Wesley Pilgrimage

Dear Readers,

I am taking a hiatus from posting, since I need to finish lots of home things before leaving for the "Wesley Pilgrimage," sponsored by the General Board of Discipleship, which begins October 4 in Salisbury, England.  It will be a 10 day tour, and then I will spend another week doing research in Oxford for this blog.

I must confess that Technology is Not My Friend.  I suspect that computers, like telephone salespeople, take advantage of one's hesitation and refuse to cooperate to prove they are In Charge.  I have a new Asus Ee-pad, which I have named "Alice" after the Alice in "Dilbert," who is smarter than anyone else at the company and is continually frustrated with how stupid her coworkers and boss are.  I am hoping she takes pity on me and cooperates while we are in England.

I understand Blogger is having difficulty posting photographs, so my plan to post blog photos with Alice may have to wait until I get home and someone can help me figure it out.  I will try to post whenever I can about early Methodist medicine, but have no idea how busy the tour, or how strong our Internet connection, will be.
So wish me the best and I will excitedly share what I discover!

(For a description and more information about the "Wesley Pilgrimage, next held April 15-24, 2013, see http://www.gbod.org/site/c.nhLRJ2PMKsG/b.5717529/k.26AD/Wesleyan_Pilgrimage_in_England.htm. 
(Source of picture: Wellcome Library, London)

"Gin Lane" and "Beer Street"

Thomas Hogarth, that commentator on London society via his paintings and etchings, tried to dissuade people from drinking gin and convince them to drink beer. Therefore, in 1751 he published “Gin Lane” and “Beer Street.”

In “Gin Lane” (above) Hogarth depicts the evils of gin. We begin in the center with the mother – a prostitute with syphilitic sores on her legs – who is so drunk she lets her baby fall into a gin den below. When you look to the left, a neglected child fights with a dog over a bone to chew on. Above the child, a man and woman are pawning their tools for gin – he his carpentry tools and she her cooking pots. To the right of them, a dead woman is loaded into a casket while her abandoned child is left on the ground. The drunk in the wheelbarrow is being given more gin, while the woman on the far right is feeding her baby gin. In front, a man who has sold his clothes for gin apparently has died, while an anti-alcohol pamphlet, “The Downfalls of Mrs. Gin” falls out of his basket.

 

In “Beer Street” (above) although people are drinking they are relaxing after work and have their work tools with them. People are prosperous, happy, and affectionate. Yes, there is a crumbling building to the right of the picture, but it is the pawnbroker, who needs his beer delivered through a window possibly because he is so poor he can’t come out.
These and other efforts led to the increased restriction of gin sales and when the price of grain to make gin rose, “the gin problem” decreased throughout the second half of the 18th century (Olsen, 240).
Both images from Wellcome Library, London.
There is a really nice comparison between the two depictions at http://en.wikipedia.org/wiki/Beer_Street , if you are interested.

Gin

“[T]he principal sustenance (if so it may be called) of more than a hundred thousand persons in this metropolis [of London],” was Henry Fielding’s description of gin.  If his estimate was correct, then 1 in 7 Londoners was addicted to gin.  It’s estimated that people drank an average of six gallons a year.  It was cheap – a penny for half a cup.  Shops even advertised somebody could get drunk for a penny and “dead drunk” for twopence.  To get dead drunk was so prevalent that for an additional three pennies one could rent a double bed of straw in order to sleep until sober.  Everyone – men, women, and children – then slept together in a single room while drunk (Olsen, 239).    Alcohol was considered the panacea for everything, and was the drug of choice for the English (Olsen, 241).

“Wine cures the gout, the cholic [stomach pain], and the tisic [tuberculosis],

And is for all men the very best of physic.

He that drinks small beer, and goes to bed sober,

Falls, as the leaves do, that die in October.

But he that drinks all day, and goes to bed mellow,

Lives as he ought to, and dies a hearty fellow.” (Olsen, 240.)

You can imagine the number of people who died from the effects of alcohol and alcohol poisoning.  Would you have thought, though, that nursemaids would give it to pauper children in their care to keep them quiet?  In 1751, 9000 children died of gin poisoning (Picard, 124).

Alcohol

So if your food is tainted and your water is poisoned, what is another alternative?  Coffee was too expensive. Although the English love tea, it was also expensive – tea leaves were so dear that after the rich had used them once, they were resold by enterprising cooks to the poor for reuse (Olsen, 238).  The price of tea was controlled by the East India Company (an English firm).  In 1700, when poor and middle income families made £15-50 per year, a pound of tea cost £1!  (Waller, 193-94.)  Tea also has no nutritional value.  So people drank alcohol, usually too much (Olsen, 238).

Rich people drank French, Rhenish, Spanish and Portuguese wines.  Middle income people drank or made home-brewed beer, including cock-ale.

“To make cock-ale, take ten gallons of ale [beer] and a large cock [rooster], the older the better, parbroil the cock, flea him and stamp him in a stone mortar till his bones are broken (you must craw and gut him when you flea him), then put the cock into two quarts of sack, and put to it three pounds of raisins of the sun stoned, some blades of mace, and a few cloves: put all these into a canvas bag, and a little before you find the ale has done working, put the ale and bag together into a vessel.  In a week or nine days’ time bottle it up, fill the bottles to just above the neck, and give it the same time to ripen as other ale.” (Olsen, 192.) – The Compleat Housewife, 1739 (http://en.wikipedia.org/wiki/Cock_ale, accessed 24 September 2012).

However, once imported Dutch gin was introduced to the poor, it caused devastating effects.  More about that tomorrow.

Food with additives

Not only was food inadvertently contaminated, but things were added to it to make it more palatable.  Professionally made bread included chalk and alum to make it white.  Bread in London was described by a doctor as “a deleterious paste mixed up with chalk, alum, and bone ashes, insipid to the taste and destructive to the constitution.”  Bread could also be made with bad corn.

Not only was there lead in drinking water, but acids in foods released the lead used in pottery or pewter containers, and cooking in copper and brass pots added those poisonous chemicals to food, too.  Turpentine was used to flavor gin.  (Picard, 64-65.)  Sugar was cheap but whitened by lime (the chemical, not the fruit).

The cholesterol levels in people of this time must have been incredible.  Not only was meat the mainstay of the middle and upper classes, but butter was lathered on vegetables and meat, and cheese was eaten in huge amounts.

 

Additives that were thought to be helpful included spices familiar to us.  Black pepper was supposed to cut phlegm and help with digestion (however, it inflames the blood if crushed to small).  Ginger helps with gas (“the expulsion of wind”).  Saffron unstuffs pipes of the lungs, and cloves are good for the head, heart, stomach, and eyes. (Waller, 187-88.)  Obviously, if your meat was spoiled you would want to add spices to cover up the rancid taste

Food without refrigeration

You could easily get sick on food in 18th century England. Hannah Glasse’s advice in her book “The Art of Cookery Made Plain and Easy” included a chapter on shopping. Watch for spoiled milk and vegetables contaminated by human waste, she advised. Butchers routinely sold spoiled meat as fresh, so Glasse recommended, “observe the colour of the meat; for it is be stale or tainted, it will be of black colour, intermixed with yellowish or greenish specks. If it be old, the flesh will be tough and hard, the fat contracted, the hoofs large and broad, and the heel horny and much worn.” (Olsen, 232-33.)
The British were famous for how much meet they ate. French visitor Henri Misson wrote, “I always heard they were great flesh eaters, and I found it true. I have known several people in England that never eat any bread, and universally they eat very little. They nibble a few crumbs, while they chew the meat by whole mouthfuls.” (Waller, 180.)
Remember how we talked about the filth on the streets of London when animals were led to slaughter? They were slaughtered in the open air and then sold in the open air. Think flies, flies and more flies. Think no refrigeration and the stench of rotting blood.
So not only was meat (which the poor got seldom) contaminated, vegetables contaminated, but the water was also contaminated. Sewage ran off London streets into the Thames River and then the river water was piped through lead pipes to either homes or to numerous public pumps. (Olsen, 238.) Lead poisoning is particularly bad for children, as it affects neurological development and can cause behavior problems and learning disabilities. The poisoning can be bad enough in both adults and children to cause seizures, coma, and death. Think of the safe and wonderful plumbing we have today! And the next time you open your refrigerator, give thanks.

Quacks

And then there were the quacks, the people whose treatments or concoctions were out and out fraudulent. We’re already acquainted with Dr. John Case.  This is his advertisement:

 

Hogarth (below) shows what he thinks of quack doctors in his moral painting of the viscount Squanderfield holding a small pill box, which probably contains mercury pills or venereal disease “cures.” The young woman is a prostitute, dabbing her mouth where an early syphilis sore is located. The office is filled with the accoutrements of a medical practice – skull on desk, skeleton in closet (!) next to a life size anatomical figure, and an apothecary’s showcase to the left holding earthenware. (Wellcome Library, accessed 11 September 2012.)

The worst were the mountebanks, who travelled around selling their supplies from a portable stage in the street. Ned Ward reported that he observed a couple of women fighting with a rowdy crowd around them, when suddenly:

“Just as the squabble was ended and before the rabble was dispersed, who should be stumbling along upon his hidebound prancer [horse], but a horse-mountebank, who seeing so rare an opportunity to hold forth to a congregation already assembled, spurred up his foundered Pegasus [a mythological horse with wings], and halting in the middle of the crowd, plucked out a packet of universal hodge-podge, and thus began his oration to the listening herd.”
The quack was advertising a packet for six pennies with a combination of:
 A pill that gave one twenty stools to take away twenty distempers
 A plaster that was good for all wounds, pains and aches, broken bones, “or any hurt whatsoever”
 A powder to fortify the stomach, by protecting it from infections, recovery when one had overeaten, and getting rid of worms
 An antidote to other medical treatments, such as mercury, arsenic, and opium. This one also cleaned and refastened one’s teeth.
Ward recounts: “This impudence so tickled the ears of the brainless multitude that they began with as much eagerness to untie their purses, and the corners of their handkerchiefs [where they had tied their coinage], and to be free of their pence, as they usually are to buy apples by the pound, or to purchase the sight of a puppet show, that it was as much as ever the doctor could do to hand out his physic fast enough. Thus they continued flinging away their money, showing there were fools of all ages, from sixty to sixteen, many of them looking as if they could scarce command as much more till next Saturday night when they received their wages; till at last, either the doctor broke the crowd of their money, or the crowd the doctor of his physic. Then away he trotted on horseback with their pence, and left his patients to trudge away on foot with his packets.” Ward thought it appalling that these quacks would plan as a “business to cheat the common people not only out of their money, but often out of their health, which is far more valuable.” (Waller, 90-93.)

(All pictures from Wellcome Library, London.)

This picture identifies John and Charles Wesley preaching in the background! Even around the message of God, the mountebanks took advantage. Wonder if any of them were converted?

Next time, we'll go back to talking about why people were so willing to try any kind of cure, even if it seems ridiculous to us.  Now aren't you grateful for physicians and pharmacists and the FDA and physical therapists and nurses and all of the other medical people you can trust?

Apothecaries

Apothecary with wife, son and assistant making various powders and tinctures.  (Source: Wellcome Library, London)

“The term apothecary, often used between the 1600s and 1800s, does not refer to the chemist and druggist, or pharmacist. It was used for individuals living in London who had passed the examinations of the Worshipful Society of Apothecaries of London, founded in 1617, or to their often less well qualified counterparts in the provinces. The role of the apothecary developed out of the role of the spicer or pepperer – or grocers – someone whose trade included crude drugs and prepared medicines. The Grocers had their own Guild – professional body in the City of London- from the 13th century. The Apothecaries split from them in 1617 to form their own Society.

“Although the apothecary's practice included a strong dispensing element, it was more all encompassing than the handling of drugs and chemicals. Apothecaries were also examining and treating patients, but they did not charge for these services – only for the medicines supplied. Following a ruling in the Rose Case (1701-1703/4), apothecaries became legally ratified members of the medical profession, able to prescribe as well as dispense medicines.

As apothecaries moved into a more advisory role, pharmacists (or chemists and druggists) could develop their own area of preparation and supply of medicines. However, this put them in competition with the apothecaries who were also still involved in the same area. The apothecaries attempted to control the chemists and druggists' activities in 1748 with a proposed new law to control the supply of medicines. This didn't progress.” – Royal Pharmaceutical Museum (http://www.rpharms.com/about-pharmacy/history-of-pharmacy.asp, accessed 9 September 2012.)

By the early 19^th century, apothecaries had become doctors who dispensed their own medicines, in other words, English general practitioners (or GPs). (Worshipful Society of Apothecaries in London, http://www.apothecaries.org/index.php?page=101, accessed 9 September 2012.)

Barber-surgeons

Physicians were not expected to either draw blood or perform surgeries.  These tasks were the responsibility of the surgeons, or the barber-surgeons.  Their training was even worse than the physicians, and they often got stuck with jobs the physicians did not want, such as in prisons and on ships during war.  Other than bleeding, surgeries were very rare, since everyone knew the dangers of infection although they did not know how infections were passed.  The typical surgeries were cutting out cancers of the skin and breast, removal of stones in the bladder, tonsillectomies, drilling holes in the scalp to relieve pressure on the brain, and amputations. No clean surgery rooms in this age – surgeries were performed on wooden operating tables with sawdust on the floor to absorb the blood.  Surgeries were short – a good surgeon took out bladder stones in 30 seconds to a minute and amputated a leg in 2-4 minutes (Olsen, 262-64). 

Surgeons knew more about anatomy than physicians.  In London surgeons had to have served a 7 year apprenticeship, whereupon they became members of the Worshipful Company of Barber-Surgeons.  The barbers did blood-letting, extracted teeth, shaved beards and heads, and made wigs.  Since the barbers sold condoms, their partners the surgeons ended up being the experts at venereal disease (Waller, 86-89).

 

18th century amputation instruments used by surgeons (Source: Wellcome Library, London)

Physicians, part three

A physician and a surgeon doing their respective work -- the physician is checking a vial of urine and the surgeon is "bleeding" the patient while his assistant is ready with the bleeding bowl. (Source: Wellcome Library, London.)

To counteract their bad reputations (earned when a lot of them had deserted London during the 1665 plague), one group set up what we would call a low cost health clinic, which they called a public dispensary.

“That the physicians might clear themselves of this false charge, they have been obliged to set their care of the poor more in the eyes of the world than heretofore; not only giving advice gratis to the poor at their own and the patients lodgings, but appointing public dispensaries also for the poor to resort to every day of the week (except Sundays) where they may both have the best advice gratis, and also proper medicines, for their respective cases at the lowest value; whereby the poor are at once delivered from the danger of the apothecaries ignorance in practice, and alos from the oppressive charge of their medicines.” – The Necessity and Usefulness of the Dispensaries Lately Set Up by the College of Physicians in London for the Use of the Sick Poor.
(Waller, 84-85.)

 However, Wesley and the Methodists did the same thing. He set up two clinics in 1746 – one at his home base the Foundery, and one in Bristol – that dispensed both advice and remedies for free. Regarding the Foundery clinic, he wrote, “I found there had been about six hundred [patients] in about six months. More than three hundred of these came twice or thrice, and we saw no more of them. About twenty of those who had constantly attended did not seem better or worse. Above two hundred were sensibly better, and fifty-one thoroughly cured.” (Wesley, John, “Journal,” quoted in Rogal, Samuel. “Pills for the Poor: John Wesley’s Primitive Physick” in The Yale Journal of Biology and Medicine 51 (1978), 81-90, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2595647/, accessed 16 September 2012.)

More next time on the other branches of health care – apothecaries and barber-surgeons.

Physicians, part two

Most people thought physicians were quacks. For example, there was the shocking and lurid case of Mary Toft [or Tofts], who apparently gave birth to a litter of rabbits. She fooled several imminent physicians, whose careers were then in question. She was anatomically able to insert portions of animal carcasses and small rabbits inside her vagina, and then faked giving birth. Since she never got anything from it other than attention, her motives were unclear. The medical profession was severely mocked for its gullibility, and the primary doctor published an advertisement in the Daily Journal to try to explain himself. His patients deserted him and he died in poverty.

(University of Glasgow Special Collections Department. “The Curious Case of Mary Toft: 1726”, August 2009, at http://special.lib.gla.ac.uk/exhibns/month/aug2009.html, accessed 16 September 2012.)

Mary Toft "giving birth" surrounded by physicians. (Source: Wellcome Library, London.)

Dr. John Case was not a physician, although he titled himself one – how would the gullible and ill know any differently? He advertised “the excellencies of Doctor John Case’s pills for the speedy cure of violent pains without loss of time or hindrance of business on the other,” reported Ned Ward in his nonfiction book “The London Spy”. (Waller, 90.)
It is easier to understand a lot of the physicians being almost incompetent, when those educated at Oxford and Cambridge got rotten educations, and the better universities were Glasgow and Edinburgh. Except for London, York, Newcastle, and Bristol (each had a long-established physicians or barber-surgeons’ guild), one did not have to take an examination to practice medicine. There were many physicians who had formerly been clergy, (Olsen, 262) including John Wesley’s great-grandfather Bartholomew Wes(t)ley, who became a physician full time after his refusal to sign a government document that required use of certain prayers, rites, and sacraments as prescribed by the Church of England, and thus was fired from his pastoral position.
(Maddox, Randy. “John Wesley on Holistic Health and Healiing” in Methodist History, 46:1 (October 2007), http://archives.gcah.org:8180/xmlui/bitstream/handle/10516/564/Methodist-History-2007-10-Maddox.pdf?sequence=1, accessed 13 September 2012.)

Being a physician then did not produce the respect it does now.

Physicians, part one

The Wellcome Library has entitled this etching as "Physician Arguing with A Patient." Doesn't he look snobbish?  You can see the patient is a wealthy person, of such financial resources that she is able to afford a physician.  (Source: Wellcome Library, London)

“The practice of physick in London and seven miles round, being for near two hundred years settled by law, wholly in the College of Physicians in London … [but] they come to enjoy so small a part of it [the business and profit of practicing medicine]. Chymists and distillers, astrologers and mountebanks, midwives and nurses, and the whole train of broken-tradesmen doctors have everyone their share. There are not a few [patients] that are their own doctors, and practice upon themselves; and there is hardly any one so unkind, as not to recommend to his sick friend what has done himself good. The College can only blame these last for indiscretion: And the former are the most of them hardly worth the charge of prosecution; yet the College have been ever and anon making an example of one or other of them, to strike terror into the rest.” – The College of Physicians.
In other words, the physicians ought to treat everybody, according to the physicians. After all, they had 14 years of education at Oxford or Cambridge and could study Hippocrates and Galen in ancient Greek and Latin. (Hippocrates and Galen were known as the fathers of Western Medicine. Hippocrates lived 460-370 BC and Galen 129-about 200 AD.) The pharmacists, known as apothecaries, only served a 7 year apprenticeship.
However, in 1700 there were only 60-80 physicians in London, serving over 500,000 Londoners. The apothecaries numbered 1,000. There weren’t enough physicians, they were expensive, and they didn’t seem to be able to cure more successfully than anyone else. Although they talked a good talk, as quoted above, they were mostly thought of as quacks who catered to the rich. To be fair, people didn’t consult them until patients were very ill, so the ill person could have been beyond hope the first time they ever saw a physician.
(Waller, 82-83.)

Almost anyone can give health care advice

We’ll cover more about medical personnel in 18^th century England later, but it was quite common for someone educated and intelligent to diagnose and treat others.  They didn’t even have to be medically qualified.  Not only John Wesley, but Samuel Johnson, who wrote “A Dictionary of the English Language” and was a great literary critic, was proud of his medical knowledge.[1]

Did you know that part of the training for a Church of England clergy in the 1700s was in medical care?  The Church even gave out licenses to practice, especially in small towns and rural villages where people usually had no other source for medical advice.[2]

 

The man on the right is Samuel Johnson -- notice he is wearing a wig, while John Wesley (below) is not. Johnson had such poor eyesight that he often singed his wigs because he held the candle too close to his eyes.[3] One reason Wesley probably did not wear a wig was because he didn’t need to shave his head to prevent lice attaching to the roots, since he was very fastidious and clean

Sorry – off on a tangent.  Therefore, as clergy and an intellectual, Wesley felt perfectly within his rights to write a health care book and to recommend treatments.

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[1] Picard, xvii.

[2] Madden, Deborah. “Wesley as an Advisor on Health and Healing” in Maddox, Randy and Jason Vickers, The Cambridge Companion to John Wesley(New York: Cambridge University, 2010), 181.

[3] Picard, 226.

Images: Wellcome Library, London.

What the heck does "Primitive Physick" mean?

And why would anyone name their blog after it?  John Wesley believed that the Church should return to the model of the early and original formation of the Body of believers, especially the Church before Constantine (272-337 AD).  To him, “primitive” meant early or original.[1]  “Physick” was a term indicating health care, especially “how to live in accordance with nature by proper diet and exercise, both to restore health and to retain it,” says Randy Maddox.[2]  We would probably use the term “holistic medicine” as the modern meaning of “physick.”

 So John titled his health care book “Primitive Physick.”  I called this blog primitivephysick because I wanted to understand the health care of the early Methodists, and then share it with you in an entertaining and interesting way.  Please, however, note that I am citing resources the same as I would for a term paper, so you know the info is legit.

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[1] Snyder, Howard.  Northern Nazarene University. Quoted from http://weley.nnu.edu/johnwesley/translating-wesley’s-writings-into-late-20th-century-american-general-english, accessed 1 September 2012.

[2] Maddox, Randy.  “John Wesley on Holistic Health and Healing” in Methodist History, 46:1 (October 2007), 4-33.

Frontispiece from one of the editions of "Primitive Physick" by the Rev. John Wesley. Source: Wellcome Library, London.

Bethlem Hospital

Yesterday, you saw Tom Rakewell ending up in Bethlem Hospital, one of the London hospitals for mentally ill people.  These are the statues from over a former door at Bethlem.  They represent "melancholy" and "raving."  Today I would identify them as the two opposing emotional states of bipolar disorder, what we used to call manic-depression.  One pole of bipolar is severe depression ("melancholy") and even suicidality.  The other pole is mania ("raving") to the point where someone is unable to control themselves and has pressured speech, tangential conversation, and can be either irritable and angry or grandiose and euphoric.  The guy above is so manic he has to be shackled.  Since people were bipolar 250 years ago, how can anyone argue it is not a biochemical imbalance?  (Image courtesy Wellcome Library, London.)

Great website on Bethlem Hospital at http://www.bethlemheritage.org.uk. Click on the “Visiting Bethlem” section. Clicking on the “How to Use” box worked better for me than on the “Click Here to Begin”.
For a description of what visitors would have seen of the hospital, click on “Attitudes to Mental Health”, go to 1760 on the timeline and click on the female “FAQ” photo posted there.
“Was visiting ever a positive experience?” is presented when you click on the male FAQ photo
For a theological reason to visit Bethlem, move the timeline cursor to 1780 and click on the woman’s photo.
For one gentleman’s abhorrence of gawkers visiting Bethlem, click on the 1796 box.
If you click on ‘Visitors” and then on the FAQs above 1700 and 1790, the questions of what people really saw at Bethlem and why visitation was stopped will be answered.
For another perspective on how patients were treated, go to “Staff” and then the box marked “1786.” Accessed 9 and 12 September 2012.

"Rake's Progress" in 1733

Source:  Wellcome Library, London.

William Hogarth was an English artist and engraver, who painted a moralistic series about Tom Rakewell, a symbolic dissolute young man who over time marries wrongly, spends all his money, drinks all the time, and eventually ends up in Bethlem Hospital.  Have you ever used the term, “bedlam”?  The word came from the colloquial description of what happened at Bethlem Hospital (check the spelling – it was not “Bethlehem.”)  Hogarth painted the series to be made into engravings people would buy, and this is probably his best known series.

The Bethlem Hospital website says it best, “The engravings depict Bethlem in caricature but of course Londoners and visitors had another, more direct source of information about conditions inside the hospital – until 1770 they could visit the hospital in person without restriction.  At holiday times, especially, Bethlem attracted quite large crowds.  It was even listed as an attraction in tourist guides of the time.  There is no suggestion that the Hospital ever objected to the way in which Hogarth had depicted it – indeed, he was elected onto its Court of Governors in 1752.

“This last scene takes place in one of the long corridors or ‘galleries’, which ran the length of the building and functioned as ward space.  Patients were housed and treated in separate areas of the hospital according to gender and diagnosis.  Metal grilles helped maintain the separation.    Though some patients were secluded, the majority had relatively free movement through the gallery as can be seen here. 

“Tom Rakewell lies in the foreground in a pose reminiscent of the statues by Caius Gabriel Cibber which surmounted the entrance to the Moorfields building.  [I’ll post a picture of that tomorrow.]  He already appears to be manacled.  His fellow patients exhibit signs of different disorders.  The man standing on the stairs represents religious delusion; the seated man below him, disappointment in love. In a cell on the other side of the gallery, a man wearing the crown (but otherwise naked) suffers from delusions of grandeur.

"Surveying the scene, and using their fans to hide their blushes, are two lady visitors.” – from www.bethlemheritage.org.

More on Bethlem Hospital and care of the hospitalized mentally ill tomorrow.

 

Sewage

“Sweepings from butchers’ stalls, dung, guts, and blood, / Drowned puppies, stinking sprats, all drenched in mud, / Dead cats and turnip tops” all ran into the streets whenever it rained, wrote Jonathan Swift in his poem, “Description of a City Shower.”

You could tell you were approaching London by the stench of sewage and other waste dumped on the outskirts of town. Streets were covered with human excrement and urine, since many people used the streets to relieve themselves and often chamber pots were dumped outdoors. Add to this all the animals walked to market – cattle, sheep, pigs, and poultry -- and the stuff they left behind, and then the rotting stuff left over after they were slaughtered … well, you get the idea.

If you were middle or upper class, you might have the plumbing to be able to dump your excrement without having to go outside. Then you hired a “night man and rubbish carter” or “night soil collector” to come nightly to empty your cesspit under the house. If your home had this kind of plumbing, it stank to high heaven because the odors came right back up the pipes (think about the smell of a pit toilet at a park). Fortunately, in 1775, Alexander Cummings invented the U-bend filled with water, which prevented the smells from rising. U-bends are still in use today. Now can I make the joke about 18th century crappers really smelling like crap?

Oh, and all of this leaked into the water supply.

(Olsen, 59, Waller, 95. Picard, 14-15 and 45-46, Waller, 95.)

Fancy chamber pot with funny verse on it. Source: Wellcome Library, London.

This is a satirical cartoon from 1788. The man with the crown is actually the Prime Minister, but I have included this to show he is sitting on a commode with the chamber pot underneath.
Source: Wellcome Library, London.

Forceps and instruments

Obstetrical forceps of 18th century.
Source: Wellcome Library, London

Surgical instruments, 18th century.
Source: Wellcome Library, London.

The Wellcome Library is a wonderful website to find pictures of both modern and historical medical practices and artifacts.  I would highly recommend it!  To quote them, "Wellcome Images is a medical picture library and the world's leading source of images on medicine and its history."   http://images.wellcome.ac.uk/

Childbirth (for babies)

Like the mother, childbirth wasn’t a picnic for the baby, either. In order to get it to breathe, noted obstetrician Dr. Smellie recommended the baby be “moved, shaken, whipt [author’s italics]: the head, temples, and breast rubbed with spirits, garlic, onions or mustard applied to the mouth and nose.” If that didn’t work, then he suggested blowing into the mouth to expand the lungs. Early CPR, aye?
By 1700, forceps had just been invented for assisting with the removal of the infant or its corpse.

(Picard, 158)

Childbirth

“When they [pregnant women] are in labour, and when they lie in, they encompassed with many difficulties and dangers …” – John Peechy. OK, think of it. All of you who have had a Caesarean section, in the 18th century, your chances of dying during childbirth were pretty good. Caesareans were only done if the mother had already died or there was a good chance she would. And if she didn’t die before or during the birth, the infection caused by the surgeon’s unwashed hands would do her in, since the infections were almost 100% fatal. There was a move from female to male midwives, called “man-midwives,” and one of the biggest complaints about them was they used forceps too often. Female midwives were not allowed to use surgical instruments because they were not part of a professional association (Like the College of Physicians, for example) and not allowed to form one. Female or male, however, nobody washed their hands or their birthing tools. This resulted in “childbed fever”, also known as puerperal fever. Even in uncomplicated deliveries, women could still get and die from puerperal fever. It didn’t help that the method of “assisting” the birth was to lubricate the midwife’s hands with duck grease and literally pull the baby and the placenta out, ripping the mother. Tradition was the soiled bed linen was not to be changed until she was allowed to sit up, two weeks after the birth. It is amazing any mother survived. Waller, Maureen. 1700: Scenes from London Life. (New York: Four Walls Eight Windows, 2000), 47. Olsen, 269-70. Waller, 50. Olsen, 269-70. Waller, 49. Waller, 52.

Life Expectancy

John Wesley lived a LONG time for his time – 87 years. Charles lived until he was 80. They came from a long-lived family – dad Samuel died at 72 and mom Susannah at age 73. Their brother Samuel lived to 49, still pretty good for the time. Liza Picard explains life expectancy in the 18th century like this: 50-60% of London children died before the age of 10 (especially before the age of 2). When adolescents came to London to get jobs, they would sicken and die because they had no immunity to London diseases. For a woman, she then has to get through child-bearing years – no easy feat – and old age was considered to be 30. In England and Wales in 1751 the life expectancy was 36.6 years according to modern-day estimates. However, living in contagious, polluted and over-crowded London, it’s thought expectancy was mid-20s. Don’t you feel really healthy now?

(Picard, Liza. Dr. Johnson’s London: Coffee-Houses and Climbing Boys, Medicine, Toothpaste and Gin, Poverty and Press-Gangs, Freakshows and Female Education (New York: St. Martin’s Press, 2000), 156-57.)

Why?

Why in the world would I write a blog like this on such an erudite subject? In The United Methodist Church deacons are clergy called to work in the world. I am a psychiatric nurse now, and have been a hospice nurse and a parish nurse. I like history, and am taking a trip to England on the Wesley Pilgrimage. Although my starting point is John Wesley because he was the primary force (besides God) in forming the unique river of Christian faith called Methodism, I expect to find other spiritual leaders who addressed health at the beginning of the Methodist movement. So how does that apply to your life? I think every one of us takes our current medical care for granted. I'd like to show you how far we have come since the 18th century, led by the Holy Spirit. If I can discover it, I'd like to also explore the integration of faith and health at that time. So I will be posting featured facts for your frequent and frenzied fascination

Lice

Since this blog is about medicine in the time of John Wesley (1703-1791) and the beginnings of Methodism, let’s begin with information about ordinary health. We’ll start with the really creepy stuff. Lice. Lice bite to suck blood. Since people seldom took full baths and most often simply washed their faces and hands, lice stayed with you. They were found most in crowded places like military camps, hospitals and prisons, but they could also infest the most aristocratic homes. Wooden bedposts were prime breeding grounds. You could even get a job as a lice catcher. They were so bad in hospitals that they stuck to walls, beds, and even physicians’ clothing. Patients at Chelsea and Greenwich Hospitals raced captured lice against each other. Lice did have one redeeming attribute however, if you wanted to treat yourself for jaundice, you ate nine live ones. Yuck! (Olsen, Kirstin. Daily Life in 18th Century England (Westport, Connecticut: Greenwood Press, 1999), 267-68, 133, 265, and 273.)

This blog will sometimes take itself seriously and sometimes not. Thanks to my professor for this contribution! Click the text to see a "Horrible History" about 18th century medical care.