Comparing 18th Century Medical Practices

CASE 2:  Medicine and Childbirth

Global Context: Comparing Eighteenth Century Medical Practices

For centuries, Western European doctors, philosophers, artists, and others had shared an intense interest in dissecting the human body and exploring its structure and function. During the eighteenth century, medical researchers used techniques and tools from the experimental sciences (chemistry and physics) to produce ever more impressive discoveries about the body and its functions. During the last half of the nineteenth century, this scientific revolution in medicine produced breathtaking new cures and therapies that utterly transformed the way that doctors diagnosed, treated, or prevented disease.

But at the time that Jizhai was writing, these scientific discoveries had only a limited impact on everyday medical treatment. Many of the common beliefs of eighteenth-century Europe and America would seem strange to us today. For example, people widely assumed that many diseases were caused by exposure to “miasmas.” This term referred generally to foul or unhealthy air, particularly that produced by rotting matter in a swamp or garbage heap. The term “malaria,” for example, literally means “bad air” and embodies the original belief that this disease was caused by miasma. Another important explanation for disease was the theory of “humors.” Humoral medicine had its roots in the teachings of the eminent Greek physicians Hippocrates (460–377 BC) and Galen (129–216 AD). According to this theory, the body was animated by four fluids (“humors”): blood, phlegm, yellow bile, and black bile. If the humors were in balance, the person would be healthy. If they were to become imbalanced, the person would become ill, and the doctor would have to find some way to restore the balance. One of the most important ways to restore balance was “bloodletting,” which the doctor would try to reduce the amount of blood in a person’s body by making him or her bleed. One common method of bloodletting was to cut open a vein on the patient’s arm. Doctors also might use leeches to suck blood out through the patient’s skin. Bloodletting was a common medical therapy in eighteenth-century North America and Europe where the procedure was used for a variety of conditions, including difficult childbirth. In fact, bloodletting continued to be used into the nineteenth century. In eighteenth- and nineteenth-century North America, bloodletting was often combined with the use of “purgatives,” namely strong laxatives and medicines that would induce vomiting and further reduce blood in the body. One of the most widely used purgatives was “calomel” (mercurous chloride), which was a form of mercury. Such techniques were promoted in North American medical schools, as well as in household medical handbooks.

Of course, doctors did study anatomy and physiology and tried to apply this knowledge to medicine. Surgery had always been a major part of European medicine and an important area of study. However, we have to keep in mind that the scope of surgery during the eighteenth and nineteenth centuries was much more limited than it is today. Although anesthetics were first discovered at the end of the eighteenth century, they were not used in surgery until after the 1840s. Before the 1860s, surgeons were also unable to prevent infection during surgery. Therefore, until the second half of the nineteenth century, many surgical patients died from shock or infection, and doctors performed surgery only as a last resort. Overall, we can see that the rise of scientific medicine did not immediately replace older ideas about how people contracted illness or how they should be treated. Even when doctors applied scientific discoveries to medicine, it was not always obvious that these improved matters. A good illustration of this is the rise of the “man midwife” (male birthing attendant) and the “lying-in” (maternity) hospital in eighteenth-century Europe.

Continue to: Eighteenth Century Obstetrics

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