Monday, April 28, 2008

On the science of bleeding, or, And people wonder why I don't particularly like doctors!

{Photos by rocketlass.}

Near the conclusion of Henry Fielding's black comedy of rascality The Life of Mr Jonathan Wild the Great (1743), Thomas Heartfree, a good man falsely condemned for a variety of frauds actually perpetrated by the amoral Jonathan Wild, learns of his reprieve mere moments before ascending the gallows. Fielding writes,
It would be impertinent to offer at a description of the joy this occasioned to the two friends, or to Mrs Heartfree, who was now again recovered. A surgeon, who was happily present, was employed to bleed them all.
I read that passage on the way home from London, a few days after a visit to the old operating theater in the garret of St. Thomas's church, where multi-bladed bleeding implements were nestled in display cases alongside other terrifying tools of early modern medicine. Being confronted with the reality of that most cringe-making of outdated medical practices reminded me of my first encounter with therapeutic bleeding, which I imagine I share with many a bookish kid. It came at the hands of Robert Louis Stevenson, in those glorious opening scenes of Treasure Island (1883), where an ordinary boyhood is disrupted by the arrival of mysterious strangers--one of whom has a stroke:
"The man has had a stroke, as I warned him. Now, Mrs. Hawkins, you just run up-stairs to your husband, and, tell him, if possible, nothing about it. I must do my best to save this fellow's trebly worthless life, and Jim here will get me a basin."

When I got back with the basin, the doctor had already ripped up the captain's sleeve and exposed his great sinewy arm. It was tattooed in several places. "Here's luck," "A fair wind" and "Billy Bones his fancy," were very neatly and clearly executed on the forearm; and up near the shoulder there was a sketch of a gallows and a man hanging from it--done, as I thought, with great spirit. "Prophetic," said the doctor, touching this picture with his finger. "And now, Master Billy Bones, if that be your name, we ll have a look at the colour of your blood. Jim," he said, "are you afraid of blood?"

"No, sir," said I.

"Well, then," said he, "you hold the basin;" and with that he took his lancet and opened a vein.

A great deal of blood was taken before the captain opened his eyes and looked mistily about him. First he recognised the doctor with an unmistakable frown; then his glance fell upon me, and he looked relieved But suddenly his colour changed and he tried to raise himself crying:--

"Where's Black Dog?"

"There is no Black Dog here," said the doctor, "except what you have on your own back. You have been drinking rum, you have had a stroke, precisely as I told you, and I have just, very much against my own will, dragged you headforemost out of the grave."
I remember being both horrified and fascinated when I first read that, feeling instantly that I was in a world markedly different from my own--almost certainly my first experience of literature's enlivening of the past.

The operating theater, which was placed in the garret of St. Thomas's church in the mid-19th century when the adjacent St. Thomas's Hospital was desperate for space, was sealed up around the turn of the century and forgotten for more than fifty years. Now it is a fun little museum, alternating displays of herbs (with signs explaining their real and supposed medicinal powers, such as coral's powers over "Monsters, Incubii, Succubii, Phantasmata and all Evil Spirits") with cases of medical implements that were once state-of-the-gruesome-art. The operating theater itself encapsulates the horrors of Victorian medicine: as a placard explains, it rests on a false floor above three inches of sawdust, so that blood spilled by the doctors--who wore frock coats "stiff and stinking with pus"--wouldn't seep through into the sanctuary below.

Of most interest to the literary tourist, however, is the fact that John Keats studied at St. Thomas's, and presumably attended lectures in the operating theater. But Keats soon realized that he was not suited for a medical career: according to Lord Houghton,
When he had once entered upon the practical part of his business, he found his mind so oppressed with an over-wrought apprehension of doing harm that he determined on abandoning the course of life to which he had devoted a considerable portion of his small fortune.
A letter Keats sent to a friend in 1817 pinpoints the decision in a moment of distraction while bleeding a patient:
My last operation was the opening of a man's temporal artery. I did it with the utmost nicety, but reflecting on what passed through my mind at the time, my dexterity seemed a miracle, and I never took up the lancet again.
At least Keats realized his shortcomings; a contemporaneous account of his medical mentor, Mr. Morgan, related in the operating theater museum, is postively chilling:
A tall, ungainly, awkward man, with stooping shoulders and a shuffling walk, as deaf as a post, not overburdened with brains, but very good-natured, and liked by everyone. His surgical acquirements were very small,his operations very badly performed, and accompanied with much bungling, if not worse.
It seems that Keats probably made the right decision in choosing the relatively developed art of poetry over the still-blind gropings of Regency medicine. Remind me not to visit the past unless I'm sure my time machine is prepared to yank me back at the first sign of sickness.

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