The Mystery of the Exploding Teeth and Other Curiosities From the History of Medicine

by Thomas Morris

  Notwithstanding the sick discover tokens of life, we should not cease to continue our assistance since they sometimes expire after these first appearances of recovering. Lastly, though they should be manifestly reanimated, there sometimes remains an oppression, a coughing and feverishness; and then it becomes necessary sometimes to bleed them in the arms, and to give them barley-water plentifully.

  The barley water doesn’t sound too bad an idea, at least. Some of his suggestions are fairly dreadful, but Tissot concludes by condemning certain other treatments that are even worse:

  These unhappy people are sometimes wrapped up in a sheep’s, or calf’s, or a dog’s skin immediately flayed from the animal: but their operations are more slow, and less efficacious, than the heat of a well-warmed bed.

  Yeuch. This was, in fact, a measure often resorted to—though more usually on the battlefield, where warm blankets were sometimes hard to come by.

  The method of rolling them in an empty hogshead is dangerous and misspends a deal of important time. That also of hanging them up by the feet ought to be wholly discontinued.

  Probably for the best. In fact, these were venerable and widespread practices. The “hogshead” method entailed securing the patient on top of (or within) a barrel placed on its side, which was then rolled back and forth. This gentle oscillation was supposed to evacuate water from the lungs, as was the cruder expedient of suspending the patient upside down. But these techniques were already beginning to go out of fashion: fifteen years later the influential Edinburgh physician William Cullen denounced them, asserting that they were “extremely dangerous, and often destroy the small remains of life.”

  Tissot concludes with another helpful tip:

  The heat of a dung-heap may also be beneficial: and I have been informed by a sensible spectator of it, that it effectually contributed to restore life to a man, who had remained six hours under water.

  I humbly submit that the “sensible spectator” was talking through his fundament.

  SALIVA AND CROW’S VOMIT

  The University of Pavia in northern Italy is one of the oldest in the world, founded in 1361. It has a distinguished history of experimental scientific research: Alessandro Volta, the pioneer of electrochemistry, was professor there for forty years beginning in 1779.

  While Volta was working on his voltaic pile—the first electric battery—his colleagues in the medical faculty were also producing world-leading research. Alas, some of it has not aged well. An article in the Annals of Medicine for the Year 1797 reports a lecture given by Dr. Valeriano Brera, a brilliant young physician who had been appointed professor at the tender age of twenty-two. In later years, Brera published a number of important works, including a book about parasitic worms that correctly challenged the theory, prevalent at the time, that such organisms were generated spontaneously inside the human body. But this earlier paper, reporting a clinical trial of a novel treatment that he had conducted in the city’s hospital, is not quite in that class of scholarship:

  This new method of exhibiting remedies, first proposed by Dr Chiarenti of Florence, and afterwards extended by Dr Brera of Pavia, has excited too much attention in Italy and in France, to permit us to leave it unnoticed, however little we may be disposed to coincide with its supporters in their opinion of its vast utility, and expectations of the benefits to be derived from it.

  Not exactly a ringing editorial endorsement.

  Dr Chiarenti recommended the gastric juice as an excellent remedy in diseases originating from debility of the stomach.

  Making a patient ingest the stomach acid of another person (or animal, as it turns out) is certainly a brave clinical decision. The originator of the idea, Francesco Chiarenti, was a resourceful medical researcher who had published a book on the composition and function of stomach fluids.

  In giving opium at the same time, he found that it often occasioned much uneasiness and vomiting. This he ascribed to its remaining on the stomach undigested, from the vitiated* gastric fluid not acting on it; and led him to reflect on the reasons why opium, administered externally, had so little action.

  A question of huge interest to doctors of the late eighteenth century, particularly Italian ones. The anatomist Paolo Mascagni, who in 1787 published the first comprehensive description of the lymphatic system, had suggested that the quickest way of getting medicines into the circulation was not by swallowing them but through the skin. His doctrine, known as the iatroliptic* method, used ointments and unguents in place of oral medicines. But physicians who tried his method noticed that some drugs that were effective when ingested had almost no effect when rubbed on the skin. It was not at all clear why opium, for instance, was a powerful analgesic when swallowed but not when used as an ointment. Dr. Chiarenti deduced that it was not absorbed in the stomach immediately but only after it had first been altered in some way by the gastric juices. If he could replicate this process outside the body, he reasoned, maybe it would be possible to make a preparation of opium that would pass through the barrier of the skin. He decided to test this theory by experiment.

  An occasion soon offered. A woman, afflicted with violent pains, refusing to take opium by the mouth, was a fit subject for commencing his trials. He mixed three grains of pure opium with two scruples of the gastric juice of a crow.

  Why a crow? This is not explained, but in his book, Dr. Chiarenti observes that crows are enthusiastic devourers of putrid meat, indicating that their gastric juices may be particularly powerful—if not necessarily the sort of thing you’d want to rub into your skin.

  It soon emitted a strong and penetrating smell . . .

  I bet it did.

  . . . which diminished gradually. In half an hour, the opium was perfectly dissolved; but it was permitted to remain twenty-four hours. It was then mixed with simple ointment, and rubbed on the backs of the feet. In an hour, the pains were entirely gone; and, never returning, the woman remained cured.

  This may have had nothing to do with the foul-smelling morphine/crow’s vomit concoction, of course—faced with the prospect of a second dose, I would probably pronounce myself miraculously cured, too.

  By the difficulty of procuring a sufficient quantity of the gastric fluid to enable him to carry his experiments the length he wished, he was led, by analogy, to substitute in its place saliva; and the result answered his expectations.

  And why not? You may as well smear crow spit on your patients as crow vomit. Five other physicians tested the technique, using it to administer a variety of drugs, and claimed similar results. Professor Brera believed he had found what he was looking for: a way of turning an oral medicine into a topical ointment.

  From all these observations, he is led to conclude, that every animalised fluid is fitted by nature to render remedies capable of being absorbed.

  A number of Italian practitioners adopted Dr. Brera’s methods with enthusiasm, and one or two eminent French physicians continued his research for a decade or so. But for some inexplicable reason, the crow’s saliva ointment treatment never really caught on.

  THE PIGEON’S-RUMP CURE

  Eclampsia is a serious condition affecting women before, during or after childbirth. The name means literally “shining forth,” a metaphor (or perhaps euphemism) for the seizures that characterize the condition, which arrive suddenly and dramatically. The cause of eclampsia has never been identified, although it is always preceded by pre-eclampsia—a combination of symptoms including high blood pressure and protein in the urine.

  Until the late nineteenth century, doctors also recognized a malady they called the eclampsia of children. This was a misnomer: Although infants can suffer seizures that look like those observed in pregnant women, the likely causes of the two are quite different. For instance, infants affected by fever often display febrile convulsions, which look serious but do not necessarily indicate any sinister underlying condition.

  In a t
extbook published in 1841, the Handbuch der medizinischen Klinik (Handbook of the Medical Clinic), the German physician Carl Friedrich Canstatt offered a really rather odd approach to treating children with “eclampsia”:

  One remedy I must mention here whose unequivocal effects I have myself witnessed, however inexplicable the phenomenon. If one holds the rump of a dove against the child’s anus during paroxysm, the animal quickly dies and the attack ceases just as rapidly.

  One wonders what strange sequence of events led to this discovery. Ten years later, the Journal für Kinderkrankheiten (Journal for Childhood Diseases) picked up on this odd little aside. It reported that several physicians had been prompted to try the remedy for themselves. One of them was a Dr. Blik from Schwanebeck:

  A nine-month-old child, full-bodied, healthy and alert, with no signs of teething, was attacked by eclampsia, which recurred in ever-increasing seizures, and calomel,* valerian,* musk,* baths, mustard,* and enemas were used in vain. When yet another convulsion occurred, the anus of a young dove was held against the child’s until the seizure was over. The attack was fierce, but the child survived.

  Not long afterward, the journal received a communication from a reader in St. Petersburg. Dr. J. F. Weisse was the German-born director of the children’s hospital in the Russian city:

  Dr. Weisse had read the earlier article with interest. He was, he explained, already familiar with what later became known mockingly (in the English-language literature) as the “pigeon’s-rump cure”:

  Long before the publication of Canstatt’s Handbook I had already read—I do not remember where—about this strange method; but his approval induced me to apply it myself at an appropriate opportunity.

  Dr. Weisse had, it transpires, used the magical pigeon’s bottom on two separate occasions.

  On August 13, 1850, during the night, I was called to a four-month-old child, who was suddenly attacked by eclampsia. After two days of unsuccessfully treating him by the usual means, and meanwhile believing this was a suitable opportunity for the experiment, on the third day I told the mother, a Russian lady of property, about this magical agent; I added, however, that I myself had little faith in it, but believed it to be completely harmless.

  Not having any faith in a treatment is not a terribly good starting point for using it, but I suppose if all else had failed, you can understand his position.

  I had not been mistaken in my assumption, for the suggestion was met with approval, and they immediately proceeded to procure a pair of pigeons for the emergency. Early on the following morning, when I visited the little patient again and had almost forgotten the birds, I was received by the lady’s fourteen-year-old son who opened the door, speaking to me in broken German: “The dove is dead and the child is very healthy; come on, Mama will tell you about it.”

  Certainly an arresting opening to a conversation.

  The woman approached me with a joyful face, solemnly shook my hand and led me to her child, who was sleeping soundly. I learned that the previous day after my visit there had been several convulsions in quick succession, but at seven o’clock in the evening such a violent fit had occurred that, despairing of the boy’s life, they had resorted to the pigeon. The woman’s sister, who carried out the operation according to my instructions, told me that shortly after the bird had been applied to the child’s anus it had gasped for air several times, closed its eyes periodically, then its feet had twitched in spasm and finally it had vomited. At the same time the child’s seizures became weaker, until at the end of half an hour it sank into a peaceful sleep, which lasted for five hours. The pigeon, however, afterwards could not stand on its feet, nor did it touch the food that had been offered, and finally expired about midnight.

  Net result: one healthy child, but one dead pigeon. You win some, you lose some. Dr. Weisse was encouraged by this experience but frustrated that he had not been on hand to witness the miraculous cure for himself. On the next occasion, he was more fortunate:

  This case concerned a boy of one year and eight months who for a long time had been suffering from dyspeptic disorders related to dental work and had been under my medical supervision for several weeks. On the evening of the 8th of October 1850 I received a letter asking me to hurry as soon as possible to the child, which had suddenly suffered a seizure.

  When he arrived at the child’s bedside, he found the boy unconscious, with trismus (a locked jaw) and half-closed eyes. Every so often, the child’s face and extremities were gripped by spasms. The lockjaw made it impossible to give medicines by mouth, so the doctor suggested the pigeon cure:

  A few minutes later a pair of pigeons was brought in and I was able to put the procedure into practice myself. About ten minutes after the application, I noticed that the pigeon I was holding opened its beak several times, as if gasping for breath. The child’s spasms were now becoming more infrequent and weaker, but his pulse was also sinking more and more. After half an hour I realised that the pigeon had closed its eyes and let its head hang down; it was dead. I now had the other animal brought to me and laid it in the same way on the anus of the child, whose pulse, however, could soon no longer be felt—and after only ten minutes it lay there as a corpse. The dove, however, remained alive.

  Scant consolation to the devastated parents. Dr. Weisse concludes with a mystifying appeal to his peers to continue this unusual research:

  Finally, I cannot but urge all colleagues to repeat such experiments with the remedy as much as possible, for it seems clear what a great benefit to the treatment of children, especially those of the lower classes, would emerge if it were proved to happen this way.

  Noting that St. Petersburg is teeming with pigeons, he also acknowledges that in other parts of the world, they are not so abundant. But he’s got that covered, too:

  In the meantime, experiments with other poultry are necessary.

  You may think I’m being a bit hard on poor Dr. Weisse: After all, it’s not fair to judge the doctors of two hundred years ago by today’s standards. They had their reasons for choosing the remedies they used, however odd they may seem to the modern reader. But even many of his contemporaries thought Dr. Weisse’s ideas were downright silly. An anonymous writer in the British and Foreign Medico-Chirurgical Review could barely withhold his glee, quoting Horace: “risum teneatis?” (“Can you help but laugh?”) This is his pithy verdict on the treatment:

  We mentally offered . . . the advice of an old French physician, who, on being asked his opinion of a new remedy that was highly praised for its extraordinary virtues in a certain disease, very gravely replied, “Dépêchez vous de vous en servir pendant qu’il guérit!”

  The Frenchman’s bon mot translates, more or less, as: “Hurry up and give it to him, while he’s still getting better!”

  MERCURY CIGARETTES

  Nineteenth-century medical opinion on the subject of smoking was sharply divided. On the one hand, many prominent doctors condemned the practice as unhealthy, or even suggested that it caused cancers of the mouth; on the other, plenty of physicians believed that smoking eased coughs and other respiratory disorders by promoting the production of mucus. But for a brief period, some members of the profession also saw the cigarette as the ideal drug-delivery mechanism: Medications could be easily mixed with tobacco and then inhaled with the smoke. A definite step forward from the days of blowing it up the patient’s bottom—although maybe not a very big step.

  In 1851, the editor of the London Journal of Medicine gave his approval to an interesting new idea from the United States: cigarettes laced with mercury.

  The inhalation of various medicines along with the smoke of cigars or cheroots has been more than once recommended in this journal. In prescribing the method, the physician must take care that the patient be clearly told that the smoke is to be drawn into the lungs; and the mode of doing this must be properly explained to him.

  Quite—suck all the health-gi
ving carcinogens into those lungs!

  Mr J.H. Richards, of Philadelphia, writes as follows in the Medical Examiner for June 1851—“I have been informed by a gentleman of intelligence, who has resided for a long time in China and Manilla, that mercury, which is there regarded as a specific in the severe forms of hepatic* disorder incident to the climate (and leading to its employment to an extent that would be considered extravagant by Europeans), is constantly exhibited in the following novel and peculiar manner. The black oxide* is introduced into the Manilla cheroots, and, being inhaled, is thus presented in the form of vapour to the most absorbent surface in the body.

  An absolutely horrendous notion. When heated, the “black oxide” decomposes to metallic mercury, tiny droplets of which would have coated the mouth, airways and lungs.

  “It certainly is a speedy plan of producing salivation. I mention this fact, as it is interesting in itself, and may suggest other applications of the same principle.”

  If you’re going to kill yourself by smoking, you might as well do it even more quickly by smoking mercury, I suppose.

  Would this plan be admissible in pneumonia? Perhaps not.

  Given that pneumonia is a potentially fatal infection involving the lungs, “perhaps not” does not begin to cover it.

  It is right to state that the smoking of mercurialised cigars is by no means, as Mr Richards supposes, a novelty in the practice of medicine. The following formula was given many years ago by Bernard: “Cigarettes Mercurielles. Bichloride of mercury, 4 centigrammes; extract of opium, 2 centigrammes; tobacco deprived of its nicotine, 2 grammes.” These cigarettes are recommended in syphilitic ulcerations of the throat, mouth, and nose.