Fearfully and Wonderfully Made

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1855, anatomy, antique book, Bible, Christianity, human body, medicine, nineteenth century, old book, picture, Psalm 139, Psalms

The following picture is part of an advertisement for a “new” medical text in the back of Calvin Cutter’s A Treatise on Anatomy, Physiology, and Hygiene: Designed for Colleges, Academies, and Families, a book from 1855 that I scooped up at a used  book sale a couple years ago, found under the mysterious heading “GENERAL” (because, curiously, the good medical books are never categorized under “medicine” at these sales):

I find this both amusing and interesting at the same time. “STUDY ME,” it states, “I am fearfully and wonderfully made.” With his finger thrust authoritatively in the air, and decently clothed (not prancing about in exposed muscles, bones, and sinews as people often appear in medical texts), this little boy’s method of calling young scholars to educate themselves about human anatomy is fittingly stern (got to love the all-caps) yet subtle… and refreshingly modest. It is also religious.

My only annoyance is that it doesn’t attribute that it is a Biblical quotation, for it comes from Psalm 139:4. In full, it is, “I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well.” (NIV) However, I doubt a reference would have been necessary in the 1850s, in the days before reading Bibles in schools raised disapproving brows…

We ought to be educated about anatomy — in spite of any fear it might bring forth — because we truly are fearfully and wonderfully made. When considering how little we truly know about how we are made, how we function, and how we fall apart, we are fearfully made. Yes — we know a great deal more than we did two-hundred years ago. I feel we often need to be reminded that we still have a great deal to learn. One cannot forget how many consider anatomy fearful in the grotesque sense. I was a member of that crowd for many years. But the more one learns, the easier it is to cast the shivers and cringes aside and appreciate our admirable mechanics. And we are wonderfully made in terms of how intricate, sturdy, and complex the human form is. We are more resilient than you may think — and yet so delicate at the same time. No mortal man could conjure anything as amazing as what God has wrought.

We are fearfully and wonderfully made — and not one breath, swallow, blink, or twitch of the finger is to be taken for granted. To be educated of such matters is to better appreciate some of God’s finest work.

And I’m happy to have that little fellow from 1855 remind me of that which I should not need to be reminded… But we’re woefully forgetful creatures.

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Of Nineteenth-Century Hiccup “Cures”

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cures, diaphragm, health, hiccough, hiccups, medicine, quackery, singultus

When I’m in a public place, I find that I have to restrain myself when I encounter a person I’m unacquainted with who is suffering from a stubborn bout of hiccups.

I’d love to say, “Poor thing, it appears you’re suffering from a case of synchronous diaphragmatic flutter!” I’ve tried it on family members. It scares them right away (the hiccups, not my kin). But I know better than to scare unsuspecting random mothers out of their wits when their young children sporadically pop in the air making ridiculous hic! noises every few seconds. That would be very naughty of me, but that doesn’t change the fact that it’s tempting.

Synchronous diaphragmatic flutter is actually nothing other than hiccups or hiccough in medical lingo. It is also known as singultus, that being the Latin terminology. I like to call it the curse of the wobbly diaphragm from time to time. However, I think I enjoy German word, Schluckauf, even more.

It’s indisputable that hiccups are nuisances. We all know the basic cures. Hold your breath. Gulp cold water at top speed or in various ridiculous positions. Startle the hiccup victim senseless. I always found sugar to be the most effective cure; however, my high school biology teacher swore that drinking water while holding your ears and nose closed was the one-and-only true method. It worked like a wonder for a little while. I still prefer sugar.

I’ve read somewhere that Hippocrates recommended sneezing as a cure for hiccups. I wonder how many people can do that on command.

But what was done for hiccups in the 1800s? I did my best finding off-the-wall treatments. Most books I found only mentioned hiccups as symptoms for ailments, but few said what to do about the hiccups themselves. I did come across the old water-guzzling, sugar-dissolving, breath-holding, scare-the-patient standbys.

In Our Home Physician (1873), George Miller Beard also suggests swallowing vinegar or lemon juice, and goes on to say, “…when it occurs after a full meal, everybody* knows that a little brandy generally puts it to a stop.” Count me out of that everybody. For hiccups accompanied by fever or inflammatory diseases, Beard recommends “opium, henbane, and similar narcotic medicines.”** Opium, needless to say, had many purposes in those days, and this suggestion did not surprise me in the least.

And then there’s good ol’ Dr. Gunn. I came across a digital edition of Gunn’s New Domestic Physician from 1861, which I thought I would compare with my tangible copy of Dr. Gunn’s Household Physician from 1901 (the two-hundred and tenth edition, revised and enlarged — oh, how I love this book, for it is a source of endless entertainment). The two books are very similar, but after so many editions, a few changes are inevitable — even in regard to hiccups.

The 1861 edition includes my favorite sugary method, the strict “‘nine swallows’ of cold water, taken without breathing”, fennel seed tea, compound spirits of lavender, anise, castor oil and spirits of turpentine, mustard drafts applied to the stomach and abdomen, sweet oil and fresh milk (if the hiccups come from poison, which happens to the best of us), warm baths, peppermint with sulphuric acid, tincture of musk and tincture of hyoscyamus (if nervousness if the culprit), and, the biggest eye-opener (or eye-shutter), “Inhaling chloroform will also be good.” That single sentence stands out to me. He does not elaborate any further. Not in the 1861 edition, that is.

…I’m sorry, but I couldn’t resist this image here.

Forty years later in the two-hundred and tenth edition, it is no longer necessary to take nine swallows of water, or any specific number at that. All of his other cures still apply. However, he has more to say about the chloroform: “It may be necessary to completely anaesthetize the patient with Chloroform or Ether.”*** In other words, just knock ’em out full-force. The fact that this is a “household guide” both amuses and frightens me.

I’ll stick with the sugar.

__________________________________

*My emphasis.

**Please, please, PLEASE do not exercise these methods — they are listed for historical amusement only.

***The same applies with chloroform and ether. Please refrain from this “cure.”

Of Medicinal Leeches and Sophia Hawthorne

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1800s, American literature, animals, bloodletting, Hawthorne, health, History, leeches, Medical History, medicinal leeches, medicine, nature, New England, nineteenth century, Sophia Peabody Hawthorne

“Those incomparable, lovely, delicate, gentle, tender, considerate, generous, fine, disinterested, excellent, dear, elegant, knowing, graceful, active, lovely, animated, beautiful leeches have done me a world of good.”

That’s what Nathaniel Hawthorne’s future wife, Sophia Peabody, said of leeches when she was a teenager. I don’t think I’d ever be able to speak of a leech with such exuberance, but… I’m happy for Sophia that they gave her such delightful relief, or that she at least thought they did.

Sophia Peabody Hawthorne

Sophia was an invalid of sorts, starting in her youth. Headaches plagued her. Loud noises set her head throbbing, and she was the sort to languish about with the typical 19th-century melodrama of her suffering. She tried numerous treatments — leeches among them. Pursuing art brought relief as well, and I personally believe it was this distraction from her malady that did her more good than any bucket of leeches.

I recently laid eyes upon my first live medicinal leeches at a local science museum. Knowing their significance in medical history, I was excited to see those two serpentine, blobby beasts clinging to the side of their little watery aquarium. Certain Youtube videos of the Mütter Museum’s director and his pet leeches came to mind (I admit they make me cringe to watch and make me feel somewhat faint, but I do think it’s cute that their names are Harvey and Hunter). And as I watched those real-life leeches, I was so thankful that I’m not living in the heyday of blood-letting via leeches (not that I’d want to endure any sort of blood-letting for that matter). Of course, you cannot forget mechanical leeches, either!

Leeches: Interesting enough to look at from a safe distance. But I’d rather not have them clinging to me. And no, I would not like to have one for a pet.

As for Sophia… she ought to curb her enthusiasm, or all the leeches will be after her.

Medicinal Leech: “I’ll alleviate your ills and you’ll give me dinner in payment. What’s not to like?”

Of Surgery in Melville’s “White Jacket”

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1800s, books, Cadwallader Cuticle, Herman Melville, literature, medicine, Navy, nineteenth century, novels, sailing, sea, ships, surgeon, surgery, White Jacket

I love reading surgical narratives — factual or fictional, old or new, but that of the 1800s definitely intrigues me the most, as folks who have traipsed by here already know. I was delighted to find an entertaining example of such in Herman Melville’s novel White Jacket. In fact, I think this particular scene is a literary gem, dripping with darkly comical mockery of nineteenth-century surgery in general.

Aside from the surgery, it is a very good book as a whole for those who enjoy things of the Melvillian, nautical sort (as I obviously do). I’m amused by the woes that befall the poor narrator because of his unfortunate, less-than-practical white jacket, the lavender-infused Selvagee who ought not have gone to sea, and the “fire it right into ’em” method of publishing. As for the beard massacre, however — the poor fellows! Rather distressing. There are many passages that are either informative or chuckle-inducing, much like the case with Moby Dick, except White Jacket lacks strong a driving motive like the obsessive hunt in his better-known tome. In White Jacket, the Neversink is simply…  going home.

Herman Melville

Ah, but the surgery! — and what makes it the most fun and satirical, the surgeon. His name is Cadwallader Cuticle, M. D., and he is the learned surgeon of the fleet who loves to dive in the teaching role in the midst of operations. His person is mangled. His teeth — artificial. His eye — well, he only has one. He’s bald, scrawny, and could look much more lively. As expected, Cuticle is a devout collector of medical specimens and curiosities that have a tendency to horrify everyone but himself. And although he says he likes to avoid amputations if possible, he cannot hesitate when he sees a chance to take up the saw. Besides, it’s dull work for a surgeon on a man-of-war when there are no battles. This is his first major case in three years.

And Cuticle isn’t the only surgeon mentioned in the book. One cannot forget the aptly named surgeons Bandage, Wedge, Sawyer, and Patella. And while Cuticle’s colleagues are against the operation, all it takes is one lop-sided, deferential “yes” from young, obsequious Patella to encourage him to pronounce that an operation must take place immediately — at 10:00 tomorrow morning.

There are certain aspects of the scene that make it particularly entertaining to me. The surgery is performed not on a traditional operating table, but on a death-board. And, of course, a reference is made to the surgeon’s negligence of hand-washing — Cuticle offers Sawyer to wash at a basin after the procedure since it is time to eat dinner, but admits that he never uses it. A mere wipe of a handkerchief is suffice.* A sprinkling of anatomical jargon spills forth from Wedge, much to Cuticle’s annoyance, and much to my pleasure. Plus, there is the cadaverous appearance of the toothless Cuticle coupled with the presence of a skeleton (used for an educational prop) that sends the patient into a state of terror, who has a strong tendency to faint.

I did wince when one of the younger surgeons noted that Cuticle can remove a leg in one minute and ten seconds. All I could think was, “Liston could have done that so much faster, you sluggard!” But, sadly for the majority of non-fictional patients, Robert Liston’s speed was far from the norm.

Robert Liston–swiftest saw in 19th-century surgery

Melville ended up poking fun and pointing out lamentable realities at the same time in a very skillful manner. It got me excited, especially considering that many authors of fiction from that time period would shy away from the amount of grisly detail that Melville was brave enough to portray. (NOTE: The description of the amputation itself is not for the squeamish.)

*Now, Melville was obviously disturbed by this breach in hygiene. Bear in mind this book was written in the late 1840s… And it took several decades after that for hand-washing to fully catch on in the medical profession, even though Melville’s mentioning of this makes it obvious that some contemporaries of the general public found these habits disgusting. Very interesting.

Of Animal Medicine

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Cats, Dental, health, medicine, Pet, Teeth cleaning, Tooth, Tooth Resorption, Veterinary medicine

I’m used to human medicine. I read about it often, historically and in the modern sense, often comparing the two. It’s amazing to see the great progression made from just the 1800s. And some things don’t change much at all. Medical history fascinates me. I’m not certain as to why, but it’s one of those strange facts in life that I won’t waste any time analyzing.

But animal medicine — that’s when I get weak and start to whimper. They don’t complain like humans. On a frustrating note, animals cannot tell us when or how they are hurting. And those innocent faces, the imploring, sad eyes that humans have yet to truly master. I’m used to the fact that people get sick. But I just can’t bear an ailing animal.

I do, however, have a deep respect for those who have the strength to help animals that are feeling poorly. And I also love James Herriot’s stories. Who doesn’t?

My cat recently had another medical adventure. Going in for a dental cleaning, it was discovered that he had a bad case of tooth resorption* — 15 teeth had to be extracted, mostly from the upper jaw. The little guy ended up being under anesthesia for about two and a half hours, factoring in cleaning time and surgery time. That’s longer than I’ve ever been under, and the most teeth I’ve had removed at one time was two. He experienced something more intense that I ever had in the dental department, and I don’t know which one of us was more shaken by it. And seeing his teary eyes when I picked him up from the vet office didn’t help matters at all.

He was obliging enough to pose for a sketchy portrait the day after his procedure, and hooray! — he actually looks content.

Thankfully he is recovering well. He’s taking it easy, of course, and it will take some adjusting with his new lack of teeth, but I am very relieved that he is on the mend and is pretty much back to his usual happy self.

Cat skull and teeth drawing (Photo credit: Wikipedia)

*For those not familiar with tooth resorption, it is, most simply put, breaking down of the tooth from the inside, exposing the root. It is painful. And it is very common in cats, moreso than in dogs, and extraction is all that can be done — at least at this point in history.

Of Thorwald’s “The Century of the Surgeon”

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books, health, Jurgen Thorwald, Medical History, medicine, out of print, rare books, surgery, The Century of the Surgeon

Of every book relating to medical history I have read thus far, my favorite and the one I most highly recommend is Jürgen Thorwald’s The Century of the Surgeon. Now, there’s a good side and a bad side to it.

The good side is that it is a very entertaining and informative read.  And it doesn’t strip history into a dry list of discoveries, milestones, names, and years (certain books come to mind that I will refrain from mentioning). Thorwald presents the history via first-person narrative so that it reads like a novel, and it also gives the historical figures greater depth and personality. Thorwald creates the fictitious Mr. Hartmann, a surgeon who watches the advancements of surgery unfold throughout the nineteenth century. It starts with Hartmann witnessing his first surgical procedures, performed by none other than John Collins Warren.  Hartmann is also present for the first ether operations both in America and in England (he is even invited by Liston himself!). A young Joseph Lister personally shows him through his hospital ward. An exciting description of an early heart surgery on a patient suffering from a stab wound is saved for the conclusion.

Perhaps it is not for the faint of heart or weak of stomach due to the detail in which some procedures are described, but I’ll toss the warning out there because the average person would consider some of the material to be graphic, and I admit there are some intense sections. Nevertheless, I still consider it a fantastic introduction that breathes much life into medical history.

Jürgen Thorwald, author of Century of the Surgeon 

The negative aspect to The Century of the Surgeon is that it is extremely difficult to find. It was first published in 1957, is currently out of print, and at the time of writing this post, the only copy of it I see for sale at Amazon costs over $500. I was fortunate enough to borrow a copy from my university’s library when I was a student. I remember waiting for my December finals to be all out of the way so I could read Century at leisure! And it was worth the wait. The sad part was returning it. And the frustrating part — trying to find my own copy.

I did manage to find a Reader’s Digest condensed version of it reaching behind some books in a public library. It was used as a mere spacer — clearly  not a wanted book. So I bought it for $2. It is indeed something. Complete with a cover that creaks like a neglected door when I open it. But it simply isn’t the same, so the search continues.

The Reader’s Digest 1957 condensed version of The Century of the Surgeon, which also contains Lobo, By Love Possessed, Duel with a Witch Doctor, and Warm Bodies… works of fiction that I could live without.

For those interested in borrowing Century of the Surgeon, it is not a total impossibility. See if your local library system owns it. If not, ask about getting it through inter-library loan (I have a feeling that university libraries are more likely to own it than public libraries). I also found one ebook copy at Open Library that can be borrowed. And if it ever gets back in print — what a blessing that would be!

I was happy to learn that I’m not the only person around to recommend this book as a starting place for learning about med history. Sherwin B. Nuland, author of How We Die (and one of my favorite medical writers), gave it a thumbs-up in an interview here: http://www.americanscientist.org/bookshelf/pub/sherwin-nuland. And I have to admit, if you can’t get your hands on Century of the Surgeon, his book Doctors: The Biography of Medicine is another excellent starting place.

Of Lister and Henley

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Amputation, antisepsis, England, In Hospital, Medical History, medicine, nineteenth century, poetry, Sir Joseph Lister, The Chief, tuberculosis, victorian, William Ernest Henley

One of the many factors that excites me about limiting the majority of my research to a certain period in history is when it brings people of two different disciplines together that I already liked as separate entities, especially if one of those people is in the medical profession. Such is the case with William Ernest Henley, Victorian poet, and Sir Joseph Lister, who just so happens to be my personal favorite surgeon of the 1800s.

For those unacquainted with Lister, he is known for his antiseptic techniques in surgery in the latter part of the nineteenth century. Louis Pasteur’s articles inspired him to set out on his battle against bacteria and infection in an age when mortality rates in surgery were alarmingly high. His techniques, which utilized carbolic acid, were tedious, not to mention that Listerism was frowned upon by many other surgeons in its earlier days, who thought it all to be mere humbuggery. Many limbs and lives were saved thanks to the efforts of Lister. He was, however, a transitional figure — although he did rinse his hands in carbolic, he was not the militant hand-washer that Ignac Semmelweis was some decades before.

Sir Joseph Lister in his youth (Photo credit: Wikipedia)

For William Ernest Henley, pain was an inescapable fact of life. He suffered from tuberculosis of the bone; his left leg was amputated at the age of twelve. By the time he was twenty-four, the possibility of amputation loomed over him again, this time in regard to his right foot. He had read of Lister in newspapers, and was desperate to avoid another amputation. He saw this controversial sepsis-fighting surgeon as his only hope. Even Lister was skeptical about this new case, warning him that he might have to resort to amputation, but in the end, Henley was able to keep his foot.

During his stay at the Royal Infirmary in Edinburgh, he read voraciously, wrote like mad, and taught himself three languages, making up for the spotty education he received as a boy due to his poor health. It was also during this time that he wrote the collection of poems, In Hospital. For anyone interested in nineteenth-century medicine, and especially for anyone interested in Lister, the poems of In Hospital are true gems. It’s fascinating to get glimpses of life in the Royal Infirmary from the eyes of a long-time patient. A cozy experience it was not. He desolately describes it as a place “half-workhouse and half-jail.” But there is life in his fellow patients, ailing though they may be, as described in “Children: Private Ward” and “Romance”, which is about the sailor who eventually became his brother-in-law. Henley also creates some colorful depictions of the staff at the hospital, as in his two “Staff-Nurse” poems.

William Ernest Henley (Photo credit: Wikipedia)

Even Lister makes several appearances in his poetry, the most notable of which is in “The Chief.” Henley’s admiration for Lister, not to mention his gratitude, is obvious in this work. Here are the last few lines quoted below:

His wise, rare smile is sweet with certainties,

And seems in all his patients to compel

Such love and faith as failure cannot quell;

We hold him for another Herakles,

Battling with custom, prejudice, disease,

As once the son of Zeus with Death and Hell.

Henley’s poetry is stylistically unique in that he was an early writer of free verse (obviously, this is not the case in “The Chief”). To my eyes, it gives much of his poetry an anachronistic look — some might say he was ahead of his time. I confess I’m usually not a fan of free verse, but I feel he pulls it off quite well, and when it comes to In Hospital, I’m primarily interested in what he is saying.

I might add that Henley is most known for his poem “Invictus.” I confess it isn’t one of my favorites, in spite of its popularity. I’m partial to the poems of In Hospital and Rhymes and Rhythms. And as for “The Chief”, I’m sure it made modest Lister blush to a prodigious degree.

Lister (Photo credit: Wikipedia)