history of medicine – Jennifer Sherman Roberts

Laughing at History

By Netherlandish (possibly Jacob Cornelisz. van Oostsanen) [Public domain], via Wikimedia Commons

Yesterday the website The Mary Sue published a post of mine, a short, lighthearted little thing about the malady known as green sickness.

After it was published, I committed the cardinal internet sin of reading the comments. Normally I don’t do that, but The Mary Sue’s readers are savvy and smart, and I was curious what they said.

Most comments were written in the same vein as the post—funny, a little snarky, lighthearted. But one comment made me pause. In a nutshell, it asked “Why is this something to laugh at? Surely this was a real problem for some people.”

It’s a compelling point and one worth bearing in mind, always. When we laugh at things from the past, are we demeaning the lived experience of real people?

I hope I would never do that. I did, however, want to poke fun at a system of beliefs about women that reduced them to uterine function. The theory behind green sickness was that a virgin was vulnerable to all sorts of maladies because the ultimate function of the uterus was to be occupied, either by a man’s seed or by a child, and until that happened, it was a site of blocked humors and disease that made a maiden sick, weak, and listless.

It’s the same system that attributed a host of physical and mental disorders to a woman’s “wandering womb.”

It’s crucial we remember the role that set of beliefs played in the history of medicine, how it served as a foundation for the ways we think about and discuss women’s health.

It informs the social structure that allows Todd Aiken to mystify reproductive biology and argue the rarity of child conceived in a “legitimate rape” because “the female body has ways to try to shut that whole thing down.”

That system still shapes the way we talk about menstruation and menopause, even about PMS.

Every day I read news stories that sound like they come right out of Margaret Atwood’s A Handmaid’s Tale. Women’s reproductive rights are being eroded day by day, from mandatory transvaginal ultrasounds to the limits on abortion even in the cases of rape or health of the mother.

And for a chilling analysis of how the past seems to repeat itself when it comes to the regulation of women’s wombs, read this piercing analysis by Margaret Lewis of the similarities between 17th-century infanticide trials and the 20-year sentence given to Purvi Patel. (Especially shocking is the use of the “lung test,” which has been recognized as scientifically flawed for the last 200 years.)

We need to remind ourselves of that system that used biology to define women, by their very nature, as weak, helpless, and incapable of decision or action without a man’s help.

I deeply appreciate that commentor’s reminder that there are real people behind these stories and diagnoses and treatments. It’s something I hope never to forget.

But I don’t think I can stop laughing at the ridiculousness of a system that reduces women to one particular organ. Because if I don’t laugh, I’ll cry.

Scratching “The Itch Infalable” at The Recipes Project

I wrote this blog post for The Recipes Project: Food, Magic, Art, Science, and Medicine about a 17th-century anti-itching recipe: Scratching “The Itch Infalable”: Johanna St. John’s Anti-Itch Cure

On the downside, you may get psychosomatic itching after reading it, much like in 5th grade when you watched all those educational movies about lice. On the plus side, there is a largely gratuitous picture of an adorable scratching cat.

Feeling crabby

Urania’s Mirror, Sidney Hall [Public domain], via Wikimedia Commons

Happy birth-month to me!

My birthday was last week, and, as per usual, I was out of sorts.

I’ve never really enjoyed my birthday, to be honest. It’s not that I mind getting older. Heck, I have Gratiano’s line from The Merchant of Venice–“with mirth and laughter let old wrinkles come”–etched onto a mirror in my bathroom. And it’s not because of past experiences. The last 40+ birthdays have been pleasant enough.

No, I think the reason I dislike my birthday so much is that it come in JULY, which is HOT, and MUGGY, and SLOOOOOOW. I vastly prefer the crisp busyness of October, or the sparkly excitement of December, or the stinging promise of April.

The other reason I dislike having a birthday in July is that it makes me a Cancer. As a child, I was always looking out for markers of my identity (most of us do that, right? I’m not alone, right? Gulp). The easiest and therefore most popular way to do that is to look up your zodiac sign, and I always hated the descriptions of “me” (the Cancer “me”). I still do. This description is an excellent example of NOT me. (I especially love this: ” Cancers often find that a robust workout session is just the tonic for their touchy feelings.” Snort.)

I’m a Cancer. And I thought that sucked.

I got that the crab symbol came from the constellation—unlike some of the other zodiac signs, it kind of fits (if you squint). But I still hated it. First: who wants their zodiac symbol to be a crab, a synonym for a grouchy malcontent? Second: the Crab was the mascot for our local minor-league baseball team, and I would see the cranky and dissatisfied look on his ugly little crustacean face everywhere. Third (luckily I only learned this as a teenager): “to have crabs” = (ahem) not exactly socially acceptable.

But the worst and most confusing part of “being a Cancer”: what did it have to do with the horrific disease people whispered about, the menace that terrified my parents enough that they almost stopped smoking, that prompted me and my friends to put on sunblock in the anemic Northern California sun?

For a while as a child, I even thought that being a Cancer meant I would, eventually, get cancer. In kid logic, that kind of makes sense, right?

A few weeks ago, I read an excellent article entitled “Wombs, Worms and Wolves: Constructing Cancer in Early Modern England” by Alanna Skuse that finally answered the question I’d forgotten I’d had: what is/was the connection between Cancer, the zodiac sign, and cancer, the terrible disease?

According to Skuse, a Wellcome Trust Scholar at the University of Essex, the tumors that came to be recognized as cancer were named after their appearance:

“Not only were they [tumors] peculiarly gruesome even by the standards of the age, but, crucially, they evoked the very name of the disease, a derivation of the Greek karkinos, or crab. Round and red, the tumour appeared like the body of that creature, whilst the blood vessels extending outward were ‘verie like unto the feete of crabbes, descending from the round compasse of their bodies’.”

The connection then—the resemblance of the constellation and the tumors of physiological mutation to a crabby little crustacean—is just coincidence.

I am very relieved.

Virgos: you are on your own.

The Coolest Thing You’ll See All Day: The Renaissance Anatomy “Pop-Up Book”

My eldest daughter—burgeoning animal-rights activist and wannabe vegan (alas, she likes bacon and cheese too much to commit)—is supposed to do her first dissection soon in biology class. She is not happy about it, and after some thought, I realized I wasn’t really either: with all of the virtual tools at our disposal, do we really need to kill animals and expose our kids to harsh chemicals for 7^th-grade biology?

So I’m doing some prep to make a case to the school district for using a virtual program like Frogouts or McGraw Hill’s dissection tool.

This may be a moot point (as the school district may already have something in place as a substitution), but it got me to thinking again about the bizarre history of dissection practices and early instances of virtual dissection. Unlike in current medical schools, where a cadaver is shared between three or four medical students, in the middle ages dissections occurred in a theater. The actual cutting was performed by a surgeon—a relatively low-level practitioner who couldn’t claim the vaulted status of physician. Guiding the surgeon was the professor of medicine, who sat on high and read from Galen, the undisputed ancient authority on medicine. Actual physicians seldom (if ever) cut into a real body (there’s some discussion of this here), like this:

medieval dissection — Illustration of a dissection from the Fasciculo di Medicina, ed by Johannes Ketham, 1493

In the Renaissance, a physician named Andreas Vesalius challenged Galen’s primacy and encouraged physicians and medical students to cut into the bodies themselves. Though the idea caught like wildfire, there was a hitch: it was not easy (and often not lawful) to obtain human bodies for dissection. At different times and in different places, those wanting to dissect a human body had to obtain them from professional grave-robbers who kept the anatomists in fresh bodies.

It is perhaps due to the desire to have first-hand experience, and the difficulty of getting fresh bodies, that there was a boon in the publication of what are called “fugitive sheets,” or what a professor of mine in grad school called “Renaissance pop-up books.” Basically, they are anatomy books with illustrations that can be lifted and folded back to provide a sort of early modern virtual dissection. Here’s a great example of a fugitive sheet from the Wellcome Collection:

Anatomical fugitive sheets of a skeleton, male figure and a female figure. Wittenberg, 1573

Anatomical fugitive sheet, male figure

Anatomical fugitive sheet, female figure

(Really, you have, have, have to click on these to see them—they’re cool.)

Anatomical flap books were not just a Renaissance phenomenon, however. Here’s an amazing website from Duke University Library’s exhibit, Animated Anatomies.

And here it is in video form:

And if that is not the coolest thing you’ve seen all day, then . . . well, you have an amazing life.

For Valentine’s Day: The 17th-Century Method for Knowing When Your Heart is Broken

I’ve been happily married for almost 18 years, but my kids listen to enough Taylor Swift (Lord help me) for me to know what a broken heart means in 21st-century America: It means “breaking down and coming undone,” feeling that “I’m only me when I’m with you” (don’t get me started on how messed up this is), and sopping up the “teardrops on my guitar” (Taylor Swift lyrics).

Maybe what Taylor needs is a good dose of 17th-century medical inquiry. How did you know when your heart was broken? When it stopped beating. Probably because of a plague.

For a more nuanced understanding of the workings of the heart, we owe a debt of gratitude to physician and natural philosopher William Harvey, who is credited with “discovering” the circulation of the blood. Harvey was the first to systematically describe the action of the heart and the circuitous motion of the blood in the body.

Before Harvey, most physicians followed 2nd-century Roman physician Galen, who theorized that the heart’s role was to produce the body’s heat: venous blood came from digested food that was “cooked” in the liver and imbued with vital spirit. Other parts of the body sucked up this blood for nourishment. Some of the blood that went to the heart passed through the ventricular septum, where it was further refined and mixed with “inspired air” from the lungs. This new concoction was the arterial blood, also used for nourishment.

One critical problem for 17th-century doctors, however, was that medical schools favored a model of dissection in which the professor merely read anatomical texts; a hired anatomist (sometimes, if not often, himself illiterate) did the actual dissection. So the anatomy professor did not always realize that what was in the text was not what could be found in the body itself.

Harvey, who insisted on performing dissections himself, observed that the heart simply does not behave the way the textbook said it would. Nor, to his aggravation, could he find any proof that ventricular blood could pass through the septum.

Another vexing problem for Harvey was how the blood could circulate around the body without reversing direction, pooling in the hands and feet. This was cleverly solved, however, by considering a discovery made by his professor at Padua, Hieronymus Fabricius, that veins had valves that could stop the flow of blood. Harvey relied on a beautifully simple experiment to show the function of the veins: you can see it in the video below from 23:16-24:55Do be careful, however, as the rest of the video has much blood and organ stuff.

William Harvey and the Circulation of the Blood. Douglas Fisher Productions. 1978

Here, also, is a picture of the experiment.

Image of veins from Harvey’s Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus, Wikimedia Commons

So, play along at home, my friends! Try these experiments: if your blood does not flow in the correct direction, likely your heart is broken. But if the experiment is successful, your heart is in fine working condition and primed to have a very happy Valentine’s Day.

Edited to add: I told my daughter about this post, and she sent me this meme to share with you all. We are clearly a family of literalists.

Vile-Hearted Renaissance Peckerhead of the Month–September

"Forceps.Smellie" by http://en.wikipedia.org/wiki/User:Ekem - http://en.wikipedia.org/wiki/Image:Forceps.Smellie.jpg. Licensed under Public domain via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:Forceps.Smellie.jpg#mediaviewer/File:Forceps.Smellie.jpg — “Forceps.Smellie” by http://en.wikipedia.org/wiki/User:Ekem – Licensed under Public domain via Wikimedia Commons –

While doing research, I often come across fascinating tidbits or though-provoking morsels I want to share. For example, did you know midwives would sometimes place chunks of nutmeg or cloves on a laboring woman’s thigh, reasoning that the baby would be attracted to the delicious scent and want to make its way into the world?

See, that’s pretty cool. Not very useful, but pretty cool.

Sometimes, though, I come across a story that infuriates me so much I want to scream out loud (generally not recommended in a library, by the way). It’s for such occasions that I’m setting up the Vile-Hearted Renaissance Peckerhead of the Month Award.

The first of the candidates is one of two chaps named Peter Chamberlen, whom I stumbled upon while researching the childbirth preferences of Queen Henrietta Maria (1609-1669). Peter and his brother Peter (and yes, I’m channeling Newhart here http://www.youtube.com/watch?v=TN6UAzYY8qg) were sons of a French Huguenot emigre who moved to England in 1576 to escape religious persecution. The two Peters became midwives (yeah, I didn’t know there were male midwives in the Renaissance, either), and one of them (probably Peter the Elder, though nobody really knows) invented the obstetrical forceps.

Great, wonderful, lovely. The forward advance of medical knowledge, countless lives saved, etc. etc.

Except not. The bastard Peters kept their forceps invention secret for 150 years. They carried the forceps into the birthing room in a lined box, and they only brought them out after everyone had left the room and the laboring mother was blindfolded.

Can you imagine?

I was lucky, living in the 21^st century, that there was no need for forceps in delivering my two beautiful children; both were born by c-section. But I’m pretty sure that had I lived in the 17^th century, my first delivery would have needed those forceps (the second wouldn’t have, because I would have died in the first).

I remember lying there helplessly, ashamed of feeling as though an alien being were ripping me apart (I absolutely could not think of her as a baby by that point), praying for anything to stop the pain, the fear. I think of all those women of the Renaissance in that same position, women and children who could have survived with the skillful use of forceps to help along a delivery.

And those guys kept them secret, hidden in a box, as did Peter the Younger’s son, Dr. Peter (yes, again) Chamberlen, and Dr. Peter Chamberlen’s sons, Hugh, Paul, and John Chamberlen, who all joined in the family trade. Hugh Chamberlen tried to sell the secret to the French govenment, but was sent away penniless when he failed to successfully deliver the baby of a woman with a severely deformed pelvis.

Finally, when Hugh Chamberlen’s son—named Hugh (yes, again) Chamberlen—having no male heirs to train up in the family trade, leaked the secret in the beginning of the 18^th century.

So, for extreme selfishness costing the lives of countless women and children, the first Out of Time Blog’s Vile-Hearted Renaissance Peckerhead of the Month award goes to Peter Chamberlen. Congratulations, asshole.

For more info on the Peters and Hughs Chamberlen:

http://wellcometrust.wordpress.com/2010/04/12/history-of-medicine-of-forceps-and-family-secrets/

http://fn.bmj.com/content/81/3/F232.full