Medicine in the Victorian Era

Introduction

Humans throughout history have developed and implemented medical beliefs to explain and attempt to mitigate birth, death, injury and disease.

While valid medical knowledge obviously exists throughout history, before the Victorian era it was largely bound up in magical and religious contexts.

The Victorian era is often presented today as sort of a quaint, nostalgic era.

Alternatively, Victorian streets serve as the setting for some of our more classic horror fiction because of the effects of a centralizing, industrialized society.

While both these views may be true from our modern perspective, both also miss the point.

The Victorian era, defined as the length of Queen Victoria's reign from 1837 to 1901, was a period of history offering unprecedented scientific discoveries and global exploration.

People living in Western societies at that time had every reason to believe that the ancestral enemies of disease, malnutrition and madness would soon be conquered forever.

Victorian literature reflects an almost divine sense of hope for the advances science would bring, and, in fact, science as we know it today was definitively formed in this time.

We have a difficult time imagining the Victorian era today. In our modern times, most citizens of Western societies take things like food inspection, adequate sewer systems, centers for disease control, refrigeration, aseptic techniques, anesthetics, and antibiotics for granted.

We've gotten to the point where most of us never even see the multitudes of workers checking our groceries for safety or pasteurizing our milk.

Try, then, to imagine a world in which sewage systems were a brilliant innovation after centuries of open street canals, in which contagion finally started to be understood after centuries of ignorance, and mechanical innovation became precise enough to reliably see things smaller than the human eye can even detect unaided.

The Victorian era contributed previously unimaginable inventions and changes to our very way of life.

Pre-Victorian Culture and Context

Before the 19th century, the world had struggled through several periods of alternating education and ignorance.

In medicine, herbalism was the most consistently effective tool at the physician's disposal, and herbalism itself was (and still is) often plagued by superstition and magical thinking.

For instance, today we know that overdose on angelica (Angelica archangelica) can cause some very problematic side effects and shouldn't be done except under the supervision of a knowledgeable herbalist. However, because of the name and beneficial effects that angelica can have when properly administered, it was often seen as a cure all and thrown at everything the herbalist didn't know. Of course, this type of treatment often caused more harm than good.

In another example of medical magical thinking, multitudes of Europeans did not eat tomatoes or potatoes for years after their discovery in the New World because tomatoes and potatoes both are part of the same family as nightshade. Nightshade is a deadly plant even in minute quantities, and relatives were believed to be equally as deadly on general principle.

A lot of ancient medical knowledge was contained in religious texts.

For instance, the Old Testament of the Bible contains multiple passages for communal living that make a lot of sense to any modern microbiologist.

If you're living in a desert without modern antiseptics or antibiotics, certain precautions like isolating infected people, washing after handling a corpse, isolation of menstrual blood, and avoiding pork and blood that spoil easily make a whole lot of sense.

These guidelines are still followed today by many Jews for devotion's sake, and I mean no disrespect to them for it. However, these commandments also did a lot to avoid contagion vectors in ancient Jewish tribes, thus avoiding the wrath of God as expressed by disease.

Prior to the Victorian era, disease was seen by many peoples and cultures as a social/religious problem.

You didn't get sick because you caught a virus, you got sick because you offended a spirit or deity with your actions.

This paradigm is still a problem for many medical aid programs in sub-Saharan Africa today, where native people want to know what spirit or deity they offended to get the HIV virus and what spells can they do to appease the spirit and get rid of said sickness.

Translating the Western medical knowledge about the HIV virus to the native people in such a way as those affected truly understand, and more importantly, believe the medical aid volunteers, serves to highlight the vast differences between the pre- and post-Victorian attitudes. Rescue societies are finally starting to avail themselves of another Victorian invention, anthropology, to try and bridge the huge culture gap.

This social/religious context for disease also makes historical calls to God for enemy smiting make a lot more contextual sense.

Plague could strike anywhere, and for any reason, rendering resistance to an invading army rather impossible. Besieged populations stuck with insufficient room to properly dispose of human waste and forced to live in close conditions were especially susceptible to plague epidemics, thus giving a besieging army easy pickings.

The circumstances surrounding the Black Plague are perhaps the best illustration for historical views on disease.

We know today that bubonic plague is carried by fleas that usually ride on rats. However, medieval people were aware of no such thing.

By and large, they believed that bubonic plague was some sort of curse or judgment by God. Cats, the main urban predators of rats, were also associated with witches and black magic. Therefore, the populace of many countries killed cats wholesale, thus allowing the rat population to run rampant and sealing their own fate.

Was history prior to Queen Victoria completely without reasonable, sane medical knowledge?

Well, of course not. Hippocrates, Galen and the Islamic physician Avicenna are considered among the fathers of modern medicine.

We know that the Romans were so medically advanced that they developed the first cataract surgery.

Hippocrates and Galen both wrote extensively on diagnosis and treatment in the Greek and Roman eras.

Avicenna expanded upon their work during the heyday of Islamic civilization.

In addition, India and China had their own, millenia tested medical systems.

However, during the Dark Ages many people couldn't read, books were hard to come by anyway, and anything out of Islam was automatically suspect. India and China weren't even on the Western map at the time except through Islamic merchant intermediaries.

During the Dark and Middle Ages, most doctors were monks, and most hospitals were attached to monasteries.

Monasteries held the vast majority of surviving books, and monks often had the time to look up from subsistence to learn enough about medicine to be effective.

However, even into the Renaissance when private citizens started again learning medicine, few drugs existed beyond opium and quinine.

Superstition infused herbalism, folk cures, and metal-based compounds, all of which could be and often were poisonous, supplied the vast majority of "medications" people took.

Victorian Culture and Context

Then, the Victorian era showed up with a bang and a roar. The beginning of the 19th century didn't look all that different from the entirety of the 18th, but by the end the world resembled the one we know today.

This transformation is often underappreciated in its scope. Considering the length of time that change had usually taken the vast majority of Western society, this is somewhat akin to waking up to find yourself in the world of science fiction tomorrow. No wonder science fiction became so popular, it seemed to be right within reach.

For the first time, religion started to lose its grip on broad groups of people.

Objective observation came into vogue among the higher levels of society, and scientists had time for those time-consuming experiments. Scientists also had improved laboratory techniques and precision laboratory tools as a gift of industrialization.

In fact, industrialization was giving everybody more time to do things like read and discuss philosophy, fiction, art and, of course, science. We first saw the deleterious side effects of industrialization in the Victorian era as well, with the fogs of London and the miserable masses of child labor required to run the factories of the time.

The Victorian era was also the first time that many people could go and interact with wildly different cultures and environments.

Prior to the world-spanning British Empire of Victoria's reign, travel had meant going maybe a hundred miles from the place of your birth. Everything else was either exploration or full-scale moving, usually for colonization or immigration. People didn't go on pleasure jaunts to other countries until newly invented railways made it easier.

This sudden and relatively wide-scale collision with other cultures, worldviews and environments made objective observation both easier and more popular.

Inventions started being widely implemented seemingly at the speed of light. In fact, light was one of the main inventions of the time, starting with the gas light and heat system of London started in 1880's. For the first time in history, streets were relatively well lit at night, allowing a lot more of a nightlife than in centuries past. The first incandescent electric lights were introduced in London in 1882, although they wouldn't become common for many decades to come.

At the same time, the first city-wide sewage system was implemented in London in 1858 connecting 82 miles of main sewers with 1,000 miles of street sewers. Prior to the building of this massive system, sewage systems had basically constituted an open canal down the street.

A world that had previously been dirty and dark suddenly became relatively clean and well lit.

However, keep in mind that this was London. Life wasn't all gaslit wonder and clean streets everywhere by any stretch of the imagination. London was the center, home and heart of the Victorian era, and millions around the world continued to suffer terribly from all the same old things, along with the new invention of colonialism that discounted their basic humanity and sought to undermine their cultures for material gain. Even in London, thousands upon thousands died in terrible conditions brought about by factories and lack of knowledge or wisdom regarding public health.

In short, the Victorian era was a time of incredibly rapid change, advancement and experimentation. It improved the lives of countless people with its inventions and its new philosophies, but it had a dark side of oppressed people, cultural indifference to outsiders and ethically questionable actions based on nationalistic interests instead of anything resembling humanitarian or compassionate beliefs. Sound familiar?

Victorian Advances in Medicine

Human medicine transformed practically overnight in the 19th century by advances in chemistry, laboratory technique and precise medical equipment, particularly made possible by advances in precision metal and glass working. The list of Victorian medical inventions is quite extensive, including:

Anesthetics in 1846

The opthalmoscope in 1851

The hypodermic syringe in 1853

Antiseptics in 1865, along with proof of germ theory

Pasteurization in 1862

Discovery of tubercule bacillus (responsible for tuberculosis) in 1882

Discovery of cholera bacillus in 1883

Rabies vaccination in 1885

Chicken cholera vaccination in 1885 (cholera accounted for approximately 2000 deaths PER WEEK in the cholera epidemic of 1848)

The contact lens in 1887

The X-ray in 1895

Not all of these inventions were products of British scientists, of course, and it's a grave disservice to the scientists of other countries, particularly Germany, France and Russia, to suggest that they were. However, London is where they were often first presented, and though resistance was occasionally high due to outdated modes of thinking, accepted on a broad scale.

Resistance to new medical ideas should not be underestimated, as proven by the story of Ignaz Sammelweis (1818-1865) who mandated that physicians wash their hands before attending women in childbirth. Those physicians who followed his guidelines saw an immense reduction in new mother deaths from childbed fever, but this idea wasn't widely accepted until Joseph Lister (1827-1912) simultaneously proved germ theory and developed the first antiseptic.

Nursing also came to the forefront as a profession in the Victorian age due to the work of Florence Nightingale, who opened St. Thomas Hospital in 1852 to attend to some of the injured coming home from the Crimean War. She proved that nurses could provide increased patient hygiene and nutrition that overworked doctors did not have the time to attend to, and revolutionized the medical world in doing so.

Victorian Ideas of Cleanliness and Infection

Keep in mind that these were all new, radical notions to your average Victorian, and often barely understood notions at that. Full and comprehensive knowledge of how contagion works for bacteria and viruses was still fairly far off in the future.

Your average Victorian citizen had no idea that some viruses could travel through air, while some needed to go through bodily fluids.

They also often did not understand that a symptom-free person could still be contagious.

In addition, food inspection and freedom from food-borne illnesses was also still fairly far off, and consistent food refrigeration was still several decades away even at the end of Victoria's reign.

Antiseptics were still rare, antibiotics unknown.

Therefore, Victorians did the best with what they had, and their regimes to fight dirt and contagion would put most housekeepers to shame today.

The huge jump in human survival during the Victorian era had less to do with concrete, applicable medical advances, many of which were in development, and more to do with increasing awareness of public health and nutrition.

Conclusion

Because the standards for cleanliness and medicine in the Victorian era had to be meticulous in order to effectively fight largely unknown, unseen enemies, they can still prove useful today for people who suffer from chronic disorders of all sorts.

These medical measures are often wonderful to protect small children from parental contagion, and also to help the patient not suffer reinfection from their surroundings by increased ventilation and systematic cleansing.

While the Victorian era is often known for its quack cures playing on new cultural knowledge and ignorance, Victorian medicine still has a lot to offer to those willing to apply discernment and common sense.

Main Write by L. Ice, Editing by D. Urquhart

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