The Horrors of Pre-Anaesthetic Surgery

L0034242 Five surgeons participating in the amputationI often joke that The Chirurgeon’s Apprentice is all about ‘the horrors of pre-anaesthetic surgery’ and yet, I’ve never written an article which focuses primarily on the patient’s experience before the widespread use of ether beginning in the 1840s. Suffice-to-say, it was not a pleasant affair.

In 1750, the anatomist, John Hunter, colourfully described surgery as ‘a humiliating spectacle of the futility of science’ and the surgeon as ‘a savage armed with a knife’.[1] He was not far from the truth. Surgery was brutal and only to be undertaken in extreme circumstances. In 1811, Fanny Burney had a mastectomy after being diagnosed with breast cancer. She later recorded the incident vividly for posterity:

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—& I almost marvel that it rings not in my Ears still!

S2Fanny (pictured right) went on to depict her own terror as one that ‘surpasses all description’. The agony, she said, was ‘excruciating’. So terrible was the operation that her surgeons decided to limit her anxiety by choosing a day at random and giving her only two hours notice before they began.[2]

Fanny was one of the lucky ones. Not only did she survive surgery, but she also went on to live for another 28 years. Others were not so fortunate. When Stephen Pollard underwent an operation to remove a bladder stone in 1828, he did so under the gaze of 200 spectators. What should have lasted 5 minutes ended up taking almost an hour. The surgeon, Bransby Cooper, fumbled and panicked, cursing the patient loudly for having ‘a very deep perineum,’ while the patient, in turn, cried: ‘Oh! let it go; —pray, let it keep in!’[3]

Pollard died the next day.

Pain was not just an unavoidable side effect of surgery. Most surgeons operating in a pre-anaesthetic era believed it was a vital stimulant necessary for keeping the patient alive. This is why opiates and alcohol were used sparingly, and typically administered shortly before (not during) a procedure, as the loss of consciousness was considered to be extremely dangerous.

_100Today, patients are laid flat on an operating table. Before the latter half of the 19th century, however, patients were often sat upright in an elevated chair. This prevented them from bracing when the surgeon’s knife began to dig into their flesh. Unsurprisingly, they were also restrained, sometimes with leather straps. The operating chair depicted on the left is not dissimilar to ones which would have been used during these earlier periods.

The patients weren’t the only ones who felt anxious before an operation. Surgeons, too, were apprehensive about cutting into living bodies. The Scottish surgeon, Charles Bell (1774 – 1842), was described by one colleague as having ‘the reluctance of one who has to face an unavoidable evil’.[4] John Abernethy (1764 – 1831), a surgeon at St Bartholomew’s Hospital, confessed to shedding tears and being physically ill before or after a particularly terrible operation. He described the walk to the operating room like ‘going to a hanging’.[5] And William Cheselden (1688 – 1752) once remarked that ‘no one ever endured more anxiety and sickness before an operation…’[6]

Surgery was a last resort, and one which brought with it considerable risks. During an operation, patients could die from the sheer amount of blood lost during a procedure. In hospital operating theatres, a wooden box was placed under the patient to catch blood and pus during the surgery. Additionally, sawdust was placed under the floorboards to catch the overflow. Even if a patient survived the traumatic ordeal, he or she might die from post-surgical infection.

Surgeons, of course, were aware of these risks, and went to great lengths to avoid operating. The historian Stephanie Snow argues that because of these dangers, ‘an elaborate etiquette of medical consultations developed’ before a decision was made to operate.[7] Indeed, only a handful of surgeries took place each month at most of the major London hospitals in the first half of the 19th century. Robert Liston—known as ‘the fastest knife in the West End’—lost 1 in 10 patients in the operating theatre at University College Hospital during this period. His success rates were fairly good. Surgeons at nearby St Bartholomew’s lost approximately 1 in 4.[8]

This does not account for the number of patients who died later of complications.

Very few people who underwent surgery recorded their thoughts for posterity. They either did not have the resources to do so, or the inclination to write about their painful experiences. George Wilson—a Professor of Chemistry at Edinburgh University—underwent a foot amputation in 1842. He remembered ‘the fingering of the sawed bone; the sponge pressed on the flap; the tying of the blood-vessels; the stitching of the skin; and the bloody dismembered limb lying on the floor’. Later, he wrote that these memories were not ‘pleasant remembrances’ and were ‘never welcome’.[9]

When reading descriptions like these, it is easy to understand why so many patients’ voices are now lost to us. All too often, their memories, like the surgeries they suffered, were simply too painful to endure.

 

1. Quoted in P. H. Jacobson, 'Dentistry's answer to "the humiliating spectacle'", Journal of the American Dental Association (1994), p. 1576.
2. The full description of this surgery can be found in Fanny Burney, Selected Letters and Journals, ed. Joyce Hemlow (1986), pp. 127-41.
3. Druin Burch, Digging up the Dead: Uncovering the Life and Times of an Extraordinary Surgeon (2007), p. 26. A fuller description of this incident can be found in an earlier article I wrote here.
4. J.M. Arnott, quoted in Gordon Gordon-Taylor & E.W. Walls, Sir Charles Bell: His Life and Times (1958), p. 82. Originally quoted in Peter Stanley, For Fear of Pain: British Surgery, 1790 - 1850 (2003), p. 205.
5. George Macilwain, Memoirs of John Abernethy, 2 vols (1854), Vol II, p. 203. Originally quoted in Stanley, For Fear of Pain, p. 204.
6. William Cheselden, The Anatomy of the Human Body (1741), p. 334. Originally quoted in Lynda Payne, With Words and Knives: Learning Medical Dispassion in Early Modern England (2007), p. 79.
7. Stephanie Snow, Blessed Days of Anaesthesia (2008), p. 4. I am hugely indebted to Snow for pointing me to some of the sources cited in this article.
8. Matt Soniak, '"Time Me, Gentlemen": The Fastest Surgeon of the 19th Century', The Atlantic (24 October 2012).
9. Jessie Aitken Wilson, Memoir of George Wilson (1860), pp. 296-7. Originally quoted in Stanley, For Fear of Pain, p. 276.

Public Health & Victorian Cemetery Reform

In 1843, the Scottish cemetery designer, John Claudius Loudon, explained that the purpose of a burial ground was to dispose of the dead ‘in such a manner as that their decomposition, and return to the earth from which they sprung, shall not prove injurious to the living.’ [1] A decade earlier, London cemeteries had reached critical mass. Death rates were rising within the city due to overcrowding and outbreaks of cholera, tuberculosis, diphtheria, smallpox and typhus. Burial grounds were bursting at the seams, causing one Reverend John Blackburn to remark:

I am sure the moral sensibilities of many delicate minds must sicken to witness the heaped soil, saturated and blackened with human remains and fragments of the dead… [2]

C1The rate at which burials were growing was mind-boggling. According to one report, many cemeteries around London were burying as many as 11,000 people per acre. To put this in perspective, most cemeteries today accommodate 750-1,000 burials per acre—a tiny fraction of what was acceptable in the past. [3]

Bodies were literally crammed on top of one another. Most graveyards contained open pits with rows and rows of coffins exposed to sight and smell. Pit burial was so common in London that two men asphyxiated on the methane and other gases emanating from decomposing bodies after falling twenty feet to the bottom of one such pit in the early 19th century. [4]

For those living nearby, the smell was unbearable, especially during the summer months. The houses on Clement’s Lane in the East End of London backed into the local churchyard, and ‘ran with stinking slime.’ The stench was so overpowering, that occupants kept their windows shut all year long. Even the children attending Sunday school could not escape these unpleasantries. They learned their lessons as insects buzzed around them, no doubt originating from inside the church’s crypt which was crammed with 12,000 decomposing bodies. Even after the chapel was closed in 1844, it continued to be used, this time for ‘Dances on the Dead’ (see illustration, below) until the bodies were eventually moved to West Norwood Cemetery a few years later. [5]

L0073464 Illustration of a dance hall above a cemetary area

With this in mind, it’s hardly shocking that people in the 19th century wanted to reform cemeteries. Londoners were up to their noses in blackened corpses and stinking slime. But for the Victorians, this wasn’t just about the aesthetics of living in a city bubbling over with rotting corpses. It was about public health.

During this period, people associated bad odours with disease. It’s easy to understand why. Poor areas where people were jammed together in cramped living quarters would have smelled horribly. It was the poor who would have been forced to live near graveyards and open burial pits. Not surprisingly, these areas were also hotbeds for disease. The English reformer, Edwin Chadwick, was particularly concerned with ‘putrid emanations’ from corpses, which he argued were ‘injurious to the health of the living’. [6] He believed that lead coffins were especially dangerous:

The retention of bodies in leaden coffins in vaults is objected to, as increasing the noxiousness of the gases, which sooner or later escape, and when in vaults beneath churches, create a miasma which is apt to escape through the floor, whenever the church is warmed. [7]

According to Chadwick, the Austrian Emperor had banned the use of coffins altogether for this very reason, insisting that ‘all people should be buried in sacks’ for sanitary purposes. The Turks also recognized the dangers of lead coffins, and made it mandatory that pine be used as an alternative as it ‘decays rapidly,’ thus allowing the corpse to return to the earth more naturally. [8]

Chadwick would not get his wish with respect to lead coffins. However, change did come about in the form of cemetery reform. In 1832, Parliament authorized the General Cemetery Company to build a large, park-like cemetery in Kensal Green, a suburb of London. Shortly afterwards, other ‘garden cemeteries’ sprung up outside the city centre: West Norwood (1837), Highgate (1839), Abney Park (1840), Brompton (1840), Nunhead (1840), and lastly, Tower Hamlets (1841). Collectively, these cemeteries are known today as the ‘Magnificent Seven’ (see slideshow below).

People continued to bury their dead within the city for two decades after the establishment of Kensal Green and the garden cemeteries. By 1852, burials within central London were finally outlawed, and the days of overcrowded graveyards died with their last occupants. In 1885, Britain’s first legal crematorium opened in Woking. It wasn’t until 1968, however, that cremations outnumbered burials. [9]

Today, nearly 73% of people who die in Britain are cremated.

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1. John Claudius Loudon, On the Laying Out, Planting, and Managing of Cemeteries, and on the Improvement of Churchyards (1843), p. 1.
2. Edwin Chadwick, Report on the Sanitary Condition of the Labouring Population of Great Britain. A Supplementary Report on the results of a Special Inquiry into The Practice of Internment in Towns. (1843), p. 134.
3. Ibid, p. 135.
4. Ruth Richardson, Death, Dissection and the Destitute (1987), p. 60.
5. Sarah Wise, The Italian Boy: Murder and Grave-Robbery in 1830s London (2005), p. 52.
6.Chadwick, Report on the Sanitary Condition, p. 31.
7. Ibid, p. 135.
8. Ibid, p. 136.
9.  I am greatly indebted to Ruth Levitt and her article, ‘A Grave Dilemma,’ in BBC History (May 2014) for inspiration & information for this article.

The Hung & Drawn Quarterly

HDQgibbet1I’m very excited to announce the launch of The Hung & Drawn Quarterly on Grave Matters! Illustrated by Adrian Teal, this comic follows Chris Skaife, Ravenmaster at the Tower of London, and myself on grisly adventures through history, documenting four terrible tales from each century. Beginning in the fifteenth with the execution of the Duke of Clarence, the series takes a humorous look at the dark history of crime and punishment.

Adrian, Chris and I don’t get paid for the content we offer on Grave Matters. If you would like to support our work, we now have an online shop where you can purchase artwork from The Hung & Drawn Quarterly (signed/unsigned), or make a donation to receive a laminated bookmark. We really appreciate any support you can give us on this new endeavor.

So without further ado, please click here to read the first in our grisly series! We hope you like it!

The Double Casket of Thomas & Mary Souder

PM15I remember rummaging through an old trunk in my grandmother’s house when I was a child and coming across what seemed to me at the time a very unusual photograph. It was a monochromatic image of a beautiful, young woman lying in a white casket (not dissimilar to the photo on the left).

Curious, I plucked the photo from the trunk and went to find my grandma, who was parked at the kitchen table sorting through the piles of mail that inevitably found its way into her house everyday. She told me that the woman in the casket was a distant relative of mine named Lena, who had died tragically at the age of 17. “You know, people used to take photos of the dead back then,” she said, taking the picture from me and studying it closely as if she had never seen it before. “Imagine that,” she remarked before placing the photo on the kitchen table and turning her attention back to the endless heaps of mail sitting on the table.

To a child, the image was haunting, and I never quite forgot it. It wasn’t till later in life, however, that I understood the historical significance behind the photo.

My grandmother was right (something she relishes hearing even to this day). Postmortem photos began to emerge shortly after commercial photography itself became available in 1839, and carried on being popular into the early 20th century. This was a time when people in Western Europe and North America had an intimate relationship with the dead, so it was inevitable that the recently deceased would feature prominently in Victorian family albums. The fact that my grandma only has one postmortem photo in her possession is now more unusual to me than the image itself.

Postmortem photos from the Victorian period varied considerably in presentation. The dead were not always photographed in their caskets, as you might expect. Often, they were propped up in chairs, occasionally alongside the living. This was especially common when the deceased was a child, as in this example above.

Sometimes, the dead’s cheeks were coloured to mask the telltale signs of decomposition, or the eyes drawn over to look as if they were open. R. B. Whittaker in New York described the latter services as “Fast Asleep and Wide Awake” in an advertisement card from 1860.

Other times, the corpse did not appear in the photo at all. Rather, it showed the gravesite with mourners standing around a tombstone. Yet no matter how different each photo was from another, death was always at the heart of these images.

By far one of the most unusual postmortem photos I’ve come across is that of Thomas & Mary Souder (below), taken at the time of their deaths in July, 1921. The couple died within 48 hours of each other from “the flux,” known today as dysentery—an intestinal inflammation that causes severe diarrhea that leads to rapid loss of fluids, dehydration and eventually death.

There are two forms of dysentery. One is caused by a bacterium, the other, an amoeba. The former is the most common in Western Europe and the United States; and is typically spread through contaminated food and water. Many people succumbed to the flux in the 19th and early 20th centuries, especially during wartime when access to clean water was severely restricted.

Thomas and Mary were in their late 70s and early 80s when they contracted the disease, and so their untimely demise is not shocking, especially when we consider this occurred before the discovery of penicillin (1928). What is surprising, though, is the double casket in which they were buried. For me, it raises many questions: was the casket commissioned while the two were dying or after both had passed away? And if the latter, how long had the Souders been dead before this photo was taken?

The Fort Worth Star Telegram in Hurst, Texas reported the deaths of the Souders on 16 July 1921:

Even death failed to separate Jefferson Souder…and Mrs. Mary E. Souder…his wife for more than half a century. Side by side, they will be laid to rest in the same casket in the little cemetery at Hurst Sunday afternoon after the span of more than an average lifetime, during with they were never separated. Only a few days intervened between their deaths. Mrs. Souder passed away at the old home near Hurst Wednesday. Her husband’s death followed Friday afternoon.

PM11The simple stone that marks their graves in Arwine Cemetery today gives no hint at the extraordinary casket that lies beneath the ground.

Sadly, this is not the only time two people have been buried together. In 2008, Ben and Arron Peak, two brothers who died tragically in a drunk driving accident, were buried in a double casket painted with the colours and logo of Manchester United, the boys’ favourite football team. Wilfred and Ann Fallows—husband and wife—were also buried this way after they died in a head-on collision in 2012. Most recently, Kelsey and Kendall Adams—two young children who were brutally murdered in New Orleans last year—were laid side-by-side and buried together.

So, as intrigued as I was by the Souders’ postmortem photo, I, for one, am glad that the double casket does not appear more frequently in my research. For when it does, it almost always involves a tragic tale filled with sorrow and unthinkable grief.

 

Death’s Doll: The World’s Most Beautiful Mummy

They call her ‘Sleeping Beauty,’ the world’s most beautiful mummy. Rosalia Lombardo died from pneumonia in 1920 at the tender age of 2. Her body was embalmed by Alfredo Salafia (below), put into a glass coffin, and placed inside the Capuchin Catacombs in Palermo, Italy. If it were not for the oxidizing amulet of the Virgin Mary resting atop her blanket, you would swear she had died a few days ago.

Very little is known about Rosalia’s life, and, until recently, even less was known about Salafia’s preservation methods.

Embalming as a means of memorializing the dead has ancient roots, dating all the way back to the Egyptians beginning in 3200 BC. During this period, embalmers removed the internal organs before rinsing the empty cavity with palm wine and filling it with natron salts. Over the next 40 days, the body would begin to dry out and mummify. The internal organs—which were washed, coated with resin and wrapped in linen strips upon removal—were either placed back into the body’s cavity at the end of this process, or stored in canopic jars.

This method is very different from the one used today, in which preserving fluids are pumped through the corpse’s vascular system. The end result is very different as well. Instead of a dried-out mummy that bears little resemblance to the living, you get a corpse that looks more or less as if it is sleeping. Vascular embalming became popular in the mid-19th century, and was largely driven by the sentimental desire to return the bodies of dead soldiers to their hometowns for burial during the American Civil War.

Embalming techniques varied greatly in the late-19th and early-20th centuries. For many years, Salafia’s formula remained a mystery. That was until Dario Piombino-Mascali at the Institute of Mummies and the Iceman in Bolzano tracked down Salafia’s living relatives who had in their possession a number of the embalmer’s handwritten papers. In his notes, Salafia revealed that he injected little Rosalia with a mixture of formalin, zinc salts, alcohol, salicylic acid and glycerin. It was the latter which prevented the little girl’s body from drying out too much. It was the zinc salts which gave her corpse its rigidity and stopped her cheeks and nasal cavity from caving in.

Nearly 100 years after her death, Rosalia looks unnervingly alive. In 2009, an MRI of Rosalia’s corpse produced the first 3D image of the little girl and revealed that all her organs were perfectly intact. Moreover, in time-lapse photos, Rosalia’s eyes open and shut, showing her blue irises to be nearly undamaged by decomposition (video below). The eyelid movement is most likely caused by changes in room temperature and humidity down in the catacombs, yet it has fueled many cult beliefs that Rosalia’s spirit returns to the body.

Little “Sleeping Beauty” draws thousands of people to the Capuchin Catacombs each year. Visitors armed with cameras and iPhones each vie to get a shot of her lying in her glass coffin. But for me, Rosalia is an unsettling sight. She is a reminder of the dangers of childhood in a pre-penicillin era, and represents her family’s unwillingness to let go of her even in death.

In her defiance to decay, Rosalia Lombardo has become Death’s doll, an eternal playmate that can neither age nor disappear.

Medicine’s Dark Secrets – Update

MDS LOGO

My Dear Donors,

It is with a heavy heart that I report to you that I have given notice of termination of my contract with Big Baby Productions Ltd, and will no longer be involved in Medicine’s Dark Secrets.

Over 7 months after filming finished, the production was significantly behind schedule and, in my view, was unlikely to be finalised. In an effort to find a way forward, I recently approached Big Baby Productions with an offer to take on the final costs of getting the production finished and made into a DVD for donors, in exchange for the footage and rights to Medicine’s Dark Secrets. My intention was to make it something that we could all be proud of, and to help ensure you, as donors, received your perks.

Unfortunately, Big Baby Productions declined this offer, and countered with one that I considered impractical and not commercially viable. In a final attempt to resolve matters, I extended my offer once more, asking Big Baby Productions to respond by 28 March 2014. That date has now lapsed with no response from them.

However, it has come to my attention that Lesley-Anne Morrison, the director of Medicine’s Dark Secrets and CEO of Big Baby Productions, has contacted several donors suggesting that she had recently sought to enter into negotiations with me and that she was waiting for my response. That is not the case.

Moreover, in a recent update via IndieGoGo to donors on 25 March 2014, Big Baby Productions has implied that the content and format of Medicine’s Dark Secrets would be undergoing major changes. I was not informed of this, nor did I consent to this.

As many of you know, I put my heart and soul into this project. I worked hard with Big Baby Productions on Medicine’s Dark Secrets for two years (during which time I did not receive any payment from them and incurred personal expenses), and I had high hopes that I would see the production on television.

I know that this update will come as a huge disappointment to you. I want you to know that I did not take this decision lightly. I have several exciting projects on the horizon, and through them, I will endeavour to make this up to you in some form or another. I have always appreciated your support. And, of course, do not hesitate to contact me with any questions.

Sincerely,

Dr Lindsey (The Chirurgeon’s Apprentice)

Dead Men’s Teeth: A History of Dentures

827034-001I remember as a little girl being utterly terrified at my great-grandmother’s dentures. The first time that I ever realized that she had false teeth was when I found them peculiarly suspended in a glass of water on the kitchen counter. The jaw was unhinged, as if it was perpetually locked in a ghastly scream. Another time, the dentures were simply sat on her bedside table, grinning horribly at me like some kind of sick advertisement for why children should brush their teeth at night.

I wondered if all ‘old’ people had these frightening contraptions.

Now that I’m all grown up (sorta), I recognize that modern dentures are far less scary than their predecessors, which are truly the stuff of nightmares.

L0043833 Napoleon Bonaparte's ToothbrushIt probably will not come as a surprise to most readers that people in the past suffered from tooth decay the same as we do today. Early toothbrushes with their horsehair bristles (see Napoleon’s, right) often caused more problems than they prevented, and toothpastes or powders made from pulverized charcoal, chalk, brick or salt were more harmful than helpful in the 18th and 19th centuries.

Most of us have had cavities in our lives. Some of us are even old enough to have had them filled with amalgam, a mixture of mercury, silver, tin and copper. But in earlier periods, having a cavity filled was not an option. Once a tooth began to rot, one had little choice but to have it pulled, sans anaesthetic.

In the 18th century, the tooth key was the preferred tool for pulling teeth. The claw was placed over the top of the decaying tooth; the bolster, or the long metal rod, was placed against the root. The key was then turned and, if all went well, the tooth would pop out of the socket. Unfortunately, this did not always go to plan. Often, the tooth shattered as the key was turned and had to be plucked from the bleeding gum tissue piece by piece.

As time progressed, incidents of tooth decay rose as sugar and tobacco became more readily available, creating a market for dentures. Early versions were made of ivory or animal bone, and typically incorporated the teeth of executed criminals or exhumed bodies. See, for example, George Washington’s dentures.

When the first President of the United States was inaugurated in 1789, he only had one remaining tooth left in his mouth. Dr John Greenwood—a dentist from New York, and former soldier in the Revolutionary War—fashioned a set of dentures from hippopotamus ivory, using gold wire springs and brass screws to hold together the human teeth he had procured. There was even a hole left for his one remaining tooth.

D4

Photo courtesy of the New York Academy of Medicine

Contraptions like this were cumbersome and painful to wear. But more so, these teeth were often plucked from the mouths of those who had died from syphilis, thus infecting their new owners when contaminated tissue came into contact with open wounds in the mouth.

What practitioners really needed was access to young, healthy teeth. That opportunity presented itself during the Battle of Waterloo in 1815, which led to the deaths of 51,000 men, many of whom left behind a perfectly lovely set of teeth after they shuffled off this mortal coil.

‘Waterloo Teeth,’ as they were known, referred to any teeth stolen from the mouths of dead soldiers in the 19th century, and was a term even employed during the Crimean and American Civil Wars. Body-snatchers followed armies into battle, and returned home with bagfuls of teeth which they then sold to dentists and surgeons for a very high premium.

D1As superior as these dentures were to older versions, they still carried with them the stigma of underworld thievery, which didn’t sit well with the toothless upper-classes. Eventually, dentists were forced to develop new techniques using new materials (such as porcelain) to create dentures that didn’t require the use of dead men’s teeth.

Still, this practice continued well into the 19th century, prompting a Professor of Anatomy at Trinity College to remark on the hypocrisy of the rich about their attitudes towards bodysnatching:

I do not think the upper and middle classes have understood the effects of their own conduct when they take part in impeding the process of dissection…very many of the upper ranks carry in their mouths teeth which have been buried in the hospital fields. [1]

And, of course, the teeth of those who died fighting on the battlefield.

1. Qtd in Ruth Richardson, Death, Dissection and the Destitute (1987; repr. 2000), p. 106.

Announcing the Launch of Grave Matters 

GraveMatters

I don’t like to brag (okay, I do) but I know an amazing number of talented people. One of them is Chris Skaife, Yeoman Warder (Beefeater) and Ravenmaster at the Tower of London.  Together, he and I have launched a new website which will focuses primarily on the history of crime and punishment; and what happened to criminals before, during and after execution. We’ve got a lot of gruesome things planned for the site, so please do check it out if you are interested. Our first post is on ‘5 Shocking Facts from the Scaffold’ – you won’t believe some of the stories we’ve dug up!

Click Grave Matters to visit the website. And make sure you “like” our page on Facebook to keep up-to-date on the latest articles!

The Syphilitic Whores of Georgian London

harrisPeople think I’m obsessed with syphilis, and maybe I am. But it’s only because of my recent indoctrination into 18th-century history by aficionados of the period, such as Lucy Inglis, Adrian Teal and Rob Lucas.  I can’t read 10 pages of a medical casebook without coming across a reference to lues venerea. By the end of the century, London was literally crawling with the pox.

And it’s no surprise. Sexual promiscuity was as much a part of Georgian England as were powdered wigs and opium. For a few pennies, a gentleman could pick up Harris’s List of Covent Garden Ladies, or Man of Pleasure’s Kalendar—a pocket guide to London’s prostitutes published annually starting in 1771—and peruse it as he might do a fine wine list.

For three guineas, a man could partake in the pleasures provided by Miss L—st—r at No. 6 Union Street, whose ‘neighbouring hills [are] full ripe for manual pressure, firm, and elastic, and heave at every touch.’ [1] If three guineas were too much, one could always spend a third of that for a night with Miss H—ll—nd at No. 2 York Street, who, ‘tho’ only seventeen and short, is very fat and corpulent…a luscious treat to the voluptuary.’ [2]  And for those who fancied a woman ‘rather above the common height’, they could visit Miss S—ms at No. 82 Queen Ann’s Street East, who frequently attracted lovers of a ‘diminutive size’ who loved ‘surmounting such a fine, tall woman.’ [3]

L0033923 A prostitute leading an old man into the bedroomThe guidebook wasn’t all slap and tickle, though. Hidden within these pages were warnings about the dangers of sleeping with diseased prostitutes.  Military men were cautioned against Matilda Johnson, since ‘it is thought by some experienced officers, that her citadel is in danger, on account of a quantity of fiery combustible matter which is lodged in the covered way.’ Some warnings were not so subtle (or hilarious). The guidebook alerts its readers to Miss Young, who had ‘very lately had the folly and wickedness to leave a certain hospital, before the cure for a certain distemper which she had was completed.’ The book ominously adds that she has ‘thrown her contaminated carcass on the town again.’ [4]

Yes, syphilis was ubiquitous in 18th-century London. Aside from abstaining or entering into a monogamous relationship with a healthy partner, there was very little one could do to protect oneself from the pox. Condoms, though available during this period, were rarely employed. When used, they were frequently reused multiple times, defeating their purpose as safeguards against contamination.

SyphilisThat said, the telltale signs of the disease could often be seen on those suffering from the pox, allowing the astute observer to steer clear of infected persons. In this wax moulage (left) by the talented artist, Nicole Antebi, you can see the effects of the disease on the face and mouth. Blemishes such as these came to be associated with prostitution. Georgian women went to great lengths to cover these marks with ‘beauty spots’ made of fine black velvet, or mouse skin.

Those who suffered from the pox often turned to surgeons for help. Before the discovery of penicillin, syphilis was an incurable (and ultimately fatal) disease. The longer it went on, the worse the symptoms became. In addition to unsightly skin ulcers like the ones mentioned above, sufferers could experience paralysis, blindness, dementia and ‘saddle nose‘, a grotesque deformity which occurs when the bridge of the nose caves into the face.

L0034508 A patient suffering from the adverse effects of mercury treatMany treatments involved the use of mercury, which could be administered in the form of calomel (mercury chloride), an ointment, a steam bath or pill. Unfortunately, the side effects could be as painful and terrifying as the disease itself (see illustration, right, of patient suffering from over-exposure to mercury). Many patients who underwent such treatments suffered from extensive tooth loss, ulcerations and neurological damage. In many cases, people died from mercury poisoning. Indeed, it’s hard to fault Miss Young for throwing her ‘contaminated carcass on the town again’ after refusing to continue treatment that most likely included mercury.

Prostitutes bore the brunt of it when it came to syphilis in Georgian London. Yet despite the dangers, women entered into the profession at an astonishing rate. An estimated 1 in 5 women were ‘Ladies of the Night’ during this period. Some entered the sex trade as young as 12 years of age; and many could expect to make as much as £400 per year. [5]

Still, the financial advantages of prostitution meant little if one contracted the deadly disease. The two syphilitic women mentioned above did not appear in later editions of Harris’s List. Their fates were sealed once their secrets had been exposed. No doubt countless other women suffered the same future after they became infected, losing not only their livelihoods, but also their lives to this dreadful epidemic.

Am I obsessed with syphilis? Yes. But for good reason!

1. Harris’s List of Covent Garden Ladies or Man of Pleasure’s Kalendar for the Year (1788), p. 16.
2. Ibid., p. 18.
3. Ibid., p. 36
4. These two examples come from Harris’s List (1779); however, I originally found them in Wendy Moore’s excellent book, The Knife Man: Blood, Body-Snatching and The Birth of Modern Science (2005), p. 127.
5. These facts and figures can be found in Dan Cruickshank’s book, The Secret History of Georgian London (2010).

The Battle of the Tooth Worm

_toothwormI come across a lot of strange objects in my research: books bound in human skin, prosthetic noses made of silver, iron coffins with safety devices to prevent premature burial. But perhaps one of the strangest objects I’ve seen is the one pictured on the left.

This is a depiction of the infamous tooth worm believed by many people in the past to bore holes in human teeth and cause toothaches.  But before I tell you about this fascinating piece of art, let me give you a quick lesson in dental folklore.

Tooth worms have a long history, first appearing in a Sumerian text around 5,000 BC. References to tooth worms can be found in China, Egypt and India long before the belief finally takes root (pun intended) into Western Europe in the 8th century. [1]

Treatment of tooth worms varied depending on the severity of the patient’s pain. Often, practitioners would try to ‘smoke’ the worm out by heating a mixture of beeswax and henbane seed on a piece of iron and directing the fumes into the cavity with a funnel. Afterwards, the hole was filled with powered henbane seed and gum mastic.  This may have provided temporary relief given the fact that henbane is a mild narcotic. Many times, though, the achy tooth had to be removed altogether. Some tooth-pullers mistook nerves for tooth worms, and extracted both the tooth and the nerve in what was certainly an extremely painful procedure in a period before anaesthetics. [2]

_Toothworm3The tooth worm came under attack in the 18th century when Pierre Fauchard—known today as the father of modern dentistry—posited that tooth decay was linked to sugar consumption and not little creatures burrowing inside the tooth. In the 1890s, W.D. Miller took this idea a step further, and discovered through a series of experiments that bacteria living inside the mouth produced acids that dissolved tooth enamel when in the presence of fermentable carbohydrates.

Despite these discoveries, many people continued to believe in the existence of tooth worms even into the 20th century.

The piece of art at the top of the article is titled ‘The Tooth Worm as Hell’s Demon.’ It was created in the 18th century by an unknown artist, and is carved from ivory. It is an incredibly intricate piece when you consider it only stands a little over 4 inches tall. The two halves open up to reveal a scene about the infernal torments of a toothache depicted as a battle with the tooth worm, complete with mini skulls, hellfire, and naked humans wielding clubs.

_toothworm4

It is, without a doubt, one of the strangest objects I’ve come across in my research; and today, I pass this random bit of trivia on to you in the hopes that you may use it someday to revive a dying conversation at a cocktail party.

1. W. E. Gerabek, ‘The Tooth-Worm: Historical Apsects of a Popular Belief,’ Clinical Oral Investigations (April 1999): pp. 1-6.
2. Leo Kanner, Folklore of the Teeth (1928).