Bristolians were ignorant as to what part cleanliness played in good health.
During most of the Victorian era, people - including doctors - knew very little about the causes of disease. Health was a challenge because for most of the 19th century, people understand about germs. People had no idea why they became ill, and often, medicine was no more than guesswork. If a serious illness did not cause death, often some of the 'remedies' might!
Frequently, people drank from the same unwashed cup which others had used. They did not take baths very often, and when Bristolians traveled, they typically slept on dirty sheets where many others had slept, or else they shared a bed. Bristolians were ignorant as to what part cleanliness played in good health, and they knew nothing of the fact that germs thrive in dirty places.
In the first part of the 19th century, people generally believed that bathing too often removed protective oils from a person's skin, leaving them open to disease. If a person was ill, sunlight and fresh air were not allowed into their room. It was felt that cold, fresh air made people sicker. Sick people were told to stay in bed, not realizing how important it was for recovery to actually get a little exercise.
People believed that diseases traveled through the air, in the water, and underground. They associated sicknesses with 'miasma' (a noxious or unpleasant vapour), and doctors carried scented sticks which supposedly kept the disease from reaching the nose and entering the body.
Victorians typically had a strong faith in God, which allowed them to courageously face both illness and death. During the 19th century, death was simply 'a part of life', something that the Victorians just had to face. On the other hand, there were healthful benefits to living during the 19th century! The air was fresher; there was no smog to contend with (outside of the city). The sun shone more brightly, and food contained no chemical preservatives. People also had to walk long distances and do hard physical labour, both of which helped to maintain their bodies.
Unfortunately, however, early doctors were basically very limited in the ways they could treat patients. Because they did not know the cause of disease, they treated the symptoms only. For example, if a person had a rapid heartbeat, the doctor might give him/her a medication or herb to slow the heart rate, but would not cure the cause. Early doctors could not operate, and most medicine of the early 1800s was of little, or no help.
In order to understand the practice of 19th century medicine, one must understand the theory of disease that was predominant in the day.
The medical theory of the day held that poor health was caused by either too much or too little stimulation or inflammation of the nervous system. Symptoms of those diseases caused by overstimulation included high fever, strong pulse, flushed skin, rapid breathing, agitation (excceding restlessness and mental distress or shaking) and active delirium (hallucinations and illusions accompanied by extreme excitability). Treatment for these diseases included bleeding, purging, sweating, blistering, and minimal amounts of food. Sedatives might also be used to calm these excitable symptoms.
Understimulation was characterized by a weakened or depressed state. Symptoms included weakness, exhaustion, weak pulse and respirations, general wasting and quiet delirium marked by confusion of ideas and and slowness of mental action rather than by excitement. Treatments for these conditions included alcohol, drugs or stimulants, and large amounts of food.
It was also felt that good health depended upon a proper balance of nerve stimulation to muscle, blood vessels, and intestinal tract. It was then recommended that to restore this balance to an afflicted person either stimulants or sedatives could be used.
Doctors performed 'bleeding' or 'bloodletting' to remedy symptoms of most diseases.
This procedure involved cutting the patient and draining 'extra or unwanted' blood.
The practice of bloodletting seems barbarian to our modern mind, but was very popular among physicians of the 1840s. As much as 20 ounces of blood would be bled at a time, this sometimes repeated ten times a day, in severe cases of fever, or severe pain.
Unfortunately, physicians thought the blood volume a person has was about twice what it actually is, so undoubtedly much harm was actually done as the heroic therapy was vigorously used.
Purging, Vomiting, and Sweating
The idea here was to relieve the body of harmful poisons which may be caused by inflammation. Medicine was given to induce vomiting, sweating, or purging (relieving the body of fecal material i.e. using the restroom).
Cases of respiratory illness were treated with a procedure called 'cupping' or 'blistering' of the chest. Intended to relieve lung pain, the procedure required the filling of a small glass cup with alcohol which was ignited and applied directly to the skin; the resulting blister was then lanced. The idea was that the inflammation of the interior organ would then be transferred to the skin and relieved through blistering.
Not surprisingly, most deaths in Bristol occurred due to illness rather than injury. Disease spread quickly through the poor due to close living quarters, lack of sanitation, want of knowledge about contagion and infection, and inadequate diet.
We do have a list of hospital cases which occurred between 1842 and 1849. There were 3,415 cases, of these there were 1,717 of malarious fevers, 331 cases of disease of the respiratory organs, 287 cases dealing with the digestive organs. principally diarrhoea, collica, and obstipatio, with an occasional case of hepatitis and dysenteria.
There were 133 cases of disease of fibrous and muscular tissues and 77 cases of diseases of the brain and nervous system, most caused by habits of intemperance. There were 45 cases of venereal disease, primarily syphilis and gonorrhea. There were also 467 surgical cases, 145 abscess and ulcers, and 322 wounds and injuries. Lastly, there were 17 deaths.
Symptoms include fatigue, depression, a rash on the chest and abdomen, diarrhea and occasionally bloody stools. It was caused by bacteria found in fecally contaminated food and water, although at the time, doctors did not know about bacteria and thought that it was caused by noxious substances found in the air produced in crowded or close conditions.
Since fatigue and depression accompanied this disease, stimulants such as alcohol would have been used to treat the fatigue. Fever indicated inflammation and other poisons in the body so drugs to induce vomiting would have been administered and blistering agents applied. Cold compresses and sponge baths were used to reduce temperatures.
Diarrhea and Dysentary
One of the most common illnesses and one which took many lives, diarrhea and its more severe companion, dysentary were also caused by fecally contaminated water and food. Causes can generally be contributed to poor sanitation. Diarrhea symptoms included watery loose stools and low grade fever, whereas dysentary was accompanied by bloody stools and high grade fevers. Treatments often included purging, sweating , and inducing vomiting, to rid the body of unwanted material. This proved to be a huge mistake because it had the effect of further dehydrating someone who was already dehydrated.
Another killer was cholera, which was accompanied by severe diarrhea, vomiting and muscle cramps.
Most cases dealing with the brain and nervous system resulted directly from alcoholism, a widespread problem among Bristolians. The extensive use of opium as a painkiller, often prescribed to be mixed with whiskey, resulted in numerous cases of addiction and withdrawal. Delirium tremens, a symptom of alcohol and drug withdrawal, were treated as a common ailment rather than an avoidable condition.
Prior to the modern hospitals being built in Bristol an important part was played by the dispensaries. The Bristol Dispensary was founded in 1775 in Penn Street and later the headquarters were at Castle Green, while a branch was opened at Malago Road, Bedminster.
The object of these institutions was to provide medical officers who would advise the dispensary, visit the sick at their own homes and supply all necessary medicines. In addition these officers were to render assistance to poor lying-in married women.
The work of these dispensaries was only made possible by private subscription. A subscriber of one guinea received a book of notes containing 5 sick notes, (which could be given entire as ‘free’ notes, or the notes could be divided and used as a note of recommendation, the patient paying half a crown for treatment upon presenting it at the dispensary); one mid-wifery note (which could be used as a sick note) and two notes of recommendation entitling the bearer of each note to medical attendance, on payment of five shillings and presentation at any dispensary, or any branch of it.
A donation of £21 constituted a life subscription and entitled the donor to the same privileges as an annual subscriber of one guinea. No person could be admitted to a dispensary for treatment without a printed recommendation signed by a subscriber.
When fully established the staff of the Dispensary consisted of three Honorary Physicians, three House Surgeons, eight Medical Officers, two Dispensers and four Midwives. In the 130 years up to 1904 half a million poor people had received relief and, in 1904, patients at Castle Green numbered 8,000 and at Bedminster, 2,554.
In 1900 the activities of the Bedminster Dispensary covered an area bordered by the west side of the railway, Sheene Road, Merrywood Road (up as far as the Cut) and then along Whitehouse Street. Dr R.C. Leonard was the Medical Officer of this number 8 District.
By 1929 notes were mostly bought by business firms for the benefit of their employees. Finally, in 1948, the Dispensary’s work as an out-patient’s clinic came to an end.
In 1831 the site of the newly proposed Bristol General Hospital was confirmed to be in Guinea Street. The property belonged to Dr Kentish, a honorary Physician to the Bristol Dispensary and founder of vapour baths at College Green. The property cost £3,750 and part of it, a timber yard and warehouse, was at once sub-let.
The officers elected were a President, Treasurer, Secretary, three Physicians, an Apothecary (who received £60 a year and was allowed pupils and apprentices). The honorary staff were elected for a 10 year period, but could be re-elected. They were allowed three pupils and apprentices each who, for their training, paid 10 guineas to the charity, which it still was at this date. Subscribers paid one or two guineas a year and life subscribers 20 or 30 guineas according to the privileges desired.
The opening date for the hospital was November 1st, 1832, when the beds numbered but twenty and none but Bristolians were admitted. Early financial difficulties were lessened by private donations and the work of a Ladies Committee which raised funds with bazaars etc.
Nurses were paid 7 guineas a year for day nurses and 6 guineas per year for night nurses. They did not receive board and lodging.
The present General Hospital was built in 1858, on the site of the Bathurst Basin Iron Works.
Other hospitals of lesser importance in Bedminster have been the French Hospital at Knowle, and which almost certainly had an association with the French prisoners imprisoned in the district in the 18th century; the Small-Pox Hospital on Nover’s Hill and Clift House Temporary Hospital - used for Scarlet Fever cases.
After the breaking up of the early hospitals which had served Bedminster, no doubt treatments and other medical practices would have followed a pattern similar to those of the rest of the country.
Through the medium of the Bristol newspapers the inhabitants of Bedminster would have been thoroughly conversant with the many 'infallible' cures of the 18th century. The many traditional herbal cures would have been resorted to, either because of lack of money to pay a doctor, or because of lack of faith in the latter’s ministrations. The inability on the part of the medical profession to cure some of the common diseases of the day drove some - mainly the wealthier class - into the clutches of advertising quacks.
They, in order to emphasise the validity of their claims, went into great detail when advertising the sterling qualities of their wares. Thus, an advertisement in Felix Farley’s Journal in 1753, for 'Dr Griffith’s Famous Sugar Cakes', stated:
'A boy - of a midwife in Noah’s Ark Alley, near Narrow Cross, Redcliff Cross, by taking these cakes voided a vast quantity of worms, two in particular with heads like hogs, black eyes and legs and tails like serpents, and lived for five days after being voided'.
In retrospect, the cure would appear to be more disturbing, mentally, than the affliction had originally been physically.
For ladies, the Bristol Mercury of 1790 offered the 'Royal Chemical Wash Ball' which had been '... in the highest repute with the nobility and public near thirty years back'. It was said to rid the skin of all blemishes including '... tetters(?), ringworm, Momhew, sun-burnt scruff, pimples, pitness or redness of the Smallpox
Sometimes a letter purporting to come from a beneficiary of a treatment was set out as an advertisement, a practice in common use to this day. A man by the name of Stibbirt Cocksedge enthused over 'Dr Hayman’s Movedant’s Drops' as a relief and cure for his 'intolerable ichorous pimples'. The description of his condition is most graphic. One can imagine him scratching away to obtain relief; prior, of course, to his use of the Movedant’s Drops.
Russia Oil - recommended for the loss of hair by both men and women - was also said to restore the loss of hair on horses etc. In fact, it appeared to be capable of restoring hair on anything except brushes.
The tobacco industry must have welcomed a report which appeared in Felix Farley’s Journal in October 1790. This referred to a man who had lost his speech and had gone to Exmouth to bathe in the salt water for restoration of his health.
And a few nights ago he dreamed that if he smoked tobacco he should again be restored to his speech and the following day he smoked three pipes, soon after which, to the surprise and joy of his wife and family, he was perfectly restored to his proper speech.
This, surely, must have been the original 'Pipe dream?'.
The prevalence of skin parasites and skin disorders is confirmed by the advertising of 'Dr Baker’s truly prepared Quicksilver Girdles'. This was - '... very proper to be worn by those that travel journeys, for it absolutely prevents the person being infected, tho’ they lay in bed with, or after, one that has had the disease ever so bed.
Saturday, February 20, 2010
Bristolians were ignorant as to what part cleanliness played in good health.