Gout

Gout was as common among aristocracy as the plague was among the poor. Through the years, kings and nobles alike fell prone to this crippling disease and it mentioned numerous times in texts of the ages. But what exactly is gout and does it still exist?

Gout was known as a rich man's disease for the simple reason that it came about from eating plenty of rich food. That is why Henry VIII suffered from it for years. I will quote WebMD here, "Your chances of getting gout are higher if you are overweight, drink too much alcohol, or eat too much meat and fish that are high in chemicals called purines." Too much alcohol and meat? That doesn't sound like eighteenth century aristocracy at all! But all sarcasm aside, alcohol and meats were the main staples of western diets throughout the centuries.

All those purines in the food would cause extra uric acid in the blood, which is fine in small quantities but really bad, in large because it crystallizes in the joints. Ouch! In most cases this begins at the big toe (as Gillray displayed in his artistic interpretation of gout) and can move up the leg. As you can imagine walking is very painful; gout is put into the same category as arthritis.

Nowadays when a doctor diagnosed gout, you can get a shot and take some painkillers. Back in the Georgian era the common diagnosis was to take a trip to Bath for some of the "healing waters" which did little except maybe relax you. Unless there was some corticosteroids in that tap room water you drank, you were out of luck!

Georgiana's Illness

The Enlightenment may have brought new interest, knowledge, and advancements in medicine but health care in the 18th century was still primitive. Georgiana was one of the many victims of early medicine. Compared to her sister and Bess *rolls eyes* who both had weak dispositions and were continuously ill, Georgiana was pretty healthy and would occasionally suffer from migraines. 1780 is the first record of any complaint she made of eye trouble. She began applying a daily application of water, brandy, and vinegar which did nothing but sting. Her doctor instead prescribed washing it out with milk.

In 1796 Georgiana's eyes were bothering her more, especially during and after her migraines. In July the pain increased and her right eye began swelling...and swelling. In a matter of days it had grown to the size of an apricot. Harriet and Lady Spencer quickly came as well as three of the best eye surgeons England could offer. Anticipating the screams that would soon echo through the house from 'treatment,' the children were sent away to protect them from being traumatised. Loyal Harriet described her sister's screams in a letter saying, "After hearing what I did tonight I can bear anything."

Laudanum (the same drug Georgiana may have suffered an addiction too previously) was used to subside the pain. At one point Georgiana almost died from strangulation when a doctor squeezed her neck in order to flush her eye out with blood. Her eye was also bled which was thought to help greatly. Lady Spencer described the horror of her daughter's altered appearance, "The inflammation has been so great that the eye, eyelids and the adjacent parts were swelled to the size of your hand doubled, and projected forward from the face." It was inevitable that she would loose sight in that eye. Lady Spencer went on to say that an ulcer had formed and burst on top of the cornea and that her swollen eyelids were scarred from the leeches.

When everything was over it was almost as if someone had died. Georgiana stayed in a darkened room to receive well-wishers with a veil covering the lump on her face. She could only detect shapes in that eye and her other eye's vision was now blurry. For weeks any light or motion put her in extreme pain. As a woman who had spent most of her life in the spotlight, Georgiana was frightened beyond belief of everyone's reaction to her facial deformity. The stress had physically aged her and her right eye now drooped, she was no longer the stunning duchess who remained light-hearted and gay in every situation. She let the experience defeat her.

It was a long time before Georgiana recovered from her insecurity and ventured back out in public. She would now arrange her hair in order to cover her right eye as a means of coping with stares.

After reading Foreman's biography, Dr Schraibman went about trying to determine the possible causes of the Duchess' affliction. Based on the evidence Dr Schraibman has inferred that the disease was likely Cavernous Sinus Thrombrosis which I won't even begin to decipher but you can conviniently read his report here.

Mother Knows Best

"I am sorry Ly E. Foster's cough is worse, indeed she should not stay in such a climate as this, every hour may be of the utmost consequence to her."

Lady Spencer
26 August 1784

The Bedlam of Bethlam

bed⋅lam [bed-luhm]
–noun
1. a scene or state of wild uproar and confusion.
2. Archaic. an insane asylum or madhouse.

Are the holidays driving you nuts? Inspired by fabulous reader Kristi, who always sends me awesome emails, I thought what better a time to talk about "the mad" then the holiday season.

Because insanity or mental illness were misunderstood throughout much of history the people who suffered from these conditions were usually mistreated. This also meant those with mental handicaps were thought to be "mad" as well. These unfortunate souls would be put in madhouses, hidden away from public view where they spent their lives being beaten or even killed.

In 1247 the Sisters of the Order of the Star of Bethlehem founded a priory on the site of what is now London Liverpool Street Station. Hmm I wonder if I can say that my friend Erin spent a night there since she was stranded at that station overnight. The building went through many changes throughout the centuries. But the Enlightenment brought a new thinking about these castaways and Bethlam Royal Hospital (as it was now called) began attempts to improve the treatment of the inhabitants. The hospital was also called Bedlam which turned into a word to mean [see above] and that's exactly how the old Bethlam was. The screaming and noise that came from the building was said to drive anyone who heard, mad themselves. Now with the Enlightenment the great thinkers set about trying to, perhaps, quiet those inside.

Firstly, they began referring to those inside as patients. After-all, Bethlam was a royal hospital. Then someone realized that the patients actually exhibited different symptoms; most notably, screaming versus not screaming. So they considerately divided these patients from each other. They made "curable" and "incurable" wings and divided the patients by sex. Bethlam was intended for short stays but if after a year the patients remained uncured they were just discharged, unless of course, someone lost track of how long a patient was there. The uncured wing allowed an alternative to giving up on the patients.

Bethlam was commended by Europe for their advancements with the mad, but of course they weren't perfect. As a means of generating more funding, you could pay a penny and view the "lunatics." Crowds peered through iron bars hoping to get a glimpse of the patients unusal looks and behavior, especially if their antics included anything of a sexual nature or violence. They were even allowed sticks to prod the poor patients. Asylum conditions were improving but they still had a long way to go.

The above figures of raving and melancholy madness graced the entrance gate of of Old Bethlam. These two allegories show how limited knowledge was of the different patients' conditions and needs.

A Harlot's Progress: Plate 5

Can't you just hear the commotion through the thin tenement walls? In Hogarth's next print in the series we find out heroine, Moll is out of prison but in a setting that is not much improved. Moll barely has a breath left in her, she is deathly ill. She slumps in her chair, half unconscious, wrapped in white linen like a specter. While she breathes her last, two notable doctors fight over her cure, too distracted by their own egos to notice their patient. The rotund, German doctor, Richard Rock argues that they should bleed her while the skinny French doctor, Jean Misaubin shouts that cupping is the way to go. Amongst the French and German accents is Moll's maid's vulgar tongue, screaming for them to pay attention to her mistress who lays limp in her arms.

Among the dissaray are two figure who seem to not be bothered by the commotion. One is the nurse or landlady who scours through what is left of Moll's possessions, looking for something worth stealing. Judging by the hovel Moll now calls home, it is unlikely that she will find anything worthwhile. A little boy is roasting a piece of meat on a string while he itches the lice in his hair. This is Moll's son. The result of a night's work.

Once again we are reminded of the former splendor of Moll's life. The fine apartment once procured to her by her Jewish lover is now a distant memory. Instead, her former lover has now given her enough money for this one, as indicated by the passover bread. Many old flames took pity on their former mistresses, like Grace Elliot, when they reached the end of their rope. But obviously, Moll is not being taken care of enough; whether it is by past lovers or current doctors. Will she be able to survive this mishap as she has the others we have seen her survive?

A Harlot's Progress Plate 1
A Harlot's Progress Plate 2
A Harlot's Progress Plate 3
A Harlot's Progress Plate 4
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No, Consumption is not actually alcohol-poisoning...

Gout has been on my mind a lot lately this weekend due to my arm randomly hurting followed by a mysterious bruise later in the week. Isn't that lovely! I need some leaches. So what better an occasion to bring up some common 18th century ailments and what they were known as in their heyday.

Apoploxy - Stroke

Chrisom - Infant death

Consumption - Tuberculosis

Falling Sickness - Epilepsy

French Pox - Venereal Diseases, specifically Gonorrhea and Syphilis which weren't always decipherable to the Enlightened eye. One supposed cure was to consummate with an uninfected person.

Goiter - Enlarged thyroid gland usually due to iodine deficiency. This could, in turn, cause bulging eyes.

Gout - A form of Arthritis due to imbalance of uric acid. Aristocrats would commonly find themselves ailing of Gout due to their taste in rich foods.

Hemiplegy - Palsy, paralysis of one side of the body usually due to Apoploxy.

Looseness - Dysentery

Lues Venera - Venereal Disease

Lung Fever - Pneumonia

Morsal - Gangrene

Puerperal Fever/Sepsis - Sepsis of the womb or birth canal

Rickets - Lack of vitamin D or calcium resulting in bow-legs

Thrush - Infection of the mouth and/or throat

Tympany - Tumors