By Becky Maskell (appearing in BYU’s Pride and Prejudice as Anne de Bourgh)
“In The Healthy Body and Victorian Culture, Bruce Haley asserts that the Victorians were concerned with health over almost all, if not all, other issues.”
Early Victorian ideas of human physiology involved a clear understanding of anatomy (at least among experts; but the populace often had hazy knowledge of the location and role of internal organs), allied to a concept of vital forces focused on the hematological and nervous systems that now seems closer to the ancient ‘humours’ than to present-day models. Little was known of biochemistry or endocrinology. Traditional ideas of the body, whereby women were regarded as smaller versions of men, and ‘turned outside in’ (i.e. with internal rather than external sexual organs) were gradually superseded by a binary concept of sexual determinism, in which difference governed all aspects of physiology, health and social behaviour. As the body was also defined as a closed system of energy, physical, mental and reproductive expenditure were held to be in competition. Hence the notions that male sexual ‘excess’ led to debility and female reproductive health was damaged by intellectual study. Hence, too, must have derived the Victorian prescription for many ailments: rest.
In the early Victorian period disease transmission was largely understood as a matter of inherited susceptibility (today’s ‘genetic’ component) and individual intemperance (‘lifestyle’), abetted by climate and location, which were deemed productive of noxious exhalations (a version of environmental causation). Water- and air-borne infection was not generally accepted.
Thus the 1848 edition of Buchan’s Domestic Medicine, with its coloured frontispiece showing the symptoms of smallpox, scarlet fever and measles, listed among the general causes of illness ‘diseased parents’, night air, sedentary habits, anger, wet feet and abrupt changes of temperature. The causes of fever included injury, bad air, violent emotion, irregular bowels and extremes of heat and cold. Cholera, shortly to be epidemic in many British cities, was said to be caused by rancid or putrid food, by ‘cold fruits’ such as cucumbers and melons, and by passionate fear or rage.
Popular Treatments and Illnesses
Treatments relied heavily on a ‘change of air’ (to the coast, for example), together with emetic and laxative purgation and bleeding by cup or leech (a traditional remedy only abandoned in mid-century) to clear ‘impurities’ from the body. A limited range of medication was employed, and the power of prayer was regularly invoked.
Diseases such as pulmonary tuberculosis (often called consumption) were endemic; others such as cholera, were frighteningly epidemic. In the morbidity statistics, infectious and respiratory causes predominated (the latter owing much to the sulphurous fogs known as pea-soupers). Male death rates were aggravated by occupational injury and toxic substances, those for women by childbirth and violence. Work-related conditions were often specific: young women match-makers suffered ‘phossy jaw’, an incurable necrosis caused by exposure to phosphorous.
Searching for Cures
In Britain, epidemiological measuring and mapping of mortality and morbidity was one of the first fruits of the Victorian passion for taxonomy, leading to the clear association of pollution and disease, followed by appropriate environmental health measures. A major breakthrough came during the 1854 cholera outbreak, when Dr John Snow demonstrated that infection was spread not by miasmas but by contaminated water from a public pump in crowded Soho. When the pump handle was removed, cholera subsided. It was then possible for public health officials such as Sir John Simon to push forward projects to provide clean water, separate sewage systems and rubbish removal in urban areas, as well as to legislate for improved housing – one goal being to reduce overcrowding. The number of inhabitants per house in Scotland, for example, fell from 7.6 in 1861 to 4.7 in 1901. Between 1847 and 1900 there were 50 new statutes on housing, ranging from the major Public Health Acts of 1848 and 1872 to the 1866 Lodging Houses and Dwellings (Ireland) Act, the 1885 Housing of the Working Classes Act and the 1888 Local Government Act. On a household basis, the indoor water-closet began to replace the traditional outdoor privy.
Scientific developments in the 19th century had a major impact on understanding health and disease, as experimental research resulted in new knowledge in histology, pathology and microbiology. Few of these advances took place in Britain, where medical practice was rarely linked to scientific work and there was public hostility to the animal vivisection on which many experiments relied. By the end of the century a new understanding of biology was thus coming into being, ushering in a new emphasis on rigorous hygiene and fresh air, and a long-lasting fear of invisible contagion from the unwashed multitude, toilet seats and shared utensils. British patent applications around 1900 include devices for avoiding infection via the communion chalice and the new-fangled telephone.
Technological developments underpinned this process, from the opthalmoscope and improved microscopes that revealed micro-organisms, to instruments like the kymograph, to measure blood pressure and muscular contraction. By mid-century, the stethoscope, invented in France in 1817 to aid diagnosis of respiratory and cardiac disorders, became the symbolic icon of the medical profession. However, the most famous British visual image, Luke Fildes’s The Doctor (exhibited at the Royal Academy in 1891) shows a medical man with virtually no ‘modern’ equipment.
Surgery advanced – or at least increased – owing largely to the invention of anaesthesia in the late 1840s. Significant events include a notable public demonstration of the effects of ether in London in October 1846 and the use of chloroform for the queen’s eighth confinement in 1853. Anaesthetics enabled surgeons to perform more sophisticated operations in addition to the traditional amputations. Specialised surgical instruments and techniques followed, for some time with mixed results, as unsterile equipment frequently led to fatal infection.
In 1895, at the end of the era, came Wilhelm Roentgen’s discovery of X-rays, and in due course the photo of Roentgen’s wife’s hand became a potent sign of medical advance through scientific instruments. But overall the 19th century is notable more for systematic monitoring of disease aetiology than for curative treatment.
Names of Illnesses
Many medical terms from the 19th Century are currently outdated, but definitions can still be found online. Most of the definitions of diagnoses in the glossary that follows are from medical dictionaries or medical texts compiled at different points in the nineteenth century.
GLOSSARY OF DISEASES
|AMERICAN PLAGUE||yellow fever|
|APOPLEXY||paralysis due to stroke|
|BILIOUSNESS||liver disease symptoms. Bilious is defined as having an undue amount of bile. Bilious fever is defined as a fever _supposed_ to be caused by a liver disorder. (It probably also has something to do with gallbladder disease.)|
|BRAIN FEVER||today known as meningitis|
|BRIGHT’S DISEASE||Glomerulonephritis (kidney inflammation)|
|CHLOROSIS||iron deficiency anemia|
|CHOLERA||an acute infectious disease characterized by severe diarrhea, vomiting, muscle cramps and prostration. The severe dehydration leads to shock and death.|
|DROPSY||Congestive heart failure. Taken from an old “Cyclopedic Medical Dictionary” : ‘dropsy; from Hydrops, a condition rather than a disease. morbid accumulation of water in the tissues and cavities.’ It goes on to mention dropsy of the amnion, belly, brain, heart, chest, peritoneum, tubes (e.g. fallopian) and uterus. It could be congestive heart failure or just a general accumulation of fluid in unwanted places. (Not the bladder after too much beer though!|
#1. A condition rather than a disease. Morbid accumulation of water in the tissues and cavities. (chest=thorax)
#2. a fever with vomiting of bile. (a symptom due to disordered condition of the liver.)FATTY LIVERCirrhosisGLANDULAR FEVERMononucleosisGRIPPEan old term for influenzaJAIL FEVERTyphusLOCK JAWTetanusLUNG FEVERpneumoniaLUNG SICKNESSTuberculosisMILK SICKpoisoning resulting from the drinking of milk produced by a cow who had eaten a plant known as white snake rootMORMALgangreenPLAGUE/BLACK DEATHBubonic PlaguePODAGRAGoutPOTTS DISEASETuberculosis of the spinal vertebraeQUINSYanother name for tonsillitis; acute inflammation of the tonsil <& surrounding tissue>, usually forming an abscess.SOFTENING OF THE BRAINcerebral hemorrhage/strokeVARIOLAsmallpoxWINTER FEVERpneumonia
Douglas, Laurelyn. “Health and Hygeine in the Nineteenth Century.” http://www.victorianweb.org/science/health/health10.html
Marsh, Jan. “Health & Medicine in the 19th Century”
Tebbetts, Peggy. “Nighteenth Century Diseases.”