Plague Houses and Pandemics – Some comparisons between 1665 and 2020

Posted on 19th September 202420th September 2024 by Lee Coppack | 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 21^st and the 17^th centuries was the realisation in the 17^th 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

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

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

Posted on 28th July 202428th July 2024 by Lee Coppack | 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 3rd June 20243rd June 2024 by Lee Coppack | 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 20^thcentury, 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.

An unflattering view of English medical education in the 1840s

Posted on 12th March 202412th March 2024 by Lee Coppack | Leave a comment

In about 1841, Belgian doctor Constantin Pierre Crommelinck toured various psychiatric institutions in England, France, and Germany. His report reviewed not just various English asylums and also the training of English doctors. Peter Carpenter recounts his none too flattering findings.

Constantin Pierre Crommelinck (1814-1884) was the son of a Belgium surgeon who trained as a doctor and became a teacher of anatomy at the École de Médecine in Bruges. He initially had some success as a surgeon, but then turned to psychology and psychiatry. There is no official biography for Crommelinck, but his entry in Dutch in Wikipedia indicates he was not an easy colleague.

In about 1841, he toured various psychiatric institutions in Belgium, France, England and Germany and also investigated the training of English doctors. The following year, he reported his findings to the Belgian Minister of the Interior Jean-Baptiste Nothomb: Rapport sur les hospices d’aliénés de l’Angleterre, de la France, et de l’Allemagne. (A report on asylums of England, France and Germany, 1842).

In this report, he made recommendation for the design and therapeutic organisation of future Belgian asylums. His descriptions of various asylums in England are little known in the UK, other than that of Gloucester Asylum, which appears in several biographies of Samuel Hitch, the founder of the first British psychiatric association in 1841.

Hunterian anatomy school, London, 1839 by R. B. Schnebbelie, Wellcome Collection

English medical education mocked

In the same report, Crommelinck took the opportunity to make very pointed remarks on the English medical profession and medical education. While commenting on the richness of England’s material resources, he mocked the surgeons’ habit of having an apprenticeship and then attending a selection of classes in London. He wrote:

“At the end of three years’ training with a physician or surgeon, where the pupil has learned (and how else?) physiology before anatomy, therapeutics before pathology, and practice before anything else, he goes back to school, … spends two years there, and qualifies as a physician or surgeon-apothecary. These two years pass like the other three, with the only difference that all the branches are no longer taught by one and the same individual, but by five or six, all teaching pell-mell, without troubling themselves about each other or prescribing to their disciple any order to follow. …Thus the pupil begins, and attends pell-mell, lessons in physiology, anatomy, therapeutics, pathology, medical and surgical clinics, childbirth, etc.

Having attended lessons from each teacher, Crommelinck then went on to describe the anatomy lesson as the most absurd, ridiculous and contrary to common sense. “I will cite among others the one that Mr. Macmurdson gave at St. Thomas Hospital. It was the tenth since the opening of his course; it related to the mucous membranes: all the students, with two or three exceptions, were true beginners. Fifty jars containing different pathological or monstrous alterations of the mucous membranes were placed on the table.

“Mr. Macmurdson took a notebook from his pocket and, using his finger to mark his place, began to read very fast a long, profound and learned dissertation on the past, present and future, healthy and sick, natural and monstrous state of the mucous membranes in man as in other animals. The most scabrous questions of theory and practice were discussed in this reading; he talked about typhus, inflammation, cancer, tumours haemorrhage, bleeding, leeches, calluses, strictures, astringents, styptics, molluscs, pachyderms, mammals, Peyer’s glands, Brunner’s glands – do I know what a jumble of absurdities did not come out of his mouth, while seriously begging his students to pay scrupulous attention to the elementary principles that were going to develop before them?”

[Pages 69-71, Peter Carpenter’s translation]

Rather than pretending to listen and understand, wrote Crommelinck, the students had fun cutting figures in the benches, whispering among themselves and kicking each other. They “ended the farce by applauding excessively when the hour of freedom arrived.”

The lecturer compared with Molière’s comedic doctor from the play Le malade imaginaire, was probably Gilbert MacMurdo, a surgeon at St Thomas’s in the 1846 Medical Directory. It is surprising that Crommelinck named an individual, but the early signs of irascibility seem to have ripened into vitriol later in his career.

Peter Carpenter is a retired psychiatrist who researches the history of UK mental health institutions.

Further reading:

Rapport sur les hospices d’aliénés de l’Angleterre, de la France, et de l’Allemagne is available at the Wellcome Library and the library of the Royal College of Psychiatrists. Digital copies can be found by internet search.

https://nl.wikipedia.org/wiki/Constantin_Crommelinck

Bringing X-rays to the front

Posted on 8th January 20248th January 2024 by Lee Coppack | Leave a comment

Edwin Aird describes how Marie Curie created radiological cars to take X-rays to the battlefront in Word War I.

In 1914 at the beginning of the First World War, Paris was under threat of invasion from Germany. The situation was sufficiently alarming that the French Government moved to Bordeaux. And Marie Curie moved the precious 1 gm of radium that she had isolated to deposit in a bank in Bordeaux in a very heavy lead pot.

Once the radium was safe, Curie returned to Paris, where one of her daughters took her to visit a hospital to see the war wounded. Curie quickly realised the potential value of having X-rays near the battle front for surgeons to use. As her daughter Eve Curie wrote: “A luxury, the magic arrangement whereby a rifle bullet or fragment of shell could at once be discovered and localized in the wound.”

She already understood the properties of X-rays, but taught herself their application, production and development, fluoroscopy (not so called at the time), and the components of X-ray systems, generators, transformers etc. To get the X-ray machines to the front, however, meant mobile units or radiological cars. And they did not yet exist. So she created them.

Les Petites Curies

Founding director of the Red Cross Radiology Service, Curie built her first radiological car from a large Renault. She persuaded wealthy acquaintances and the Union of Women of France to help her build a fleet of 20 radiological cars. They became known as Petites Curies. Her daughter Irene, (who later received a military medal and won a Novel prize herself with her husband, F. Joliot) assisted in the field.

The image shows Marie Curie's level of involvement with the mobile X-ray machines.

Marie Curie at the wheel of one the Petites Curies, the mobile X-ray machines she created

The conditions under which Curie worked must have been horrendous, but she played down the overall impact of the noise/smells/dangers. Eve Curie said: “She was never to speak of the hardships and dangers to which she exposed herself during those four years… She showed her working companions a careless and even gay face…The war was to teach her that good humour is the finest mask of courage”.

According to Marie Curie herself, during these years it had been possible to X-ray approximately 900,000 injured people. She wrote: “Towards the end of 1918 there were more than 500 fixed and semi-fixed radiological stations in service in the hospitals of the territory and in the armies with a further 300 mobile devices on cars, on sterilisation trucks and motor surgical ambulances. Approximately 400 radiologists served these devices, aided and partly replaced by auxiliary personnel, including manipulators trained at the Institute Curie.”

Marie Curie died in July 1934 from pernicious anaemia, which she attributed to the high X-ray exposures she received during the war.

She remains one of the few people to receive two Nobel Prizes and the only woman to do so. The French Academy of Sciences rejected her membership in January 1911 – only months before her second Nobel Prize. It never elected her. Otherwise, her brilliance, drive and public service were widely acknowledged. In total, she received 8 major prizes, 16 medals, 104 titles and authored 483 papers.

Marie Curie and her daughter Irene

References and further reading

Curie, Maria, “La Radiologie et la Guerre” (in French) : Marie Curie. Librairie Felix Alcan 1921
Curie, Eve, “Marie Curie”: (1938, Windmill Press Surrey)
Van Tiggelen, Rene (Brussels), “La Grande Guerre 1914-1918”
Simthsonian Magazine Oct 2017
Jogensen, TJ BJR Papers: “Marie Curie and Pierre Curie and the discovery of radium” by Eve Curie BJR July 1950;” Marie Sklodowska Curie 1867-1934” by Claud Regaud BJR, Sept 1934
Thomas, Adrien, “The first 50 years of military radiology 1895-1945” European J Radiology 2007; 63: 214-219
https://www.pbs.org/newshour/science/the-day-marie-curie-got-snubbed-by-the-french-science-world

Edwin Aird is retired Director of Medical Physics at Mount Vernon Hospital, Northwood with more than 40 years in NHS as researcher, teacher and examiner.