Why Anna and Sophie have chapped hands

In the 19th century the most important advance in medical science was called (at the time) Listerism.  Simply put, Joseph Lister, working with  Louis Pasteur’s advances in microbiology and the discovery that bacteria cause putrefaction and infection, came to a conclusion:  In a medical setting the first line of defense is to keep the patient isolated from all such bacterial agents. There were two ways to achieve this: Antisepsis (using chemicals, usually carbolic) or asepsis (using heat) to sterilize.  In 1881 John Tyndall wrote

Living germs  … are the causes of putrefaction. Lister extended the generalization of Schwann from dead matter to living matter, and by this apparently simple step revolutionized the art of surgery. He changed it, in fact, from an art into a science.

In 1876 Lister came to the U.S. to lecture about his findings.

In 1878 Dr. Lewis Stimson performed the first demonstration of an antiseptic surgery in the United States, using  Lister’s antiseptic technique while amputating a leg.

In 1881 President Garfield died not from the bullet fired by an assassin  but because the physicians treating him rejected Listerism and caused massive, systemic infection by probing his wounds with unsterilized instruments and dirty hands.

As the summer waned, Garfield was suffering from a scorching fever, relentless chills, and increasing confusion. The doctors tortured the president with more digital probing and many surgical attempts to widen the three-inch deep wound into a 20-inch-long incision, beginning at his ribs and extending to his groin. It soon became a super-infected, pus-ridden, gash of human flesh.

This assault and its aftercare probably led to an overwhelming infection known as sepsis, from the Greek verb, “to rot.” It is a total body inflammatory response to an overwhelming infection that almost always ends badly — the organs of the body simply quit working. The doctors’ dirty hands and fingers are often blamed as the vehicle that imported the infection into the body. But given that Garfield was a surgical and gunshot-wound patient in the germ-ridden, dirty Gilded Age, a period when many doctors still laughed at germ theory, there might have been many other sources of infection as well (Markel).

At least some people were paying attention, because in 1883 Dr. Stimson was asked to operate on former President Grant’s leg.

This photo was taken in the surgical amphitheater  at Bellevue in the early 1880s.  By modern standards it’s shocking (note especially the bloody floor), but it should have also been shocking to physicians in 1880.  I’m sure medical historians have written about the factors that led American physicians to reject the findings of Pasteur and Lister, but my guess is that it was simple hubris.

Because there were physicians and surgeons who accepted scientific findings and practiced antisepsis and asepsis, I felt justified in having Anna and Sophie act like sensible human beings and wash their hands. And instruments. And everything else. In carbolic.


Cheyne, W. W.  Antiseptic surgery: its principles, practice, history and results, London 1882.

Kessin, Richard H.  and Kenneth A. Forde. “How Antiseptic Surgery Arrived in America.” P&S 2007.  link.

Markel, Howard. The dirty, painful death of President James A. Garfield. PBS,  September 16, 2016. link 

Pennington, T. H. “Listerism, its Decline and its Persistence: The introduction of aseptic surgical techniques in three British teaching hospitals, 1890–99.” Medical history 39.01 (1995): 35-60.

Tyndall, J. Essays on the floating-matter of the  air. London, 1881.

 

newspapers.com: the agony and the ecstacy

Despite the very high price, I subscribe to Ancestry.com for two reasons: First,  it’s an outstanding resource for a historical novelist, because it gives me access to images of documentation (for example, birth and death certificates; citizenship applications) and to census pages which in turn tell me a lot about the way people lived. If I need to name a character and I’m stuck, Ancestry.com will rescue me. If need a sense of how much a bricklayer earned in 1880, a little digging there will provide that information. 

Before you ask: yes. I do need this kind of information. Historical novelists are the personification of OCD.

Second, a full Ancestry.com subscription gives me access to Newspapers.com.

Not so long ago I had to have access to a university library’s off-site research databases before I could look things up in historical newspapers. Now there are many free online sources, including the Library of Congress. Newspapers.com is not free (and not cheap) but the database is huge, and includes papers from small towns as well as big urban centers, going back in some cases to Revolutionary era publications.  If you are writing about the Civil War, there’s nothing you can’t find through Newspapers.com.  

For my own purposes, I have looked for (and found) reliable information on a wide range of topics including:

  • The materials used in different kinds of clothing, and the price ranges;
  • What vegetables could be put on the table fresh from the market on a given day;
  • What an 1884 obituary  looked like, and who they were about (hint: not poor people);
  • Society wedding details;
  • What was being sold in which stores, for how much;
  • Public opinion on matters as diverse as elevated trains and vaccinations;
  • What a dressmaker did, and what s/he earned;
  • Crimes, small and large, in detail, including robberies, kidnappings, assaults, gang fights, forgery, impersonation, and fraud
  • Arrests for gambling and prostitutions.

Here’s an interesting example of an unusual story that I clipped. I may never use it, but it caught my eye.  From the New-York Tribune, Friday, 30 November 1883. Page 2:

 

As useful and wonderful as Newspapers.com is, it is not flawless. Its usefulness depends on the quality of its search engine, which is iffy and can be terribly frustrating at times. So for example, I used it today because I wanted to get a sense of when the term ‘intern’ began to be used for medical students. I searched ‘intern’ in newspapers published in New York (state) from 1875-1885, and I got 3,613 results. While I didn’t go through every return, I’m fairly sure that ‘intern’ was not used to refer to medical students in a clinical training setting. In fact, only one of the returns had anything to do with medicine. In an 1880 NYT article intern was defined as a “representative of the [medical] staff” in describing a hospital internal dispute.

The problem is that optical character recognition still has some way to go, and the proof is right here. In searching for ‘intern’ Newspapers.com gave me newspaper articles with the following words highlighted:

  • systems
  • Winters
  • interest
  • lantern
  • of
  • tavern
  • interview
  • letters
  • intend
  • William
  • interpose
  • intense
  • interment
  • patent
  • association
  • Eastern
  • internal
  • international

‘Internal’ and ‘international’ make sense, but William, tavern, patent, Eastern?  So I wasted an hour looking through multiple pages with false returns like these. This has happened in the past, and I wrote to customer support at the time outlining what was going on. I never heard back from them. 

Is Newspapers.com worth the expense, given this unfortunate glitch? For me it is, but then not many people worry about the price of a lamb chop in 1884. Or how infants were offered for adoption:

What ails you?

I had an email from Cristy:

Hello,
I am most of the way through The Gilded Hour and loving it! Yet I am torturing myself trying to figure out what “common ailment” the slack faced young girl from chapter 43 suffers from?! Please enlighten me!

It’s a very short passage Cristy is asking about. Anna and Elise are discussing a patient who is very young and whey-faced, or pale. She is pale because she’s lost a lot of blood, which follows from abortion. A woman who takes too much of certain herbal combinations that stimulate menstruation can end up hemorrhaging.

If there is no infection present and the abortion wasn’t incomplete, there is a good chance the young woman can be saved. 

Cristy, thanks for taking the time to write and ask about what interests you.

The Gilded Hour sequel: NOT YET.

Not done, but making progress. I can offer you the image I’m using for a writing prompt. The cover design will be out of my hands — as ever — so this is just temporary. It’s from a painting by Whistler, and was painted at the right time. 

The title is a fragment from a poem by Rumi: “The wound is the place where the light enters.”

sequel-where-the-light