Is it better to be a milkmaid?

In the early 18th century, Lady Mary Wortley Montagu would discover the inoculation process for smallpox while she was living in Turkey. She had lost a brother to the disease, and barely survived it herself. Smallpox in the 18th century was particularly virulent; the CDC says it had an average a 30% death rate for those who got it. The inoculation was done using actual scabs from people who had smallpox, inserting it under the skin through a cut. Lady Montagu had her son inoculated while in Turkey, and her daughter in England when she returned in 1721. She then campaigned to popularize the method in Europe.

But Edward Jenner gets all the glory, even today, because he developed a vaccine to replace the inoculation. Inoculation is an old idea — you take some likely material from a living victim of the disease, and put it in a person who hasn’t had it (similar to the convalescent plasma being tried today). But there is always a danger of actually giving the healthy person the disease. A vaccine uses a more benign substance to achieve the same immunity.

I was taught in college that the discovery of the smallpox vaccine came out of the realization that milkmaids didn’t get smallpox. This was apparently because in leaning their cheek on the cow while milking, they acquired cowpox, a very mild disease. The cowpox antibodies protected them from smallpox.

There is a wonderful mythology around Edward Jenner and his 1796 vaccine. It’s based on the story of a milkmaid he met when he was a boy, bragging about her lovely skin that would never be scarred by the pox.  Rather like the story of George Washington and the cherry tree, it was created by a later biographer. The real story is more ordinary. Nevertheless, milkmaids didn’t get smallpox.

I learned today that an old vaccine for tuberculosis may have some value in helping with the current virus. The New York Times article says:

The B.C.G. vaccine has an unusual history. It was inspired in the 1800s by the observation that milkmaids did not develop tuberculosis.

The active ingredient of the Bacillus Calmette-Guerin vaccine is Mycobacterium bovis, which was isolated from a cow in 1908. It was made into a proven vaccine by 1911, and is today used in areas with high tuberculosis danger.

Unlike the Jenner/smallpox tale, the story of BCG inspiration and milkmaids is harder to track down. I can find nothing in a verifiable source, other than popular/journalistic websites copying each other’s phrasing, to confirm the background of the discovery.  Closest I could get was a 2008 Russian article saying that milkmaids and others close to cattle could carry a latent infection that gives a false positive for a tuberculin skin test. I couldn’t find anything even saying that milkmaids didn’t get tuberculosis. Is this a case of people just mistaking one apocryphal tale for another?

But we know that Mycobacterium bovis is to Mycobacterium tuberculosis as cowpox is to smallpox — a similar, less deadly disease that protects against a more virulent one. The Lancet warns that it might not be effective against the current virus, and there might not be enough available, but it has helped people with similar respiratory diseases recover faster.

I’d still like to think that milkmaids would be safer.

 

Thoughts on locked-down London

I came upon this wonderful film today.

The walker is taking a walk I’ve done many times, from Trafalgar Square bus stop, round Canada House, across the Square, up Charing Cross Road, across to Leicester Square, out past the Chinese gate, past the Swiss thing, through Piccadilly Circus and up Regent Street.

But when I make this walk, I am jostled by tourists and shoppers. I’m usually trying to get from one place to another. And although I sense the buildings, see their shapes out of the corner of my eye, I’m rarely able to take a good look. Stop on the pavement and you’re a target; stop in the road and you’re flattened.

The film was made the day before lock down, so that would be 22 March.

Some would, I’m sure, describe this filmed walk as eerie, or creepy (a word that goes back to Victorian times, it turns out). Some might say it’s something out of science fiction, or note how clean the air is without so many vehicles, or even (as the filmmaker does) call it “empty”.

To a historian, and quite possibly the social scientist, the only thing that’s missing is modern-day crowds. All the history is there, in the buildings themselves. You can actually see the base of the National Gallery without the tall Yoda actor in front of it, the whole front of the Cafe Royal, the way the shops on Regent Street hug the corners. Normally, the bottoms of the buildings, where they meet the pavement, can’t be seen at all. Outdoor shop displays, homeless people, piles of rubbish bags outside everywhere usually prevent that. Here the whole building design can be viewed.

The dearth of people also makes it possible to see the statues.  The lions at the base of Nelson’s Column are marvelously bereft of climbers. There’s the statue of Edith Clavell on Charing Cross Road, normally hard to get to between the close traffic on either side and the inevitable political campaigners in front of her.  Piccadilly Circus is usually blocked by people taking pictures of each other, and of themselves. And I saw something new: the Paddington Bear statue in Leicester Square (I’m there a lot, because that’s where the cut-price ticket booth is). I had to look that one up to find they recently installed movie-themed statues I can see next time. Maybe.

Even the rubbish bins look quite fashionable without the actual rubbish overflowing out of them.

You can also see the security measures: the steel bollards, the heavy planter boxes, the metal fencing around the square, the measures put in place to make it more difficult for someone to run a vehicle into a group of people. And like London itself, the video is unplanned, accompanied by the soundtrack of a Jesus preacher in Piccadilly Circus. It leant the whole thing a sort of Assassin’s Creed tone. I kept expecting Ezio to go walking in front of me, bumping into pedestrians and rattling armor.

Please understand, I am not in any way downplaying the horror of the pandemic, or the extraordinary cost in lost trade and jobs. But it’s so rare to rejoice in the cleanliness and design of the city. One usually doesn’t get that chance.

Essential women

The New York Times recently reported that American women are taking the place of men in the pandemic work force, as one in three of the jobs dominated by women have been deemed essential. Female employees dominate health care, social work, and retail, as well as the unpaid labor involving child and home care.

And it’s news!

Except it isn’t, of course. Immediately the Great Depression of the 1930s comes to mind. With many men unemployed, women took over to the point where some declared it an era of matriarchy (consider Ma Joad in The Grapes of Wrath). Despite unemployment statistics, women’s numbers in the workforce increased rather than decreased. In the movies, women’s roles became stronger and more nuanced (and it would be almost 90 years before they became strong again). Female students and faculty also opened new avenues in educational settings. And then, like now, their work was underpaid.

But it also happened before the 1930s. Clerical work had been a male purview prior to the American Civil War, then women took it over. From the mid-19th century onward, many entered the nursing profession, formerly dominated by men. Then consider two world wars, where women went to work in factories because so many men were at war.

It’s not that men aren’t available now — it’s that the industries which are male-dominated are the ones hardest hit by the pandemic: commerce and finance.

Consider that during the 1918 pandemic, the U.S. had similar economic problems (here’s a good source, but skip to page 20). The difficulties were short term, and began with an pay increase in many places. This benefit was also short term. Just like in the Black Death, when 1/3 of the population of Europe died, workers in demand can insist on more pay temporarily, until the traditional forces regain the strength to stop them.  Smithsonian Magazine claims that the pandemic increased women’s rights, their service convincing people to support suffrage.

Women fill the gap, then, (1) when there are not enough men around, or (2) when the jobs dominated by men are temporarily not needed, or (3) when they dominate the sectors needed most. We have the latter case now. And we know it won’t mean more respect, or more pay in the long run. But it certainly isn’t news.

Order now! (100 years ago or so)

As Amaz*n gets overloaded, and Instac*rt can’t find the diet soda, we journey back 100 years or so to see what we could have ordered then, delivered to our homes. It turns out, quite a lot. Montgomery Ward could deliver pretty much anything: pianos, washing machines, tools, ready-made clothing. The Sears Catalog boasted pages and pages of everything from canning jars to do-it-yourself houses.

During the pandemic of 1918-19, Sears also produced their seed catalog. It began with an disclaimer about how the events of the past few years have made people realize we need to grow more food, but they can’t be held responsible for the many factors (weather, soil) that could make your seeds not grow. They knew that many people were starting gardens for the first time, so they gave advice:

I was pleased to find that the Montgomery Ward catalog of 1920 had their priorities in order: chocolate at the top, washing soda at the bottom:

(I could use a Bluing Paddle, actually. I am one of the few remaining people who use bluing.)

I counted seven pages just of chairs (not counting loveseat-style). To give an idea of selection, here’s just a tiny clip of the index from that catalog:

Need to get me some of that canoe glue, and find my paddle. Oh wait — I can order one.

Fake Fitzgerald or Real Telegram from 1918

The last couple of weeks this has been going around. Like a lot of people, I was hoping it was real.

I thought it was real not because I know Fitzgerald, but because I know Hemingway. But it wasn’t real. It was from McSweeney’s.

According to Esquire, we all wanted this to be real because we’re all looking for reassurance that we can survive this crisis. I’m a historian, so in addition to being embarrassed because I was tricked, I wanted to then find real documents that could accomplish the same thing.

Here’s what I found:

Western Union Telegram signed [Hon.] Edward Rainey, [San Francisco Mayor’s Office], to Hon. Harvey Neilson, Santa Barbara, California Mayor’s Office.

1918 October 31.

“If you have not already taken such steps strongly urge universal wearing of masks to prevent or check influenza epidemic. Cases here rose steadily from two hundred per day October Six to over two thousand October Twenty-fifth. On Twentieth, some our people wore masks, on Twenty-first on recommendation Health Board, Mayor [James] Rolph issued proclamation calling for everybody wearing masks. Nearly whole population complied. Red Cross backed with advertising and two days later supervisors passed ordinance requiring wearing by all persons. Practically whole population in masks. By Twenty-third, five days after first masks appeared or three days after use became general new cases dropped approximately fifty percent. Deaths at peak 194, yesterday only 103, many of these having been sick for some days. New cases decreasing daily. Health authorities say San Francisco probably get through with far less distress and death than Eastern cities which started with about our figures but keep on going up while ours went down. All agree masks largely responsible. Sending this for your information because I have seen the whole terrible effect of epidemic here, because masks have saved untold suffering and many deaths, and because Santa Barbara my old home city. Portland, Seattle following San Francisco lead.”

Source: Online Archive of California, UCLA Special Collections
Collection of personal narratives, manuscripts and ephemera about the 1918-1919 influenza pandemic, 1917-1923
https://oac.cdlib.org/findaid/ark:/13030/kt2t1nf4s5/entire_text/

 

So. Wear your masks, Californians, and know that it will end.

Home health tips from Miss Nightingale

While she was not writing about people quarantined in their homes, Florence Nightingale’s Notes on Nursing (1859) were about caring for people in their homes, and doing it well.

Nightingale is known, of course, for her service during the Crimean War and her active reform of nursing and hospital hygiene in the mid-Victorian era. She’s the one who realized that many deaths in military hospitals were unnecessary, caused by unhygenic conditions rather than wounds or injury. And she came to this conclusion when aneasthetics were in early days, and antiseptics as yet unknown (Joseph Lister would start his famous work after the war).

Contrary to her “lady with the lamp” image, Nightingale was a no-nonsense, if not actually abrasive, person. She was once even cussed out by a doctor who might have been the first woman to get a medical degree in Britain, except that s/he identified as a man (more on this person in a future post).

I have had a copy of Nightingale’s Notes on Nursing for awhile. I don’t even recall why I bought it. I assumed it was a book for teaching nurses, since Nightingale founded her school of nursing at St. Thomas’s Hospital. But it’s a book about nursing, not just in hospitals, but in the home. And her emphasis, not surprisingly, in on creating healthy conditions.

It is also not surprising that this was considered a job for women, and in my opinion this book should reside on a shelf alongside Mrs. Beeton’s Book of Household Management, published in series at the same time, and printed as a book only two years later.  Most people know that Ms. Nightingale was a big advocate of fresh air. In fact, the odd configuration of the new St. Thomas’s Hospital, opened in 1867, was the result of her promotion of cross-ventilation.

Have you ever opened a window for fresh air, and it became so chilly you wished you could leave the heat on? Nightingale recommends this, or at least keeping the fire going with a window open, so that an ill person can have fresh air. She points out that you can keep the patient warm with blankets, and safely allow fresh cold air into the room.

Her book also notes that opening doors and windows is to no avail if the air that comes in isn’t fresh. If your room opens onto a utility closet, or you leave your chamber pot open under the bed (oh those master bathrooms!), or your window overlooks a refuse heap, you are not doing any good with air. Ill people really should be taken out into the garden to get a little sun and air, which I see done all too seldom. I’ve been in elder nursing homes where the windows don’t open and the only outside is a little paving of cement in a courtyard. Nightingale was not a fan of courtyards — the air isn’t fresh enough, going round and round.

              Too much bedding, too many visitors

All of her advice was based not only on her experience, but on research and statistics. Her faith in scientific endeavor was firm. In the early 1860s, when the plot was being hatched for passing the Contagious Diseases Act, she argued against it based on statistics. The idea was that preliminary arrest and examination of prostitutes would prevent venereal disease in the military. The act would give the police power to arrest any woman they suspected of being a prostitute. Many who were against the idea argued on the basis of feminine modesty, or the inappropriateness of making a private disease a public issue, or the likely abuses by the police. Nightingale argued on facts: everywhere that harsh measures arresting and examining prostitutes had been enforced by a state, the V.D. numbers had actually increased rather than decreased.

Her household nursing advice seems so common-sense, and yet is often ignored, then and now. She had to recommend that damp towels be spread out to dry, that one not chit-chat inanely with someone who wasn’t feeling well, and that one should always sit beside the sickbed rather than hovering over it, forcing the ill person to crane their neck. And here’s more:

  • Reading the patient the funny bits of a book you’re reading (update: bits and memes off the internet) is extremely annoying to the ill person.
  • Quiet is important, because when someone is ill certain sounds can be distressing or even intolerable.
  • A bedroom, where one sleeps, is not the same as a sickroom. A person in bed because they are ill needs not only air but light, and should be able to see out an open window.
  • The bed needs to be aired daily — in fact Nightingale suggests two different beds so the sheets of one can always be aired. Not doing this, or using too much bedding and thick mattresses, leaves the patient essentially in their own waste of sweat and their own breathed air. (The current metal hospital bed is likely based on the iron ones she recommended.)
  • Cleaning must be thorough. Damp cloths, not dusters that just raise the dust into the air. Carpets are horrible even if lifted and beaten 3 times a year (I can just imagine what she’d think of wall-to-wall carpeting). Bad smells indicate organic matter is stuck to things, and it shouldn’t be.

See why I want this filed next to Mrs. Beeton? It’s far less about medical nursing than about good housekeeping. The medical advice reminded me of Hippocrates, especially when it came to diet (“The diet which will keep the well man healthy may kill the sick one”). But at this time, when there is more than the usual concern about people being ill at home, it’s still good advice.

 

H.G. Wells and the biology lab at home

Even if H. G. Wells’s biology students weren’t ordered to stay home, most couldn’t access a biology lab. And yet they had to be prepared for the practical examinations in their field. Wells knew that many of them were working on their own, unable to afford a tutor. How could he best prepare his students?

At the time, Wells was employed by the University Correspondence College, so his students were at a distance, most of them in the UK. Since there were no good biology text-books available for at-home study, Wells wrote one (well, two — part one on vertebrates and part two on invertebrates and plants). Part One was published in 1893, and is his first published full book.

Wells, then 27 and not yet an acclaimed author of science fiction, was also teaching an on-site biology laboratory at Red Lion Square. The University Tutorial College (the UCC’s London branch) had set up excellent facilities. But not everyone could come to London. Some would save up for years just to come for the examinations.

Challenged by this problem, Wells dedicated the last part of his textbook to creating laboratory “practicals” at home. He called it “A Syllabus of Practical Work”.

In it, he explained how to set up ones kitchen table, find the appropriate specimens, and work them in conjunction with the instructional pages and diagrams. In the first edition he had done the diagrams himself, but the reviews had been less than enthusiastic. So in the second edition he asked his former student, now companion, Catherine Robbins, to do them:

 

Students must do the reading first, of course:

We would impress upon the student at the outset the importance of some preliminary reading before dissection is undertaken. No one would dream of attempting to explore a deserted city without some previous study of maps and guide-books, hut we find again and again students undertaking to explore the complicated anatomy of a vertebrated animal without the slightest, or only the slightest, preparatory reading. This is entirely a mistake.

He then provided a list of equipment needed:

For such dissection as the subject-matter of this book requires, the following appliances will be needed :
(a) Two or three scalpels of various sizes.
(b) Scissors, which must taper gradually, have straight

blades, and be pointed at the ends, and which must bite right up to the tips (or they are use- less). Two pairs, small and large, are advisable
(c) Forceps, which must hold firmly, and meet truly at the points.
(d) Two needles set in wooden handles.
(
e) An ordinary watchmaker’s eye-glass is very helpful, but not indispensable.
(f) A dissecting dish—an ordinary pie dish will do—
into which melted paraffin wax has been poured, to the depth of, say, three-quarters of an inch, and allowed to solidify. (This wax may be blackened by mixture with lampblack. If the wax floats up at any time, it can, of course, be remelted. Or it may be loaded with lead.)
(g) A rough table or board (for the rabbit and dog-fish).
(h) Blanket pins, and ordinary pins.
(i) A pickle or other wide-mouthed jar, and some
common methylated spirit.
(j) A microscope, with low power of 1 in. or 1/2 in., and
high power 1/6 in. or 1/4 in. Glass slips and cover glasses, and a bottle of very weak (1 per cent.) solution of salt.

And suggestions of where to obtain them:

Animals for dissection may be obtained from the recognised dealers, who usually advertise in such scientific periodicals as Nature, Natural Science, and Knowledge. Sinel (naturalist, Jersey) is the most satisfactory dealer in dog-fish in our experience; Bolton (Malvern) will supply Amphioxus through the post. Frogs and rabbits may be obtained anywhere. The tame variety of rabbit is quite satisfactory for the purpose of dissection.

And instructions on how to do away with Fluffy:

I know I certainly have chloroform around the house.

But the point is that yes, many things one wouldn’t ordinarily think of as being doable at home, can be achieved with a little money and some ordering by mail. Students at the University Correspondence College had a high success rate in the Matriculation, Intermediate, and Bachelors examinations in Biology.

 

Visiting 1862: The International Exhibition

I’ve been doing some research into London in the year 1862. For me, this is stepping back 25 years from my usual research area, so I find a lot of surprises, in addition to this novel technique for social distancing:


The first thing to do after putting on my crinoline was to find good maps of London, big maps where you can see street names and even buildings:

Guide to the what? The International Exhibition of 1862. Although the Great Exhibition of 1851, with its Crystal Palace, is more famous, this one was supposed to be even bigger. You can see the catalogue here. It took place in South Kensington, on Cromwell Road, where the Natural History Museum would be later.

The Victorianist blog has some good information, and points out that the death of Prince Albert in December 1861 put a damper on the whole proceedings from the start. And it says the building, above, cost £300,000 but the cost was covered by the profits from the Great Exhibition of 1851. My studies of Victorian science education claim that the entire system of British science education was basically financed by the same pool. Which makes me think that the money from the Great Exhibition of 1851 is like pieces of the cross. There is no possible way that they made enough profit in 1851 to fund everything that’s been claimed.

Another page with information is here.

And look, they even had cameras then:

 

 

A historian’s tools

I love computers, but sometimes it’s gotta be tape, scissors, and crayons.

St Thomas’s Hospital at the Zoo

The cholera ward, of course, was in the giraffe house…

In my recent researches of St. Thomas’s Hospital, Southwark, I have discovered an unusual episode, a time when the hospital went to the zoo.

St. Thomas’s Hospital was located on Borough Street in Southwark from the medieval period until 1862. (What remains of it, the Old Operating Theatre Museum and Herb Garret, is my all-time favourite museum in London.) At that time, the railway was forcing itself through the area as companies competed with each other. The proposed railway went right through the heart of the hospital grounds. So in 1862 the hospital was sold to the railway company, for £296,000, according to this.

Guy’s and St. Thomas’ Hospitals shown on “Improved map of London for 1833, from Actual Survey. Engraved by W. Schmollinger, 27 Goswell Terrace”

‘St Thomas’s Hospital 1860’, aerial view. Credit: Wellcome Library, London. Wellcome Images, Roberts, G.Q., A brief history of St Thomas’s Hospital (1920)

A new hospital site was arranged to be built where most of it still stands, in Lambeth, across from the Houses of Parliament. But this site wasn’t complete until 1871.

View of St Thomas’s Hospital with plan taken from Henry Currey’s, St. Thomas’s Hospital, London. [London] : [Royal Institute of British Architects], 1871 [St Thomas’s Historical Books Collection PAMPH. BOX RA988.L8 T1 CUR]

Most sources skip over this gap. Where did the hospital go in the meantime, for nine years?

It went to Surrey Gardens, in Newington, Walworth, in September 1862. Surrey Gardens had been a pleasure garden, like Vauxhall. It had a zoo. But as business declined, the animals were sold off to build a huge music hall. The hall was gutted by fire in 1861, which coincidentally led to a court case that determined you cannot hold someone to a contract when it’s impossible to fulfill it (in this case, a concert reserved for a burnt-out hall).

St. Thomas’s Hospital decided to lease the whole property, repaired the building, and repurposed some of the zoo.

I’ve been looking for histories and records of St. Thomas’ Hospital to learn more about the situation at Surrey Gardens. The St Thomas’s Hospital Report of 1867 is available, for some reason, at Google Books. Amputation fatalities, I discovered, were lower at the new location.

[Aside: there were also some figures in the Report tables that seem odd to me. How could the average stay in hospital for an ankle sprain be 11 days (p602)? This made me wonder whether one had to stay in hospital to be allowed off work, or whether people really had no one at home to take care of them (or no home — quite possible in a poor neighborhood), or whether ankle sprains were for some reason more serious then? Four men and four women had sprained their ankle that year, and the average stay was 11 days? Perhaps they had more wrong with them than a sprained ankle.]

The giraffe house really was the cholera ward, and the old elephant house was used for dissections. That piece of information comes from a book about Florence Nightingale, who was a big part of all this. She had opened her first nursing school at Old St. Thomas’ only two years before the move, and helped provide for room and board for nurses at the hospital. She also helped design the new Lambeth hospital for maximum light, ventilation, and separation of patients into pavilions. [And she promoted hand-washing as the best anti-infective, as true now as it was in 1860.]

The Illustrated London News of December 1862 (copy available at HathiTrust) features a quick column on how the facilities at Surrey Gardens boasted the “rapid and complete conversion of the old buildings to their new and beneficent uses”, and imagined the gardens would provide a unique opportunity for medical students to stroll and contemplate. Nightingale, who believed in patient access to the outdoors, would have approved this. She wrote a letter to Henry Bonham Carter (her cousin and the Secretary of the Nightingale Fund) on the advantages of temporary buildings for hospitals, but it isn’t available online.

The 9-year relocation gets only a single-sentence mention in Wikipedia. That’s a shame. It seems like such an interesting interlude.