Cholera Conundrum

Epidemiology, Famous Victorians

Max Joseph von Pettenkofer was a Bavarian chemist known for his research on practical hygiene and implementing many hygiene-related standards in German cities, including improving the state of drinking water, sewage disposal, and general cleanliness. 🚿 While all of this work positively contributed to public health, it was also a result of Pettenkofer’s alignment with the miasmatic theory rather than the germ theory of disease. 🌬️ And even though Pettenkofer did not deny the existence of bacteria, he thought they weren’t enough to cause sickness and had to be accompanied by bad living conditions, miasmatic air, and dirt in general. This belief made him at odds with Robert Koch, the discoverer of the bacterium responsible for cholera outbreaks and proponent of the germ theory of disease. 🔬 The two scientists did not see eye to eye with each other on how to deal with German cholera outbreaks in the 1880s, which only made things worse. 😷

Pettenkofer was so adamant that Koch was wrong that he decided to perform a perplexing experiment on himself in 1892 (when he was 74!). To prove that cholera could not develop without poor hygiene and subsoil rather than drinking water, he decided to drink a cholera bouillon laced with bacteria isolated from the stool of a person who had already died of that disease. 💀😱 To make sure his experiment was viable, he decided to do it in front of an audience and obtained the sample from Koch himself. He had also emptied his stomach beforehand and neutralized any leftover acid with sodium bicarbonate. 🤢

How this fantastic example of self-experimentation ended? After experiencing watery diarrhea for a week, Pettenkofer stated that he did NOT come down with cholera, and his symptoms were associated with something else. In reality, he contracted a mild case of cholera and was probably saved from death by the fact he already had had contact with the disease a few years earlier. 💀 When asked why he was willing to risk his own life, he stated “I would have looked Death quietly in the eye for mine would have been no foolish or cowardly suicide; I would have died in the service of science like a soldier on the field of honor.”

You can read more about this and other self-experiments in Who Goes First?

“A Christmas Tree with Lamps of Skulls”

Epidemiology, Medicine, Surgery

The San Francisco Call, December 27, I898
“A Christmas Tree with Lamps of Skulls”

The Vision That Appeared to a Demonstrator of Anatomy at Midnight.

It was 12 o’clock last Saturday night when Dr. W. O. Wllcox climbed the stairs of 21 Powell street to go to his room. It was just the time when graveyards yawn and give forth their dead; but the doctor had no reason to suppose the spirits of the air would haunt him in the privacy of his own chamber, so he opened the door without hesitation and stepped inside.

There was no need of striking alight. The room was illuminated by a score of prim and ghastly lamps, that clung to the green bangles of a Christmas tree standing upon a table. They were skulls, and the eyeless sockets flashed fire from within as they nodded their grisly heads to the swaying of the branches.

On the table under the bone-fruited tree were some of the doctor’s dissecting knives, gleaming balefully in the eye light from the skulls. There were crossed shinbones lying on the black tablecloth, white as the symbol of death on a pirate’s ensign, and more skulls— evidently windfalls from the boughs above. Between the jaws of one of these was a half-smoked cigarette, which the grinning head seemed to be thoroughly enjoying.

There were skeletons of hands, feet and other parts of the human bony building, mingled with the steel implements of surgical craft, and to many of these objects of cub-medico humor were attached cards bearing inscriptions as appropriate as witty.

By means of one of these inscriptions one skull complained bitterly of the unusually long time between drinks. Another, whose way in this world had probably strayed from the straight and narrow path, demanded ice and steam beer, while the head of a child declared it had been the victim of a mother’s neglect.

Dr. Wilcox is a demonstrator of anatomy in one of the colleges, and although the students of his class declare they never would do such a thing as desecrate a Christmas tree with the products of the grave, still the doctor is looking among them for the one who planned his pleasant Christmas surprise.

Source of the story: The San Francisco Call archive

Good Old Hospital Stink

Epidemiology, Medicine, Surgery

Last time we explored early 19th-century hospitals as the perfect breeding ground for insects and diseases. 🐜 In the pre-germ-theory world, dirty clothes, unwashed linens, festering wounds, and limited access to clean water were pretty standard for a hospital experience, followed by outbursts of such diseases like rubella or cholera. 💀 Unfortunately, many surgeons contributed to this situation by not washing their hands, not disinfecting surgical instruments, and … glorifying their blood-soaked frock coats and surgical aprons. 🩸

You see, it was believed that the dirtier the surgical attire, the more busy and successful its owner was. 💉 Some surgeons even wore clothes that had previously belonged to retired staff members as a sign of respect and keeping traditions alive. Those who wore “butcher’s aprons” mostly did so to protect their private, nice clothing and didn’t wash them anyway. As you can imagine, these pus- and blood-soaked, never-washed items were basically rotting and gave out a putrid smell which was lovingly referred to as “the good old hospital stink.” 🧀

The situation slowly began to change in the mid-19th century, when several doctors (e.g. Joseph Lister, Ignaz Semmelweis, Thomas Dent Mütter) tried to popularize washing the surgical attire and promoted the idea of cleanliness in general, for which they were often ridiculed. 🧼

To learn more about 19th century hospitals, check out Lindsey Fitzharris’ book The Butchering Art. A highly recommended read!

Bug-Catcher

Epidemiology, Medicine, Surgery

In the early 19th century, a visit to a hospital was a horrific experience. 😱 The sanitary regime was non-existent and the putrid smells of disease, dirty linens, and unwashed clothes penetrated the hospital building and its walls. While wealthier people were cared for in their own homes, the poor were forced to withstand awful hospital conditions, where the probability of dying was three to five times higher than in a household. (That’s why hospitals used to be called “houses of death”). 💀 

No wonder that a hospital environment was a perfect ground for spreading both diseases and … insects. 🐜 While the former were still believed to caused by miasma, the latter seemed to be easier to deal with. A hospital infested by cockroaches or lice could hire a specialist called a bug-catcher. In fact, a Chief Bug-Catcher would earn more than a surgeon, whose job at this time was still closer to a barber-surgeon than to a fully-respected medical profession.

I found this fantastic description of the bug-catcher profession in Lindsey Fitzharris’ book The Butchering Art. A highly recommended read!

The Great Stink

Epidemiology, Everyday Life, Great Inventions, Medicine

The summer of 1858 was exceptionally hot for Londoners – the temperatures averaged 34–36 °C (93–97 °F) in the shade, reaching even 48 °C (118 °F) in the sun. This unbearable weather was however overshadowed by something even more unbearable: the Great Stink. 🤢

The source of this unbelievable stink was the Thames, which served as a sewer for all human, factory, and slaughterhouse waste in the area. As the London population doubled in the first half of the 19th century, so did the problems surrounding the river that served as the main source of “fresh” water. Apart from the offensive smells, Thames was also the source of cholera outbreaks and other diseases. The situation was dire and many people, including journalists and scientists, urged the government to take appropriate action even before the events of 1858.

In 1848 the Metropolitan Commission of Sewers was supposed to deal with the problem. A prominent engineer called Joseph Bazalgette created plans for a new sewerage system which was estimated to cost £5.4 million. These plans weren’t accepted by the government, which even suggested that cleaning up the river wasn’t really their problem, even though they had to use scented handkerchiefs, tobacco, and curtains covered with chloride of lime to protect themselves from the putrid smells in the Palace of Westminster. 💩

When the Great Stink of 1858 knocked at the House of Commons’ doors, there was no excuse to postpone dealing with it any longer. As the level of the river dropped because of the heatwave, “a huge pile of human waste was left piled up right next to Parliament.” Benjamin Disraeli described it as a “Stygian pool, reeking with ineffable and intolerable horrors” and proposed a bill supporting the modernization of the sewer system based on the Bazalgette’s plans. 🥰

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This comic was made thanks to Mateusz, who won the possibility of becoming the main character in a local charity event. Thanks! 💜

Don’t forget to check out this awesome video on the Great Stink

The Great Book Scare

Epidemiology, Everyday Life, Medicine

The Great Book Scare was a period between 1880 and 1920 when the general public was obsessed with the idea that library books were a major source of epidemics. 📚😱

Even though the evidence for this was small, especially compared to other potential disease sources, many in the U.S and the U.K. believed that library books could spread everything from tuberculosis to smallpox. 🦠🦠 The authorities and doctors alike started to come up with ideas on how to limit the risk such as treating books with vapors from heated carbolic acid crystals, using formaldehyde, and … just completely destructing books if they had come into contact with a sick person. 😷

Finally, the fear has died out after it turned out that library workers and patrons weren’t really getting sick more often than others. You can read more about these regulations in this article.

Wash Your Hands

Epidemiology, Famous Victorians, Medicine

While working in Vienna General Hospital in the 1840s, Ignaz Semmelweis noticed a curious thing – the mortality rate of new mothers was a lot higher in wards supervised by doctors 👨‍⚕️compared to those supervised by midwives 👩‍⚕️. After some investigating, he found the source of the problem – only doctors had access to both maternity wards and autopsy tables. Semmelweis quickly developed a theory of what he called “cadaverous particles” 🧟‍♀️🧟‍♀️ and introduced rigorous handwashing 🧼 in his clinics. Unfortunately, even though his method worked spectacularly well, he was ridiculed by most of the medical professionals until his death in a lunatic asylum. 💀

Original John Snow

Epidemiology, Famous Victorians, Medicine

John Snow was an English physician, 👨‍⚕️ best known for finding the source of a cholera outbreak in Soho,1854. By putting all known cholera cases on a map, he found the source of all troubles – a contaminated water pump. 💦 Why was it such a big deal? This discovery not only led to shutting down the pump, but also worked in favor of the budding germ theory of disease. 🦠🦠🦠 Even though Snow himself didn’t know that at the time, he contributed to the birth of epidemiology. 🔬

The third episode of the newest Victoria season talks about the Snow’s cholera investigation, so check it out! (the series doesn’t always stick well to the facts, though, you’ve been warned) 😀