Pre-Order My Book! The Butchering Art

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I’m thrilled to reveal the cover for the US edition of my forthcoming book, THE BUTCHERING ART, which will be published by FSG on October 17th.

The book delves into the grisly world of Victorian surgery and transports the reader to a period when a broken leg could result in amputation, when giving birth in a squalid hospital was extraordinarily dangerous, and when a minor injury could lead to a miserable death. Surgeons—lauded for their brute strength and quick knives—rarely washed their hands or their instruments, and carried with them a cadaverous smell of rotting flesh, which those in the profession cheerfully referred to as “good old hospital stink.” At a time when surgery couldn’t have been more dangerous, an unlikely figure stepped forward: Joseph Lister, a young, melancholic Quaker surgeon. By making the audacious claim that germs were the source of all infection—and could be treated with antiseptics—he changed the history of surgery forever.

Many of you have been devoted readers of my blog since its inception in 2010, and I can’t thank you enough for your continued interest in my work. Writing a book has been the next logical step for a very long time. The idea of telling this particular story arose during a very difficult period in my life when my writing career was at risk. It is therefore with great pride (and some trepidation) that I am turning this book loose into the world, and humbly ask you to consider pre-ordering it. All pre-orders count towards first-week sales once THE BUTCHERING ART is released, and therefore give me a greater chance of securing a place on bestseller lists in October. I would be hugely grateful for your support.

Pre-order from any one of these vendors using the links below:

*Please note that THE BUTCHERING ART will also be published by Penguin in the United Kingdom, as well as several other publishers around the world. I’ll be revealing covers for these foreign editions in the coming months, along with information on where to buy a copy.

Syphilis: A Little Valentine’s Day Love Story

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Photo Credit: The Royal College of Surgeons of England 

We don’t know much about her. We don’t even know her name. What we do know is that the woman who wore the above prosthetic in the mid-19th century was suffering from a severe case of syphilis.

Before the discovery of penicillin in 1928, syphilis was an incurable disease. Its symptoms were as terrifying as they were unrelenting. Those who suffered from it long enough could expect to develop unsightly skin ulcers, paralysis, gradual blindness, dementia and “saddle nose,” a grotesque deformity which occurs when the bridge of the nose caves into the face.

stlcfo00239This deformity was so common amongst those suffering from the pox (as it was sometimes called) that “no nose clubs” sprung up in London. On 18 February 1874, the Star reported: “Miss Sanborn tells us that an eccentric gentleman, having taken a fancy to see a large party of noseless persons, invited every one thus afflicted, whom he met in the streets, to dine on a certain day at a tavern, where he formed them into a brotherhood.”[1] The man, who assumed the name Mr. Crampton for these clandestine parties, entertained his “noseless’” friends every month until he died a year later, at which time the group “unhappily dissolved.”[2]

The 19th century was particularly rife with syphilis. Because of its prevalence, both physicians and surgeons treated victims of the disease. Many treatments involved the use of mercury, hence giving rise to the saying: “One night with Venus, a lifetime with Mercury.” Mercury 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. Many patients who underwent mercury treatments suffered from extensive tooth loss, ulcerations and neurological damage. In many cases, people died from significant mercury poisoning.

For those determined to avoid the pox altogether, condoms made from animal membrane and secured with a silk ribbon were available [below], but these were outlandishly expensive. Moreover, many men shunned them for being uncomfortable and cumbersome. In 1717, the surgeon, Daniel Turner, wrote:

The Condum being the best, if not only Preservative our Libertines have found out at present; and yet by reason of its blunting the Sensation, I have heard some of them acknowledge, that they had often chose to risk a Clap, rather than engage cum Hastis sic clypeatis [with spears thus sheathed].[3]

13Everyone blamed each other for the burdensome condom. The French called it “la capote anglaise” (the English cape), while the English called it the “French letter.” Even more unpleasant was the fact that once one procured a condom, he was expected to use it repeatedly. Unsurprisingly, syphilis continued to rage despite the growing availability of condoms during the Victorian period.

Which brings me back to the owner of the prosthetic nose. Eventually, she lost her teeth and palate after prolonged exposure to mercury treatments. Her husband—who may have been the source of her suffering—finally died from the disease, leaving her a widow. But it wasn’t all doom and gloom for the poor, unfortunate Mrs X.

According to records at the Royal College of Surgeons in London, the woman found another suitor despite her deformities. After the wedding, she sought out the physician, James Merryweather, and sold the contraption to him for £3. The reason? Her new husband liked her just the way she was – no nose and all!

And that, kind readers, is a true Valentine’s Day love story…Ignore the part where she most certainly transmitted the disease to her new lover.

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1. Origin of the No Nose Club. Star, Issue 1861 (18 February 1874), p. 3.
2. Ibid.
3. Daniel Turner, Syphilis: A Practical Treatise on the Venereal Disease (1717), p. 74.

Under the Knife, Episode 10 – Al Capone’s Grave

In Episode 10 of Under the Knife, I hit the road to visit the grave of the infamous American gangster, Al Capone. Learn about Capone’s torturous descent into madness caused by advance stage syphilis, and his eventual death and burial that left his grave exposed to vandals.

If you enjoy the series, please consider becoming a patron of my project by clicking here. And don’t forget to subscribe to my YouTube Channel, and like/comment on the video!

The Surgeon who Operated on Himself

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Leonid Ivanovich Rogozov (pictured above and below right) knew he was in trouble when he began experiencing intense pain in lower right quadrant of his abdomen. He had been feeling unwell for several days, but suddenly, his temperature skyrocketed and he was overcome by waves of nausea. The 27-year-old surgeon knew it could only be one thing: appendicitis.

blog3The year was 1961, and under normal circumstances, appendicitis was not life-threatening. But Rogozov was stuck in the middle of the Antartica, surrounded by nothing but thousands of square miles of snow and ice, far from civilization. He was one of thirteen researchers who had just embarked on the sixth Soviet Antarctic Expedition.

And he was the only doctor.

At first, Rogozov resigned himself to his fate. He wrote in his diary:

It seems that I have appendicitis. I am keeping quiet about it, even smiling. Why frighten my friends? Who could be of help? A polar explorer’s only encounter with medicine is likely to have been in a dentist’s chair.

He was right that there was no one who could help. Even if there had been another research station within a reasonable distance, the blizzard raging outside Rogozov’s own encampment would have prevented anyone from reaching him. An evacuation by air was out of the question in those treacherous conditions. As the situation grew worse, the young Soviet surgeon did the only thing he could think of: he prepared to operate on himself.

Rogozov was not the first to attempt a self-appendectomy. In 1921, the American surgeon Evan O’Neill Kane undertook an impromptu experiment after he too was diagnosed with a severe case of appendicitis. He wanted to know whether invasive surgery performed under local anesthetic could be painless. Kane had several patients who had medical conditions which prevented them from undergoing general anesthetic. If he could remove his own appendix using just a local anesthetic, Kane reasoned that he could operate on others without having to administer ether, which he believed was dangerous and overused in surgery.

Lying in the operating theater at the Kane Summit Hospital, the 60-year-old surgeon announced his intentions to his staff. As he was Chief of Surgery, no one dared disagree with him. Kane proceeded by administering novocaine—a local anesthetic that had only recently replaced the far more dangerous drug, cocaine—as well as adrenalin into his abdominal wall. Propping himself up on pillows and using mirrors, he began cutting into his abdomen. At one point, Kane leaned too far forward and part of his intestines popped out. The seasoned surgeon calmly shoved his guts back into their rightful place before continuing with the operation. Within thirty minutes, he had located and removed the swollen appendix. Kane later said that he could have completed the operation more rapidly had it not been for the staff flitting around him nervously, unsure of what they were supposed to do.

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Emboldened by his success, Kane decided to repair his own inguinal hernia under local anesthetic eleven years later. The operation was carried out with the the press in attendance. This operation was more dangerous than the appendectomy because of the risk of puncturing the femoral artery. Unfortunately, this second surgery was tricky, and ended up taking well over an hour. Kane never fully regained his strength. He eventually came down with pneumonia, and died three months later.

Back in Antartica, Rogozov enlisted the help of his colleagues, who assisted with mirrors and retractors as the surgeon cut deep into his own abdomen. After forty-five minutes, Rogozov began experiencing weakness and vertigo, and had to take short breaks. Eventually he was able to remove the offending organ and sew up the incision (pictured below, recovering). Miraculously, Rogozov was able to return to work within two weeks.

blog4The incident captured the imagination of the Soviet public at the time. After he returned from the expedition, Rogozov was awarded the Order of the Red Banner of Labour. The incident also brought about a change in policy. Thereafter, extensive health checks became mandatory for personnel before their departure for Antartica was sanctioned.

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Under The Knife, Episode 9 – The Barber’s Pole

At last! A brand new episode of Under The Knife!

In Episode 9, I discuss the history of the barber’s pole, and how it relates to a bloody practice from our medical past. Learn how the barber’s pole got its red & white stripes.

If you enjoy the series, please consider becoming a patron of my project by clicking here. And don’t forget to subscribe to my YouTube Channel, and like/comment on the video!

Under The Knife – Reboot!

It’s been 18 months since I’ve filmed an episode of my YouTube series, Under The Knife. But that ends today! Check out the trailer to the series reboot, which may or may not involve my severed head. A NEW episode is coming next week. If you haven’t subscribed to the channel, please do. You’ll be automatically entered to win macabre little trinkets before the launch of our next video.

My team and I have a lot of fun, quirky things planned for the series in the coming months. Under The Knife combines traditional storytelling techniques with animation, special effects, and artwork to bring the medical past alive. I hope you enjoy watching the new series as much as I enjoy filming it for you.

“We Have Conquered Pain!” The Uses & Abuses of Ether in History

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The surgical revolution began with an American dentist and a curiously sweet-smelling liquid known as ether.

Officially, ether had been discovered in 1275, but its stupefying effects weren’t synthesized until 1540, when the German botanist and chemist Valerius Cordus created a revolutionary formula that involved adding sulfuric acid to ethyl alcohol. His contemporary Paracelsus experimented with ether on chickens, noting that when the birds drank the liquid, they would undergo prolonged sleep and awake unharmed. He concluded that the substance “quiets all suffering without any harm and relieves all pain, and quenches all fevers, and prevents complications in all disease.” [1] Yet inexplicably, it would be several hundred years before it was tested on humans.

00_01_morton-inhaler-replica-mThat moment finally arrived in 1842, when Crawford Williamson Long became the first pioneer to use ether as a general anesthetic when he removed a tumor from a patient’s neck in Jefferson, Georgia. Unfortunately, Long didn’t publish the results of his experiments until 1848. By that time, Boston dentist William T. G. Morton had won fame by using it while extracting a tooth painlessly from a patient on September 30, 1846 [see Morton’s inhaler for administering ether, right]. An account of this successful procedure was published in a newspaper, prompting a notable surgeon to ask Morton to assist him in an operation removing a large tumor from a patient’s lower jaw at Massachusetts General Hospital. After the demonstration, someone nicknamed the surgical amphitheater the “Ether Dome,” and it has been known by this name ever since.

It was an incredible breakthrough. Up until that point, surgery had been brutally painful. The patient, fully awake, would be restrained while the surgeon cut through skin, tissue, muscle, and bone. Surgeons were lauded for their brute strength and quick hands. A capable surgeon could remove a leg in under a minute. But with the discovery of ether, the need for speed in the operating theater had now vanished.

On November 18, 1846, Dr. Henry Jacob Bigelow wrote about this groundbreaking moment in The Boston Medical and Surgical Journal. He described how Morton had administered what he called “Letheon” to the patient before the operation commenced. This was a gas named after the River Lethe in classical mythology which made the souls of the dead forget their lives on earth. Morton, who had patented the composition of the gas shortly after the operation, kept its parts secret, even from the surgeons. Bigelow revealed, however, that he could detect the sickly sweet smell of ether in it. News about the miraculous substance which could render patients unconscious during surgery spread quickly around the world as surgeons rushed to test the effects of ether on their own patients.

The term “etherization” was coined, and the use of ether in surgery was celebrated in newspapers. “The history of Medicine has presented no parallel to the perfect success that has attended the use of ether,” a writer at the Exeter Flying Post proclaimed. [2] Another journalist declared: “Oh, what delight for every feeling heart… the announcement of this noble discovery of the power to still the sense of pain, and veil the eye and memory from all the horrors of an operation…WE HAVE CONQUERED PAIN!” [3]

5A curious by-product of all this was the ether parties that sprang up all over the world. Thomas Lint, a medical student at St. Bartholomew’s Hospital in London, confessed: “We sit round a table and suck [on an inhaling apparatus], like many nabobs with their hookahs. It’s glorious, as you will see from this analysis of a quarter of an hour’s jolly good suck.” [4] He then went on to describe several “ethereal” experiences he and his fellow classmates had while under the influence of the newly discovered substance.

Ether wasn’t just inhaled. It was also drunk, like alcohol. In Ireland, the substance replaced whiskey for a while, due to its low cost (a penny a draught). After drinking a glass of water, “ethermaniacs” would take a drop of the drug on their tongues while pinching their noses and chasing it with another glass of water. Taken this way, ether hit the user hard and fast. Dr. Ernest Hart wrote that “the immediate effects of drinking ether are similar to those produced by alcohol, but everything takes place more rapidly.” [5] Recovery was just as swift. Those taken into custody for drunken disorderliness were often completely sober by the time they reached the police station, with the bonus that they also suffered no hangover. In this way, 19th-century revelers could take draughts of ether several times a day, with little consequence. [6]

Today, the “Ether Dome” at Massachusetts General Hospital has become a national historic landmark [pictured below], visited by thousands of members of the public each year. Although surgeons haven’t operated there for well over a hundred years, the room is still used for meetings and lectures at the hospital. The Ether Dome looks more or less like it did 165 years ago. Display cases at either end of the room contain surgical instruments from Morton’s day, their blades dull and rusted with age. At the front of the room an Egyptian mummy lords over the phantom audience. One can almost detect the sweet smell of ether in the air from so long ago.

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1. Quoted in Steve Parker, Kill or Cure: An Illustrated History ofMedicine (London: DK, 2013), 174.
2. “Etherization in Surgery,” Exeter Flying Post, 24 June, 1847, 4.
3. London People’s Journal, 9 January, 1847.
4. Punch, or The London Charivari (December 1847), 259.
5. Quoted in David J. Linden, Pleasure: How Our Brains Make Junk Food, Exercise, Marijuana, Generosity & Gambling Feel So Good (Viking, 2011), 31.
6. Sterling Haynes, “Ethermaniacs,” BC Medical Journal (June 2014), Vol. 56 (No.5), 254-3.