Footnotes on Friday

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The disease that made you in fashion

One of the biggest killers of humankind in history (apart from other humans) has been a tiny organism we now call Mycobacterium tuberculosis.

In ancient Greece, it was considered the most prevalent disease of the age. Throughout history, it has been feared and the symptoms treated with despair. And in the nineteenth century, it was a fashionable way to die.

The most common form of tuberculosis attacks the lungs. Sufferers experience chest pain, fatigue, night sweats, loss of appetite leading to a general wasting away, and a persistent coughing up of phlegm and later blood (and bits of lung tissue). Eventually the patient’s lungs are so invaded by the disease that they suffocate and die. Sounds sexy, right?

No. Not that bit. What our Regency and Victorian poets and artists admired was those features of the disease that fit their ideas about the causes of illness and their concept of beauty.

First, not knowing about germs, they thought that the causes of the illness varied by social class. When the poor died in their filthy overcrowded rooms, they had the Graveyard Cough, the White Plague, the King’s Evil (so called, because the touch of a king was thought to be a cure for the version of the disease we now call scrofula, a tuberculous swelling of the lymph glands). These were diseases of poverty, immorality, and criminality, which were all clearly linked, since poverty was obviously the fault of the poor. (Come to think of it, some modern commentators haven’t moved on from that belief.)

When the wealthy died, it was clearly a different disease, since they were rich, moral, and altogether less smelly. It was consumption, so called because the person grew thinner and thinner. It was, so medical theory had it, an excess of emotion and genius typical of the artistic mind that slowly consumed the patient. They were killed by fiery passion.

And look how lovely they were while they died! Was it fashionable to be slender (rather than hearty and robust like the working classes)? Not being able to eat made you thin. Was it fashionable to be pale (rather than tanned like those horrid workers who must toil in the sun)? Loss of blood will make you positively pasty.

Since one in four deaths in the nineteenth century was caused by the disease, many fashionable poets, musicians, painters and authors died of consumption, which confirmed, in the minds of the fashionable, that their creativity had killed them. Add to that the predilection of said creative types to glorify death by consumption in their poems, operas, and novels, and hey presto. A horrible slow wasting death becomes desirable.

Kirana, Jules’s mistress, is slowly dying of consumption in my current work-in-progress, Unkept Promises. Her death will be written some time in the next few days, poor soul. 

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The man who could have saved millions

Look up maternal mortality figures for Britain and the United States in the eighteen and nineteenth centuries and through to the 1930s, and you’ll see why childbirth was so feared. Every year, between four and eight women would die for every 1000 total births, during the birth or within the following 42 days. Factor in that few couples practiced ways of limiting conception, and women faced this risk time after time. Breastfeeding was a time-honoured way of spacing babies, since conception is suppressed in many women while fully breastfeeding, but by the nineteenth century, wet nurses were fashionable for the upper classes, so men commonly had nine or ten children, often with two or more wives in succession.

Puerperal fever, the killer in many cases, was no respecter of persons. Indeed, physicians were more likely to carry the disease than midwives, since they went from attending to autopsies and infectious diseases straight to assisting at a birth. Mary Wollstonecroft died in 1797, after a doctor was called to help remove the placenta when she gave birth to the baby named for her, who would later become well known as Mary Shelley.

The father of hand-washing

Use the internet to look up who first discovered that hand-washing saved lives, and the name Ignaz Semmelweiz will populate your search screen. He was a Hungarian doctor who, in the 1840s, began collecting mortality statistics in two maternity wards. In one, staffed by doctors and their students, mortality rates were five times as high as the other, staffed by midwives. He made several changes to align the routine between one ward and the other, but to no effect. Then one of the pathologists died. He’d pricked his finger during the autopsy of a woman who died of puerperal fever, got very sick, and died. Apparently, such deaths among pathologists were not uncommon, but Semmelweiz noticed that the man had shown all the symptoms of puerperal fever.

Semmelweiz realised that puerperal fever wasn’t uniquely a post-natal disease of mothers. He then theorized that doctors were getting little pieces of corpse on their hands when they dissected bodies, and those caused the fever. He made his doctors and students wash their hands and instruments in a chlorine solution, and maternal deaths in the doctors’ ward dropped dramatically.

Problem solved.

Hold on. Not so fast.

While all the facts about Semmelweiz are true, the appellation ‘father of hand-washing’ is wrong for two reasons.

First, he wasn’t the first

He wasn’t  the first to notice the correlation. In the 1790s, Alexander Graham, a naval doctor who had retired from the sea to work in a hospital in Aberdeen faced an epidemic of puerperal fever, and recorded his conclusions about the 77 cases in his care.

‘… it is a disagreeable fact that I, myself, was the means of carrying the infection to a great number of women.’

He recommended burning the women’s bedclothes and told doctors to carefully wash themselves and to change their clothes between patients.

In the United States, a few years before Semmelweis, physician and poet Oliver Wendell-Holmes drew the same inferences.

‘… the disease known as puerperal fever is so far contagious as to be frequently carried from patient to patient, by physicians and nurses.’

They weren’t the only ones.

In France, there was Antoinne Germain Labarraque. In Ireland, Robert Collins, In Britain, Thomas Watson. All of them advocated hand-washing to save lives.

Second, no one wanted to know

Medical science laughed at the notion that doctors might be inadvertently killing patients.

Gordon was hounded out of Aberdeen, and had to return to the navy, where his knowledge of handwashing informed his surgical practice and undoubtedly saved many sailors. But not medical practice. Labarraque, Collins, and Watson fared better, being honoured for their medical achievements, but scoffed at for their theories of hygiene, their recommendations disregarded.

Semmelweiz, perhaps because of his aggressive attitude, was the worst treated of all. He publicly berated those who didn’t agree with him, in increasingly abusive terms. In one letter, he said:

I declare before God that you are a murderer and [history] would not be too unfair if it remembers you as a medical Nero.

In 1865, aged only 47, he was committed to an asylum, probably beaten, and died of sepsis — ironically, the same infection of the blood stream that was still killing all those women he tried to save.

There’s good news, and there’s bad news

Even after Lister proved the connection between germs and disease, hand-washing took a long time to catch on. In the Scandinavian countries, midwives adopted hand-washing early, and had the earliest drop in maternal deaths. Other countries reluctantly followed, the United States as late as 1930. All the evidence in the world is not enough to change minds that are set on what they want to believe.

Even today, close to one third of maternal deaths in Africa and other developing parts of the world are from puerperal fever. They could be prevented by washing hands in an antiseptic solution and wearing clean clothes (if such supplies plus the knowledge we take for granted were available to birth attendants).

 

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Will You Be My Valentine?

When the Bluestocking Belles first began working on a box set based around a Valentine’s Day Ball in Regency Bath, I had a few question. Was Valentine’s Day celebrated back then? How?

I knew the Victorians had hand written cards, and the Americans in the late 19th century brought in printed cards. And I knew Valentine was a Roman, killed for his faith and remembered for kindness to lovers. I didn’t know much else, but a bit of research soon put that right.

Wild Lupercalia

Long before the fifth century, when the three possible claimants for the story of St Valentine were around, the Romans had a feast in the middle of February that celebrated fertility. It included a ritual in which men killed animals and then used their hides to whip the women who lined up for the opportunity. The proceedings also including a jar full of names to pair men and women up for the duration of the festival – or longer, if they found they liked one another.

Valentine – but which Valentine?

When Christianity became the preferred religion, or so the theory goes, the bishops looked around for a replacement festival; one that wouldn’t involve quite so much blood and sex, but still let people have a good time.

They had a handy day already: 14 February was the feast day of three martyrs, both called Valentine. One was a fellow who refused to convert to paganism and was executed. According to legend, before he died he performed a miracle to heal the daughter of his jailor, and sent her a letter signed ‘from your Valentine’. Not much is known about the third, except that he died in Africa.

The other was a Roman priest who performed weddings for soldiers forbidden to marry, which in time led to the connection between St Valentine and lovers.

Beloved friends

At first, St Valentine’s Day was for celebrating any kind of love by showing affection. However, by the late fourteenth century, the idea of courtly love was in full swing, and the medieval author wrote a poem in which he firmly associated St Valentine and his day with romance.

As the years passed, the tradition developed. Lovers exchanged gifts, poems, letters, and handmade cards to celebrate the feast. Lovelorn suitors might give a Valentine’s Day token to impress the beloved. By the eighteenth century, the association of the saint between the saint and a wider definition of love had disappeared from England. But the association of the day and lovers was going strong, and it was only going to increase in the nineteenth century. In 1815, the year of our Valentine’s Day ball, such an event was entirely possible, and we can certainly expect our characters to keep up the tradition of giving hand-made tokens of affection to the object of their love.

It would be another thirty-five years before a entrepreneurial American woman would create the first print run of Valentine’s Day cards, but our story was feasible, and we were off.

~*~

Valentine’s from Bath releases on Saturday. Only 99 cents for more than 450 pages of stories. See the Belles’ project page for details. The blurb below is from my novella, one of five in the collection.

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Getting dressed in Regency England

This week, I thought you might like to see what goes into getting our heroines and heroes dressed.

First, the heroines:

 

And now for the heroes. This is from the movie about Beau Brummel. If you’re shy, don’t watch the beginning. (The shirt would have been put on over the head, with buttons only at the neck. But hey.)

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Join the library! (Regency-style)

My heroine Charis didn’t like much about the social rounds in Bath. Had her mother been prepared to pay the subscription she would have enjoyed the circulating library.

By 1814, many towns and most cities had at least one circulating library, perhaps run by a bookstore or printer, but often a stand-alone business. Books were expensive. A 3-volume novel cost the equivalent of 100 dollars in today’s money. Paying a yearly subscription to a library meant you could borrow books that would otherwise be out of your reach.

Rules for a Subscription Library

Circulating libraries became social places, where ladies could meet and be seen. The reading rooms often offered games, and the libraries might also sell other merchandise.

As a member, you could purchase a copy of the library’s catalogue (for about sixpence). You could choose your book from the catalogue, and take a couple home, then another couple when you’d finished those ones. (The number you could borrow at a time varied from library to library.)

What would they think of my library, which I ‘visit’ over the Internet, and which allows me to download 15 ebooks at a time? Or, for that matter, my personal ebook collection, which numbers in the 1000s, many of which have cost me less than five dollars?

(Charis appears in The Beast Next Door, a novella in Valentines from Bath.)

Also see:

The Circulating Library in Regency Times: https://janeaustensworld.wordpress.com/2010/08/30/the-circulating-library-in-regency-times/

The Circulating Library:

https://janeaustensworld.wordpress.com/2010/08/30/the-circulating-library-in-regency-times/
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Annoying Napoleon

For my latest novella, The Beast Next Door, I researched hospitals that might have performed the surgery I needed. It had to be offshore, because the hero came home after ten years away. And not all places in Europe that might have accomplished surgeons were available — the return happens in 1814, at the end of the Napoleonic wars.

I started looking at Italy, because surgery was an important branch of medicine in Italy as early as the 16th century, unlike England, where gentleman became physicians who never touched their patients, and surgery had a recent history as a job for barbers.

Northern Italy was out. No English aristocrat would send even an unwonted child into territory controlled by Napoleon. The kingdom of Naples and Sicily, however, did not fall into Napoleon’s hands until 1806.

So my Eric was sent to one of the first and best-known of Italy’s hospitals. Santa Maria del Popolo degli Incurabli, now known as Ospedae degli Incurabili, still stands today as a modern medical facility.

It began in the late 15th century when Charles of France invaded Naples leaving a small gift behind. To this day Neapolitan’s call it the French disease. The French call it the Neapolitan disease. It has various other names but the best known as syphilis.

When it first arose the disease was deadly and many hospitals were opened for the incurable.

The Incurabili in Naples was built in 1521. A Catalonian woman, wife of the Spanish viceroy, was stricken with paralysis and miraculously cured. She founded a church and hospital comprising a group of small monastic communities where she devoted the rest of her life to caring for the sick.

Ancient camphor tree in the hospital’s medicinal garden.

Over the centuries the hospital became a medical school where the breadth of studies far surpassed the English model. Pharmacy, surgery, both medical and palliative care, all were both taught and practised.

An interesting touch for Christmas, the hospital is associated with the Naples tradition of crib scenes. According to historical records, some of the early cribs were built in an oratory at the hospital.

Locating Eric, my hero, in the Kingdom of Naples gave me further ideas for my story. When Napoleon invaded the kingdom of Naples in 1806, he was 14. Trapped behind enemy lines, he and his tutor disguised themselves as Neapolitans and took to the mountains, where they joined a band of insurgents, harassing the troops of of Napoleon’s puppet kings, first as brother and later his brother-in-law.

I love the way that works.

The Beast Next Door is a novella in Valentines from Bath, a Bluestocking Belles collection on preorder, to be published on 9 February.

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Staking the castle

You’ve all read them. The stories where the heroine is at risk because a father, uncle, brother, or husband has lost the family fortune, or where the hero cannot wed because he had inherited an impoverished estate from the gambling waistral who was the previous incumbent.

Gambling, especially the gambling of the upper classes, is a frequent plot device in our Georgian and Regency stories, as it should be since it was a frequent feature of Georgian and Regency lives.

Not just upper class lives, of course. People at every level of society, both men and women, loved nothing more than a bet, on anything from a horse race or boxing match to which cockroach would be first to run the length of the table.

For the most part, our stories look at the upper classes, though. We are compelled by what Arthur Pitt, in explaining the focus of his Masters dissertation, calls:

… the undeniably romantic allure of the richly decorated gaming clubs or the reckless gambling of dynastic fortunes [which] rather trump[s] the dingy and dull penny games played against street walls or in alehouses. (Arthur Pitt, MA dissertation, A Study Of Gamblers And Gaming Culture In London, c. 1780-1844)

Card and dice games

Card games – whether for no, low, or ruinous stakes – were everywhere. Evenings at home or out at dinner would often include card games. Hostesses holding a ball or party usually had a card room, where those fond of such games could spend the evening. Gentlemens’ clubs also set aside a room or two for their members to play cards, as did gaming ‘hells’, both low and high.

Some ladies supplemented their income by ‘holding the bank’ in private card parties held in their houses. As long as they retained the appearance of merely being a hostess, and not in business, such a venture would dent their reputation but might not ruin it.

Whist (the precursor of Bridge) was very popular. Four players, in two teams, chose a trump suit and played a strategic game to win each round (called a trick). Loo is also often mentioned. It is played in a similar way to Whist, except the dealer deals an extra hand, which a player can choose to pick up and play in preference to their own.

Piquet was a game for two players, with a complicated scoring system and the potential for huge wins or losses.

Vingt-et-un is today called Twenty-One (same name, but in English). Each player draws one card at a time, in an attempt to get cards that add as close to 21 as they can get, but without going over.

In Faro (or Pharoah – or Basset, the game Pharoah was derived from), the dealer takes cards from a special wooden box and lays them face up on the table. One suit of the cards is pasted to the table in numerical order, and players place their bets by putting what they want to stake on one or more cards. Various rules decide whether a card drawn from the box wins for a player with a stake on the same number, or loses.

Hazard is a dice game, rather than a card game. Players bet on the numbers to be rolled.

Of course, gaming tables were just the start. Next week, I’ll take a look at the Betting Books, and later at horse racing.

This blog post on Jane Austen’s World has a list of further links at the end. https://janeaustensworld.wordpress.com/2008/11/30/gambling-an-accepted-regency-pastime/

I also consulted:

https://harlequinblog.com/2011/02/gambling-in-regency-england/

https://englishhistoryauthors.blogspot.com/2012/09/a-profitable-vice-gambling-in-regency.html

https://www.cherylbolen.com/gambling.htm

https://allaboutromance.com/gambling-in-historic-england/

http://www.riskyregencies.com/2012/05/21/regency-gaming-hells/

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The railway revolution

I’m continuing with a travel theme, and taking a look at my favourite mode of transport: trains. Those of us who are old enough to remember life before the internet have some idea what railways meant to how human beings live on the planet.

As they spread across one country after another in the nineteenth century, they opened unprecedented opportunities for trade, allowed investors to make huge fortunes, and gave ordinary people access to places, goods and services that had previously been exclusively for locals or the wealthy.

They also destroyed industries and the communities built around those industries.

Travelling at speed

Before trains, the fastest form of travel was a galloping horse. Set up a succession of horses spaced about ten miles apart, and you could get a message from London to Edinburgh in, perhaps, 48 hours (depending on road conditions). Travelers without such a facility would take four to eight days. In Victorian times, a train would take 16 hours to do the same journey.

Moving in bulk

Before trains, you could move goods in bulk (by barge or ship), or you could move them at speed (relatively speaking), but not both. Same with people. An army on the march could cover 30 to 50 miles a day, or boat down a river at whatever speed the current traveled. Trains reached 60 miles an hour by 1840, carrying people and goods at speeds never before possible.

Unintended consequences

Trains made the suburbs possible. They put a day trip to the seaside within the reach of ordinary city dwellers. They allowed factories to shift their goods across nations and across borders. They also furthered the depopulation of the countryside, replaced local goods — especially foods — with products brought from far away, and changed social habits, employment, and culture.

Massive engineering projects opened up inaccessible places to travelers and settlers, often at the expense of local communities.

Trains upped the head count in a disaster. An accident to a horse might take a single rider. One to a coach might result in several deaths. When a train hit another in a tunnel in 1861, 23 people died and 176 were injured.

In both positive ways and negative, trains changed the world.

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Why Georgian England partied at the full moon

I’ve been studying sunrise and sunset, moon rise and moon set, and moon phases charts for December 1814 and January and February 1815. My characters in my latest work in progress live in a quiet corner of the country within an hour’s carriage ride of Bath, and want to attend the assemblies there. Dreadful roads and poor lighting are an accident waiting to happen, which the Georgians knew even better than we do, living in a world where street lighting hadn’t spread beyond the wealthier parts of the bigger towns.

If you lived in a large country house and wanted to hold a party, you’d probably arrange it for a time when the moon would give your local guests sufficient light to see their way, perhaps with a bit of assistance from a pair of carriage lamps (fueled by oil). According to some research done by the US army, your driver would be able to pick out sufficient detail for safe driving at a distance of 400 metres on a cloudless night under a full moon that is high enough in the sky to light the road you’re using. This could drop as low as 20 metres at the quarter moon, making for a very slow trip.

In town, those out for the evening would send footmen or hired link boys to go ahead of the carriage with links (bundles of rush dipped in pitch and set alight to make a torch) or oil lamps. I guess close neighbours might have done that in the country, too. But not my characters — they have too far to go, so are stuck with partying only on a fine and moonlit night.

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Carriages, horses, boats, and Shank’s pony

I’ve read a few novels recently where the protagonists make amazingly fast journeys, leaving London in the morning and arriving in York for afternoon tea, or zipping across the Mediterranean in what must be a jet powered sailing ship. It always throws me out of the story. So, in the interests of the pleasure I get from well-researched books, here’s my rule of thumb for early 19th century travel. Times don’t allow for rest, changing horses, storms or other adverse conditions, or particularly fast journeys over a short distance.

Walking: ten miles in 3.5 hours

Carriage or horse: ten miles in 1 hour

Ship: four knots (four nautical miles in 1 hour)

Try these resources as a starting place for further research:

Sarah Waldock on speed of travel in Jane Austen’s England

Teach us history on Travelling in the early 19th century

Royal Museums Greenwich on sailing times in the 18th century

And posts of my own:

All at sea — travelling the Mediterranean

Three roading heroes