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Category Archives: Medical History

Guest Blogger: Eleanor Sullivan: Herbalism: Scientific or Sorcery?

Ever wonder what people used to cure old-fashioned ills? Before penicillin?

Plants, that’s what.

 

plant-images4-150x150[1]

 

Recently, I had the opportunity to meet a practicing herbalist in Minneapolis, a young woman with a quick smile and quicker wit. Lise Wolff opened my eyes to a different health care world. (For those who don’t know, I’m a nurse turned author.)

From pre-historic times to today, herbal remedies have been used to treat human ills. Often they were the only treatments available. Our existence is testament to their effectiveness. Scoffed at by medical men (yes, they were all men), herbalists and their close cousins, homeopaths, nevertheless persisted. What was known as mainstream medicine at that time, however, would be unrecognizable by today’s practitioners. Purging, puking, and bleeding as well as dosing with heavy metals, such as mercury, harmed more often than cured, their unwary patients. (See Medical Care in the 19th Century-Part One and Part Two for more on this era’s archaic practices.)

 

medicine-box[1]

 

Herbal Remedies

Herbs can be collected in the wild or cultivated in gardens. Most remedies are derived from the leaves that are harvested at the peak of their effectiveness, but sometimes the stems, roots, or early shoots prove more useful. Leaves may be dried and used in teas or combined with starch or lard for poultices. Plant parts may be soaked in water or oil, and the solutions used in tinctures, decoctions, essential oils, salves, or ointments. I watched Lise melt beeswax and combine it with St. John’s wort solution that she poured into metal cups, left to solidify and use as an ointment to treat burns, sores, and cracked lips.

In the 19th century women, often midwives, treated ill family members and neighbors with herbs, a practice passed down through generations. Realism meets fiction as Adelaide, the protagonist in my Singular Village Mystery series, works as both a midwife and herbalist in 1830s Zoar, Ohio.

Doctrine of Signatures

After famously burning classic medical texts, 16th century German physician Paracelsus declared that plants resembling human body parts could cure ails in that organ, a concept that became known as the doctrine of signatures. Thus, “like treats like.” For example, St. John’s wort doelike shape renders it perfect for treating skin wounds.

Homeopathy

Similarly, Samuel Hahneman, a 19th century German physician, agreed that like treated like but took treatments one step further, diluting substances over and over until it appeared that nothing of the original substance remained. These dilute substances, however, proved remarkably effective. The practice became known as homeopathy.

In fact, homeopathy was practiced in 19th century Zoar. Here’s a photo of a medicine box of homeopathic remedies found in Zoar’s historic artifacts.

The medical community today would argue that neither herbal remedies nor homeopathy are scientifically proven to be effective. Regardless, patients dissatisfied with mainstream medicine, often turn to alternative practitioners, such as herbalists. Medical practice is continually evolving as new remedies and treatments emerge and others decline. Might chemotherapy be deemed archaic 200 years from now?

Eleanor Sullivan: http://www.eleanorsullivan.com

Watch as Adelaide confronts problem illnesses and birthings (along with solving a murder!) in the next Singular Village Mystery: Graven Images, due September 1st!

 

Graven Images cover.indd

 

Q and A: What Potentially Fatal Disease Could My Young Female Character Suffer From in 1955?

Q: I have been browsing through FORENSICS AND FICTION but do not see the perfect solution for my story. In my WIP, set in 1955 St. Louis, a 10 year old girl has a medical problem which is difficult to diagnose. She has been living on the streets but is rescued by an older woman who takes her for medical help. Once the doctor determines the problem, he recommends treatment. Trouble is, the only place for treatment is California, so they must take a road trip. (I want it to be CA because I want them to travel on Route 66)

At first, I considered exposure to sewer gas as a good diagnosis. But once she got out of the sewers she would get well. That won’t do. I’m thinking it must be an autoimmune disease or a parasitic or unusual infectious disease. Can you think of a fatal disease in those categories which would have had cutting edge treatment being done experimentally in CA in the 50s?

Catherine Leggitt, Author, Inspirational Speaker

www.catherineleggitt.com

A: As you pointed out, sewer gas wouldn’t work since once your young lady was free of the environment its effects quickly reverse. I would suggest leukemia. In 1955, acute leukemia in a child that age was common, there was no treatment, and most sufferers died. The mortality remained around 90% for many types of leukemia until well into the 1970s. It could be months or many years between first becoming ill and dying, but death was almost inevitable in 1950s. The timeline would depend on how aggressive the particular leukemia was and how well your child handled it. But medicine could do very little.

In leukemia, white blood cells (WBCs) are overproduced by the bone marrow. These cells are abnormal in that they don’t fight diseases as do normal WBCs. This would leave the child susceptible to infections such as pneumonia, urinary tract infections, even the flu. Each bout of any of these could be weathered with antibiotics—penicillin and sulfa drugs were around in 1955—or she could die from any of these diseases.

Leukemia Cells are seen here as large and purple; the smaller pale red ones are RBCs

Leukemia Cells are seen here as large and purple; the smaller pale red ones are RBCs

As the WBCs increase in the bone marrow they literally “squeeze out” the marrow cells that make red blood cells (RBCs) and platelets. Low RBCs we call anemia and here she would be fatigued, short of breath with activity, and her physical abilities would be limited by these factors. She might appear pale and take on the look of someone who is chronically fatigued, which she would be. Platelets are involved in blood clotting so with low platelets she would bleed easily, with even the most minor trauma. She could easily have episodic nose bleeds and would bruise very easily.

Most leukemia victims suffered all three of these derangements–high but abnormal WBCs, low RBCs, and low platelets–so your girl could have any of the above symptoms, in any combination, and in any degree of severity.

Since there were no effective treatments in 1955, patients and parents sought all kinds of treatments. Herbs, electrical current, tonics of all types (most of which were alcohol based), faith healers, and almost anything you can think of. Your young girl could easily be referred to someone “out in California” by her local St. Louis doctor.

This should give you a lot to work with for your story.

Google Leukemia and you will find many sources but remember that things are much different now than in 1955. Here are a couple of links to get started:

http://serc.carleton.edu/woburn/overarching/leuk_treatment.html 

http://www.nature.com/leu/journal/v15/n4/full/2402065a.html

 
7 Comments

Posted by on February 20, 2013 in Medical History, Medical Issues

 

Quacks Are Everywhere and Have Been For a Long time

One of the things I like about reading the Journal of the American Medical Association (JAMA) is the section on articles published in the Journal 100 years ago. In November of this year an interesting article that was published on November 9, 1912 was republished. There was titled “Telepathic Diagnosis!”

It seems that Dr. J. A. Quackenbos uncovered the story of a telepathic Belgian woman who apparently had the power to diagnose diseases from afar. It seems to perform her magic she must be put into a quasi-trance by hypnosis and from there she can psychically travel to the afflicted person and look inside them and determine what their medical problem might be. Wow. Wish I could do that. It would’ve saved me countless hours of head scratching and worry over the past 40 years.

Patent Meds

Patent Medicines

At first glance you might think that Dr. Quackenbos is the origin of the term quack. But that’s not the case. It actually comes from the old Dutch word kwakzalver, which means  a person who chatters or prattles. From that the word quack, which means someone who fraudulently pretends to have medical skills that are not real, evolved. Quacks have been with us throughout history from the ancient patent medicine and snake oil salesman to the modern day manufacturers of pills and tonics and potions that are supposed to cure everything from schizophrenia to diabetes. Is all PT Barnum supposedly said, “There’s a sucker born every minute.”

 

PT Barnum and Tom Thumb

PT Barnum and Tom Thumb

 

 
5 Comments

Posted by on December 5, 2012 in Medical History, Medical Issues

 

Nightmare Sperm Donation

It seems that a Danish sperm donation facility failed to determine that one of its donors had an uncommon genetic disorder and might have passed it along to several of his “offspring.” The usual screening apparently failed to uncover the genetic markers for the disorder and as many as five children might have “inherited” the abnormal genes.

The disease in question is called Neurofibromatosis Type 1, or Von Recklinghausen’s Disease. It is characterized by multiple types of neurological tumors and cafe-au-lait spots–patches of light brown pigmentation whose color is reminiscent of coffee with milk.

 

Severe Neurofibromatosis

Severe Neurofibromatosis

 

Cafe au lait spots (black arrows) and a Neurofibroma (white arrow)

 

Though controversial, and over the years other diagnoses have been entertained, this might be the disorder that afflicted Joseph Merrick, The Elephant Man.

 

Joseph Merrick, The Elephant Man

 

A medical nightmare for these children and their families.

 

 
 

How Could My Time-traveling Physician Save the Life of My 15th Century Heroine With a Blood Transfusion?

Q: I am writing a time travel where one of the characters is a modern doctor who is sent back in time (15th century) with his family. I want to have him do something medical to save the life of the heroine (I was thinking heroine needs blood transfusion which would require a blood typing system) Any idea how it could be accomplished? I was also thinking that the heroine has rare blood type. Would that be Type B?

Doreen Jensen, Ontario, Canada

A: This is an interesting scenario in that you have someone with modern knowledge transported back to medieval times. This means he would have all the medical knowledge of transfusions––which of course did not exist then––but no scientific equipment to help. Not to mention that merely bringing it up might get him killed by the church––but that’s another issue.

The first human transfusion took place in France in 1667 when Jean-Baptiste Denis successfully transfused sheep blood into a fifteen year old boy. The first human to human transfusion was in 1818 and was performed by James Blundell on a patient suffering from postpartum bleeding. Even he had no way of matching the blood and, in fact, didn’t understand that there were blood proteins that made transfusions incompatible between many people and successful between others. It wasn’t until 1901 that Karl Landsteiner discovered the ABO blood groups and begin to understand the nature of transfusions and transfusion reactions. In 1939, the Rh factor was discovered, also by Landsteiner along with several other physicians, thus refining the process further.

So your time-traveling doctor would know all of this and would also know that transfusions are only successful if the donor and recipient match one another as far as blood type is concerned. But he would have no way of testing the donor and recipient for blood type and compatibility, which of course is essential to avoid harming or killing the recipient. But, there is a way around this. He would know that two compatible bloods could be mixed and no reaction would occur while if they were not compatible clumps would form. We call this agglutination and it is the basis of a transfusion reaction. He could simply mix the blood of the donor with that of the recipient––which is more or less the way it’s done today––and look for this reaction. The problem? This agglutination can only be seen microscopically and there were no microscopes in the 15th century.

The microscope was discovered in 1590 by two Dutch spectacle makers–Zacharias Janssen and his son Hans. They employed the glass lenses they used in their spectacle making, which had been around since the 13th century. When they placed these lenses in tubes, they discovered that they magnified any image viewed through the tube. This was the precursor of the true microscope which was developed nearly 70 years later (1660s) by Anton van Leeuwenhoek. So, your modern physician would know this and could perhaps fashion his own crude microscope from spectacle lenses. This would allow him to see any agglutination that might occur. He could then simply take the recipient’s blood and test it against several potential donors and see which one had the least reaction. This would be crude cross matching but it could work. He would then know whose blood to use in the transfusion process.

 

Q and A: Do Tight Corsets Cause Medical Problems?

Q: In my story, set in 1908 in Toronto, a 35 year-old women who has been using corsets strenuously for many years (perhaps for 20) suffers the ill effects of the tight lacing common at that time. I want the effects to be sudden and dramatic, to threaten her within an inch of her life, or kill her. However the result, she is rushed to the hospital and doctors try to save her. In the weeks leading up to the emergency event where it is discovered that the effects of the corset on her skeleton and her organs is the cause of the medical crisis, her face is showing the effects of the impending crisis. When the emergency occurs, her dress is torn off and the medical effects, or at least their exterior consequences, are revealed. One of the problems may be that she tied the corset in such a way that it flattered her figure as much as possible (the ‘wasp waist’) but that had dire bodily effects.

Whitney Smith, London, England
http://www.whitneysmith.ca

 

A: Medical problems with corsets are exceedingly rare but there are a few things that could happen. If the corset was so tight that it fractured a rib, it could puncture and collapse a lung––we call this a pneumothorax. Though this is not typically lethal, in 1908 it very easily could have been. Now we treat these with chest tubes—plastic tubes inserted through the chest wall into the space between the lung and the chest wall. The tube is attached to a suction device and left in place for a few days until the lung heals and re-inflates. These weren’t available in 1908.

Also a tight corset can restrict breathing so that the person does not take a deep breath for extended periods of time. This can lead to areas where the lung tissue collapses––we call this atelectasis. This can serve as a location for pneumonia to develop, which could be lethal, particularly in 1908 as there were no antibiotics available to treat this.

The binding effect of the corset could also cause chronic gastroesophogeal reflux, where acids are constantly pushed up into the esophagus. This happens in people who overeat and go to bed and then wake up with heartburn. With a corset this external pressure will keep pressing on the stomach and pushing the undigested food and acids up in the esophagus. This can lead to esophagitis––an inflammation of the esophagus. This in turn can lead to bleeding, which could result in death.

If the corset was extremely tight and the victim moved in certain positions, she could damage internal organs such as the spleen, liver, or bowel. The spleen, which sits in the left upper part of the abdomen, is particularly vulnerable to this type of injury. It is often injured in motorcycle and bicycle accidents and could be injured by a corset if the victim bent over suddenly. A ruptured spleen, liver, or bowel often causes severe internal bleeding that can be deadly.

Corsets can also cause a reduction in blood return to the heart through the major veins of the abdomen and lead to dizziness and fainting. Here the victim could fall down stairs or strike her head on the floor or furniture, leading to death from bleeding into and around the brain.

Your lady could also survive any of these events. If she had a collapsed lung, it could heal itself and she could do fine. If she contracted pneumonia, she could survive even without antibiotics. If she had a bleed from esophagitis, the bleed itself could stop on its own and she could do fine. If she ruptured an internal organ, surgery could be performed to repair the injured organ or, in the case of a ruptured spleen, to remove the spleen––the spleen is almost never repaired but rather is removed when damaged. We do not need it to survive and it’s very difficult to repair. If she struck her head and suffered bleeding into or around her brain, she could be unconscious for a few hours or a few days and yet survive even though there was no real medical treatment at that time for this type of injury. With a bleed around the brain–called a subdural hematoma–the one technique your 1908 doctor could employ would be the placement of what we call Burr holes (trepanning). This is simply opening a hole in the skull with a drill or similar device, which allows the doctor to remove the clot and relieve the pressure that builds in the brain with this type of injury. If a secondary infection didn’t arise your young lady could survive even this event.

This should give you several options for your story.

 
 

Black Death Bug Identified–Again

Ring around the rosies,
A pocket full of posies,
Achoo! Achoo!
We all fall down.

This innocent sounding nursery rhyme dates to the Black Death and underscores the effects and forms of this disease. Bubonic Plague caused swollen and necrotic lymph nodes, called buboes, and a circular pinkish rash (the ring of the rosies). Placing flowers  (posies) in your pocket was supposed to ward off the bad air, or evil spirits, or whatever your belief of choice for the cause of the disease. Of course, this didn’t work. When it progressed to Pneumonic Plague, where the victim coughed, sneezed, became short of breath, and coughed up blood, death followed very quickly (all fall down).


The Black Death was a human disaster of catastrophic proportions. Though estimates vary, when it struck Europe between 1348 and 1350, it killed 30-60% of the population and probably reduced the world population from approximately 450 million to 350 million. It disrupted travel and trade, set one village against another, and shook the foundations of medicine and religion. No one knew what caused it and prevention and treatment were mysteries. Nothing worked. No medicine or prayer or ceremony slowed its march or relieved those afflicted. If neither the medical practitioners nor the clergy of the day could help, then of what use were they?

All the populace could do was to burn or bury the dead, often in mass graves. Mourning, prayer, and fear then followed.

 


The cause of The Plague is the tiny bacterium we call Yersinia Pestis. That was the long held dogma anyway. More recently some have questioned this and have proposed other causes such as the Ebola virus, small pox, typhus, and several other organisms.

But recent studies seem to support dogma. Hendrik Poinar and colleagues at McMaster University in Hamilton, Ontario, recently found a very interesting way to exam the DNA from bones and teeth removed from a plague mass burial pit near London. Their “molecular probe” revealed that the causative agent was our old friend Yersinia Pestis after all.

 

Guest Blogger: Eleanor Sullivan: 19th Century Medicine, Part 2

I want to welcome back Eleanor Sullivan with the second of her two-part series on the state of medical care in the 19th Century.

 

Medical Care in the 19th Century-Part Two

 

Previously I blogged about the illnesses that 19th century people suffered along with what they thought caused them to become sick. This blog will reveal the treatments they endured.

Because illness was believed to result in internal weakness (or sin) or that the external environment had invaded the body, aggressive treatment was designed to rid the body of its noxious incursions. Blood-letting, purging, and puking were the preferred treatments.

Blood letting, Purging, and Puking

Blood letting relieved excess blood and returned the flow to normal, it was thought. This was such an accepted belief that the reason women were believed to have fewer illnesses is because they bled regularly. To relieve pressure in the blood, the doctor lanced a blood vessel and often used glass cup to produce a vacuum to draw the blood out. Blood-sucking leeches might also be used. Often the patient would faint from the blood loss, assuring the patient and the doctor that the treatment was indeed successful.

The goal of purging was to evacuate the bowels, another way of ridding the body of unwelcome invaders. If a cathartic, using such body-damaging medicines as mercury (called calomel), wasn’t successful, enemas would be given until the body had been flushed of all contaminants.

Puking was induced by several means. Ipecacuanha root (known today as ipecac) crushed into a powder or lobelia bark, also powdered, were administered in a tincture. If nothing else was available, warm salt water could induce vomiting. Again, every bit of disease must be eliminated from the body.

Medicines and Pain

Powerful medicines were believed to be necessary to combat powerful illnesses. Mercury again was a favorite. Producing dramatic effects, such as headaches, tremors, and loosened teeth, patients were certain that they were receiving potent care. Mercury poisoning was not unusual. In fact, Louisa May Alcott is believed to have died in 1888 of mercury poisoning from the mercury she’d received for a bout of typhoid in 1863.

Pain was another sign that the medicine was potent. Patients persisted in downing medicines even realizing they suffered from its ill effects. Thank goodness for opium! Opium, and its form in a tincture, laudanum, was commonly and legally available. Opium masked symptoms so patients felt grateful relief.

Opium and alcohol were also the basis of patented medicines, promoted to cure every ailment, including venereal diseases, tuberculosis, or “female complaints.” It wasn’t until 1906 when Congress passed the Pure Food and Drug Act, forcing manufacturers of patent medicines to reveal their ingredients and discontinue false advertising claims, that the widespread use of patent medicines ceased.

Herbs and Homeopaths

Medical treatment in the unsettled parts of America (and most of the country was unsettled in the early 19th century) was especially arduous, albeit they were often spared the rigorous administrations of medical doctors (licensed as early as 1811 in Ohio). Care often fell to a local midwife who administered herbal substances. Recipes were handed down through families and communities and often helped. My character, Adelaide, is a midwife and herbalist in 1830s Ohio.

Homeopaths also treated 19th century patients. Homeopathy was promoted by a German physician, Samuel Hahnemann in the 18th century. Hahnemann observed that cinchona bark, used to treat malaria, induced symptoms of malaria. Thus, he surmised that inducing symptoms with highly diluted preparations would cause the patient’s own vital force to expel the disease. He called this the law of similars. There is no scientific evidence that the treatment was effective. Again, patients were spared energetic medical treatments and may have recovered on their own. The leader of Zoar, Joseph Bimeler, who appears in my stories, was trained in homeopathy in Germany before emigrating to America.

Surgery, Anesthetics, and Antiseptics

Surgery in the early 19th century was crudely done (usually by a barber), often unsuccessful (that is, the patient died), and excruciatingly painful. As the century progressed, however, use of anesthetics emerged to sedate the patient during the operation, carbolic acid was used as an antiseptic to prevent infection, and German surgeons used steam heat to sterilize instruments. Surgery continued to advance as the 20th century dawned.

In the end, the people who survived were sturdy stock. Many of us owe our good health to our robust ancestors.

Eleanor Sullivan is the award-winning author of books for nurses, the Monika Everhardt mystery series, and her latest, Cover Her Body, A Singular Village Mystery. www.EleanorSullivan.com

 
 

Guest Blogger: Eleanor Sullivan: 19th Century Medicine, Part 1

I want to welcome Eleanor Sullivan to The Writers Forensics Blog. She will post a two-part series on the state of medical care in the 19th Century.

Medical Care in the 19th Century—Part One

As a nurse for more than 25 years, I’ve seen my share of changes in medical care. From starched white uniforms, paper files, and long hospital stays to casual scrub suits, electronic records, and one-day surgeries, change has characterized the medical and nursing professions. But, as I began my quest to learn about 19th century medicine, nothing prepared me for the difference between then and now.

Let’s start with what diseases were called. You might not recognize these today. According to a mortality schedule, the causes of death in Tuscarawas County, Ohio in 1850 included dropsy, flux, canker, apoplexy, spasms and my favorite, “no opening.” Other than the last one (I can only guess at that!), here’s what we call those diseases today:

Dropsy—edema, usually from cardiac failure

Flux—diarrhea caused by dysentery

Canker—inflammation caused by infection (remember, no antibiotics existed then)

Apoplexy—unconsciousness caused by a stroke

Consumption—tuberculosis

Ague—malaria

So we’ve come a long way. Now we have diagnoses confirmed by symptoms, lab tests, x-rays, CT scans, and MRIs. We know what causes most diseases, how to prevent many (vaccines anyone?), and how to treat most others. We’re not perfect. Cancer, heart disease, and strokes still kill.

But we think we’re pretty smart. Just knowing the cause directs researchers to the cure. Back then people thought they knew what caused illness, too.

Internal Causes

The cause of disease, it was believed, was inside the person. Those who became ill were weak. Or unclean. Or they sinned and God brought on their illness to punish them. Remember Job of the Bible? God tested him. With that example in mind, religious folks admonished the sick to admit their sins and ask God for forgiveness. But what if they didn’t get well? I guess God wasn’t satisfied with their confession.

External Causes

The outdoors brought on many illnesses, according to 19th century Americans. The night air was filled with miasmas, poisonous, foul-smelling, dark-colored vapors that held malevolent power. Mists rose from the ground (or more likely, stagnant water) like wicked sprites to creep over the land and threaten the populace with their toxic fumes.

Nineteenth century Americans lived in fear of the miasmas. The solution was to keep inside with tightly-closed windows no matter how hot it was. (I wonder how many died of heat stroke instead.) Miasmas weren’t everywhere, though. Some locales were known for them and travelers were admonished to take care to avoid any place where they saw fog.

What illness did they fear miasmas brought? Everything! Any illness after exposure to night air was thought caused by it.  What 19th century people didn’t believe was that illness traveled from person to person. It rose up out of their surroundings instead.

But they were wrong.

Though not entirely. Germ theory evolved during the late 19th century but antisepsis to prevent diseases from germs lagged behind. Florence Nightingale, the founder of contemporary nursing, insisted on cleanliness, especially rigorous hand washing, when caring for the wounded during the Crimean War in 1854. Her patients improved but still it would be years until the medical community would be confined that they could prevent the spread of disease by something as simple as washing their hands. (This problem still exists today in modern hospitals where lack of adequate hand washing, among other safety problems, causes thousands of deaths each year, according to the Institute of Medicine.)

But don’t be too quick to dismiss 19th century beliefs. Blame the victim is still true today. If he hadn’t smoked, drank, overate,  etc., he wouldn’t have cancer, cirrhosis, or heart disease. That’s not entirely wrong but, remember, even people who never smoked, exercise, and eat healthy still die. There’s no getting out of it.

You think what you’ve read so far is bad? This is the first part of a two-part blog on medical care in the 19th century. Come back next month to hear how they treated illness. Then you’ll be exceedingly glad to be living in the 21st century!

 

Eleanor Sullivan is the award-winning author of books for nurses, the Monika Everhardt mystery series, and her latest, Cover Her Body, A Singular Village Mystery. www.EleanorSullivan.com

 

 
9 Comments

Posted by on October 9, 2011 in Medical History

 
 
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