Surgery in hospitals (and homes)

As surgeons separated from barbers, took anatomy classes, practiced dissection, and joined hospitals, their expertise increased.  Surgeries happened in both hospitals and homes.  They were not done for repair, but for issues that could be visibly seen, such as cancer and gangrene, or when the pain got to be unbearable, as in bladder stones.  Not many people died from bladder stone surgery, which was called "cutting for the stone."  Bladder stones were common due to poor access to good water (the Thames River was filthy), drinking alcohol, and not having the correct diet.

English amputation saws
surrounding
French amputation knife
Wellcome Museum, London
14 October 2012

It was not uncommon to amputate a whole limb due to gangrene, but more people chose to die of the gangrenous infection rather than to have a surgery that would lead to infection. Sixty percent of patients got "wound fever," which was thought to be a bad reaction to the surgery by the patient, catching something from the other patients, or from miasma [noxious and poisonous fumes]. The fact that bacteria was transmitted from the surgeon's dirty clothes or dirty hands, or from the multitudes of students and general public watching, was completely unknown. If the patient made it 5 days post-surgery, his or her outlook was pretty good (Mathias).



Surgery to remove a malignant armpit tumor
in Dublin drawing room, 1817
(Wellcome Library)

Again, you can see the patient above being held down for the surgery, since he was awake for it.  Fanny Burney (1752-1840) wrote of her own mastectomy on 30 Sepetember 1811,
"When the dreadful steel was plunged into the breast - cutting through veins - arteries - flesh - nerves - I needed no injunctions not to restrain my cries.  I began a scream that lasted unintermittingly during the whole time of the incision - and I almost marvel that it rings not in my Ears still! so excruciating was the agony.  When the wound was made, and the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp and forked poniards [slender and small knives], that were tearing the edges of the wound - but when again I felt the instrument - describing a curve [around the breast] - cutting against the grain, if I may so say, while the flesh resisted in a manner so forcible as to oppose and tire the hand of the operator, who was forced to change from the right to the left - then, indeed, I thought I must have expired.


Fanny Burney
www.pbs.org/wgbh/masterpiece/
wives/writers/burney.html

" ... [P]resently the terrible cutting renewed - and worse than ever, to separate the bottom, the foundation of this dreadful gland [the cancer] from the parts to which it was adhered - Again all description would be baffled - yet again all was not over - Dr Larrey rested but his own hand, and - Oh Heaven! - I then felt the Knife rackling against the breast bone - scraping it! - This performed, while I yet remained in utterly speechless torture, I heard the Voice of M. Larrey ... in tone nearly tragic, desire every one present to pronounce if any thing more remained to be done; The general voice was Yes, - but the finger of M. Dubois - which I literally felt elevated over the wound, though I saw nothing, and though he touched nothing, so indescribably sensitive was the spot - pointed to some further requisition - and again began the scraping! - and after this, Dr Moreau thought he discerned a peccant* attom** - and still, and still, M. Dubois demanded attom after attom ..." (Hemlow, Joyce, et al. (ed.) The Journals and Letters of Fanny Burney (Madame D'Arblay), vol 6 1975, 596-616, quoted by Old Operating Theatre and Herb Garret Museum.)

English amputation saws
Wellcome Museum, London
14 October 2012

 Is it any wonder that lots of patients ran away from the hospital the night before surgery? (Mathias.)

*peccant = "1. guilty, criminal. 2. Ill-disposed; corrupt; bad; offensive to the body. 3. Wrong; bad; deficient; unformal" (Johnson).
**attom [atom] = "1. Such a small particle as cannot be physically divided. 2. Any thing extremely small" (Johnson).

Hospitals

Hospitals began to be established in London in the 18th century, founded for those who were indigent and sick.  However, they probably didn't help much and may have even spread disease (Olsen, 18).  Some of the London hospitals were:
- Foundling Hospital for abandoned babies (actually an orphanage)
- St. Bartholomew's

Current hospital sign
13 October 2012

- St. Thomas's for the Sick and Poor [site of the current Old Operating Theatre and Herb Garret]
- Bethlem ("Bedlam")
- The Westminster
- Guy's Hospital [noted for having the first common privy in 1774 and the first indoor toilets in 1788 (Olsen, 265)]
- St. George's Hospital for the Sick and Lame
- The London Hospital


Entrance to
St. Bartholomew's Chapel
13 October 2012

- The Middlesex
- The New Lock Hospital for venereal disease
- 3 smallpox hospitals
- St. Luke's private hospital for the mentally ill
- maternity hospitals for the last month of pregancy and labor.

Admissions skyrocketed from 13,000 in 1744 to 38,000 in 1749.  To be admitted to most hospitals, a patient had to have an authorization letter from a hospital governor (Picard, 78-95), who was a wealthy person who had donated to the hospital both for philanthropic reasons and for the right to recommend patients for admission (Picard?).

Patients were expected to refrain from swearing; at Guy's Hospital one would be discharged after the third offense.  Patients were also expected to assist the nurses with tasks and could be discharged -- cured or not -- if they did not comply (Olsen, 265-67). 



St. Thomas's Diet, 1741
(Old Operating Theatre and Herb Garret)





A third of the patients admitted to St. Thomas' Hospital in the early 1800s were there for syphillis.  They were the first fee-paying patients.  Previously, since hospitals were charitable organizations, patients were only admitted if they were poor enough and if they were curable.  Hospitals did not admit someone who could die (Mathias).

Teaching hospitals did not exist most of the 18th century (Wellcome Museum, permanent display, 14 October 2012), although as time went along, hospitals became more willing to train both physicians and surgeons.  These posts were highly desired (Olsen, 265).  The oldest operating room in Europe is found today at the Old Operating Theatre and Herb Garret, in a building from 1703.

Surgical table with box of sawdust underneath to catch blood
Old Operating Theatre and Herb Garret
15 October 2012

Old Operating Theatre with view to stalls for students
15 October 2012

Remember, this was before the understanding of how infections were passed and therefore of sterilization.  The practice of using carbolic acid to sterilize surgical instruments and surgeons' hands did not begin until the 1860s (Mathias).  So think of the bacteria that grew in all that wood!



John Wesley, electrical quack? today

John was not a quack.  His goal was to provide good health care for people who were desperately poor.  He electrified at his three free health clinics and while he traveled.  All the profits from the sales of his texts were plowed back into caring for the poor.  He also kept empiric records of the illnesses that responded to electrical treatment, and propounded one could call electricity "the Desideratum, the general and rarely failing remedy, in nervous cases of every kind (palsies excepted)." (Wesley, Preface, Desideratum, 7, p. vi, quoted in Schwab, 181.)  He noted that paralytic cases often relapsed, while rheumatic cases showed lasting improvement after initial deterioration (Schwab, 181).

According to Dr. Gordon Gadsby, a specialist in electrotherapy from Leicester, England:
"For if we examine the following list of conditions which are treatable by electricity, especially in the form of electroacupuncture, as we enter the twenty-first century, we then find that many of the conditions listed are the same as Wesley's, with the exception of infectious conditions [remember, they did not know about the transmission of infections in the 18th century], e.g. agues [fevers] and consumption (tuberculosis) etc.
"Implications Today
"a.  acne vulgaris, acutely painful conditions; anxiety states and panic attacks; alcohol addiction; amenorrhoea; anal fissure, analgesia during childbirth; angina pectoris; ankle joint pain; arthrosis of jaw joint; asthma - bronchial;
b.  biliary colic and dyskinesia; bronchitis - chronic;
c.  cardiac neurosis; cardiovascular disorders; cholangitis; collapse; conjunctivitis - chronic; constipation; coxarthritis; coxarthrosis.
d.  deafness; depression; diarrhoea; dizziness; drug addiction; Dupuytren's contraction; dysmenorrhea; dysphagia;
e.  eczema; enuresis; epicondylitis; exhaustion states.
f.  facial paralysis; fainting; fertility - male; frozen shoulder.
g.  gastric and duodenal ulcer; gastritis; gastroenterological disorders; gonarthrosis; gynaecological disorders;
h.  hand pain; headache; haemorrhoids; hemiparesis; herpes; hyperemesis gravidarum; hypertension; hypotension.
i.  impotence; intercostal neuralgia; irritable bowel disease;
k.  knee joint pain.
l.  labyrinthitis; lactation deficiency; leg ulcers; locomotor disorders; lumbar pain.
m.  musculo-skeletal disorders - all; mental disturbances and illnesses; Meniere's syndrome; migraine; motion sickness; ME; MS;
n.  neurodermatitis; neurological disorders; nicotine addiction;
p.  periarthritis humeroscapularis; peripheral blood supply disturbances; prostatitis; pruritis vulvae; post herpetic neuralgia.
r.  renal colic; respiratory disorders; rheumatoid arthritis.
s.  salpingitis; sciatica; sense organ disturbances; sexual disturbances; skin disorders; spondylosis - alkylosing; spondylosis -cervical; sinusitis - frontal and maxillary; stress management;
t.  tennis elbow; thorax trauma; tinnitus; torticollis, trigeminal neuralgia and other facial pains including TMJ.
u.  urological disorders, symptoms and psychogenic problems;
w.  wound healing deficiency; wrist pain/carpal tunnel syndrome.
This late twentieth-century [1998] listing is even longer and more comprehensive than Wesley's (1759) list[.]" (Gadsby, 3.3.3.7, np.)

John Wesley, electrical quack? and physicians

Physicians believed that cures by electricity were theoretically impossible according to their training in Hippocrates' and Galen's methods.  Therefore, the physicians asserted, the results were either fraudulent or due to enthusiasm (Barry, 155).

 1789 medical electrical machines from
The New Royal Encyclopaedia, 2nd edition
(Wellcome Library)

William Dyer, a Bristol businessman who practiced medicine, recorded that after he bought a electrical machine (he had read The Desideratum), that several Bristol surgeons bought them and even St. Peter's Hospital in Bristol obtained one.  He sadly noted the machines "never did much good therewith, probably from want of the will and labour to attend to the application." (Barry, 153).  In 1767 the Middlesex Hospital got one, in 1777 St. Bartholomew's followed suit, and in 1778, St. Thomas's Hospital obtained an electical machine (Madden, Cheap, 248).  In 1793, the London Electrical Dispensary was founded by William Hawes (remember him?  He was the one who criticized Primitive Physick so mercilessly).  Its purpose was to give free electrical treatment to poor people, and between 1793 and 1814, the dispensary treated 300 patients per year (Madden, Cheap, 254).  

John was quite frustrated with physicians' overall lack of interest in electrical therapy (Madden, Cheap, 269-70).  He admitted in The Desideratum that "the electrical method of treating disorders cannot be expected to arrive at any considerable degree of perfection, till administered and applied by the gentlemen of the faculty [physicians]" and said this would not happen until "the gentlemen of the faculty have more regard to the interests of their neighbours than their own."  (Wesley, John.  The Desideratum, quoted in Gadsby, Gordon.  "The Rev. John Wesley MA (1703-1791) - Pioneer Electrotherapist: A History of Medicine Study" from "Electroanalgesia: Historical and Contemporary Developments", selections from PhD thesis, 1998, www.drgordongadsby.talktalk.net/page 12.htm, accessed 3 December 2012.)  By the 1781 edition of The Desideratum, the back pages included endorsements for "electric chains["] by over 10 "gentlemen of the faculty["], including four of the Queen's physicians (Malony, np), but the support for electrification was sporadic.

John's living room with original furniture,
electrical machine in back corner in glass box
(Photo used with permission of
The Museum of Methodism and John Wesley's House
London)

Electricity was used in the 1770s to restart a child's heart (Sophia Greenhill had fallen from a window), but it was also used by "Dr." Joseph Graham in his Temple of Health.  Unfortunately, due to the use of electrification in quackery, by 1900 medical electrical treatment was abandoned except for resuscitation and later, electroconvulsive ("shock") therapy (Schwab, 193).

John Wesley, electrical quack? how machine worked

This post is for all the electrical engineers, physiotherapists and psychiatrists who want to know how John's electrical machine worked.  The rest of you have my permission to skip today.

 

John's electrical machine
(Image used with permission of
The Museum of Methodism and John Wesley's House) 

"It consists of a hollow glass cylinder (7 1/2 in. long by 4 1/2 in. diameter) supported on two wooden uprights.  Through it runs a metal bar to which a handle is attached, by means of which the cylinder can be freely rotated.  A leather pad (to which is firmly attached a piece of black silk) is pressed against the cylinder.  It is controlled, very simply, by a thumbscrew.  On an attached platform (8 in. long by 5 in. wide) and mounted on a glass insulating column, is a metal arm with a thin rod (9 1/2 in. long) attached to it, at the end of which is a small metal ball 1 in. diameter.  The whole Amachine [sic] is mounted on four glass insulating legs (4 1/2 in. in height)." (Woodward, M.W. "Wesley's Electrical Machine.  Nursing Mirror (1962): 114 (Suppl. 2978), 10, 16, p. x, quoted in Maloney, np.)

 

"Presumably the patient caught hold of the ball and as the metal arm made contact with the rotating cylinder, got a shock C [sic] the intensity depending upon the vigor with which the handle was turned.  It is important to note that this was a "friction machine["] which discharged electric current in one discharge and was not a "continuous current["] apparatus such as became possible after Allessandro Volta developed the first electric battery in 1799, eight years after Wesley's death.  Continuous current apparati are those used in electroconvulsive shock treatment.  This does not mean that it was impossible to administer harmful shocks with friction machines.  By storing up current in Leyden jars, which were available to Wesley, it was possible to vary the amount of shock administered.  Also, some machines had attached "wands["] with insulated handles, which could administer varying amounts of shock dependent on the distance the wand was held from the area of the body toward which it was directed.  Current could be built up by turning the handle.  More powerful shocks jumped greater distances." (Malony, np.).

 

In The Desideratum, John reviewed the known literature of the time, including that of the Frenchmen J.P. Marat (1743-1793).  "Marat distinguished among five methods, three of which Wesley might have used.  The first method, Marat termed l'electrisation par bains in which the patient would sit in an insulated chair and hold a conductor from the machine (e.g., the metal ball) while the handle was turned to generate current.  The body was thus bathed in the warmth of electricity.  The second method was a variation of the first and was labeled l'electrisation par impression de souffle.  In this method the conductor was placed on the affected body part, which then received a focused sensation of a gentle warm breeze.  The third method was termed par frictions.  This method did not use the machine but, instead, involved rubbing flannel which had been wrapped around the affected part with a metal plate attached to a glass handle.  The fourth method, par etincelles, drew sparks from the affected organ by attaching an uncharged metal wand to the affected body part which, in turn, was connected to a conductor from the machine.  The last method listed by Marat was called par commotions.  In this procedure a strong discharge was sent across the diseased body part.  Occasionally this method induced heart attacks, convulsions, blindness, and sometimes death.  This is the friction method most akin to later psychiatric electroconvulsive continuous-current shock treatment.  It was not used by Wesley." (Malony, np).

 

"[T]here were two basic processes involved in these treatments: attraction and repulsion.  It was assumed that the human body was a conductor of electricity and that it would attract current as well as repel it, if the body was attached to some other conductive material.  In general, it was theorized that where a body part was not functioning or was paralyzed, electricity was deficient and thus, attraction treatment was needed. ... On the other hand, it was theorized that where a body part was feverish or infected, electricity was excessive and thus, withdrawal treatment was needed." (Malony, np). 

 

In The Desideratum, John notes, "In order to prevent any ill Effect, these two cautions should always be remembered.  First, let not the Shock be too violent; rather let several small Shocks be given.  Secondly, do not give a Shock to the whole Body, when only a particular Part is affected.  If it be given to the Part affected only, little Harm can follow even from a violent Shock." (Wesley, Desideratum, 71-72, quoted in Malony, np.)

John Wesley, electrical quack? treatable conditions

According to John, "ELECTRIFYING, in a proper manner, cures

St. Anthony's fire [poisoning by eating the ergot fungus which grew
  on rye (Madden, Cheap, 212)]
Blindness
Blood extravasated ["forced out of the properly containing vessels"*]
Bronchocele ["a tumour of that part of the aspera arteria, called the bronchos"]
Burns or scalds
Coldness in the feet
Contraction of the limbs
Convulsions
Cramp
Deafness
Falling sickness
Feet violently disordered
Felons [tumours "formed between the bone and its investing membrane"*]
Fistula Lachrymalis ["a disorder of the canals leading from the eye to
  the nose, which obstructs the natural progress of the tears, and
  makes them trickle down the cheeks"*]
Fits
Flooding [incontinence?]
Ganglions [tumours "in the tendinous and nervous parts"*]


"Gout" portrayed as a demon attacking a swollen foot, 1799
Photo taken at Wellcome Museum, London
14 October 2012

Gout
Head-ach[e]
Impostuhumes ["collections of purulent {pus-filled} matter in a bag or cyst"*]
Inflammations
Involuntary motion of the eye-lids
King's Evil [scorfula, form of tuberculosis]
Knots in the flesh
Lameness
Wasting
Weakness of the legs
Restores bulk and fullness to wasted limbs
Locked jaws and joints
Leprosy
Menstrual obstructions
Ophthalmia ["a disease of the eyes, being an inflammation in the
  coats, proceeding from areterious blood gotten out of the
  vessels"*]
Pain in the stomach
Palsy ["there is a three-fold division of a palsy; a privation {lack of}
  motion, sensation remaining; a privation of sensation, motion
  remaining; and a privation of both together"*]
Palpitation of the heart
Rheumatism
  [George II, King of England, had ordered an electrical machine for
   his rheumatism in 1753 (Maloney, np).]
Ring-worms
Sciatica
Shingles
Sinews shrunk
Spasms
Stiff joints
Sprain, however old
Surfeit ["sickness or satiety cased by overfulness"*]
Swellings of all sorts
Sore throat
Tooth-ach[e]
Ulcers
Wens ["a fleshy or callous ... protruberance"*].

(Wesley, Physic, 124.)
(*Johnson, Samuel.  A Dictionary of the English Language: in which the Words are deduced from their Originals, Explained in their Different Meanings, and Authorised by the Names of the Writers in whose Works they are found.  Abstracted from the folio edition, by the Author, tenth edition (London: 1792).  http://books.google.com/books?id=j-UIAAAAQAAJ&printsec=frontcover#v=onepage&q&f=false, accessed 30 November 2012.

It is interesting that John did not mention any emotional disorders on his list.  He wrote, "[I]n particular, that it [electricity] is the most efficacious medicine in nervous disorders of every kind, which has yet been discovered." (Wesley, Journal, 4 January 1768, vol 5, 247 quoted in Schwab, 198.)  We might think he is referring to anxiety or depression, but according to Samuel Johnson's dictionary (1792), "nervous" meant "1. well-strung, strong, vigourous.  2. relating to the nerves.  3. having weak or diseased nerves" and he cites George Cheyne as a source for this definition.  "Nerve" is described as "1. The nerves are the organs of sensation passing from the brain to all parts of the body.  2. It is used by the poets for sinew or tendon." (Johnson.)  Nerves were not just a concept.  They had been dissected and were physically displayed on a piece of wood as part of the Evelyn Tables, owned by the Royal Society.  You can still view them at the Hunterian Museum (no photos allowed) today.

My tentative theory is that the word "nervous" changed over the centuries, got the connotation of "neurotic", and thus we interpret John's use of electricity for nervous conditions as an early form of electroconvulsive therapy ("shock treatment") or transcranial magnetic stimulation, both used for the treatment of depression.  John does not, to my knowledge, ever mention using electricity to improve mood.  I need to do some more research on my theory, as John also wrote about nervous disorders as "often no natural disorder of the body, but the hand of God upon the soul, being a dull consciousness of the want of God ... But undoubtedly there are nervous disorders which are purely natural" and then he goes on to list misuse of alcohol and/or tea (Wesley, John.  "Thoughts on Nervous Disorders," The Arminian Magazine (1786), quoted in Maddox, Health, 16).

John Wesley, electrical quack? the book

Desideratum
(Wellcome Library)

In 1760, John anonymously wrote and published a 72 page book called The Desideratum: Or, Electricity made plain and useful. By a Lover of Mankind, and of Common Sense (Schwab, 178).  (Desideratum means "desired thing" in Latin.)  It was almost entirely abridged from other writers, especially from Richard Lovett's The Subtil Medium Prov'd (Maddox, Holistic, 25), which was the first English work on electrotherapy (Schwab, 177).

John didn't really care how electrical treatment worked.  "We know it is a thousand medicines in one: In particular, that it is the most efficacious medicine, in nervous disorders of every kind, which has ever yet been discovered.  But if we aim at theory, we know nothing.  We are soon Lost and bewilder'd in the fruitless search." (Wesley, Journal, 4 January 1768, vol. 5, 247 in Schwab, 198.)  He knew it worked because nearly half of the case studies detailed in The Desideratum were about his own patients or himself (Schwab, 188).  Before The Desideratum, John had experimented on himself, shocking himself for nerve pain and lameness (Maloney, H. Newton. "John Wesley and the Eighteenth Century Therapeutic Uses of Electricity," Perspectives on Science and Christian Faith 47:4 (December 1995), 244,  http://www.asa3.org/ASA/PSCF/1995/PSCF12-95Malony.html, accessed 30 November 2012).  To treat more people, John even carried the machine with him on preaching tours around the country (Webster, 217). He recommended it to his brother, Charles, asking him to try it and not ignore it as "a quack medicine." (Wesley, John.  Letter to Charles Wesley 26 December 1761, Letters (Telford), vol. 4, 166 in Schwab, 193).  John wrote in his journal of at least two other times he used electrification on himself, once in 1773 for pain in his side and shoulder caused by inflammation, and once in 1783 for leg cramps, fever, and tightness in the chest (Maloney, np).

1791 edition of Primitive Physic, opened to "Electrifying"
Photo taken at Oxford Centre for Methodism, Oxford, UK
16 October 2012

Oxford Centre for Methodism
Charles "Charlie" Wallace from Willamette University doing research
17 October 2012

In the 1760 edition of Primitive Physick, John included fifty illnesses that could be treated electrically (Webster, 218).

John Wesley, electrical quack?

Electricity first became popular in English society in 1747, when it was all the rage.  There were practitioners who knocked people down with electricity for a sixpence, a scientist who sent an electrical charge through a four-mile circuit, Ben Franklin was writing about it in America, and a Swiss professor cured a patient's paralyzed arm by giving it a series of small electrical shocks (Schwab, 170).  John went to see electricity at work and wrote, "How must these [experiments] also confound those poor half-thinkers, who will believe nothing but what they can comprehend?  Who can comprehend, how fire lives in water, and passes through it more freely than through air?  How flame issues out of my finger, real flame, such as sets fire to spirits of wine?  How these, and many more as strange phenomena, arise from the turning round a glass globe?  It is all mystery ..." (Wesley, Journal, 16 October 1747, vol 3, 320-21 in Schwab, 170-71).

Several persons appear to have thought about using electricity to heal within the same time frame.  Wesley wrote in 1753, "I advised one who had been troubled many years with stubborn paralytic disorder, to try a new remedy.  Accordingly, she was electrified, and found immediate help.  By the same means I have known two persons cured of an inveterate pain in the stomach, and another of a pain in his side, which he had had ever since he was a child.  Nevertheless, who can wonder that many gentlemen of the Faculty [the university trained physicians], as well as their good friends, the apothecaries, decry a medicine so shockingly cheap and easy ...?" (Wesley, Journal, 20 January 1753, vol 4, 51 in Schwab, 176.)

John's electrical machine.
Photo taken at Wesley's home
London, 13 Oct 2012 

Having read extensively about the use of electricity as a medical treatment, in 1756 John got an electrical machine:  "Having procured an apparatus on purpose, I ordered several persons to be electrified, who were ill of various disorders; some of whom found an immediate, some a gradual, cure.  From this time I appointed, first some hours in every week, and afterward an hour in everyday, wherein any that desired it, might try the virtue of this surprising medicine.  Two or three years after, our patients were so numerous that we were obliged to divide them:  So part were electrified in Southwark, part at the Foundry [his headquarters in London], others near St. Paul's, and the rest near the Seven-Dials [part of London]:  The same method we have taken ever since; and to this day, while hundreds, perhaps thousands, have received unspeakable good, I have not known one man, woman, or child, who has received any hurt thereby: So that when I hear any talk of the danger of being electrified, (especially if they are medical men who talk so,) I cannot but impute it to great want either of sense or honesty." (Wesley, Journal, 9 November 1756, vol. 4, 190-91 in Schwab, 177-78.)

Randy Maddox suggests there were three primary reasons for John's passion about electrification: (1) he had observed positive results for himself and others, (2) electricity was part of God's creation and was thus more natural than chemical treatments, and (3) it was easy to access and inexpensive (Maddox, Holistic, 25).  As always, he was concerned about those who were poor and sick (Schwab, 176).

John Wesley, supernaturalist?

First there was John's "enthusiasm," so he was already considered a religious quack.  But there were also accusations that the Methodists promoted the supernatural in their promotion of spiritual healings.  Remember the picture by Hogarth two days ago?  We know it was specifically aimed at the Methodists because under the thermometer on the right (measuring the emotional state of the brain) is a book of "John Westley's [sic] Sermons."  Note the witch and devil hanging off the main preacher's hands.


"Credulity, Superstition and Fanaticism"
William Hogarth
(Wellcome Library)

John taught that the best form of Christianity was "primitive" Christianity, with a focus on returning to the basics of the early Christian Church in the first couple of centuries after Christ.  Therefore, since spiritual healings happened with obvious supernatural involvement in those times, they should be accepted in the 18th century (Rack, 151).  John's own family had a knocking ghost in the Epworth rectory named Old Jeffrey, and he believed in it after receiving detailed letters from his family about Old Jeffrey (Old Rectory tour, Epworth, UK; 9 October 2012).  John sent one of his assistants, John Bennet, to visit Bridget Bostock twice.  At first Bennet was favorable towards her but by the second visit he was more noncommittal -- "She is an unaccountable woman.  Time will make manifest [whether her work is of Christ or not.]," he wrote.  John wrote back to Bennet that he "found no reason to doubt" her power or healings (Rack, 141-42).

"Methodists drew a rough line between what was acceptable and unacceptable in the supernatural world.  Witches and demons were real but to be opposed; folk magic on the whole was to be avoided (by the leadership that is, probably not always by the rank and file).  The magical vestiges in folk medicine may not always have been recognized as such.  [John reprinted some folk medicine cures in Primitive Physick.]  Bridget Bostock may have retained some of the marks of the village 'wise woman' but John Bennet would at least suspend judgement on her because she healed by the 'biblical' means of spittle and prayer [as Jesus did]," wrote Henry Rack (Rack, 152.)

"Who can tell, how many of those diseases which we impute altogether to natural causes may really be preternatural [extraordinary]?  What disorder is there in the human frame which an evil angel may not inflict?" wrote John (Works, 14 vols (London, 1842), VI 358; VII 315, quoted in MacDonald, 111).  Therefore, Methodists attempted to heal not only with physick but also with prayer and fasting (MacDonald, 111).  John did not prescribe only prayer or only physick for illness -- his balanced emphasis on both is still seen in Methodism today.

Although John was open to the supernatural in some situations, he also felt there were limits.  One of his lay preachers, George Bell, healed a woman of a breast abscess but in 1762 when Bell began proclaiming he was a prophet, the end of the world was coming, and then attempted to raise the dead, John expelled him from the Methodists (Rack, 149-50).  Although John supported physick, Methodist preachers were not allowed to sell "pills, drops, or balsams" to their listeners (Wesley, John. Minutes of Several Conversations, quoted in Rack, 146), unlike quacks like Joseph Graham.  And although preachers distributed copies of Primitive Physick, John defined their role as healers as strictly secondary to their more crucial roles as pastors and preachers (Rack, 152).

Yesterday and today, we focused on John Wesley, the religious "quack."  Tomorrow and afterwards, we will look at John Wesley, the medical "quack."

John Wesley, enthusiast

The upper class and intellectuals hated "enthusiasm."  In fact, a famous bishop in the Church of England said that claiming to be inspired by the Holy Spirit was "a horrid thing, sir, a very horrid thing."   Another bishop wrote a three volume book on The Enthusiasm of the Methodists and Papists Compared (Edwards, 66).  "Papists" (followers of the pope, Catholics) were suspiciously distrusted due to the religious civil wars in which the Protestant Church of England "won."  Most people thought Methodism and Catholicism had a lot in common, and trusted neither.  And although when John and Charles Wesley preached they did not intend to incite crowds to revivalist phenomena, this is what happened (Edwards, Maldwyn.  Sons to Samuel (London: The Epworth Press, 1961) 65-66).

(Source: http://images.search.yahoo.com/search/images?_adv_prop=image&fr=my-myy&sz=all&va=john+wesley+preaching)

John and Charles and their friend George Whitefield had discovered there were hundreds of thousands of people who had not been exposed to the Gospel, so they preached wherever they could.  John Calvin's doctrine of "double predestination" was the prevalent theology.  This meant that God calls only some of us to be Christians, God's grace is irresistible and the called can't do anything but be saved.  There are others who are not chosen and there is nothing they can do to be saved  The Wesleys preached that Christ died for everyone and offers universal salvation.  All persons can be redeemed but not quickly and not easily, and we must "work out our own salvation with fear and trembling" (Philippians 2:12) (Watson, David Lowes. "Q and A" lecture, Wesley Pilgrimage, 8 October 2012).  Think how poor illiterate oppressed people would feel when told they have not been automatically condemned but can change their lives through their own effort and God's grace?  Of course they would react intensely!

"While the word of God was preached, some persons have dropped down as dead; some have been, as it were, in strong convulsions; some roared aloud, though not with an articulate voice; and others spoke the anguish of their souls," wrote John (Works, viii, p. 129 ff, quoted in Holland, Bernard. "A Species of Madness: The Effect of John Wesley's Early Preaching." Wesley Historical Society Proceedings (v. 39, October 1973), 79).  By fervently preaching about hell and its agonies, John frightened some people into becoming hysterical.  Bernard Holland postulates that the reason penitent people desperate for God's forgiveness would become so hysterical is that early in his preaching John taught that, "in spite of their longing to be reconciled to God, they were nevertheless still damned until faith was given them.  It was this that so intensified the feeling of helplessness and anxiety of those who were under conviction that some of them fell down as if dead, or cried out, or became delirious" (Holland, 80-81, italics by author.)

Charles felt that often people were doing this for attention, and found it distasteful.  He wrote in his Journal on 4 June 1743 that "outward affections were easy to be imitated" and found that when he ignored a drunk who supposedly was having a religious fit, and moved some loudly crying women out of his sight, both these problems resolved (Edwards, 65-66).

Neither Charles' nor George's preaching inspired the hysteria John's did.  Eventually John agreed with Charles that those longing for faith were accepted by God, since God gave the longing even if one did not immediately have spiritual confirmation of the faith, and therefore changed his message.  Thus, after the anxiety (Holland, 83) and the novelty wore off, the unpleasant excesses of emotionalism receded.  However, the negative impressions of Methodist "enthusiasm" continued for many years (Edwards, 66).

John Wesley, quack?

John Wesley
(The New Room, Bristol, UK)

John Wesley was considered by a lot of people to be a quack, both spiritually and medically (Madden, Cheap, 12).  Religiously, he was perceived as hotheaded and "enthusiastic," which in our time is a compliment but at that time meant "fanatical."  Differences in religion had recently caused a civil war in England.  Thus, the established Church of England clergy were typically men who depended on the intellect and not the emotions, so they distrusted John's "enthusiasm" as he promoted Methodism as a way to revitalize the Church of England (Watson, David Lowes.  "Wesley and Cranmer" lecture, Wesley Pilgrimage by General Board of Discipleship, United Methodist Church, 8 October 2012).  He never had his own church in England, and would travel to different places to preach as a guest preacher.  Based on their support or opposition to his ideas, the clergy in those churches would either allow him to preach or refuse his request.  At one time he climbed on top of his father's tomb to preach because the current rector would not allow him to preach in the church where John had been baptized and John's father had been clergy for almost 40 years!  One of the reasons he preached in the open air (considered scandalous at the time), was because Church of England pulpits were increasingly closed against him.

You have learned about Joseph Graham, the quack who combined his treatments with his theology.  Quacks prospered during this time because so little was known about how the body worked and how to treat illness.  Although waning, the belief in "wise women, wart charmers and faith healers" continued, especially in the provinces (Rack, Henry. "Doctors, Demons and Early Methodist Healing" in Sheils, WJ, ed. The Church and Healing: Studies in Church History, Papers Read at the Twentieth Summer Meeting and the Twentyfirst Winter Meeting of the Ecclesiastical History Society (Oxford, UK: Basil Blackwell, 1982) 139).  In comparison to Graham, the Chelsea "doctoress" Bridget Bostock was a healer who used prayer and "fasting spittle" (spit in the mouth when one hasn't eaten in awhile).  She took no money, wore old clothes, and treated persons of all classes, seeing 500-600 patients a day.  It is to her credit that she refused to attempt raise Sir John Price's third wife from the dead, no matter how much money he offered.  He must have really liked his wives, since he embalmed the first two wives and kept their bodies in his bedroom.  The third wife refused to marry him until the bodies were dispatched (Rack, 140-41).

The governing English elite were aghast at the number of new sects with potentially subversive political agendas.  They were appalled and opposed to any religious groups that believed in, or claimed, special powers pf revelation and holiness.  Therefore, polite society molded itself to believe in rational religion and natural philosophy and to reject the intellectual bases of spiritual healing.  They went so far as to discredit "enthusiasm" by presenting it as a form of mental illness (MacDonald, Michael.  "Religion, Social Change, and Psychological Healing in England, 1600-1800"in Sheils, WJ, ed. The Church and Healing: Studies in Church History, Papers Read at the Twentieth Summer Meeting and the Twentyfirst Winter Meeting of the Ecclesiastical History Society (Oxford, UK: Basil Blackwell, 1982) 119).  Between 1772 and 1795 the entrance books of Bethlem Hospital ("Bedlam") recorded 90 patients admitted who were considered insane because of "religion and Methodism."  In fact, Wesley and George Whitefield, a fellow Methodist clergy, rescued several men and women from mad-doctors and madhouses. The two felt these people were very pious and not insane (MacDonald, 124). 



(Source: Wellcome Library, London)

This representation of "Credulity, Superstition and Fanaticism: A Medley" is by the satirist William Hogarth, published in 1761.  It makes fun of Methodist enthusiasm.  Under "A Medley" Hogarth has added the verse of 1 John 4:1, "Believe not every Spirit, but try the Spirits whether they are of God: because many false Prophets are gone out into the World."

The room is in a chaos of differing intense emotions, as (supposedly) George Whitefield is preaching and in the back John Wesley is pointing up at the "New and Correct Globe of Hell" to a terrified attender.  Mary Tofts is in the bottom left having her rabbit babies, a boy is spitting out nails, the clergyman in the middle with the cherubs is sobbing, and the young lady on the right is in such religious ecstasy that she does not notice the amorous clergyman slipping something down her dress.  For more of an explanation, see http://en.wikipedia.org/wiki/Credulity,_Superstition,_and_Fanaticism.

More on the "enthusiasm" of the Methodists tomorrow.

References

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James Graham, part 2



"A new way of preserving health and beauty"
Rambler's Magazine, 1 July 1786
(Source: British Museum)

Another of Graham's treatments was earth-bathing. In the drawing above, Graham stands leaning on his cane supervising his earth-bathing establishment. An assistant is ready to shovel dirt, while three naked women are in various stages of being buried and a clothed one observes. The best mud was "fresh, icy, cold earth brought from the top of Hampstead Hill,' but if one was too busy a chunk of turf strapped under the shirt was somewhat helpful. He would lecture while buried naked up to the neck, which was "quite enough to call up the chaste blushes of the modest ladies," according to an observer.  He stayed buried for days, fasting and lecturing almost continually (Porter, Bodies, 204-05).
 

The temple, medicines, use of electricity, and earth-bathing all seem to have been based on his universalist beliefs, which were semi-mystic. Each were to be used in conjunction with a changed moral lifestyle. Graham promoted "regimen, or your general manner of living and conducting yourselves" as being more important than "loads of harsh, nauseous, and unnatural medicines from doctors and apothecaries" (Graham, James. The Guardian of Health, Long-life, and Happiness: or Dr Graham's General Directions as to Regimen, etc. To which are added, the Christian's Universal [sic](Newcastle-on-Tyne, 1790), 1, quoted in Smith, 269). However, he also sold medicines with the caution that patients understand

"It will be unreasonable for Dr Graham's Patients to expect a complete and lasting cure, or even great alleviation of their peculiar maladies, unless they keep their body and limbs most perfectly clean with very frequent washings -- breathe fresh open air day and night, -- be simple in the quality and moderate in the quantity of their food and drink -- and totally give up using the deadly poisons and canker worms of estates, called foreign Tea and Coffee, Red Port Wine, Spiritous Liquors, Tobacco and Snuff, gaming and late hours, and all sinful, unnatural, and excessive indulgence of the animal appetites, and of the diabolical and degrading mental passions. On practising the above rules ... depends the very perfection of bodily health, strength, and happiness." (Graham, James. A Short Treatise on the All-Cleansing, All-Healing, and All-Invigorating Qualities of the Simple Earth (Newcastle, 1780), 18, quoted in Smith, 269-70.)

Graham sold both physical and moral beauty (Smith, 271).  However, he did it with a spiritual message.  Ginnie Smith writes, "Graham's constant references to coolness, cleanliness, and frequent washings with 'cold living water' were ritualistic, puritanical incantations against hot regimen [a type of treatment to balance the humours by making the body warmer] and associated evils.  The Prayer for his Christian Universal Church, which had as its aim 'to unite every affinity that there is between the elements and man ... between man and everything that there is in the universe', called for a life of 'temperance and moderation, in perfect purity, cleanness, and self-denial of body, internal and external'.  Sexual chastity and physical purity together made up a religiously oriented 'pollution theory', through which 'cleanness' would bring the spiritual and physical body materially closer to God[.]" (Smith, 270.)  Kind of hard to reconcile this with his Celestial Bed, isn't it?

This is why he is considered to be such a quack -- he underscored his products with a religious emphasis that was not widely accepted.  He attempted to make money off of his Temple, his mud-bathing houses, his medicinal remedies (while not guaranteeing them unless there was a drastic lifestyle change), and the use of electricity, yet presenting it all as spiritual practices.

There were many people who thought John Wesley was both a medical and religious quack (Madden, Deborah. 'A Cheap, Safe and Natural Medicine':  Religion and Culture in John Wesley's Primitive Physic (New York: Rodopi, 2007), 12).  After all, didn't he promote health with a spiritual emphasis?