The Butchering Art – UK Cover Reveal!

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I’m thrilled to reveal the UK cover for my upcoming book THE BUTCHERING ART, which will be published by Allen Lane, an imprint of Penguin, on October 17th. The book tells the story of the surgeon Joseph Lister and his quest to transform the brutal world of Victorian surgery through antisepsis.

Fitzharris_ButcheringArt_JKFFor those of you who are familiar with the US cover (right), you’ll notice a lot of similarities. The US cover features a painting by the 19th-century artist Thomas Eakins. It depicts the surgeon Samuel Gross, who didn’t believe in the existence of germs and made a point of not using Lister’s antiseptic techniques in the operating theater. The painting is dark and bloody, and the surgeons are all wearing their everyday clothing. These men are the last “butchers” of their profession – men who were lauded for their brute strength and speed, and who didn’t wash their hands or their instruments between operations.

In contrast, the UK cover (above) features a second painting by Eakins, this one completed a decade later after Lister triumphs and germ theory is finally accepted by the medical community. This painting is lighter, brighter, and there is a sense of cleanliness and hygiene (note: the publisher has stylized the original painting to give it a slightly modern look here). I think it’s brilliant that the US and UK covers are in conversation with one another. So here’s the important part! I would be HUGELY GRATEFUL if you would consider pre-ordering the book today if you’re in the UK. Pre-orders are especially crucial at the start of a writer’s career as they increase my chance at getting onto bestseller lists when the time comes. Click HERE.

And don’t forget you can also pre-order the US edition by clicking HERE. Info on further foreign editions to come!

The Wandering Womb: Female Hysteria through the Ages

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The word “hysteria” conjures up an array of images, none of which probably include a nomadic uterus wandering aimlessly around the female body. Yet that is precisely what medical practitioners in the past believed was the cause behind this mysterious disorder. The very word “hysteria” comes from the Greek word hystera, meaning “womb,” and arises from medical misunderstandings of basic female anatomy.

Today, hysteria is regarded as a physical expression of a mental conflict and can affect anyone regardless of age or gender. [1] Centuries ago, however, it was attributed only to women, and believed to be physiological (not psychological) in nature.

enhanced-1129-1458094853-1For instance, Plato believed that the womb—especially one which was barren—could become vexed and begin wandering throughout the body, blocking respiratory channels causing bizarre behavior. [2] This belief was ubiquitous in ancient Greece. The physician Aretaeus of Cappadocia went so far as to consider the womb “an animal within an animal,” an organ that “moved of itself hither and thither in the flanks.” [3] The uterus could move upwards, downwards, left or right. It could even collide with the liver or spleen. Depending on its direction, a wandering womb could cause all kinds of hell. One that traveled upwards might cause sluggishness, lack of strength, and vertigo in a patient; while a womb that moved downwards could cause a person to feel as if she were choking. So worrisome was the prospect of a wandering womb during this period, that some women wore amulets to protect themselves against it. [4]

The womb continued to hold a mystical place in medical text for centuries, and was often used to explain away an array of female complaints. The 17th-century physician William Harvey, famed for his theories on the circulation of the blood around the heart, perpetuated the belief that women were slaves to their own biology. He described the uterus as “insatiable, ferocious, animal-like,” and drew parallels between “bitches in heat and hysterical women.” [5] When a woman named Mary Glover accused her neighbor Elizabeth Jackson of cursing her in 1602, the physician Edward Jorden argued that the erratic behavior that drove Mary to make such an accusation was actually caused by noxious vapors in her womb, which he believed were slowly suffocating her. (The courts disagreed and Elizabeth Jackson was executed for witchcraft shortly thereafter.)

So what could be done for hysteria in the past?

e789fb4fb909b2a53918eb9a18b08db3Physicians prescribed all kinds of treatments for a wayward womb. These included sweet-smelling vaginal suppositories and fumigations used to tempt the uterus back to its rightful place. The Greek physician Atreaus wrote that the womb “delights…in fragrant smells and advances towards them; and it has an aversion to foetid smells, and flees from them.” Women were also advised to ingest disgusting substances—sometimes containing repulsive ingredients such as human or animal excrement—in order to coax the womb away from the lungs and heart. In some cases, physical force was used to correct the position of a wandering womb (see image, right). For the single woman suffering from hysteria, the cure was simple: marriage, followed by children. Lots and lots of children.

Today, wombs are no longer thought to wander; however, medicine still tends to pathologize the vagaries of the female reproductive system. [6] Over the course of several thousand years, the womb has become less of a way to explain physician ailments, and more of a way to explain psychological disfunction—often being cited as the reason behind irrationality and mood swings in women. Has the ever-elusive hysteria brought on by roving uteri simply been replaced by the equally intangible yet mysterious PMS? I’ll let you decide.

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You can now pre-order my book THE BUTCHERING ART by clicking here. THE BUTCHERING ART follows the story of Joseph Lister as he attempts to revolutionize the brutal world of Victorian surgery through antisepsis. Pre-orders are incredibly helpful to new authors. Info on how to order foreign editions coming soon. Your support is greatly appreciated. 

 

 

1. Mark J Adair, “Plato’s View of the ‘Wandering Uterus,’” The Classical Journal 91:2 (1996), p. 153.
2. G. S. Rousseau, “‘A Strange Pathology:’ Hysteria in the Early Modern World, 1500-1800” in Hysteria Beyond Freud (1993), p.104. Originally qtd in Heather Meek, “Of Wandering Wombs and Wrongs of Women: Evolving Concepts of Hysteria in the Age of Reason,” English Studies in Canada 35:2-3 (June/September 2009), p.109.
3. Quoted in Matt Simon, “Fantastically Wrong: The Theory of the Wandering Wombs that Drove Women to Madness,” Wired (7 May 2014).
4. Robert K. Ritner, “A Uterine Amulet in the Oriental Institute Collection,” Journal of Near Eastern Studies 45:3 (Jul. 1984), pp.209-221. For more on the fascinating subject of magical amulets, see Tom Blaen, Medical Jewels, Magical Gems: Precious Stones in Early Modern Britain (2012).
5. Rousseau, “A Strange Pathology,” p. 132.
6. Mary Lefkowitz, “Medical Notes: The Wandering Womb,” The New Yorker (26 February 1996).

Houses of Death: Walking the Wards of a Victorian Hospital

9deb7918e7e1d5281d6cfba4eafb711dThe following blog post relates to my forthcoming book THE BUTCHERING ART, which you can pre-order here

Today, we think of the hospital as an exemplar of sanitation. However, during the first half of the nineteenth century, hospitals were anything but hygienic. They were breeding grounds for infection and provided only the most primitive facilities for the sick and dying, many of whom were housed on wards with little ventilation or access to clean water. As a result of this squalor, hospitals became known as “Houses of Death.”

L0059152 Trade card for a 'Bug Destroyer' Andrew Cooke, LondonThe best that can be said about Victorian hospitals is that they were a slight improvement over their Georgian predecessors. That’s hardly a ringing endorsement when one considers that a hospital’s “Chief Bug-Catcher”—whose job it was to rid the mattresses of lice—was paid more than its surgeons in the eighteenth century. In fact, bed bugs were so common that the “Bug Destroyer” Andrew Cooke [see image, left] claimed to have cleared upwards of 20,000 beds of insects during the course of his career.[1]

In spite of token efforts to make them cleaner, most hospitals remained overcrowded, grimy, and poorly managed. The assistant surgeon at St. Thomas’s Hospital in London was expected to examine over 200 patients in a single day. The sick often languished in filth for long periods before they received medical attention, because most hospitals were disastrously understaffed. In 1825, visitors to St. George’s Hospital discovered mushrooms and wriggling maggots thriving in the damp, soiled sheets of a patient with a compound fracture. The afflicted man, believing this to be the norm, had not complained about the conditions, nor had any of his fellow convalescents thought the squalor especially noteworthy.[2]

Worst of all was the fact that a sickening odor permeated every hospital ward. The air was thick with the stench of piss, shit, and vomit. The smell was so offensive that the staff sometimes walked around with handkerchiefs pressed to their noses. Doctors didn’t exactly smell like rose beds, either. Berkeley Moynihan—one of the first surgeons in England to use rubber gloves—recalled how he and his colleagues used to throw off their own jackets when entering the operating theater and don ancient frocks that were often stiff with dried blood and pus. They had belonged to retired members of staff and were worn as badges of honor by their proud successors, as were many items of surgical clothing.

llanionmilitaryhospitalmoreThe operating theaters within these hospitals were just as dirty as the surgeons working in them. In the early decades of the nineteenth century, it was safer to have surgery at home than it was in a hospital, where mortality rates were three to five times higher than they were in domestic settings. Those who went under the knife did so as a last resort, and so were usually mortally ill. Very few surgical patients recovered without incident. Many either died or fought their way back to only partial health. Those unlucky enough to find themselves hospitalized during this period would frequently fall prey to a host of infections, most of which were fatal in a pre-antibiotic era.

419c2b28d1b137197a21298b24a604c0In addition to the foul smells, fear permeated the atmosphere of the Victorian hospital. The surgeon John Bell wrote that it was easy to imagine the mental anguish of the hospital patient awaiting surgery. He would hear regularly “the cries of those under operation which he is preparing to undergo,” and see his “fellow-sufferer conveyed to that scene of trial,” only to be “carried back in solemnity and silence to his bed.” Lastly, he was subjected to the sound of their dying groans as they suffered the final throes of what was almost certainly their end.[3]

As horrible as these hospitals were, it was not easy gaining entry to one. Throughout the nineteenth century, almost all the hospitals in London except the Royal Free controlled inpatient admission through a system of ticketing. One could obtain a ticket from one of the hospital’s “subscribers,” who had paid an annual fee in exchange for the right to recommend patients to the hospital and vote in elections of medical staff. Securing a ticket required tireless soliciting on the part of potential patients, who might spend days waiting and calling on the servants of subscribers and begging their way into the hospital. Some hospitals only admitted patients who brought with them money to cover their almost inevitable burial. Others, like St. Thomas’ in London, charged double if the person in question was deemed “foul” by the admissions officer.[4]

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Before germs and antisepsis were fully understood, remedies for hospital squalor were hard to come by. The obstetrician James Y. Simpson suggested an almost-fatalistic approach to the problem. If cross-contamination could not be controlled, he argued, then hospitals should be periodically destroyed and built anew. Another surgeon voiced a similar view. “Once a hospital has become incurably pyemia-stricken, it is impossible to disinfect it by any known hygienic means, as it would to disinfect an old cheese of the maggots which have been generated in it,” he wrote. There was only one solution: the wholesale “demolition of the infected fabric.”[5]

fitzharris_butcheringart_021417It wasn’t until a young surgeon named Joseph Lister developed the concept of antisepsis in the 1860s that hospitals became places of healing rather than places of death.

To read more about 19th-century hospitals and Joseph Lister’s antiseptic revolution, pre-order my book THE BUTCHERING ART by clicking here. Pre-orders are incredibly helpful to new authors . Info on how to order foreign editions coming soon. Your support is greatly appreciated. 

 

1. Adrian Teal, The Gin Lane Gazette (London: Unbound, 2014).
2. F. B. Smith, The People’s Health 1830-1910 (London: Croom Helm, 1979), 262.
3. John Bell, The Principles of Surgery, Vol. III (1808), 293.
4. Elisabeth Bennion, Antique Medical Instruments (Berkeley: University of California Press, 1979), 13.
5. John Eric Erichsen, On Hospitalism and the Causes of Death after Operations (London: Longmans, Green, and Co., 1874), 98.

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.

“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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If you enjoy my blog, please consider supporting my content by clicking HERE.

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.

THE BUTCHERING ART – Coming Soon to a Bookstore Near You!

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I’m thrilled to announce that I’ll be working with FSG-Scientific American (an imprint of Macmillan) on a book project. The Butchering Art will take readers on a gruesome journey into the world of pre-antiseptic surgery. Further details in the press release below!

Thanks to everyone who has supported and nurtured my dreams as a writer. I couldn’t have gotten to this exciting stage without you.

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