Once again, I’ve found myself researching a common childhood killer that, in our Western world, has had its fangs drawn by the twin powers of vaccination and antibiotics.
Diptheria, previously known as the Boulogne sore throat, malignant croup, was described by the Greeks 2500 years ago. In the year I’m writing about, 1825, it has just acquired the name by which we know it today, but effective prevention and treatment were still a century or more away. All my characters could do was keep their patient calm and hope that the ghastly false membrane growing from one tonsil to her uvula would not close the throat entirely, and that the child’s heart and kidneys did not become affected by the toxins the bacteria produces.
Sitting with my hero and heroine as they watched and worried, I once again gave thanks for the era and the country in which I raised my children. Some forty years ago, one of my daughters had scarlet fever as a complication of mumps. When I told our doctor her temperature and that she was rambling in and out of consciousness, he put snow chains on his car and drove up the hill to give her an introvenous shot of antibiotic. Within half an hour, she was sitting up complaining that she wasn’t allowed to play with her brothers and sisters out in the snow. It’s an experience I have never forgotten.
We live in a time and a country of miracles. In Regency England slums, overcrowding and poor nutrition meant that diptheria, scarlet fever, influenza, mumps, small pox, and other epidemic illnesses spread easily and killed frequently, but a wealthy home was no protection. Children died in numbers that we, who expect to raise our children to adulthood, find it hard to comprehend. One third of children born in the early 1800s did not reach their fifth birthday.
On the whole, I sanitise this world for my readers. My sick child survives, unharmed. I don’t make a habit of marching through my characters’ nurseries with a scythe. I am
So very true! We are blessed in our era, by what my tranquilized, pre-surgery 16 y.o. son called in a voice full of wonder a few months ago, “Duuude. The miracles of modern medicine…” The man-child was high as a helium balloon, but he was right. Up until WWII, when antibiotics became available, simple infections and illness could result in death.
Can you (or have you?) do a blog about the creation of innoculations? From what I understand, the smallpox vaccine was introduced by Edward Jenner in 1796, and who better to do a deep dive than a writer of historical romance? (Hmm…brainstorm. A heroine [raised by a physician father] who is interested in medicine and knows about the smallpox vaccine…a hero who has lost his wife and one child to the disease and doesn’t believe there’s any way to save his other child…Sound like a novella?)
Yes, a lovely Georgian tale! It was a bit tricky when a diplomat’s wife first brought it from Turkey, but the early attempts relied for their effectiveness on knowing the difference between small pox and cow pox!
https://judeknightauthor.com/2016/10/15/how-a-disease-of-cows-saved-hundreds-of-millions-of-lives/
It took a while for the world to get it right. Fortunately, small pox is ideal for eradication by vaccination: only people can catch it, reinfection is vanishingly rare, it has a short incubation time so people can’t spread it far before they diagnosed.
https://judeknightauthor.com/2021/02/27/ring-vaccination-and-the-eradication-of-smallpox/
Cynthia, here’s an excerpt from my book To Mend the Broken Hearted, where my eastern trained habiba (female physician) tells the hero about variolation and vaccination.
“I need help, Lord Ashbury. For at least the next three weeks—longer if we have more cases—the patients will require constant attendance. I cannot stay awake for three weeks.”
“Of course not. Can your companion not help? Lady Zyba? Or has she not had the disease.”
“Zyba has been variolated, as have I. However, someone I trust must chaperone and keep watch on the girls in quarantine. Zyba knows the signs to look for. So does Jeyhun, and he will watch the guard. The guard should not be at risk, nor should they bring the illness to your people. We separated when Anne first showed symptoms. However, to be certain, I have told him to keep apart from your staff in the stables.”
“Then I shall ask Minnich. One of the maids—”
The man was attempting to be helpful. Ruth rephrased what she had been going to say, which was something to the effect: Lord Ashbury, you seem to live in near isolation, with a handful of servants and those well past retiring age. None of them are fit to help.
“If you have a maid who is not elderly, and who has had smallpox, I would appreciate her help. Two would be better, so they can get plenty of rest and still do some small part of their regular work. I understand you are quite short-staffed, my lord.”
Lord Ashbury bit his upper lip. “I shall talk to Minnich. Otherwise, perhaps I can find a tenant’s daughter, or someone from the village. What do you mean by ‘variolated’? Is that some Eastern treatment?”
“It is a method of inducing a less severe form of the disease so that the patient easily recovers and is safe from infection in future epidemics.” She still had the small white scar from the cut the ṭabība, the female physician, had made on her upper arm. Her brother Drew had yelled at the pain, and Rosemary, her little sister, when it came to her turn, had wept, but Ruth and Zyba had competed to show no reaction.
“Here in England,” she continued, “variolation has been largely replaced by inoculation with cowpox. Have you not heard of the work of Dr Edward Jeffries? Vaccination, as he calls it?”
The earl shook his head. “I have not. Can you do it? Can you variolate my household? Or vaccinate them? Anyone who has not already had smallpox, that is.”
“I cannot leave my patients, but I can do it when they are well, or can instruct you in the technique. You will need to find a case of cowpox or minor smallpox to provide the matter for the inoculation. What we have here is major smallpox. It is too dangerous to use.”
“I will ask. Thank you, Lady Ruth. Though I must say you are a very odd duke’s daughter.”
“He is a very odd duke,” Ruth said, wryly.
Wow! I knew living to adulthood wasn’t as common as we thought but had no idea just how bad it really was. Thank you for this glimpse into history.
My pleasure