And sometimes you’d need special tools for the occasion, as advised by The Surgical Assistant by Walter Brickner in 1905:
The assistant scrubs the [vaginal] canal with soap and water. For this purpose he may use a jeweler’s brush. This has no bristles at the tip, and therefore hardly cleanses the presenting surface of the cervix; moreover, the bristles may lacerate the vaginal mucosa. It is better therefore, in most cases, to use a sea-sponge or gauze mop mounted in the tip of a clamp or pair of dressing forceps.
Look at that! I guess your Victorian birth plan can include all-natural sea sponge!
Many doctors did not think soap and water were antiseptic enough to purify the birth canal. For brand names, Listerine was a reliable douche, or, as instructed by the Connecticut Training School for Nurses, “Many patients require to have the vulva washed in a weak solution of the carbolic acid and glycerine,—a tablespoonful to a quart of water, to prevent the action of decomposed discharges so common at this time.”
Listerine is way more versatile than we give it credit for. It can freshen lots more than just your mouth.
Q: So to keep me from accidentally pushing the baby out too fast, they intend to blast it out?
A: That’s nitroglycerine. And carbolic acid isn’t explosive. Well, it is, of course, but the circumstances have to be just right, so, hey, don’t worry about it. It’s not a pleasant concoction, but it will end with you having the tidiest undercarriage in town! For a few minutes, anyway… cuz a bunch of your insides and a baby are coming through.
Q: You’re such a comfort. Not that I intend to use them, but what sort of medications were used to ease delivery in the Victorian era?
A: I will answer this, but I’ll need to be dealing with an open mind. If you go all “I’m not getting chloroformed or dropping acid while pregnant,” then we can’t really have a fruitful discussion abo—
Q: I am NOT getting chloroformed or… Did you say dropping acid? Are you serious?
A: It wasn’t dropping acid per se… it’s ingesting the rotten rye grains, contaminated with the bacteria ergot, which is the natural source of the drug LSD. It was super hard to portion out right—you couldn’t tell just how much the grain was infected. Too much and you experienced mania, psychosis, and hallucinations, and often died in a brutal seizure. Full disclosure, that did happen a few times in history, on a plague level, killing thousands when a community’s crops got contaminated. They called the mysterious disease St. Anthony’s Fire, but they didn’t figure out what caused it until the mid-1800s. But, in the right amounts, this early ancestor of LSD caused a constriction of blood vessels and muscles that could both hasten labor and help slow postpartum bleeding.
Rye grain with ergot (dark thorny growths) protruding.
The chloroform… yeah… just what you’re thinking. “Stuff you in the trunk of a battered 1978 Lincoln Continental in the Mojave Desert and speed toward the border” sort of chloroform.
Q: I’m still stuck on the LSD. They fed the mothers… LSD.
A: Not really. It wasn’t refined synthetic LSD like we have today. Actually, since it was only the crushed-up poisoned rye, it was just “LS,” lysergic acid. The “D” didn’t show up until 1938 when the Swiss chemist Albert Hofmann, working on making medicines from lysergic acid, added diethylamide. And he dismissed it as useless, not at all enjoying the “uninterrupted stream of fantastic pictures, extraordinary shapes with intense, kaleidoscopic play of colors” that caused him to leave work early and ride his bike home to lie down. Nineteenth-century physicians called it secale, or just ergot, and it was used kind of like Pitocin is today, to motivate a sluggish uterus into action. It wasn’t popular for long, though.
Q: Because it was both a psychotropic drug and a deadly poison?
A: Nah. Show me an effective drug of the day that wasn’t one or the other. No, it was thought to be too rough on the uterus, causing spasms. And it tended to make the mother throw up, by forcing contractions that were so hard that it “kneaded” (bruised) the cervix. A bruised cervix is an unpleasant thing. The nausea connection was made by a Dr. John Beck, writing in an 1863 edition of The Retrospect of Medicine about how you could make women vomit by poking them in the cervix.
Self-experimental test on LSD-25, Albert Hofmann, chemist: “8:00 a.m.—no effect. 8:15—no effect. 8:28.345… I JUST REALIZED I AM GOD AND THE WORLD IS MADE OF SYRUP AND LIGHTNING.”
He noted that there were quite a few women on record who vomited every time they had sex, and he figured it was because the penis kept bumping the cervix… which is extremely uncomfortable and an absolute vomit button for some ladies. But to be certain, he started poking cervixes with his finger on his lady patients. And sure enough: “I had a patient myself whom I could make retch at my pleasure by touching the os uteri [cervix] with the tip of the finger, although she could give no explanation herself as to the cause of the retching, or as to why she retched, yet the result of the touch was invariable.”
Q: “Make retch at my pleasure…” Wow. Dr. Beck and those penises had something in common. They were both di—
A:—sruptive to the comfort of the patient, most certainly. But that was only one of the reasons ergot lost its popularity. Chloroform was just more reliable.
Q: Okay. Chloroform. How did the kidnapper’s drug of choice become the favored manner of bringing new life into the world?
John Snow chloroform inhaler of the kind used on Queen Victoria.
A: Chloroform and ether, both delightful knock-out gases that could be used to anesthetize patients, came into general use around the 1840s. Chloroform was less likely to catch on fire, which is one reason it was preferred by many practitioners. Its beginnings were… rather ignoble. It was first prepared in 1831 by the American chemist Dr. Samuel Guthrie, who combined whiskey with chlorinated lime in an attempt to produce a cheap pesticide.
Then it was found useful in surgeries. Finally the leap was made to childbirth. The beauty of chloroform is described by Mary Ries Melendy in 1903, at a time when using the drug had been standard for around sixty years.
The inhalation of chloroform, according to the will of the operator, causes either partial or complete unconsciousness, and, either for a longer or for a shorter time, freedom from pain. In other words, the effects might, with perfect safety, be continued, either for a few minutes, or from time to time, for several hours; indeed, if given in proper cases, and by a judicious doctor, with perfect safety.
And how did it feel to be put to sleep by gas so as to forgo excruciating pain? Well, let’s just say… they should have sent a poet. And, oh! What luck, they did!
Oliver Wendell Holmes was a doctor and a poet, talents that came together nicely in a letter he wrote to the first man to publicly demonstrate how ether could be used to put a patient under during an operation. He wrote the American dentist William Morton in 1846 to express his admiration. He told Morton soon the whole world would be speaking of his discovery, so a name ought to be cemented: “The state should, I think, be called anesthesia. This signifies insensibility, more particularly (as used by Linneaus and Cullen) to objects of touch. The adjective will be anesthetic.… The words anti-neuric, aneuric, neuro-leptic, neuro-lepsia, neuro-stasis, seem too anatomical.”
The less exact but more common manner in which women in labor received chloroform.
Q: If chloroform is so great, how come we don’t use it now?
A: Oh dear Lord. Because it’s chloroform, woman! It’s not actually safe! It turns off the central nervous system, sometimes all the way off. It was safe by Victorian standards, standards that included drinking out of the Thames and arming twelve-year-olds with exploding muskets for bear hunting. They didn’t have a lot of options back then! Chloroform won out over poisoned ergot, ether (an effective anesthesia with a small history of exploding its patients), or Grandpappy’s triple-X rotgut whiskey straight from the jug. But still, it was hard to gauge the right amount of chloroform that would produce a peaceful twilight experience for
a delivering mother, and avoid one that would fling her straight into the waiting arms of Jesus before the many natural causes waiting to attack her even got a chance.
Besides, not everyone was convinced of chloroform’s safety. Many doctors thought chloroform relaxed the “travailing” body too much, making delivery dangerously slow. And some folks were worried about things that couldn’t scientifically actually occur, but you couldn’t expect them to know that. In 1863, Dr. Robert Johns of the Royal College of Surgeons in Ireland was published in The Retrospect of Medicine giving his theory that inhaling chloroform caused any number of complications, hemorrhage, inflammation, lung problems, and, most terrifyingly, childbed fever.
I have known puerperal inflammation frequently to have followed its inhalation, and too often with a fatal result… in the majority of those cases puerperal fever was the cause of death, which… always infectious or otherwise communicable, became epidemicized, after which even those who wisely refused the drug, “charmed it never so sweetly,” were thus inadvertently, and, in some instances, hopelessly poisoned.
As the world was still struggling with the whole “germs” idea, it was easy to mistake the correlation of “the same mothers who partake of chloroform to ease child birth sometimes also, separately, get childbed fever” with the causation of “because you’re a pitiful excuse for a woman trying to cheat the beautiful pain God gave you with chloroform, it’s giving you childbed fever.”
Q: By the way, what’s “childbed fever”? So many fictional characters die of that, but no one ever explains what it actually is.
An especially nice “lying-in” hospital.
A: The colloquial for puerperal pyrexia, or puerperal fever. It’s a little vague because puerperal isn’t the name of a virus or bacteria; it just means “related to childbirth.” It can be caused by any bacteria that infects the raw and exposed female reproductive tract after birth. With no antibiotics, it was extremely difficult to treat.
And it was often extremely contagious. In a time where no one knew how “contagious” worked. You aren’t the first person to be prejudiced against hospitals. In the mid to late 1800s, women in cities were encouraged to go to “lying-in” hospitals to give birth at the hands of a certified physician and be cared for by professional nurses. It was meant to add sanitation and safety to childbirth, and it did in many cases. Except for childbed fever.
It struck the maternity wards in epidemic fashion. Far more often than it did women who were wealthy enough (or poor enough) to deliver their babies at home. A woman would be hale and hearty with her newborn, but if the woman four beds over took sick with fever, the whole ward might have it within a week.
Of all the famous guys named Holmes in history, only one actually helped solved deadly mysteries.
Q: What was causing it?
A: This would be the time to mention that Victorian doctors didn’t wash their hands.
I mean, they would at the end of their examinations… no gentleman is going to go home to his supper after pressing his fingers upon eighteen different bloody cervixes without a spot of freshening up, but there was certainly no reason to wash them between patients. You were just going to get them all cervixed up again.
Oliver Wendell Holmes, our poet who gave us our most musical name for knock-out gas, actually had an even more pronounced role in making childbirth safer. He wasn’t the first or the only doctor to notice that women who got puerperal fever usually shared the same doctor, but he was the best writer. He wrote an essay in the New England Quarterly Journal of Medicine in 1843 called “The Contagiousness of Puerperal Fever.” What if all these women weren’t catching the same disease because they were breathing in the same “bad air,” or simply randomly falling to God’s design? What if the doctors were the ones passing the disease? And… he was largely ignored. He even republished it in the 1850s to more acclaim, but since they still weren’t sure how the disease spread, the treatise was before its time.
Q: I’m surprised they used all these drugs. Wasn’t there some sort of religious outcry against painkillers in delivery? Didn’t they think the pain was ordained by God and necessary to the bonding of mother and child?
A: “Unto the woman he said, I will greatly multiply thy sorrow and thy conception; in sorrow thou shalt bring forth children; and thy desire shall be to thy husband, and he shall rule over thee.”—Genesis 3:16
Eve Cursed by God, by Marc Chagall.
God said, right after Eve ruined paradise for all of us, that her primary punishment would be childbirth, coupled with the unquenchable desire to stay with the man who did the things that caused childbirth. So, yes, as today, many were against the use of painkillers. But not as many as you’d think.
Dr. John H. Dye noticed that God had cursed Adam at the same time to suffer labor and toil for survival. Yet the industrial age of machines had freed Adam’s descendants from that curse, and no one thought that sinful. So why couldn’t it be the same for the Daughters of Eve? “For our part,” he said, “we cannot believe the Almighty the cruel, merciless tyrant many picture Him, but believe in His wisdom, mercy and justice. He has placed at our disposal abundant means for our relief if we will but comprehend and apply them.”
Dr. Thomas Bullock, writing in an 1896 edition of the periodical American Practitioner, counted fear of chloroform and other pain control on religious grounds as one of the many “Obstetrical Superstitions” practitioners like himself must contend with while trying to do his job: “[The patient] will probably demur, saying that Dr. So-and-So told her that if ever under any circumstances she took chloroform it would kill her. If the patient does not object some of the neighboring women will ‘chip in,’ saying that it is not right to give it; that it is flying in the face of Providence.”
“Good thing I don’t walk yet, ladies, cuz the doctor left that cord long enough to trip on.”
He himself believed this ridiculousness on par with the insistence that a woman take tobacco snuff to ease passing the placenta, never raise her arms above her head lest she cause the child to strangle on its umbilical cord, or, my personal favorite: “When the child is born and the doctor is preparing to cut the cord he is sometimes interrupted and told he must cut the cord longer, as the length of the penis at maturity depends on the length the cord is cut.”
That last one being an excellent conversation starter with your mother-in-law the next time you have an awkward lull in the conversation. “Say, Linda… when you guys cut Brian’s umbilical cord… you cut it awful close, didn’t you? I mean, I love the guy, but it was like a two-inch stub, amirite?”
Like many doctors of his time, Bullock used chloroform only in the second stage of labor, when he wished the mother to be semiconscious. Before that he recommended a hearty dose of morphine, to allow her to sleep through the hours of the earliest labor pains.
Q: Knocking a mother out so she can’t experience the joy of childbirth? Awful! How disconnecting and… I’m sorry, they really just slept through hours of the feeling that someone was sawing open their lower back with a rusty steak knife?
A: Heh. It’s okay. You can admit it. You want morphine and chloroform and ether and ALL the drugs, don’t you?
Q: NO! It’s dangerous and wrong and… (shhh, okay, no, but seriously, it didn’t hurt at all?)
A: We have Queen Victoria’s own words, after she gave birth to her eighth child and used chloroform for the first time in 1853. The queen’s usually rather dour writing style was ebullient.
I have never recovered better, & dearest Albert’s untiring, love, tenderness & care for me, have as usual, been my greatest support in my hours of trial. I was taken ill early on the morning on the 7th & a boy was born to great happiness to me. Dr. Snow administered “that blessed Chloroform” & the effect was soothing, quieting & delightful beyond measure.—April 22, 1853
Q: And the baby suffered no ill effects?
A: Um… none that we can completely blame on the manner of his birth. I mean, all right, it is true
that the queen seemed to… downright dislike her youngest son, the first born under chloroform, Prince Leopold.
1858—“… he holds himself as badly as ever and is very ugly, I think uglier than he was…”
1858—“He is tall, but holds himself worse than ever and is a very common looking child, not an engaging face… and not an engaging child.”
1859—[Wishing her daughter luck with her own newest baby] “If you remember what Leopold was! I hope dear, he won’t be like the ugliest and least pleasing member of the whole family.”
1859—[Explaining why Leo isn’t coming on vacation with the family… he’s just too gross] “It would be very troublesome indeed to have him here. He walks shockingly—and is dreadfully awkward—holds himself as badly and his manners are despairing.”
1859—“I never cared for you near as much as you do about the baby; I care much more about the younger ones (poor Leopold perhaps excepted).”
Would you rather be disliked by your own mother or by the most powerful woman on earth? Oooh, sorry, Leo, didn’t see you there. That’s some rotten luck, buddy.
She did not describe her other child born with chloroform, Princess Beatrice, in anything but the most glowing terms, so we probably can’t blame the painkillers. Though some people did.
The queen’s beatdowns of Leopold slowed in her writings after 1859, when she most likely became aware of what was likely the real cause of Leo’s trouble: that he was a hemophiliac. At least we think she knew. Some historians think Leopold’s doctors kept the truth of it from the queen due to the stigma of being a “bleeder.” But she knew he was sickly. Since his birth, every bump and tumble that other children wouldn’t notice caused internal bleeding, aching joints, and bruising on Leo. Hemophilia (which can be caused by gene mutation but is not necessarily caused by the rampant inbreeding of nineteenth-century European royalty) is carried on the X chromosome, meaning it was Victoria herself who passed the disease to her son, as well as countless of her grandchildren and great-grandchildren.
Ungovernable Page 7