a quack doctor selling his ‘remedies’ on the streets of London. Saying, ‘And if Punch’s ready bâton lays its thwacks on any back with special zest, it is on charlatans and quacks.’

The cartoon highlights the movement against quackery towards the end of the nineteenth century, with a higher degree of ‘outcry’ against quacks that promoted false and unproven health claims for financial gain. While we are less likely to see ‘cure-alls’ pedalled on street corners, ‘quackery’ in the form of misinformation regarding vaccination and cancer treatments still exists as a scourge in modern medicine.

 

Flora Malein

The October 1869 Happy Thoughts article in full:

Image courtesy of Peter Burke

Sources used:

Chisholm, Hugh, ed. (1911). “Burnand, Sir Francis Cowley” . Encyclopædia Britannica. 4 (11th ed.). Cambridge University Press. p. 848.

The Wellcome Library

Tuberculosis, Philately and the history of the ‘Christmas seal’

Paris: Comité National de Défense contre la Tuberculose; Quimper: Comité d’Hygiène Sociale du Finistère, [between 1930 and 1939?]. Image Credit: Wellcome Collection, CC BY.

Christmas has long been recognised as a time of charity and fundraising. Perhaps familiar to some is the ‘Christmas seal’ – a label placed on post over the Christmas period – to raise awareness and funds for charitable organisations.

Christmas seals fall into a category known as ‘cinderella stamps’: items that resemble stamps but cannot be used in payment for postage

While the Christmas seal concept has been adopted to raise funds for many different types of charitable organisations, they have most closely been allied to raising awareness of tuberculosis. According to a New York Times article, the concept originated in Denmark in 1904, when a Danish postal worker called Einar Holbøll came up with the idea to sell the penny seals to raise money for children with tuberculosis.

Other countries quickly followed suit with fundraising seals being produced to support tuberculosis causes in Sweden, Iceland and Argentina.

At the time, tuberculosis was still one of the major causes of death globally. And despite the discovery of the M. tuberculosis bacillus by Robert Koch in 1882, no effective treatment had been found. Organised national efforts to combat the disease were looking for means to raise awareness and financial support for the disease. These campaigns can be seen as some of the very first public health initiatives, in which the financial contributions of ordinary people were used to fund treatment of a disease.

Picture credit: W. Dibb Private Collection.

The first American Christmas seals were produced in 1907 by a Red Cross volunteer called Emily Bissell, who adopted the idea to help raise money for a tuberculosis sanatorium in Delaware that was under the threat of closure if a sum of $300 was not raised.

Although she could not get permission to have the U.S. national postal service to print and distribute the seals, as they had in Denmark, she was allowed to privately sell the seals in the post office lobbies. The seals were such a success they raised over ten times the amount needed and became an annual tradition that raised major funds for The National Tuberculosis Association (now known as the ‘American Lung Association’). The American Lung Association continues to sell their Christmas Seals™. Selling tuberculosis Christmas seals has also funded major disease prevention programmes in countries, such as Canada, through chest X-ray screening or tuberculin tests.

The Cross of Lorraine

National Tuberculosis Association, 1940. Image Credit: Wellcome Collection, CC BY.

Many examples of the Christmas seals created to raise funds for tuberculosis charities contain the symbol of the double-barred cross. Symbolically known as the ‘Cross of Lorraine’, it was adopted as the symbol of the fight against tuberculosis at the International Conference on tuberculosis held in Berlin, 1902.

A French doctor – Gilbert Sersiron – proposed the emblem which had been the banner of Godfrey of Bouillon, one of the leaders of the first Crusades who successfully laid siege to Jerusalem and became it first ruler. In adopting this Crusader symbol, the cross became a symbol of the new, organised anti-tuberculosis ‘crusade’.

 

Flora Malein

 

 

 

 

 

You can read more about postal items and infectious disease in a previous post, here

Sources used:

The New York Times: https://www.nytimes.com/1989/12/24/style/pastimes-stamps.html

The American Lung Association: https://www.lung.org/get-involved/ways-to-give/christmas-seals/history.html

The Canadian Lung Association: https://web.archive.org/web/20111115234620/http://lung.ca/involved-impliquez/christmas-noel/history-histoire/index_e.php

TB Alert: https://web.archive.org/web/20090302074617/http://www.tbalert.org/about/cross.php

John, Simon (2017). Godfrey of Bouillon: Duke of Lower Lotharingia, Ruler of Latin Jerusalem, c.1060-1100. Taylor & Francis. ISBN 978-1-317-126300.

https://wellcomecollection.org/works/msbjucxs

https://wellcomecollection.org/works/hdh9a7xw

The Humble Toothbrush

This blog focuses on the humble toothbrush: that everyday object that we too easily take for granted. Although many may consider the toothbrush a fairly insignificant and disposable item, it actually has rather an interesting history…

Early forms of the toothbrush have been in existence since about 3000 BC. Some Egyptian tombs have been found to contain ‘toothsticks’ demonstrating that cleaning teeth was clearly considered an important activity thousands of years ago.

It wasn’t until 700 AD that bristle toothbrushes were invented in China. These toothbrushes comprised of handles made of bone or bamboo and while bristles were fashioned from the hairs from the back of a hog’s neck!

 

Image 1: Toothbrush with horsehair bristles, London, England,1870-1920. Credit: Science Museum, London, CC BY.

 

Image 1 shows two toothbrushes that are part of a collection from the Science Museum in London. Both are made by the firm Savory and Moore. Savory and Moore was actually a dispensing chemist, and was the only retail outlet allowed in the district of Belgravia at the time. It served the royal family so it would be reasonable to assume that the owner of these toothbrushes was fairly wealthy. The toothbrush handles are made of ivoride, whilst the bristles are horsehair.

Nylon bristles were first used for toothbrushes in 1938. This new form of toothbrush was rapidly adopted due to growing concerns about oral hygiene during the Second World War. Indeed, the first truly ‘electric’ toothbrush was invented at the end of the 1930s. However, it was deemed ineffective and so sales never really took off. 1954 saw the introduction of ‘Broxodent’, the first usable electric toothbrush. However, this toothbrush was fairly unsafe given its high voltage and the fact that it was typically used in the bathroom where the presence of water further enhanced its electrocution danger! It wasn’t until 1961 that a cordless and rechargeable model of electric toothbrush became available, manufactured by General Electric – this sold much better. The electric toothbrushes that we have today have come a long way: they run on a lower voltage, have improved battery life and are rechargeable.

And the history of toothpaste? Well that’s another story..!

 

 

Further reading

  • ‘The History of the Electric Toothbrush,’ accessed 4/8/19. Available at: https://www.electricteeth.co.uk/the-history-of-the-electric-toothbrush/
  • ‘Prison, Suicide, & the Cold-Climate Hog (the sordid history of the toothbrush,’ The Museum of Everyday Life, accessed 4/8/19. Available at: http://museumofeverydaylife.org/exhibitions-collections/previous-exhibitions/toothbrush-from-twig-to-bristle-in-all-its-expedient-beauty/a-visual-history-of-the-toothbrush

 

Lucy Havard

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

 

The Story of the Stethoscope

One might not automatically recognise the image below as that of an early version of the medical stethoscope. It certainly looks very different today. This blog focuses on the invention of this instrument, synonymous with the medical profession, over 200 years ago.

 

Laennec-type monaural stethoscope, France, 1851-1900. Credit: Science Museum, London. CC BY.

 

Where did it all begin?

The story of the invention of the stethoscope begins with a young French physician in Paris, René Laennec. It was in 1816 that Laennec was called to see a rather fat and buxom young woman with a ‘diseased heart’. Feeling awkward, embarrassed and improper at putting his ear so close to this woman’s chest in an attempt to listen to her heart, Laennec sought to find an alternative method. He described his predicament and later actions in the medical text De l’Auscultation Médiate, published in August 1819:

I happened to recollect a simple and well-known fact in acoustics, … the great distinctness with which we hear the scratch of a pin at one end of a piece of wood on applying our ear to the other… I rolled a quire of paper into a kind of cylinder and applied one end of it to the region of the heart and the other to my ear, and was not a little surprised and pleased to find that I could thereby perceive the action of the heart in a manner much more clear and distinct than I had ever been able to do by the immediate application of my ear.’

Laennec modified this method of a rolled up piece of paper to make a wooden cylinder, measuring 25cm by 2.5cm. He called this piece of equipment a ‘stethoscope’, the name derived from the ancient Greek stethos meaning ‘chest’, and skopein meaning ‘look at’. The stethoscope became an essential item in Laennec’s medical bag and he utilised it to listen to both the heart and lungs of his patients.

 

Reception

Although a few physicians resisted the introduction of the stethoscope, maintaining that it was best to listen only with one’s ear, the vast majority of the medical profession embraced its use. The invention quickly spread over Europe in the early 1820s and the design was further developed and improved upon. By the end of the nineteenth century, this wooden instrument had morphed into something more akin to the modern-day stethoscope. Flexible tubing, first made out of rubber, and then plastic, made the stethoscope both easier to use and transport; whilst binaural earpieces improved the quality of the sound for the listener. The stethoscope works by transmitting acoustic pressure waves from the chest-piece through the hollow tubes to the listener’s ears. Today, there are even more advanced electronic stethoscopes which amplify body sounds improving further the sound transmitted.

 

A 19thcentury stethoscope with a bell-shaped end. Credit: Wellcome Collection. CC BY.

 

The meaning of the stethoscope

The significance of a stethoscope in the twenty-first century cannot be under-estimated. It confers identity and, to a certain degree, status. Its wearer is automatically assured to be a member of the medical profession. It implies trust, understanding and knowledge. In this way, Laennec’s stethoscope is incredibly valuable, both from a diagnostic and symbolic perspective.

 

 

 

Further Reading

‘The story of Renee Laennec and the first stethoscope,’ Past Medical History. Available at: https://www.pastmedicalhistory.co.uk/the-story-of-rene-laennec-and-the-first-stethoscope/, accessed 9/3/19.

‘Stethoscope,’ Brought to Life – Exploring the History of Medicine. Available at: http://broughttolife.sciencemuseum.org.uk/broughttolife/techniques/stethoscope, accessed 9/3/19.

 

 

Lucy Havard