"Above all, do no harm" -Hippocrates
In school we learned the familiar history of medicine-sound science, learned doctors and lifesaving advances. But that's not how it happened...
From the ancient Greeks to the time of Lincoln, medicine actually did more harm than good. Greek physicians of twenty five hundred years ago were at least as competent, and surely less destructive, than the doctor/astrologers of the Middle Ages, or the pompous windbags of the Renaissance, or, worst of all, the medical wrecking balls of medicine's "Heroic Age", not so long ago. Only in the 20th century did medicine finally regain its stride, too late for most.
My new book, Strange Medicine: A Shocking History of Real Medical Practices Through the Ages, focuses exclusively on real physicians practicing real medicine, and an honor roll of doctors, scientists and dreamers whose twisted thinking and gut-wrenching procedures sent medicine down its winding road to nowhere.
Below is a brief sampling of the medical history your teachers never taught you:
Treasurer of the Mint, signer of the Declaration of Independence, author of medical textbooks, Benjamin Rush was America’s best known and most trusted doctor. In his thriving private practice Dr. Rush doused patients with cold water in the winter, gave them “artificial diarrhea” and bled them-in Mr. D.T.’s case, four gallons. Rush’s biggest contribution was in the area of psychiatry. Believing mental illness to be caused by bad circulation to the brain, he “twirled” patients from ropes suspended from the ceiling, for hours on end. He also invented the “tranquilizer chair," employed all over the world. This innovation restrained a patient’s hands and feet, covered his head with a wooden box and had a hole cut in the bottom, for bodily functions. Believing that pain and suffering were curative, Dr. Rush beat, starved and verbally abused his patients, and poured acid on their backs. He cut them with knives and kept the wounds open for months or years, to facilitate “permanent discharge from the brain." Known as a strong advocate for the humane treatment of the mentally ill, his likeness still adorns the seal of the American Psychiatric Association.
Our modern barber pole represents the fine art of bloodletting, to flush out those bad humors (black bile, yellow bile, blood and phlegm) Red stands for blood, white for bandages, and the cap on top the blood collection bowl. In the Middle Ages, barber-surgeons performed the task, along with haircutting and general dentistry. But bloodletting reached its peak during the 1800s, when the French alone went through 40 million leeches a year. We picture leeches clinging to the arms, legs and torso, but doctors often applied them to other, more sensitive areas. Leeches were tied off with silk thread, lowered down a person’s throat and then reeled in like a fish. Doctors also applied leeches to the vagina, to relieve uterine disease, sexual excitement and “exasperation” in general. British gentry had their wives leeched every two weeks. According to <em>A Handbook of Uterine Therapeutics and Diseases of Women</em> (1868), a “jet of blood” would spurt when a leech grabbed onto the wrong vein, and even the smoothest insertion risked a miscarriage. The textbook also spoke of leeches getting “lost” inside a woman, causing high-strung females to become “hysterical." But eventually, doctors were certain, “the leech is sure to find its way out."
The Hippocratic Oath bans doctors from poisoning their patients. Strange. But consider the Romans… Romans hated their doctors. Rome’s first official physician, Arcagthus, was given the nickname Carniflex, meaning executioner. Roman physicians were, however, expert poisoners, and Roman doctors were routinely hired by persons of high standing to kill other persons of high standing. Emperor Claudius was killed by his own poisoner, while Juvenal, an acute observer of the upper crust, wrote that a good poisoner was indispensible to anyone hoping to get anywhere in high society. He cited the faux pas of the women who, upon poisoning her husband, discovered that he had taken the antidote beforehand, and, embarrassingly, had to stab him instead. Business was so good that <em>praegustatores</em> (tasters) formed their own union, and Nero was so happy with his poisoner, Locusta, that he had her charter her own poisoning school.
England’s greatest surgeon never gave up his career as a grave robber, and in 1791 tried to steal the nasal polyps of celebrated composer Joseph Haydn: “…Mr. Hunter asked me to visit him due to some urgent circumstances. After the opening compliments some robust fellows entered the room, seized me and tried to force me on a chair. I yelled, punched and trampled with my feet until I managed to free myself. Mr. Hunter was already in stand‑by, with his surgical tools." Hunter had more success with 7’ 8’’ giant Charles O’Brien, who was ailing. Hunter demanded O’Brien’s bones when he died, so they could be put on display in his museum. O’Brien indignantly refused, and made elaborate plans to be buried at sea, in a lead casket. Hunter had O’Brien tailed by detectives. When he finally dropped dead, Hunter’s henchmen bribed the undertaker, grabbed the body and threw it into a big pot. Today, O’Brien’s bones are proudly displayed at the Hunterian Museum, part of London’s Royal College of Surgeons.
During the Renaissance, German officials recommended that pharmacists stock no less than 23 varieties of dead body parts, and a row of human skulls might stare at you from behind the counter. A model inventory from 1652 includes dried flesh, mumie (“the menstruation of the dead”), “human grains," menschenfleisch (marinated human flesh), human fat, usnea (moss growing on a human skull), and spirit of bone. Noted chemist Johann Schroeder had his own recipe: "Take the fresh, unspotted cadaver of a redheaded man...aged about 24 who has been executed and died a violent death...cut the flesh into pieces and sprinkle it with myrrh and just a little aloe. Then soak it in spirits...let the pieces dry in a shady spot." Naturally, human blood was at a premium, the fresher the better. At beheadings, doctors would push their epileptic patients to the head of the line, to catch a drop or two from still-quivering bodies. Fat, too. Combing battlefields littered with bodies during 1603s siege of Ostand, “the surgeons of the town went thither…and brought away sacks of man’s grease."
Only one copy exists of <em>Bald’s Leechbook</em>, written in the ninth century. “For one be moon-mad” it suggests, “take a dolphin’s hide, make it into a scourge, beat the person, he will soon be better.” Most notably, the <em>Leechbook</em> speaks of “elfsickess," an affliction caused by tiny, invisible elves shooting tiny, invisible arrows: "For elfsickness...go on Wednesday evening when the sun is setting where you know dwarf elder to be growing...no matter what frightful thing or man should come towards you say no word to him...dig out the plant, let the knife remain…wash it and make it into a drink...let him drink the drink afterwards, it will soon be better for him."
“He sprung across the blood-stained boards…like a duelist, calling “Time me gentlemen, time me!” to students craning with stopwatches…Everyone swore that the first flash of his knife was followed so swiftly by the rasp of the saw on bone that sight and sound seemed simultaneous… He would clasp the bloody knife between his teeth…” Speed was critical in an era before anesthesia, to minimize the risk of shock and infection. Top surgeons like Robert Liston could amputate a limb in under a minute. In 1847, Liston removed a 45 pound scrotal tumor in four minutes. It was carried to the operating table in a wheelbarrow. Sometimes Liston moved a little too fast. Liston once operated on a gangrenous leg. According to his biographer, the patient died of infection, not so unusual for the day. But during the procedure Liston also cut off the fingers of his assistant and slashed through the clothing of a spectator, who proceeded to drop dead from fright. Told that a pulsating artery in a boy’s neck could be an aneurysm, the impulsive Liston grabbed a knife from his pocket and hacked away. The boy fell dead on the spot. The severed artery, however, lives on, as an exhibit at the University College Hospital in London.
“Counter-irritation” made no sense in theory or practice, but did allow befuddled doctors of medicine’s Heroic Age to feel useful, and that counts for something. Using a “seton," a type of scalpel, a doctor would slice open an “issue." Into the large gash he’d insert foreign objects, usually dried peas or beans, to promote proper infection. He’d then re-open the wound-often every day-to make sure it didn’t heal. Some doctors used a hot iron instead, or “caustic,” a blistering agent made of strong acid. Patients sometimes registered “fear and trepidation," and prestigious medical journal <em>The Lancet </em>discouraged blisters of more than a foot square. Dr. Toogood, Senior Surgeon at Britain’s Bridgewater Hospital, wrote of treating a 20 year old woman with a hernia: "I made an issue… large enough to contain, in each, forty small horsebeans, which was...kept open for upwards of two years...she was not entirely confined to the house...by day, she rested on a small-four-wheeled carriage...she could work, draw and amuse herself."
King Charles II woke up feeling sick, so the royal barber took a pint of blood, and elite doctors another eight ounces. Charles was then made to swallow antimony, a toxic metal, and given a series of enemas. Charles’s head was shaved and blistering agents were applied to his scalp, to drive the bad humors downward. Pigeon droppings were applied to the soles of Charles’ feet, and more blood was drawn. Charles was given white sugar candy, to buoy his spirits, and prodded with a red hot poker. He was then given 40 drops of ooze from “the skull of a man that was never buried," who, it was promised, had died a most violent death. Finally, crushed stones from the insides of a goat from East India were forced down his throat. Charles II died on February 6, 1685.
Left untreated, a lovesick patient would develop pustules, shrink, then howl like a wolf and die. Greek anatomist Galen wrote, “The opening of the hemorrhoids is the surest remedy.” In 1610, Jaques Ferrand wrote his seminal <em>Treatise On Lovesickness.</em> Ferrand had no qualms about the traditional metal ring around the foreskin, but did question the effectiveness of lining the lovelorn with lead shields. And “Bernard of Gordon goes too far," he wrote, “when he says the lover should be spanked and whipped until he begins to smell bad all over.” In his <em>Surgical Cures for Erotic Melancholy</em>, written for female patients, Ferrand suggested shaving the clitoris, burning the thighs with acid and, for cases that threatened to turn into lycanthropy (werewolfism), bleeding until heart failure ensued, then searing the front of the head with a hot iron.
In the 1950s, Dr. Walter Freeman, a Yale man, became the world’s best known brain surgeon. Freeman wasn’t trained in surgery and held in disdain things like wearing gloves and creating a sterile field-“all that germ crap," he called it. But using an ice pick from the kitchen drawer he practiced at home on a grapefruit and soon unveiled his newest and greatest procedure, the trans-orbital lobotomy. It went right through the eyes, and required a carpenter’s mallet when he struck bone. Attending doctors sometimes fainted. Once, Freeman learned that a patient had barricaded himself in his bedroom. He went to the patient’s house, talked him out and then, using muscle from a policeman, did the surgery right there on the floor. At Cherokee State hospital, three of Freeman’s patients died, one because the ice pick slipped out of his hands while he was taking a picture. While on vacation Freeman would pack his wife, kids and surgical tools into the family station-wagon and do lobotomies at nearby hospitals. From his beloved national parks, he’d send his patients postcards.
The Greeks thought the wombs of lonely women, frustrated and starved for attention, broke free of the belly and migrated upwards, towards the head. Plato called the wandering womb “a living animal," Aretaeus of Cappadocia “an animal within an animal." According to Aretaeus: "[I]t moves hither and thither in the flanks…to the right or to the left, either to the liver or the spleen…in a word, it is altogether erratic." A wandering womb might cause <em>hysterike pnix</em> (hysteria), which could suffocate a woman. Steamy sex was prescribed, and a smirking Martial, the Roman poet and satirist, wrote a poem about it: "Leda told her old husband that she was hysterical and complained that being fucked is a necessity for her…what he no longer does, should be done. Right away the male doctors come forward and the female doctors step back, and her feet are lifted. What severe medicine!"