by Stephen Wade
Griffith went to talk with the Jacobs first; Evan was fully in support of the idea, wanting his girl to be cleared of charges of any fraud and deceit. After that a meeting was held at the Eagle Inn at Llanfihangel-ar-Arth, on November 30, 1869. Griffith was present, along with forty local farmers, a solicitor, and the Rev. William Thomas, a Unitarian minister who was the great-uncle of Dylan Thomas. William’s brother, Evan, was working on the new Great Western Railway, and was known at the time as ‘Evan the Guard’ but William had a reputation as a poet, and in fact had the bardic name of Gwilym Marles – names destined to become much more famous when the poet Dylan was christened ‘Dylan Marlais.’
William, who was to be instrumental in setting up the second vigil, was born in 1834, and studied at theological college in Carmarthen before going on to Glasgow University. He was back home in 1860, where he preached and ran a school. Like Gohebydd, he was a radical; so forthright was he that at one time he and his congregation were forced out of their chapel. The minister with a penchant for taking on the power base relished this project of proving the local girl to be, hopefully, a person who baffled the London professional men.
The plan was to find out, as Griffith put it, whether the girl was fed or not fed. He added that the question of how long a person could live without food was beyond their remit. What was needed then was vigilance and a proper approach to the supervision. The decision was that, with the help of Dr Phillips in London, four professional nurses would come out to Carmarthenshire and do the job, rather than any local amateurs being assigned. One of the nurses was to be a Welsh woman, as Sarah’s main communication was in Welsh, though she knew English, and read both Welsh and English.
Dr Phillips drew up a list of ten aspects of the watch to be maintained and followed, including a number of actions which would guarantee the elimination of any tricks or deceit. Perhaps the most stringent measures were the banning from the bedroom of the parents, whose bed had been in that room, and that the nurses would be the only people to prepare and check the bed, the furnishings and the clothes involved in the watching.
Locals were involved however: there would be a local committee of professional men, including doctors Lewis, Rowlands and Hughes of Carmarthen. A formal agreement was written down, and the Rev. Thomas was given the task of acting as secretary. The statement is of special interest:
This agreement, made on the 30th day of November, 1869, between Evan Jacob, of Lletherneuadd, in the parish of Llanfihangel-ar-Arth, in the county of Carmarthen, on the one part, and the committee of management this day appointed for the purpose of investigating the alleged long fasting of Sarah, the daughter of the said Evan Jacob, who agrees to afford every facility in his power for the said committee and all persons employed by them to prosecute their said investigation without hindrance, molestation, or interruption whatever for the period of fourteen days, and will during such period permit the said committee and all persons employed by them the free and uninterrupted use of the room occupied by the said Sarah Jacob.
This was signed by Evan and the solicitor, Jones, from Llandysul.
The organisers of the watch were clearly provoked by the announcement in the British Medical Journal that the new watch would ‘…once and for all, expose the imposition in which she has been so long encouraged.’ In Y Faner for October 20, 1869, Gohebydd let loose his wrath in reading the letter in the British Medical Journal, writing that the reader felt the ‘wound’ inflicted by ‘y Doctor y Lundain’ and that other papers – the Daily News, The Lancet and The Globe – had echoed the sentiments about the ‘imposition’. The radical was up for it, and he was behind the Jacob family with the full force of his rhetoric.
The nurses were from Guy’s Hospital. Not much is known about Sister-nurse Elizabeth Clinch, Nurse Sarah Palmer, Nurse Sarah Attrick and Nurse Anne Jones, but we know that, only a decade before they arrived at Pencader and were taken the mile to the Jacob home, their hospital had been in turmoil, and there was a crisis involving the nurses at Guy’s. Florence Nightingale’s reforms and words of wisdom on nurse training did not have an effect until ten years after Sarah Jacob’s years as a national celebrity and medical puzzle. The historian F.B. Smith described the situation up to the 1850s: ‘The nurses were few and ill trained. It was an unhealthy job and few women of ability would undertake it.’ Nightingale’s first nurse training school was set up in 1860 at St Thomas’s Hospital, with the aim of training nurses who could then mentor others, and so professionalism would prosper. It was all based on nursing practice and good hygiene.
In the decades between the Regency and the 1860s, nursing had been in a parlous state. Historian Mary Ellen Snodgrass points out that, in the charity hospitals, ‘The low-end job of ward staffer fell to pauper nurses, poor women who earned extra money by prostitution, who drank and took drugs on the job and who stole patient meals and clothing to give to their own families.’ There were all kinds of problems with facilities (or lack of them) and in recent years, before the nurses came to Lletherneuadd, there had been turmoil at Guy’s.
In 1849, Guy’s had coped with temporary wards and overcrowding; then in 1857 there had been the issues raised by the unacceptable attitudes and behaviour of nurses. In all kinds of places, the job of nursing was becoming a profession, and there were teething problems.
The Superintendent of Guy’s at the time, Dr Steele, reported to the committee of the hospital in 1856: ‘I have to report that the Sister of Dorcas Ward has had notice to leave the Hospital at the end of the present quarter in consequence of repeated acts of insubordination towards the Matron.’ In 1859, he wrote, ‘Delinquencies among the nurses have been unusually numerous during the week. It has been necessary in Stephen Ward to dismiss 3 out of 4 women employed in the ward and last night the nurse of Petersham Ward was completely incapacitated for work on account of drink.’
Matters were shaken up; Steele managed to change the nurses’ duties with regard to cleaning. They were expected to scrub the ward floors as well as attend patients. They were also not boarded in the hospital. Steele set about changing things, and revised the pay scales as well as removing the cleaning duties. As a result, the nurses who arrived at the farm would have been among the first nurses to be employed under more benign and considerate conditions, with a more open opinion as to their need for moral probity and sound training. Sister Clinch would have earned around £50 a year and the nurses about £30 at the time, if they were not boarded.
Thirty years later, as we know from some nurses’ diaries, there was still plenty of cleaning; there was plenty of real caring and giving treatment, but hygiene and practical comforts occupied most of their time. Nurse Violet Wilson was at St Thomas’ in 1896 and wrote: ‘I returned to the ward at 12.30 and helped to prepare the children’s dinner… When dinner was over I made the nine children I was responsible for tidy and comfortable and then dusted down the side of the ward…’ In other words, the priorities instilled in the nurses as the new ideas inspired by Nightingale began to have an effect, were cleanliness, order, discipline and what we would now call multi-tasking in a domestic way.
What the Guy’s nurses had was discipline and clear instructions. They would have known about bed changing and changing the clothes of the patient – something of particular importance in their present task as they settled into their room at the long house. The first handbooks and medical dictionaries provided drawings and detailed instructions on these essential chores. The way that beds were changed offers an interesting sidelight. It was not merely a case of pulling off old sheets and then putting new sheets on in layers. There were even notes, in the manuals and reference works, on draw sheets, as in this example: ‘When it is necessary to insert a new draw sheet, the draw sheet is folded up as in the method for changing the under sheet, and is introduced either by rolling the patient over or slightly elevating his hips. When the draw sheet requires to be replaced more frequently, it is more convenient to place the square of mackintosh on the under sheet and to i
nsert the draw sheet above it separately.’
Yet what does this convey if not a perfunctory, military-style regimen? It offers an insight into how and why the nurses had their limitations. They responded to orders: rarely did they initiate matters. Back in London, they were used to being told, not making decisions. The fact that a Welsh nurse was included makes it certain that, as well as an awareness of the need for general communication, she would be keeping her ears pricked to pick up conversations which had been previously used, perhaps, when English monoglots were around in the house. Of course, we know that at least one attempt to translate from Sarah’s speech failed. The nurses arrived, then, ready for watching, and also well prepared to perform all the basic caring things which were their main tasks.
The nurses entered the story in the early afternoon of 9 December and met the group of sponsors of the watch. Sister Clinch and her colleagues set to work in preparing Sarah’s room for the supervision. Evan and Hannah told the nurses that Sarah had taken no food nor passed any urine or emptied her bowels for the previous eight months. All they had done was dab some water on her lips from time to time. The girl was removed from her bed so that a thorough search could be made, to verify that there was no hidden food. Evan carried her across the room. From that point, the watching was to be in a situation in which the study began with a girl who was, in the words of the nurses, ‘healthy, plump and fat’. The doctors watched as the nurses searched all the furniture for hidden food. During all this, Hannah, who knew no English, lamented the whole business, hating the way her daughter was treated.
The medical men gave a last statement of the brief to the nurses: their aim was to be sure that Sarah was not given food – unless, of course, she asked for some. In spite of Evan’s insistence that he should continue bed making and other little established chores, done in the way he was used to, the nurses did their proper bed preparations, noting a strong urine stain in the bed.
Special attention was given to who could approach the girl, and why. In the first watch, the actions of the supervisors had been shambolic and no close watching really happened. Now, no-one was to go near Sarah except her parents, who could only take her hand. The doctors recalled the old farmer’s point about the frequency with which her little sister had kissed Sarah and they were suspicious of that.
The doctors and nurses wanted everything to be logged. They showed a modern sensitivity to criticism, covering themselves by issuing a statement to tell anyone who might bring forward a criticism exactly what was happening:
Thursday, Dec.9th, Lletherneuadd. Four nurses arrived at 2 p.m. The whole of the room in which Sarah Jacob was lying was carefully examined; all the furniture carefully looked into; all contents of drawers removed; the bed on which the girl was lying was carefully examined and each covering singly; the girl’s body, clothes, and her hair were fully examined. Nothing of the nature of food was found anywhere.
They all signed that statement and then a certificate of health was issued, asserting that she was ‘cheerful; face flushed; eyes brilliant; pulse regular, averaging 86 per minute; temperature in the mouth 98 deg., after two minutes’ rest. She has a warm water bottle at her feet. She seems quite well, and says she has no pain anywhere if not touched.’ The doctors, Davies and Lewis, signed this.
This was the situation then, as the nurses began their vigil. Sarah was healthy, indeed in rude health. According to the official line from the farm and also from the men of medicine and law who arranged the watch, she had taken no food, but yet was normal and with plenty of flesh. If ever there was a challenge to the experts at the British Medical Journal who had so upset Gohebydd, this was it, a slap across the face of Science by an implicit faith in what many thought ‘superstition.’
A reminder of the internal layout of the farm is worthwhile. Evan Jacob farmed 120 acres and had a good living. Unlike so many smaller tenant farmers and labourers across Wales, he could afford to have one of his children (a potential worker of course) out of action and living a life in all essentials that of a middle class lady, Elizabeth Barrett Browning for instance, who had been allowed to remain in her bed with a mystery illness for years, cultivating her artistic sensibility and becoming a poet and classical scholar. Given the strict hierarchy of society at that time, many would have seen that paradox. After all, young ladies of the better classes were expected to be frail, to have ‘the vapours’ and to be neatly wrapped in layers of clothing and tight underwear. The usual working girl would be much more of a tomboy, expected to wear working clothes and to do many tasks which were also performed by brothers.
The long house’s domestic facilities were that the kitchen was central, with its great table; adjoining this was the large bedroom shared by Sarah and her parents. Sarah’s bed had previously been in the centre of the main family bedroom, projecting into the room with the head facing the far outside wall, not the kitchen. There were bookshelves around the bed. When the watching began there was a nurse placed at each side of the bed, towards the bed-end.
Any person entering the room had to come from the kitchen, as all outside doors were along the long side of the house. There were candles by the bed-head, so a person could not creep in during a dark night and give Sarah food from the side of the bed The candles would have shone on each side of the girl, and so no other access to the bed was possible.
The term ‘neuadd’ is an old word referring to the dwelling part of the long house, and in some long houses the neuadd was the room at the gable-end, though many old long houses had the neuadd divided into two parts, the very core of the building: the kitchen and the bedroom. As to the everyday living area, that was in the back kitchen partly, but also in part of the bedroom. Bedrooms were often ‘parlour bedrooms’.
All this domestic description is important in envisaging the daily lives and movements of the family and the servant. Clearly, they could all move around between the parlour areas, the kitchen where they ate, and of course the cow-house at the far end, beyond the servant’s room. It was cosy and social: everyone would have heard everything said and done under that roof; heat would penetrate easily, as would the smells of cooking and of the animals of course. These factors all help to explain the degree of closeness between family members; no wonder then that Evan was governed by small acts of control and consideration as far as his children were concerned. A father with so much proximity to all family members enjoys a great deal of control and finds it easy to intervene, dictate rules and direct the behaviour he wants from everyone.
The times of the watches similar to hospital shifts. The nurses did not eat on duty and had to sit out their shift; Sarah had extra night-time bedding and hot water bottles at her feet. It was a case of the smell of urine and sweaty heat in that enclosed space, for the period of the watch. An interesting sidelight on the very first shift is that a neighbour came with a picnic of food, but was sent away by Hannah. The parents were still horrified by the thought of the fits and fainting Sarah was subject to.
The day began with the washing ritual, followed by a long period of reading aloud, in both English and Welsh. Sarah slept on and off. On the Saturday morning there were several points of interest, mainly that there was plenty of urine on the bedclothes and that there were marks showing faeces had been passed, though in a very small amount. A day and a half had passed, and there was a warning sign: Sarah looked quite the opposite of healthy. Her condition seems to have fluctuated, and by the second day there are some details that hint at some significant lines of thought. Sister Clinch then noticed two important details during the course of the fourth day: first, that whenever a doctor came to check on Sarah, Evan was present; second, that in the evening of day two, Sister Clinch was aware of ‘an unpleasant smell’ and found urine. This led to examination, and although Evan expected Sarah to fit, she did not, though her mouth could not be looked at, as she claimed she could not open it.
All these details lead to some reflections on the sheer complexity of Evan’s actions. On the one hand
his behaviour matches the view that he was a sensitive and caring father who was persuaded that Sarah’s ‘fits’ were severe when in fact they were not fits at all. Then on the other hand his constant patrolling and interfering naturally led people to suspect that he knew about some ruse and was covering it up, excluding the medical professionals from something that would find him out. The one detail that was a constant in these days was the fact that Sarah did not like being touched, showing hypersensitivity when skin was pressed, hence the father’s protection. In fact he still denied examination of some parts of her body.
Between the sixth and eight days – that is, up to December 17th, she was closely observed, and Dr Lewis of Carmarthen went to see her as she was in decline. The nurses noticed a distinctly new smell about her: this was referred to as ‘the smell of death’ and was almost certainly ketosis. Sarah’s liver had been storing glycogen, as the substance would not have been existent in body fat. These fatty acids are used by the body in place of glucose, and so one result is that the fatty acids cannot create energy – they cannot cross by means of blood into brain cells. But the ketone, from the liver, can do so. The ketone is processed into acetone, an organic compound, used today in chromatography. This was the source of the unpleasant smell. John Cule, writing in 1967, referred to this as a ‘pear-drop smell’. With Sarah it was mixed with the stink of urine when the nurse reported a ‘smell of death.’