The King and Madness

King George III
(1738-1820)
(Wellcome Library)

George III went mad.  Everybody knew it, and when his bouts occurred, the English wrote about it in their diaries.  "The King's determined illness, its probable event, and all its consequences, must, in one way or another, interest every mortal, and ... cast a degree of uncertainty over everybody's plans." (Extracts from the Journals and Correspondence of Miss Berry, 1783-1852, ed. Lady Theresa Lewis (3 vols., London, 1865), vol 2, p. 438, quoted in Lane, 208.)

The king had episodes of madness in 1762 and 1765.  The first time he had three blisters applied and was bled seven times, recovering after one to two months.  The second time there was more secrecy about the episode, but it seems also to have resolved in a month or two.  The worst attack began in June 1788, when he could not concentrate, understand governmental business, and became delirious (Arnold, 146-47).  He was manic: Fanny Burney recorded "he conversed upon his health near half-an-hour, still with that extreme quickness of speech and manner that belongs to fever; and he hardly sleeps, he tells me, one minute all night ... he is all agitation, all emotion, yet all benevolence and goodness."  (Macalpine, Ida and Hunter, Richard.  George III and the Mad-Business (London: Allen Lane, 1969) 19, quoted in Arnold, 147.)

Movie poster
(Wikipedia)

The court physicians had no idea what the problem was, nor what to do.  They isolated His Majesty from his family in a very cold and uncomfortable castle.  Finally Rev. Dr. Francis Willis was summoned.  He had been a clergyman who qualified as a physician when he was 39, and he ran a madhouse which had a keeper to every two patients.  The patients had jobs, were encouraged to dress neatly, had freedom to take long walks, but were disciplined with fear (Arnold, 149).  Dr. Willis arrived in December and used a straightjacket to restrain the king every time the patient got agitated.  George also had his legs blistered, he was cupped, and had leeches placed on his temples.  The blisterings were so bad he could not walk.  A special chair was made to restrain him in.  By March the king was better and Willis was rewarded with 1,000 pounds a year for the following 21 years (Arnold, 150-52).  I would highly recommend the film made about this episode, "The Madness of King George" (Hytner, Nicholas.  The Madness of King George.  Samuel Goldwyn Company, 1994).

George had episodes again in 1801, 1804, and 1810, which included
conversations with angels, being convinced he was having an affair with a duchess (he wasn't), talking constantly for hours, and being severely delusional.  He spent the last ten years of his life insane, locked up at Windsor Castle.  Because his madness had been so obvious, it became respectable to treat those who were mad (Arnold, 155-57).  After all, insanity had happened to the most prestigious man in the country.

Lock of George III's hair
(Wellcome Museum,
14 October 2012)

So what really caused George's mental illness?  This lock of hair was purchased by the medical artifacts collector Henry Wellcome in 1927, and is supposed to be King George III's.  "Recent tests on the hair may have discovered the reason for the king's episodes of so-called 'madness'.  The hair was found to have an unexpectedly high concentration of arsenic.  Heavy metals such as arsenic are known to exacerbate a hereditary condition called porphyria, which can lead to mental disturbances." (Label, "Lock of Hair, Said to be King George III's," Wellcome Museum, 14 October 2012.)  Porphyria's symptoms include hallucinations, paranoia, purplish urine, sensitivity to light, and skin problems (Arnold, 156) like edema.  It is a metabolic blood disorder, and most porphyrias are inherited (Mayo Clinic, "Prophyria," www.mayoclinic.org/prophyria, accessed 5 January 2013).

I understand that many people today object to the term of "madness."  This description is no longer used today, since it is now considered shamefully derogatory.  However, this was the description of severe and uncontrolled mental illness in the 18th century and that is why I use it.  It does give some sense of the hopelessness of mental illness at that time.

Food and early Methodists

Rev. Charles Wallace
Oxford, UK
17 October 2012

This is Charlie Wallace.  Charlie is a former chaplain of Willamette University (Salem, OR) and is now associate professor of Religious Studies there, and is working on a book about early Methodists and food.  I met him at the Oxford Centre for Methodism, where this photo was taken.  Since food is a crucial part of health, I am including Charlie's research here.  Thanks to him for sharing it with us.

Susannah, John and Charles' mother, was very strict in her food practices.  She provided no snacks, the family had 3 meals a day, and much of it they had grown or provided themselves.  They lived with food insecurity, since Samuel was such a poor manager of the Epworth rectory lands.  Sometimes Susannah did not know where the next meal would come from, but she taught her children to be grateful when God provides food.  So this sets up two perspectives in the Wesley movement regarding food:
1.  Learning to live simply and on less
2.  Thankfulness and celebration the Christian rightly feels when food is provided by God.
Later John took more of the fasting side and Charles celebrated food in his hymns.  Charles' monthly expense records illustrate a most expansive middle class life than John's.

Early Methodists acted out both strands of thought.  Rev. John and Mary Fletcher, two core and crucial Methodists, were pretty restrained regarding food.  One of John's supporters wrote them asking them not to skimp on meals.  The opposite perspective was demonstrated by a prominent post-Wesleyan preacher named Charles Atmore, who was renowned among the other preachers for knowing when to show up at the houses of his congregants at dinner time.  He would then take the best cuts of meat and enjoy the food immensely (Wallace, Charles. "Antipast in Heaven: Eating and Drinking in Early Methodism," personal interview. (Oxford, UK) 17 October 2012).



Charlie researching at the
Oxford Centre for Methodism

John tried vegetarianism, encouraged by George Cheyne's teachings from The Natural Method of Curing Disease.  He avoided meat at his evening meal, but wasn't able to sustain being a vegetarian.  He stopped tea because it made him jittery.  He did drink a small amount of wine daily, which "far from doing me any hurt, it contributed much to the recovery of my strength." (Wesley, John.  "An Extract from Dr. Cadigan's Dissertation on the Gout and All Chronic Diseases," Works, XIV, 266, quoted in Ott, On Health, 202.)  John's primary concern was people's abuse of eating and drinking -- "It is not generally the quality, but the quantity, of what we eat which hurts." (Wesley, John. "Thoughts on Nervous Disorders," Works, XI, 518, quoted in Ott, On Health, 202.)  He believed in fasting for the soul's health and thus saving more money to give those who were poor (Wallace).

Wesley family and medical care

Yesterday we talked about Charles' ailments.  Today, let's talk about the whole Wesley family.  Although they lived very long lifespans for the time period -- father Samuel until 72, mother Susannah until 73, Charles until he was 80 and John until 87 years old -- they got sick.  Susannah had gout.  John had gout, diabetes, smallpox, a testicular hydrocele,* ague,** and consumption.  He was so ill with consumption in 1753 (Madden, Cheap, 270), he thought he would soon die and even wrote his own obituary (Ott, Philip.  "John Wesley on Health: A Word for Sensible Regimen."  Methodist History (vol. 18, April 1980, #3) 195).  At a time when consumption caused 1/5 to 1/6 of all deaths in London in 1701-1777 (Rusnock, 152?), he had grounds to believe so.

Bay Standard
for dropsy (edema) and
consumptive cough
Physic Garden
Epworth, UK
9 October 2012

John believed each person should take charge of their own health, working with physicians (Porter, Dorothy and Porter, Roy.  Patient's Progress: Doctors and Doctoring in Eighteenth-century England (Stanford, CA: Stanford University Press, 1989), 36).  When he was ill, he had no problem consulting a physician, and in Primitive Physic he often encourages his readers to consult a Christian physician.  Yet Primitive Physic was written for poor people, so he wanted it to be a self-help book.  Thus, he listed ingredients by their common English names rather than using the Latin labels, which angered some physicians and apothecaries (Donat, James.  "Empirical Medicine in the 18th Century: The Rev John Wesley's Search for Remedies That Work," Methodist History, vol XLIV, July 2006, #4, 216).

Samuel Westley (1636-1670)
father of John and Charles'
father Samuel
(Wesley's Chapel, 13 October 2012)

At that time, people were continually discussing illnesses, passing along medical recipes, and also sharing the ingredients (Porter, Progress, 44).  John felt confident writing physic recipes and educating about health because not only did he consult multiple texts published by physicians and test the treatments, but several members of his family and acquaintance were medical people.  His grandfather, Samuel Westley [sic], made his living as a doctor after his ejection from the Church of England in 1662.  (Westley had previously been clergy in the Church.)  John's father's brother was a wealthy apothecary or surgeon (Maser, Frederick.  The Story of John Wesley's Sisters: Seven Sisters in Search of Love (Rutland, VT: Academy Books, 1988) 17).  John's sister Emily was courted by a medical gentleman who was a Quaker, and she married an apothecary (Maser, 23 and 25).  We have already discussed how John knew George Cheyne personally, and that he himself was treated by at least three prominent physicians, including John Fothergill.

John insisted that one's physician be a Christian because only a Christian physician would consider the soul's illnesses as well as the body's sicknesses.  Non-Christian physicians help the sick by doing "... good with regard to their bodily health.  But [they] cannot do them more good with regard to their souls, which are of infinitely greater importance." (Wesley, John.  Sermons, vol. 3, semon 98, 387, quoted in Laffey, Paul. "John Wesley on Insanity," History of Psychiatry, 12:467, October 2001, http://hpy.sagepub.com/content/12/48/467.full.pdf+html, accessed 27 September 2012.) 

*hydrocele = a pocket of fluid, "A watery rupture."
**ague = "An intermitting fever, with cold fits succeeded by hot" (Johnson.)

The other Wesley -- Charles, part 2

Window in Wesley's Chapel,
London.
Top portion shows Charles on left
in red and John on right in black,
bottom portion shows
Charles writing.
(13 October 2012)

Charles used healing imagery multiple times in his more than 9000 poems, lyrics and hymns (Webster, 231).  This was not just a concept with him, but a deep belief.  He suffered from pleurisy, neuralgia, lumbago, dysentery, piles, rheumatism, gout and scurvy* (Webster, 232).  His wife was scarred from smallpox and his infant son died of it.  Out of his 8 children, only three lived to adulthood (Webster, 240).
Charles' own physical illness caused depression and emotional turmoil.  He believed healing was both physical and spiritual (Webster, 235), as he wrote,
"Health in Thine only name we find/
Thy name doth in the medicine heal." The title of that hymn was "For One That is Sick, Before Using the Means of Recovery:"(Webster, 237.)

He especially depended on Holy Communion as a method of comfort, describing the wine as "liquid life":

"Soon as I taste the liquid life,
Sorrow expires, and pain, and strife
And suffering is no more;
My inmost soul refreshed I feel,
And filled with joy unspeakable
The bleeding Lamb [Jesus] adore." (Webster, 240.)

In a hymn based on Isaiah 40:31, which is "They that wait on the Lord shall renew their strength," he proclaimed,
"The spirit of an [sic] healthful mind:
For this I wait in pain,
This precious pearl I long to find,
And to be born again.
Spare me till I my strength of soul,
Till I Thy love, retrieve
Till faith shall make my spirit whole,
And perfect soundness give." (Webster, 235.)

Raspberry, used to treat pleurisy
Physic Garden, Epworth, UK
9 October 2012

He referred to healing herbs 549 times in his hymns (Webster, 231), certainly dovetailing with John's passion for health promotion through Primitive Physic.

Hymn singing became a mark of the Methodists, and in 1787 anthems by choirs were banned because all worshippers were supposed to sing to express their beliefs in, and emotions about, God (Brewer, John.  The Pleasures of the Imagination: English Culture in the Eighteenth Century (New York: Farrar Straus Giroux, 1997) 55).  Rev. Leslie Griffiths tells the story that when Wesley's Chapel in London was rededicated after a 1978 renovation, the Queen and Prince Philip attended.  She was heard to comment, "Don't these Methodists sing loudly?" (Griffiths, Leslie.  "Wesley's Chapel" address, Wesley Pilgrimage.  London, 13 October 2012.)  This is due to Charles.  Wesley, not Prince.

*Pleurisy = "an inflammation of [the] pleura [the membrane around each lung], remedied by evacuation, suppuration, or expectoration, or all together." (Johnson.)
Neuralgia = pain in the nerves.
Lumbago = "Lumbagos are pains very troublesome about the loins and small of the back."
Piles = "the haemorrhoids." (Johnson.)
Scurvy = weakness and excessive bleeding of gums and under skin, caused by Vitamin C deficiency.

The other Wesley -- Charles, part 1

Charles Wesley would have been more famous in his own right had he not been overshadowed by his younger brother John.  Although most people call John "the founder of Methodism," Charles was actually the one who began the small group at Oxford which was later derisively called "The Holy Club."  Over time, the group became more methodical in their Christian actions, meeting four times a week to discuss scripture and theological ideas, visiting the ill poor and those in prison, taking communion weekly,* and fasting twice a week.  By 1732 the group was mockingly called "the Methodists" (Pollock, John.  John Wesley.  (Wheaton, IL: Harold Shaw Publishers, 1989 and 1995) 50-56).  They would willingly claim this name.

Charles Wesley
(Wesley's Chapel, London,
13 October 2012)

Charles was clergy in the Church of England just like John.  His "heart conversion" by the Holy Spirit occurred three days before John's famous experience with the Spirit (John's encounter is now honored by a monument in front of the London Museum).  Charles visited Newgate Prison as part of his witness, and was asked by condemned men to accompany them to the gallows for their hangings.  He agreed.  This was absolutely shocking for the time -- upright clergy at Oxford did not bother with those who were poor, who were sick, and especially those who were criminals.  The condemned were allowed to speak before their hangings and huge crowds came because it was a form of entertainment.  One condemned man testified how Charles had brought him to Christ, and immediately after his death, Charles spontaneously preached.  The very next day, everyone connected with the 7 member so-called "Holy Club" lost their ability to preach in Church of England pulpits.  This led to them preaching in the open air, and thus reaching hundreds of thousands of persons who did not attend the Church of England.

"Execution of the Idle Apprentice at Tyburn" by William Hogarth.
This is a fascinating representation.  You see the gallows on the right?  Just to the left of it is the
Church of England clergyman going to officiate at the hanging, and then on the left
is the prisoner in a cart, holding a book.  The man next to him is obviously preaching,
and his book says "Wesley" on it.
Hogarth's message about the Methodists here is that they ministered to the willing condemned.
(Wellcome Library, London)

Charles was incredibly brave, and for the first 12 years of the Methodist movement, he is sent into the dangerous areas of the country to preach.  In 1740 there were miners rioting for bread who marched on the city of Bristol.  Charles rode out to meet them and convinced them not to riot by promising he would advocate for them.  He was a warm and friendly person who got along with people of all classes.  John was "prickly and awkward" and disliked the rich because he felt they were wasteful and uncaring (remember, he fasted to save money to give to the poor, so he was really dedicated to them).  Charles soothed ruffled feathers and could talk to anyone.  Most of the clergy who joined the Methodist movement joined because of Charles and not John.  However, John was a active doer and pusher, and thus he is considered the founder of Methodism.

 

"Dr" Rock, the quack, peddling his wares in the foreground.
In background, Charles and John are preaching.
(Wellcome Library, L0010548)

At that time, odd as it may seem to us now, only the psalms were allowed to be sung in the Church of England.  But John had learned from a German Christian group called the Moravians how powerful hymns could be, and so he encouraged Charles to use his talents to write them.  Charles wrote hymns as he rode throughout the country to preach.  (He was considered to be a better preacher than John because he was less dry and more heartfelt.)  Why write hymns?  
Because when you are trying to convert people and then trying to sustain their faith, and a lot of them do not read, music is the solution.  This, of course, was considered by the upper class clergy to be disgustingly low class, especially when Charles would write words for popular tunes of the day, including drinking songs!  John published a hymn book for Methodists, of course including hymns by Charles.  Charles eventually wrote 7000 hymns (Best, "Charles Wesley," 11 October 2012).

*The Church of England only offered Holy Communion twice a year, and even four times a year was considered highly unusual (Best).

"Which came first, teaspoon or medicine spoon?"

Happy New Year!  I would like to resume the blog with some items that don't fit anywhere else, but are enrichments to the idea of early Methodist medical care.

(Symons, Jean.  "A duchess, a physician and a spoon" (London: Royal College of Physicians, web address below), accessed 7 December 2012.)

"In 1979 a silver spoon with the inscription ‘Gift of the Dutchess of Queensberry to Lady Carbery’ was discovered at auction by Cecil Symons, a physician, cardiologist and collector of medical artefacts. Described as a ‘medicine spoon’, Cecil was intrigued to find out its origins. Why was it presented to Lady Carbery? Was it for medicine or tea? His investigation led to an eccentric duchess, who was a great beauty and literary patron with a passion for potions and dressing like a milk maid.

"The silver spoon was made around 1755 by Paul Callard in London, and is now part of the Symons Collection at the Royal College of Physicians (RCP)."  Thus begins the article I am going to refer you to today, entitled, "A duchess, a physician, and a spoon."  You can find this fascinating investigation of teaspoon versus measuring medicine spoon at

http://old.rcplondon.ac.uk/history-heritage/Collections/Museum/Symons-Collection/Documents/A_duchess_a_physician_and_a_spoon.pdf

Time away and Christmas wishes

Dear Readers,
Thank you for visiting this blog.  I often wonder who you are, since this subject seems a bit esoteric.  I find it fascinating, but I do admit that when I start talking about it, people's eyes glaze over and their smiles go a little waxen.  And I only give it three sentences of explanation!  So thank you to those of you who are interested and take the time to read this.
I will be taking a break from posting until after the New Year, since my son is home from California and my daughter from college.  I also have started a new job with lots of commuting.  I think I have maybe another 20-30 posts to go, but I'm also lousy at estimating that kind of thing.

So allow me to use one of Charles Wesley's hymns to remind us all of the incredibleness of Christmas.  We praise God because God came to earth as a mere mortal.  "Our God contracted to a span," to a short human lifespan.  "He wrapped him in our clay," meaning God sent Jesus as an infant to live in our fragile human form.  Yet Jesus was and is the Godhead -- GOD, the amazing and immortal GOD, bigger and deeper and better than we can ever understand.  Jesus came as Immanuel, which means "God with us."

"Let earth and heaven combine,
Angels and men agree,
To praise in songs divine
The incarnate Deity,
Our God contracted to a span,
Incomprehensibly made man.

"He laid his glory by,
He wrapped him in our clay;
Unmarked by human eye,
The latent Godhead lay;
Infant of days he here became,
And bore the mild Immanuel's name."
(Wesley, Charles.  Hymns for the Nativity of Our Lord - 1745, #5: 1 and 2, quoted in Manskar, Steven.  A Disciple's Journal: 2013: A Guide for Daily Prayer, Bible Reading, and Discipleship (Nashville, TN: Discipleship Resources, 2012), 9.)

A blessed Christmas to all those you like and love and especially to all those we dislike or even hate.  May you feel the presence of God with you.

Consumption, part three

Deborah Madden has written a wonderful chapter on John's recommendations for consumption -- "Pastor and Physician" (in "Inward and Outward Health," cited previously).  I quote her here extensively to explain the differing types of treatments for the differing types of consumption.

Mycobacterium tuberculosis is a micro-organism that can infect many different sites in the body.  In the 18th century, these manifestations had individual labels:
The King's Evil, also called scrofula, caused swelling in the neck, since the TB affected the lymph glands there.
Pott's Disease was TB of the spine, perhaps explaining the large number of hunchbacks of the time.
Tabes mesenterica was TB of the small intestine ("tabes" is Latin for "wasting").
Lupus vulgaris was TB erupting on the skin (Madden, "Pastor," 124).

Thus, John had many different suggestions, all based on the medical understandings of his time. Let me quote Madden:


Chamomile [camomile]
Old Operating Theatre
and Herb Garret,
15 October 2012

"We know [William] Buchan [author of Domestic Medicine] believed that the cure of consumption resided chiefly in a proper regimen, though he also suggested drinking 'bitter' plant decoctions, in 'constrict' the body and its organs, such as ground-ivy, camomile, and comfrey-root.  ... Primitive Physic lists several 'constricting' medicines designed to alleviate or even cure consumption.  These included the juice of watercress, used to treat inflammatory and intestinal disorders, especially the lungs, in the Georgian period, as well as ground-ivy or hyssop infusions, which were recommended by John Hill in his Family Herbal for coughs and obstructions of the breast.  Hyssop has fever-reducing qualities and, indeed, is still used in 'complimentary' medicine today to alleviate bronchitis.  In the eighteenth century it was used to treat inflammatory disorders.


Hyssop
Old Rectory, Epworth, UK
9 October 2012

"Due to its poisonous nature, ivy has a very powerful effect on the internal organs, blood circulation and heart.  As such, it was used by Georgian physicians to treat many different diseases.  In common with the current medical thinking Wesley prescribed a number of inhalations and vaporizations for relieving pulmonary consumption.  It was thought that inhalations acted as a 'balsam' for the lungs and eased a patient's restricted breathing and rasping cough.  He suggested inhaling burning frankincense, steam of 'white rosin' and steamed 'spirit of vitriol', the latter of which was recommended by [John] Fothergill.  Physicians believed that vitriol 'braced' the body and Wesley argued on a number of occasions that it was the best bracer available.

Sir Richard Blackmore, MD
(1654-1729)
(Wellcome Library)

John Fothergill, MD
(1712-1780)
(Wellcome Library)

"The remedy which required his patient to 'cut up a little turf of fresh earth' and inhale its healing properties might now seem quite a strange prescription, though Wesley's direction here was not as eccentric as it appears.  It had been put forward by [Sir Richard] Blackmore in his Treatise of Consumptions: turf was considered valuable for treating this disease because of its sulphurous odour.  Blackmore argued that sulphur was particularly useful and explained how the 'chymists' had styled it a 'balsam' for 'the lungs' and blood.  Turf was remarkable because it 'eminently contributes to the cure of those that are obnoxious to that distemper.'" (Madden, "Pastor," 123.)

  

Consumption, part two

In regards to consumption, John differed from from nearly all medical practitioners of the time in believing it could be cured.  He strongly believed that offering very ill patients hope was important for recovery, and he recommended both physic and prayer (Madden, "Pastor," 114).  After all, both had helped in his own recovery from consumption in 1753.  He offered more recipes in Primitive Physick for the treatment of consumption than any other illness.

"A Consumption.
"177.  Cold bathing has cured many deep consumptions: tried.
178.  One in a deep consumption was advised to drink nothing but water, and eat nothing but water-gruel, without salt or sugar.  In three months time he was perfectly well.
179.  Take no food but new butter-milk, churned in a bottle, and white bread. -- I have known this successful.
180.  Or, use as common drink, spring-water and new milk, each a quart: and sugar candy two ounces.
181.  Or, boil two handfuls of sorrel in a pint of whey [thin milk*].  Strain it, and drink a glass thrice a day: tried.
182. Or, turn a pint of skimmed milk, with half a pint of small beer.*  Boil in this whey about twenty ivy leaves, and two or three sprigs of hyssop.  Drink half over night, the rest in the morning.  Do this, if needful, for two months daily.  This has cured in a desperate case: tried.

Ginger
Old Operating Theatre
and Herb Garret
15 October 2012

183.  Or, take a cow-heel from the tripe ["the intestines, the guts"*] house ready drest, two quarts of new milk, two ounces of hartshorn shavings, two ounces of isinglass, a quarter of a pound of sugar-candy, and a race ["a root or sprig"*] of ginger. Put all these in a pot: and set them in an oven after the bread is drawn [out].  Let it continue there till the oven is near cold: and let the patient live on this. -- I have known this cure a deep consumption more than once.
184.  Or, every morning cut up a little turf of fresh earth, and lying down, breathe into the hole for a quarter of an hour. -- I have known a deep consumption cured thus:
185.  "Mr. Masters, of Evesham, was so far gone in a consumption, that he could not stand along.  I advised him to lose six ounces of blood every day for a fortnight, if he lived so long: and then every other day: then every fifth day, for the same time.  In three months he was well."  ([from] Dr. Dover.)  Tried.

Frankincense
Old Operating Theatre
and Herb Garret
15 October 2012

186.  Or throw frankincense on burning coals, and receive the smoke daily through a proper tube into the lungs: tried.
187.  Or, take in for a quarter of an hour, morning and evening, the steam of white rosin ["juice of pine"] and beeswax, boiling on a hot fire-shovel.  This has cured one who was in the third [worst] stage of a consumption.
188.  Or the steam of sweet spirit of vitriol dropt [dropped] into warm water:
189.  Or, take morning and evening a tea-spoonful of white rosin powdered and mixt with honey. -- This cured one in less than a month, who ws very near death.
190.  Or, drink thrice a day two spoonfuls of juice of water-cresses. -- This has cured a deep consumption.
191.  In the last stage, suck a healthy woman daily.  This cured my Father. [According to William Buchan, a consumptive husband whose wife had lost her infant suckled her breast milk to relieve her discomfort, and this helped his own health improve (Buchan, Domestic Medicine, 225 in Madden, "Pastor," 121).]
For diet, use milk and apples, or water-gruel made with fine flour.  Drink cyder-whey, barley-water sharpened with lemon-juice, or apple-water.


Liquorice
Old Operating Theatre
and Herb Garden
15 October 2012

So long as the tickling cough continues, chew well and swallow a mouthful or two, of a biscuit or crust of bread, twice a day.  If you cannot swallow it, spit it out.  This will always shorten the fit, and would often prevent consumption. ...
"A Consumptive Cough.
215.  To stop it for a time, at lying down keep a little stick liquorice shaved like horse-radish between the cheek and gums.  I believe this never fails." (Wesley, Physic, 44-46, 48.)

*(Jackson.)

John Fletcher was diagnosed with consumption in 1775, which was probably worsened by his high intake of milk products (remember milk could carry TB).  Fletcher's condition was critical, so John recommended travel and preaching, which he felt motivated and exercised his Methodist leaders.  Fortunately, Fletcher's doctor vetoed this action, and Fletcher did not die until 1785 and then of typhoid.  He'd only been ill two weeks with it (Forsaith).

Consumption, part one



We now know that "consumption" covered a large range of illnesses, since it described any kind of illness that included coughing and wasting away.  Over the years of the 18th and 19th centuries, the diagnosis of consumption became more and more specific until Robert Koch discovered it was caused by the micro-organism mycobacterium tuberculosis in 1882.  It is still dreaded today, since it is second only to AIDS as the most lethal illness caused by a single infectious agent and 1.4 million people died from it in 2011 (World Health Organization, "Tuberculosis," http://www.who.int/mediacentre/factsheets/fs104/en/index.html, accessed 14 December 2012).  It is the only disease that is so virulent and infectious that all US health care workers must be tested yearly for it.  You may have had a TB test yourself.

Queen Mary I (1516-1558)
touching neck to heal boy
of TB
(Wellcome Library)

"A Collection of Remarkable Cures of the KING's EVIL,
Perfected by the Royal Touch,
Collected f[r]om the Writings
of many eminent Physicians and Surgeons,
and learned Men," 1748
(Wellcome Library)

 

We have discussed "The King's Evil," which was a form of tuberculosis (TB) that settled in the neck, and was thought to be cured by the touch of a king or queen (see November 13 post).  This practice ended in the early 18th century (although the apothecary who wrote the above book hadn't seemed to have gotten the message).

"Nocturnal sweats, and great thirst, as well as purulent expectoration, are symptoms that discover a confirmed consumption ... in this confirmed state of the distemper there is generally a great dejection of appetite, and a nauseous loathing of foods, with dead sickness of stomach, frequent vomitings, which are sometimes caused by excess of green choler, like verigrease, or juice of leeks, that is often ejected, to free the stomach of its burden; and sometimes excited by a long and vehement fit of coughing, that nature employs to pump and ease the lungs." (Blackmore, Richard.  A Treatise of Consumptions and Other Distempers Belonging to the Breast and Lungs (London: 1724), 135 and 28; quoted in Madden, Deborah.  "Pastor and Physician: John Wesley's Cures for Consumption" in Madden, 'Inward and Outward Health,'  95.)

John wrote in his journal on 8 May 1777:  "I went to Yarn.  There I found a lovely young woman in the last stage of a consumption; but such a one as I never read of, nor heard any physician speak of, but Dr. Wilson.  The seat of the ulcers is not the lungs, but the windpipe.  I never knew it cured ... this young woman died in a few weeks." (Wesley, John.  The Journal of the Rev. John Wesley, A.M. (4 vols, London: J. Kershaw, 1827) 8 May 1777, vol 4, 94 in Madden, "Pastor," 95.)  In 1767, he wrote that he also had been in the last stage of consumption (Wesley, Letter to Mary Bosanquet, 16 August 1767 in Letters (Telford), vol,. 5, 61, quoted in Madden, "Pastor," 96), so he had personal experience with the illness, almost dying of it in 1753 (Madden, "Pastor," 102).  As consumption could describe varying illnesses, we do not know if he had TB.

Pewter spittoon
Receptacle for spit,
which went out of fashion in the 1880s
when it was realized spitting contributed to
the spread of diseases like TB
(Wellcome Library)

China spittoon
(Wellcome
Library)

What we label TB today is spread through the air by coughing, sneezing or spitting.  Only a few of the tiny germs need to be inhaled for the recipient to become infected.  WHO reports that 1/3 of the people in the world have been infected with TB but are not yet ill.  TB can stay latent and non-transmissible for years, but once the TB becomes active an ill person can infect up to 10-15 people per year (WHO, "Tuberculosis).








Smallpox treatments

"Small pox" per Primitive Physic:
"628.  Drink largely of toast and water:
629.  Or, let your whole food be milk and water, mixed with a little white bread:
630.  Or, milk and apples.
631.  Take care to have free, pure and cool air.  Therefore open the casement every day: only do not let it chill the patient.
632.  If they strike in, and convulsions follow, drink a pint of cold water immediately.  This instantly stops the convulsions and drives out the pock: tried.
"There may be pustules a second time, coming out and ripening like the small pox, but it is barely [simply] a cutaneous [skin] disorder.
"In violent cases, bleed in the foot: bathe the legs in warm water, twice or thrice a day, before and at the eruption; and apply boiled turnips to the feet.  Never keep the head too hot.
"In very low depressed cases, wine may be given; and if the pustules lie buried in the skin, a gentle vomit.  In many cases a gentle purge of manna ["a gum, a honey-like juice ... it is the product of two different trees, both varieties of the ash*], cream of tartar, or rhubarb.
"In the Crude Ichorose [with thin, watery secretions*] small-pox, a dish of coffee now and then, with a little thick milk in it, has often quieted the vexatious cough.
"After the incrustation [scab] is formed, change the sick: but let it be with very dry warm linen."  Dr. Huxham [John is citing the source he got the suggestion from].  (Wesley, Physic, 97-98.)

Prayer and benediction
Charles Le Brun (1619-1690)
(Wellcome Library)

Early Methodists not only depended on medical treatments, but on prayer, believing that the presence of Christ became tangible through both medicine and spirituality (Webster, Robert. "Balsamic Virtue: Healing Imagery in Charles Wesley" in Newport, Kenneth and Campbell, Ted (eds), Charles Wesley: Life, Literature and Legacy (Peterborough, UK: Epworth, 2007, 237).  Charles Wesley recorded in his journal, "My companion was taken ill of a fever.  We prayed for him in strong faith, nothing doubting.  Monday and Tuesday he grew worse and worse.  On Wednesday the small-pox appeared; a favorable sort.  Yet on Thursday evening we were much alarmed by the great pain and danger he was in.  We had recourse to our never-failing remedy, and received a most remarkable, immediate answer to our prayer.  The great means of his recovery was the prayer of faith." (Wesley, Charles. Journal, p. 238-39, quoted in Shaw, Jane.  The Miraculous Body and Other Rational Wonders:  Religion in Enlightenment England (PhD dissertation, University of California at Berkley, 1994), 74.)

Benjamin Jesty, 1805
(Wellcome Library)

As a praise for the lay practitioner of the 18th century versus the physician, let me point out to you that although Edward Jenner is considered the "inventor" of vaccinations, a woman -- Lady Mary Wortley Montagu -- brought back the idea from women in Turkey, and a farmer inoculated his family with cowpox the year before Jenner even became interested in the subject.  Benjamin Jesty was a farmer in Dorset, who, during a smallpox epidemic, successfully inoculated his wife and two sons directly from a infected cow udder in 1774 (Cule, John.  "The Rev. John Wesley, MA (Oxon.), 1703-1791: 'The Naked Empiricist' and Orthodox Medicine," Journal of the History of Medicine and Allied Science (1990), 45(1), 45-46, http://ljhamas.oxfordjournals.org, accessed 27 November 2012).

Due to vaccinations, smallpox was declared eradicated worldwide in 1980 (World Health Organization, "Smallpox," http://www.who.int/topics/smallpox/en/, accessed 13 December 2012).
*(Johnson.) 

Smallpox

"The eruption of pustular smallpox on the face of a woman.
Fig 1 depicts the mature eruption. When the last photograph was
taken incrustation had begun and brown pus was exuding from beneath the scabs.
The patient died of septic absorption."
1906
(Wellcome Library)

Smallpox was the great epidemic disease of 18th century Europe, causing 400,000 deaths a year.  London alone had 2,000 deaths a year, which is considered an epidemic of death.  The death rate after infection was 25%, particularly among small children.  It attacked both rich and poor in equal measure (Hays, J.N. Epidemics and Pandemics: Their Impacts on Human History (Santa Barbara, CA: ABC-Clio, Inc., 2005), 151).  If you did not die, you were terribly scarred for life.

Smallpox is a virus which can be passed from one person to another through breathing or contact with the pus or scabs.  The people who caught it most often were the new young workers arriving in London, who had no natural immunity.  Since there were 8,000 migrants to London each year in search of higher wages, there were a lot of people who could get sick.  It was labeled "small pox" to differentiate it from "the great pox," which was syphilis (Waller, 101-02, 2).



Comparison between smallpox and cowpox pustules
on the 10th and 11th days of the disease, 1896
(Wellcome Library)

Because of its lethality, smallpox affected history.  In 1779 France did not invade England as planned due to a severe outbreak of smallpox on their ships, causing 8,000 deaths and decimating their navy (Hays, 153).


Smallpox pustules
1908
(Wellcome Library)



Lady Montagu
(artists of the time
eliminated the pox scars
of famous people)
(Wellcome Library)

Lady Mary Wortley Montagu was beautiful before she contracted smallpox in her twenties (Cockayne, 22). She was in Turkey when she observed women taking the liquid from smallpox pustules and then transferring the liquid into small scratches on healthy people.  This prevented the healthy persons from getting smallpox.  Lady Montagu returned to England as a champion of this method and had her own son inoculated.  Unfortunately, occasionally the inoculation caused a full-blown case of smallpox (Olsen, 271-72).

"Edward Jenner among patients in the Smallpox and Inoculation Hospital"
1802
Notice the patients to the right who have already been inoculated
now have cows coming out of their arms, mouths, noses, faces, and buttocks.
The illustration derides Jenner's inoculation.
(Wellcome Library)

Edward Jenner (a star pupil of John Hunter) discovered that inoculating patients with cowpox pus would give immunity against smallpox too.  Cowpox was much less dangerous to have than smallpox (Science Museum of London, "Edward Jenner, 1749-1843," http://www.sciencemuseum.org.uk/broughttolife/people/edwardjenner.aspx, accessed 12 December 2012).  Although inoculations for smallpox were first used in London in 1721, very few of the poor would have had access to them (Madden, Cheap, 243-44).



Sarah "Sally" Wesley, painted before her smallpox
Charles Wesley's home, Bristol
11 October 2012
 

Smallpox affected Charles Wesley (John's brother).  He was called from London to his wife Sally's bedside in Bristol because she was near death from smallpox:  "I found my dearest friend on a restless bed of pain, loaded with the worst kind of disease ... From the sole of the foot, even unto the head, there is no soundness [health] in her; but wounds and putrefying sores."  Sally fought death for two weeks, surviving but terribly scarred.  However, their 16 month old son died of it (Best, Gary.  Charles Wesley: A Biography (Peterborough, UK: Epworth, 234-35).

Fever

Willow bark
Old Operating Theatre
and Herb Garret,
15 October 2012

Of course, we know today that fevers can have many causes -- infections, immune problems, cancers, destruction of tissues, metabolic problems, and the list goes on.  However, when you examine John's remedies, realize that there were really no effective treatments like we have today.  Aspirin had not yet been identified as a helpful medication.  Although the Rev. Edward Stone noted in 1758 that chewing on willow twigs, although bitter, helped his pain, when he wrote about it in 1763 nobody paid any attention.  The components of aspirin from both willow and meadowsweet were not isolated and  used to relieve pain until 1895.  Aspirin was only found to break fevers after that time (Old Operating Theatre, "Aspirin" poster, 15 October 212), 150 years after the start of Methodism.

  The "best" treatment of the eighteenth century was bloodletting.  Let's reexamine this practice after our initial aversion. 
 Bleeding effectively decreases fever for three reasons:
1.  The loss of blood decreases the body's temperature.
2.  The loss of iron in the blood decreases the number of bacteria feeding on the iron, and therefore lowers the amount of infection causing the fever.

"Breathing a Vein"
(blood letting)
(Wellcome Library)

3.  The loss of blood stimulates the pituitary gland to release vasopressin, and this in turn stimulates the body's immune response.
(Kasting, N.W.  "A Rationale for Centuries of Therapeutic Bloodletting: Antipyretic Therapy for Febrile Diseases," Perspectives in Biology and Medicine, 33 (1990), 509-16, quoted in Madden, Cheap, 229.)

From Primitive Physic:

"A Fever.

"In the beginning of any fever, if the stomach is uneasy, vomit; if the bowels, purge: if the pulse be hard, full or strong, bleed.
"332.  Drink a pint or two of cold water lying down in bed: I never knew it do hurt:
333.  Or, a large glass of tar water warm, every hour:
334.  Or, thin water-gruel sweetened with honey with one or two drachms [1/8-1/4 ounce] of nitre [saltpeter] in each quart.
335.  The best of all julaps in a fever is this: Toast a large thin slice of bread, without burning; put it hot into a pint of cold water; then set it on the fire till it is pretty hot.  In a dry heat it may be given cold; in a moist heat, warm; the more largely the better: tried.
336.  Or, for a change, use pippin ["a sharp apple"*] or wood-sorrel tea: or pippin-whey: or, wood-sorrel whey.
337.  (To prevent catching any infectious fever do not breathe near the face of the sick person, neither swallow your spittle whilst in the room.  Infection seizes the stomach first.)
338.  Or, stamp a handful of leaves of woodbine; put fair water to it, and use it cold as a clyster [rectal suppository].  It often cures in an hour.
339.  Or, smear the wrists, five or six inches long with warm treacle, and cover it with brown paper. -- See Dr. Tissot['s book].
340.  Or, apply treacle plaisters ["plaster: a glutenous or adhesive salve"*] to the head and soles of the feet, changing them every twelve hours:
341.  Or, use Doctor Boerhaave's fever-powder, viz. Eight ounces of nitre, a quarter of an ounce of camphire, half a quarter of an ounce of saffron, and eight grains of cochineal.  These are to be powdered, mixt together, and kept dry in bottle.  Ten grains taken on going to bed abate feverish heat, and procure rest.  Ten grains are to be taken every three or four hours for a continued fever.

A high Fever.
342.  Attended with a delirium and a vigilia [insomnia?], has been cured by plunging into cold water, which is a safe and sure remedy in the beginning of any fever.
343.  Such a delirium is often cured by applying to the top of the head, a treacle plaister: tried.

An intermitting Fever.
344.  Drink warm lemonade in the beginning of every fit: it cures in a few days; tried.
345.  Or, take a tea-spoonful of oil of sulphur in a cup of balm-tea, once or twice a day.

A Fever with pains in the Limbs
346.  Take twenty drops of spirits of hartshorn in a cup of water twice or thrice in twenty-four hours:
347.  Or, drink largely of cinquefoil tea.

A Rash Fever.



Ground ivy
Old Operating Theatre
and Herb Garret,
15 October 2012

348.  Drink every hour a spoonful of juice of ground ivy.  It often cures in twenty-four hours. -- Use the decoction when you have not the juice.

 

A Slow Fever.
349.  Use the cold bath for two or three weeks, daily.

A Worm Fever.
350.  Boil a handful of rue and wormwood in water; foment ["1. to cherish with heat. 2. To bathe with warm lotions."*] the belly with the decoction, and apply the boiled herbs as a poultice; repeat the application night and morning.  This frequently brings away worms from children, who will take no internal medicine; and is likewise serviceable, if the fever be of the putrid kind" (Wesley, Physic, 62-64).
* (Johnson.)

Syphilis

Supposedly brought by Christopher Columbus from the Americas to Europe, the first outbreak of European syphilis was immediate in 1493-94 (Porter, Blood, 13).  The English called it "the French disease" (Arnold, 305), due to their dislike of the French.  Identification of a single celled parasite as the cause would not be made until 1905, but the diagnostic test was immediately developed in 1906 and by 1910 10,000 syphilitic patients had been cured by the drug Salvarsan (Porter, Blood, 103).



"The Quack Doctor's Studio" -- William Hogarth
The young rake is returning the useless pills the "doctor" has given him,
while the rake's prostitute covers her syphilitic sores by her mouth
(Wellcome Library)

"The patient is affected with an unusual pain in the genitals ... a spot, about the size and coulour of a measle, appears on some part of the glans ... A discharge appears from the urethra ... the aforesaid pustule becomes an ulcer ... Great pain during erections ... Pain in the head, arms and ankles .... Crusts and scabs appear on the skin ... The bones of the skull, shin-bones, and the arm-bones, are raised into hard tubers ... The bone becomes carious ["rotten"*] and putrescent ["the state of rotting"*] ... ulcers destroy the cartilege of the nose.  This they eat away; so that the bridge sinks in and the nose flattens ... At length, limb by limb perishing away, the lacerated body, a burden to earth, find ease only in the grave." - Thomas Sydenham, MD (Waller, 105).  Sydenham did not make the connection that syphilis also caused progressive dementia, with grandiose delusions, increasingly poor memory, slurred speech, facial tics, and unstable ambulation (Arnold, 242).




Natural and Political Observations ...
Made upon the Bills of Mortality
1662
(Wellcome Library)

Venereal disease was considered disgraceful.  When someone died of syphillis, often the searchers were bribed to record the cause of death as something else, and when John Graunt studied the Bills of Mortality he believed that only truly hated people were recorded as dying of it (Waller, 104-05).

One of every three patients admitted to St. Thomas's Hospital was for syphillis, and was hospitalized for 2-3 months for treatment with mercury.  Since no one understood the remission and recurrence of the disease, if a patient had been "cured" and then they returned to the hospital, they were whipped as punishment for returning to their evil ways (Mathias).  Wives often got the diseases from their husbands, who everyone thought had been cured (Waller, 104). 

Artificial nose
Wellcome Museum, London
(on loan from Hunterian Museum)
14 October 2012

However, there were "No Nose Clubs" formed in the 18th century for people who had lost their noses to syphyllis, accidents or war.  Often false noses were attached to glasses (Artificial nose display in "Superhuman" summer special exhibition, Wellcome Museum, London, viewed 14 October 2012) or made to adhere on their own (see left).

"The Martyrdom of Mercury," 1709
(Wellcome Library)

 John's lack of suggested treatments for venereal disease was unusual.  The diseases were rampant, and practitioners made a lot of money off "cures." (Madden, Cheap, 255-56).  "Dr" Rock, the quack, was famous for his "Incomparable Electuary" which he peddled as the "only venereal antidote" (Porter, Bodies, 15).  However, John does not mention any treatments in Primitive Physic's 14th edition (the one republished by The New Room in Bristol).  Physicians gave mercury orally, by injecting it into the nose and genitalia, and putting it in ointment to be applied to affected skin areas.  It had awful side effects, such as hyper-salivation, nausea, and diarrhea, but it did decrease symptoms (Waller, 105-06).  Mercury also caused loss of teeth (Porter, Bodies, 15).