SCIF Study 2 - Susan Hardy

Learning about Bodies

By the 18th C, university anatomical teachings were declining
in quality whilst private anatomy schools were set up as moneymaking ventures. In London, the Scottish Hunter Brothers were
the archetypal medical entrepreneurs.
William Hunter was the face, having two entrepreneurial
ideas: being a fashionable physician (respect by middle-classes,
more upper-class than typical physicians, well-dressed), and starting
an Anatomy School for paying students (future physicians and
surgeons). He became a man-midwife, which they claimed were
better as they had technology (forceps - put under babies head),
publication (anatomical atlases - showed position of baby in uterus)
and practice.
John Hunter was less articulate (strong accent) but liked
making things and was a brilliant anatomist (whilst William was the
face), and did drawings and hands-on demonstrations. He collected
animal skeletons from all around the world in the Hunterian Museum
by boiling down the animals, which he used for comparative
anatomy. They called the bodies subjects, one of which was the
Irish Giant (the Hunters were interested in freaks - fat, thin, tall,
short, deformities; sent men to stalk him and paid for dead body)
which was an attraction for students. However their results were
practical (e.g. discovered popliteal aneurism - blowing out of blood
vessel in leg, could lead to haemorrhage, which occurred in coach
drivers knees) to which they could apply a treatment (in this case
conservative surgery which conserves the limb by cutting out the
aneurism, collecting blood vessels and relying on collateral
circulation).
Bodies from hanged felons were given to unis (by a 17 th C
royal decree - dissection was seen as an extra punishment), but not
anatomy schools, which instead made deals with condemned
prisoners families for money (although not often), or body
snatchers - deals with poor law hospitals and gravediggers for the
bodies, which left the poor at risk as bodies were not considered
legal property. However popular press fuelled middle class panic.
In the 1820s, Dr. Robert Knoxs Anatomy School in
Edinburgh was popular but also expensive as it had a good supply of
bodies, which came from William Burke and William Hare from
accidental mass murders, which started off by ones wife owning a
boarding house and dead bodies were sold to Dr. Knox. Lead to
murder by burking (smothering and breaking neck) which was
done on the poor, possibly those going to die soon. There was no
police force, only informants/witnesses. They became careless and
were caught, and Hare explained everything and dobbed Burke in,
and was pardoned (Kings Evidence) whilst Burke was hung in a
large crowd and dissected by Professor Monro from a uni, and a
mask of his face was made. There were copy cat murders in London,
which resulted in dishonoured surgeons (others outraged against
stigma) and The Anatomy Act of 1832 (pushed by Jeremy Bentham;

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body preserved) which basically made taking unclaimed, destitute
dead bodies legal (but now requires approval). Thomas Wakleys
The Lancet (surgical knife) was the first medical journal which
encouraged people to be critical, stopped medicine being ridiculous.
Learning more about Bodies: Post-Mortems and Vivisections
Murders for bodies were somewhat pointless as they didnt
know if the patient was well, ill, lifestyle, diet, only gave some
structure, not function. In the 19 th C, Paris was the hub for cutting
edge teaching and experience in medicine and surgery for European
and American students, and the Hotel Dieu was the generic French
name for hospitals meaning House of God (shows religious
influence). The symbol of the doctor changed from a flask of urine to
a stethoscope.
In 1789 the French revolution (liberty, equality, fraternity) saw
the monarchy (church) fall, leading to a secularisation (loses
religious significance) of the state and mass executions of
aristocrats (nobles and Church) by guillotine (humane - originally
used by physician for vitalisitic experiments: checking if body
moved, eyes fluttered to see if still living). It also led to a rise in
secular middle class professionals, allowing a proliferation of
physicians and surgeons (as before couldnt do anything without
approval or patronage of monarchy, now achievements based on
ability). Hospitals had Schools of Health that focussed on practice
(and order and reason), not theory alone.
Larger hospitals had poor patients, and the patients life
stories were communicated to the doctors (although not always
reliable). Extensive examination was used for patients: inventum
novum (percussion of the chest; tapped it, listened for things like
tuberculosis where there was fluid in the chest cavity; idea from
tapping beer barrels to determine emptiness) and immediate
auscultation (listening directly to heart and chest), however there
were social and moral/ethical issues.
Rene Laennec (1781-1826; died of tuberculosis) invented the
stethoscope to overcome intimacy (idea from rolling up paper) using
mediate auscultation, which was more efficient. However
treatments were still Hippocratic (blood letting and purging).
Patients were also studied from bedside examinations (first stage)
right until post-mortem dissections (second stage), to compare and
correlate the body and disease, showing how disease worked in a
person.
Medical research also began at the tissue level (French for
fabric; histology). 21 types were identified, and pathological
changes (like internal lesions) were noted. The large number of
bodies allowed for a comparison between the normal and abnormal,
and they began to think of specific diseases (not just a diseased
body). However without microscopes this was all based on the
senses.
Claude Bernard (1813-1876) was a uni professor without
patients who was famous for the repeatability of his experimental

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methods in vivisection. Wrote Introduction to the Study of
Experimental Medicine in 1865 which looked at milieu interieur
(internal environment), believed internal body stable and resistant
to external environment unless affected by physiological
disturbances like miasmas or poisons. He lacked the students to
share his work.
German Rudolph Virchow (1821-1902) held conjoint uni and
hospital positions and wrote Cellular Pathology in 1858, which
supported Bernards findings. Believe looking microscopically also
became necessary for medical research. He was also popular with
students (a good lecturer).
This didnt necessarily result in treatment. Emperor Frederick
of the newly united Germany (son-in-law of Queen Victoria) had a
sore throat and eventually lost the ability to speak, and a tissue
sample was taken for cellular diagnosis, however he died (son Kaiser
started WWI) which didnt give doctors a good reputation.
There were many reactions to vivisection (which was done on
animals). It was not approved of as the West came to treat animals
with nobility and sentimentality, and animal rights and womens
rights became a conjoint movement with female activists like
Frances Power Cobbe who founded the BUAV. David Ferrier (18431928) showed work on neuroscience to an international conference
with his experimental subjects (dogs, monkeys) to which there was
outrage. The Vivisectionists Wife was Bernards wife, and she and
his daughter opposed his work and supposedly free animals in his
cages.
Microbe Hunters
Initially diagnosis and explanations were stories, often with
supernatural interventions (gods displeased with you change
behaviour/offering), an imbalance of humours caused by lifestyle
(environment, diet, exercise), miasmas (state of bad air, swamps
and malaria, bad smells), lesions in tissues in the body, and
eventually the ideas of specific diseases caused by invasion of the
body (contingent (subject to chance) contagionism). Before the 19 th
C, illnesses like leprosy and smallpox couldnt be explained by
stories as they were passed from person-to-person, but not all
followed this pattern and there was no elaboration on the means of
transmission. In the 16th C, there was the great pox (syphilis).
Many blamed connections between native populations from New
World voyages and warfare and the explorers, and it was transferred
back to Europe in a virulent form (in comparison there was small
pox, so apparently this was much worse). However bones from the
11th-12th C had these lesions in Europe, so it may have been an old
contagion that happened to pick up around then that happened to
pick up around then.
Diagnosis was done by symptoms (rashes, pustules), however
this may have confused it with other diseases, and it was referred to
as the "French/Spanish/Italian/English disease" as it was unpleasant,

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unsightly and unwanted. Its name was coined in the 19th C after
Girolamo
Fracastorio's
(1484-1530;
physician,
poet
and
philosopher) protagonist in a poem about a shepherd with syphilis.
He also wrote De Mortis Cortis, (About the Contagion of Death) in
Latin. Fracastorius suggested it could be caused by imperceptible
particles". At the time it was cured with mercury ointment (cheap
but nasty - similar to cauterisation; hid so others didn't know they
were sick) or guaiac bark (expensive as it had to be imported so
only the rich could afford, steamed or soaked in powder, less nasty).
Fuggers (a Swiss firm) had a pharmaceutical monopoly on the ales
bark.
Spectacles were already being manufactured in Low Countries
(western coast of Europe) however there was a greater need for
magnifying technology. Antoni van Leeuwenhoek (1632-1723)
manufactured and experimented with his own equipment, seeing
"animalcules" (could have been sperm, blood, cells or microbes. By
the 19th C microscopes improved (following Virchow's push to look
microscopically).
French Louis Pasteur (1822-1895) was a chemist trying to
stop wine going off for the wine industry, and in his swan-necked
flask experiments he found there was no fermentation or
putrefaction in the absence of biological entities, believing germs
(seeds of disease) had floated and caused these processes.
Diseases began to be thought of as entities with specific symptoms
and specific microbes invading the body and creating a
manifestation by specific internal and external symptoms. There
was a move from physiological explanations to bacteriological, like
typhoid which was originally described as the state of a body, now a
specific entity.
In the 1840s, surgery took off with anaesthesia being brought
into city hospitals, resulting in more and slower operations (which
often resulted in more infections). In the 1860s, Joseph Lister
suggested the use of carbolic acid as a means of antisepsis, applied
as a spray.
Robert Koch (1843-1910) hunted and named microbes by
staining and fixing them in petri dishes, then examining them under
a microscope. He believed each disease was caused by a different
microbe, and this set off mass microbe hunting (as many wished to
have a microbe named after them). In the 19th C in cities and
during WWI there was another epidemic of syphilis, and whilst the
microbe was found and diagnosable, there was no cure at the time.
The Hunt for the Magic Bullet
The term "magic bullet" comes from the 1840s German Opera
about Caspar the Hunter where he hunts with a gun (which would
have been dangerous in those times as unreliable), but he isn't
successful so he makes a deal with the devil to always hit, but there
will always be the devil's bullet which may come at anytime and hit
anyone. Now magic bullets are often antibiotics, as they are fired

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into the body to kill microbes whilst leaving the body unharmed.
Developments include microscopy, microbe hunting in animal fluids,
fixing and staining, and Koch's Postulates (injecting to see if same
symptoms result).
Many ideas are pursued as they are needed at the time, such
as venereal diseases like syphilis (altered facial structures as bone
became brittle (primary stage), shameful affliction with stigmata
(spots/lesions; secondary stage), and general paralysis of the insane
(GPI; tertiary stage)), which lead to a demand for a cure. Arsenic
was the 19th C drug of choice as it was unregulated, easily
obtainable, and could be claimed for other uses like killing rats, a
face wash, a stimulant or used in paint/wallpaper. Arsenic
compounds were then researched as small quantities had been to
known to be cured. Erlich and Hata found Salvarsan 606, which
they produced industrially. In WWI, there was not enough so
propaganda was used to warn against consorting with prostitutes,
mercury used for treatment if low supplies.
Alexander Fleming (1888-1955) discovered the first real
magic bullet at St. Mary's Hospital, London in the late 1920s. He had
been working on war wounds, and mould spores landed on his petri
dishes which resulted in bacterial inhibition. He turned this into
"mould juice" which treated infectious boils, abscesses and
carbuncles topically (without side effects), and in 1928 wrote a
paper on penicillin, however there was little further work done on it
as it was difficult to produce and was unstable.
Howard Florey and his team at the Dunn School of Pathology,
Oxford isolated and purified the active ingredient and tested it on
mice (producing it in milk churns, lemonade bottles, bedpans and
baths as they had little funding as it was being spent on WWII). His
wife Dr. Ethel Florey administered it and found it was generally
successful, surprising at the time for people to come back from the
dead, sounded almost religious. Florey went to the US to mass
produce (as there was no war there at the time, but despite the US
being neutral until 1943 it was only supplied to British allies). This
was a sae and effective broad-spectrum antibiotic, however it
couldn't help with viruses and some were allergic to the antibiotic.
Meanwhile Fleming becomes a wartime propaganda media
personality, despite having not much to do with it. It raised many
ethical problems like who could get it as production of limited
(soldiers vs. children), whether it would encourage/condone immoral
behaviour, whether Fleming or Florey should get the fame (both +
Ernst Chain - main supporting member - got 1945 Nobel Prize), and
the effects of overuse of antibiotics (people wanted it even if didn't
need, however resistance was built which compromised immunity).
A new plague returned, AIDS, which may have come from
Africa and appeared to be prevalent in the west amongst
haemophiliacs (blood transfusions), intravenous drug users
(hypodermic syringes) and the homosexual community (sexual
freedom). In terms of drugs (Panacea) there was no cure, only

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management, whilst information/education on healthy living
(Hygiea) was used, often through fear campaigns (Grim Reaper
posters, ancestral memory of plague).
Smallpox (the speckled monster) in Europe and Australia
Rhases (860-932 CE) from Persia wrote Treatise on Smallpox
(spoke about disease with bumps, we believe it was smallpox), in
which he believed it was caused by putrefying and fermenting of the
blood which caused pustules/lesions on the skin, and found it was
common in the young. Cures mainly came from the West included
placement in closed, heated rooms to sweat out the ferments or
humours, however this was not affordable for the poor. Variola minor
became variole major (more abundant) in 16 th C, as it was refreshed
by people that hadnt been in contact with it before (New World
exploring). Preventions mainly came from the East, where children
were exposed to mild cases (as it was noted a person never gets it
again), and dried matter from pustules was blown up nostrils, and
later inserted through surface scratches (scarifying with matter) for
a mild, localised reaction. The monster also defied class barriers,
as Englands Queen Mary died (1694), however Frances King Louis
XV (1757) survived.
In the early 18th C, the east met west, as Lady Mary Wortley
Montague brough news of Eastern practices, and had her own
children inoculated (through scarifying), and they ran a controlled
trial in England, reporting results at a meeting of the Royal Society
in London in 1714 where they appeared reasonably successful. By
the 1740s, inoculation was improved with shallowed scratches and a
greater chance of a localised, mild reaction, administered by
common people advertised in the local press (physicians were a bit
posh for commoners, grass roots campaign). However whilst this did
some good, it also spread the disease.
In the 18th C, the poor crowded in cities, and the failure of
Panacea meant the rediscovery of Hygiea and an attempt to clean
the environment. However the upper and middle classes saw them
as a threat of disease. They had higher expectations of health, and
were more rational than providential (religious), and use patches
(small dots) and makeup to hide disease. Both syphilis and small
box were stigmatising and ruined reputations and beauty (scarred
horribly afterwards), so in prostitution girls fresh from the country
were often used as they were less likely to have been in contact
with these diseases. It was noted that women from the countryside
(pretty milkmaids) werent affected by smallpox, and using this
grass roots wisdom cowpox was used as a variole vaccinae
(vaccus is Latin for cow).
Dr. Edward Jenner (1749-1823) was a country practitioner and
pupil of John Hunter who asked him, Why not try the experiment?
and he immunised using the weaker strain in cows (not an original
idea), which he wrote about in his book, The Cow Pox. However
many didnt like the idea of putting animal matter into humans,

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contamination occurred (as no sterilising and shared between
people), had side effects (as the strain wasnt always mild), and the
poor were least likely to be vaccinated whilst being at greatest risk,
remaining a threat to others.
It came to Australia by ship, and a vaccine institute was set up
in Sydney in the 1840s. The contagion spread throughout the
Aboriginal population from coast-to-coast and back (although some
dont believe to be as detrimental as first thought). In 1881-2 there
was a revival of smallpox (but only 154 cases confirmed with 25.9%
death rate), so premier Sir Henry Parkes set up the Board of Health
with the power to disinfect residences by ordering 3000 gallons of
carbolic acid. There was fear, panic and xenophobia (racism), and
patients were isolated in their own homes (with no means of wage)
or sent to North Head Quarantine Station (miserable conditions,
forced, no wage, pres claimed poor were stealing taxes in doing so
when they didnt even want to go). The Coast Hospital at little Bay
(now Prince Henry Hospital) was established as another isolated
area. By 1966 there were mass smallpox vaccinations by the WHO,
and it was declared eradicated by 1974 (with the last death in 1978
with a lab worker in Birmingham, UK).
In Australia there is no smallpox and infectious diseases are at
a lower rate in the general population. Some say better lifestyle
(although polio broke out in 1950s despite good hygiene), whilst
others believe due to immunisation (1.5% of children under 7 not
vaccinated due to vaccine refusal). There are questions as to
whether it is an individual decision, or whether direct (goaling) or
indirect (not allowed to attend school) compulsion is needed. We
also rely on herd immunity, but natural immunity (if we lead healthy
lives we dont need poison to fight poison) is also something fought
for.
The Medicalisation of Madness
Initially there was a supernatural approach, in which they
were believed to be possessed by Gods or the devil. Some were
believed to be saints (spoke in tongues, had strange dreams).
Experts were priests who used exorcism (attempted to drive out the
spirit) which was much like current psychology (spoke calmly,
touch/contact). According to some sources in worked in some
instances.
The natural approach was that everyone was different and
madness was just part of lifes rich tapestry, however many were
outcast as freaks, monstrosities (many of whom had to join a circus
for work) or the village idiot (acceptance was hard is people were
aggressive or disruptive). Up until the 19 th C many hid mad relatives
in attics (if rich house was large enough, had servants to care for
them) as they didnt want to lower the status of the family.
The punitive approach was supported by the British 1714
Vagrancy Act (similar acts in Europe), where anyone behaving in a
violent or disruptive manner in the streets (even just shouting,

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throwing things, being rude or sleeping on the street) were locked
up as towns were supposed to be more organised. This led to the
18th C penal code (many laws to protect people and their property
from madmen, even in minor offences), resulting in overcrowded
prisons and hulks (shacks on the river) as America had become
independent so they were sent to the Australian colonies. Many
were set free, and whether mad or driven mad (many claimed due
to sunstroke in NSW), some went to institutions within hospitals and
hospitals just for mad people, the first being Gladesville. By the 18 th19th C, there was a trade in lunacy where unwanted relatives (even if
not mad, just irritating) could be placed if committed, and they were
placed in The York Retreat (run by religious group Quakers where if
they behaved well they were treated like ladies and gentlemen) and
Bedlam (which had a private section for the wealthy).
There were many theories to these causes (which focussed
on the workings of the body), including an imbalance in the four
humours, chemical ferments that disordered the brain (16 th-17th C),
then in the later 17th C nerves thought of as a hydraulic system of
hollow pipes with fluid under pressure allowing the mind to control
the body, and eventually nerves were like wires with electrical
impulses, and short circuiting was the cause of madness.
In diagnosis, there was mania which occurred in men,
hysteria in women (Greek for uterus or womb), or melancholia
(gender neutral).
Treatments include bloodletting until the 18th C (cutting vein,
letting blood out, you feel lighter). Trepanning (drilling/digging holes
in skulls, but not brain, only shallow, let out some bad substances,
almost Hippocratic) was also used. For mania they could also be
calmed by having a plainer diet or constricted physically like
straight jackets with no vision to limit stimulation (as they were
overstimulated), whilst in melancholia they were under-stimulated
and hence given red wine and red meat or swung around. By the
19th C it was more medicalised, and Pinel (who did autopsies after
the French revolution on monarchy) believed they werent criminals
but patients, taking away their shackles and putting them in beds to
be examined. Later in the 19th C, French doctor Charcot researched
the workings of the brain, and displayed his patients (nearly always
female) to students (male), however many claimed they were hired
actors which he admits to as sometimes reality wasnt dramatic
enough. His pupil Sigmund Freud advocated for the talking cure
whilst the patient was on a couch in the late 19th C in Vienna.
After WWI neurasthenia (war-related shell shock or PTSD;
some thought it just to be the effects of the sound) occurred in men
and women (however their brain fever occurred from the pace of
modern life). By the 20th C, drugs and surgery (frontal lobotomy: cut
front of brain, makes less violent, however often did more damage
as in the case of JFKs sister) had been developed to alter
consciousness and mood, as well as electro-convulsive therapies
(ECT). However in the Chelmsford Private Hospital, Sydney in the

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1960-70s, patients (afflicted mainly with schizophrenia, but also
obesity, depression and addition) were treated with deep sleep:
barbiturates + ECT, which put patients in a vegetative state so they
could control levels of stimulation, however there were 26 deaths
reported and a Royal Commission Investigation, with many cases
only being resolved recently.
In the 20th-21st C there was de-institutionalisation as they
realised it wasnt good for people as many were crowded, how lower
standards than those expected and were expensive. The 1970s saw
an anti-psychiatry movement where everyone was seen in a
naturalistic approach and madness was just one place on the
continuum of human behaviour. The mad were led back into
communal homes.
Forensic Medicine
Forensic (Latin for in the forum/public domain/trial) medicine
is the application of medical science (technological and laboratory
methods). By mid-19th C in most countries med students had to go
through standardised exams and qualifications. Qualified med
graduates were put on medical registers, however they werent
always up-to-date (as doctors were busy attending patients), so
signing death certificates, treating patients and use in legal cases
may have been done by those other than the ones qualified. Doctors
became the expert witnesses in murder trials, considering physical
evidence at the scene of crime (although not always there), looking
for physical matches (connections between murderer and victim),
and usually were local GPs.
In 1807 the first chair of Forensic Medicine at Edinburgh
University was elected (although they didnt do much, but the fact it
existed was noteworthy), and in 1813 Mathiew Orfila became a
professor of forensic chemistry in Paris. His textbook Treatise on
Toxicology reflected the main 19th C method of murder (poison).
Arsenic was often used as it was easily obtainable and commercially
produced (for rat poison, womens cosmetics to whiten skin, dyes
and wallpaper, and for arsenic eaters as a stimulant), and its
symptoms were confused with cholera (as it produced almost
identical gastrointestinal problems). The first female serial killer ,
Mary Ann Cotton, killed husbands and children in the mid-19 th C
after insuring their lives to reap money, and moved around the
country doing so.
In 1832 the Marsh test for arsenic was first used in a jury
trial, which Marsh later described in 1846 in the Edinburgh
Philosophical Journal, however sometimes there were contamination
problems as was case with Dr. Alfred Taylor, which gave it a bad
name, Forensic examination was considered the cinderella of
medicine, requiring no formal training but rather using morbid
anatomy and pathology. It was considered the beastly science,
horrible and looked down up, and unfortunate errors and erratic
experts didnt help. Physiognomy (early profiling by judging

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character from their face) was instead viewed as the better
forensic science, however it may have even complicated the Jack
the Ripper murders in 1888 (as they may have done some actual
detecting if not focussed upon this), and in the case of Lizzie Borden
she was accused of murdering her parents with an axe however
despite evidence against her was let go because she looked
respectable.
Sir Bernard Spilsbury (1877-1947) was the first celebrity
expert witness and rescued forensic medicine, being an Assistant
Resident Forensic Pathologist at St. Marys Hospital, London, where
by 1905 pathologists were required to perform post-mortems in
sudden or unexplained deaths. In the Crippen case, Crippen was
hung for chopping up his wife and putting her in the cellar, but
recent DNA findings suggest the body may have been wrongly
identified (so at the time good, now bad). In the Brides in the Bath
case in 1915, George Joseph Smith had been taking new wives
during wartime to boarding houses where there were baths and they
had mysteriously died (could have been stroke, epilepsy, heat
stroke, accidental drownings), so Spilsbury was called in and he
noted no visible injuries and baths were too small for spasm, so he
experimented at a police station where he found by puling legs the
person would drown from the gush of shock (didnt just assume).
This case opened the worlds eyes to how crimes could be linked, the
freed and recklessness of serial killers, and the media (newspapers,
photography, telephone and telegraphs) allowed for better
communication, which allowed these similar crimes to be linked.
Spilsbury was knighted in 1923, but didnt write a book or train/work
with anyone, and he committed suicide during WWII after he lost a
son to the war and may have had guilt from knowing some cases
were wrong.
REMEMBER: DISCUSS WHY TOPIC IS IMPORTANT IN HISTORY
OF MEDICINE
Better Babies
In early times, birth was a rite of passage and secret womens
business (those that helped give birth were women - midwives or
wise women), wrapped in swaddling bands (bandages) as body is
pliable (e.g. believed encouraged babies to grow legs straight). High
mortality for women and children in medieval times (not unexpected
at time, women wrote letters before death). Focus not just on body
but soul, so priest may attend (male) to ensure baby was accepted
into the religion (baptism) just in case they died. Before 16 th
century, lower outward manifestation of love which grew until the
16th C. In 17th C, wise women had herbal medicines and gave spells
or incantations for mother to say, however many babies died or
were deformed due to malnourished mothers, wise women were
blamed (witchcraft). Midwifery was then a less enticing job, so male
midwives (physicians looking to open patient base) took over,

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including the Hunter brothers. Hunter brothers had atlases with
drawings of children in utero, aided understanding. Midwives also
had technology: The Chamberlen forceps (grabs baby around head;
17-18th C), which was a response to obstructed births (that often
lead to deaths) - but they didnt allow other practitioners to see.
This mostly appealed to middle-class women who wanted more
cutting-edge technology with fashionable man-midwives in their
own homes. Moral and ethical problems (male and female
interaction), and women moved from birthing stools to bed with
covers (not only for decency but also so people didnt see the idea
of forceps and steal it), which meant slower births (as gravity
couldnt assist).
James Simpson (UK physician) used chloroform in 1840s for
anaesthesia in birthing, however births also became longer as
mothers unable to push, and ethics about religion (childbirth should
be in pain). Queen Victoria had a child with anaesthesia and
supported the idea.
Poor/destitute for mothers go to Benevolent Asylums
(hospitals for birthing), which lead to overcrowded hospitals with
diseased, malnourished people which lead to puerperal (childbed)
fever from cross-infection, which lead to many deaths of mothers
and increased orphans.
Ignaz Semmelweis (1818-65), Hungarian in Vienna (minority)
looked at students and midwives clinics (many preferred to have
birth on street than in students), and found deaths much higher in
student doctor places, and Semmelweis found they brought disease
from post-mortems (called morbid matter, germs not known). Death
of colleague who got a cut on his finger confirms his suspicion.
Suggested medical students wash their hands (unpopular,
nitpicking).
By late 19th-20th C, surgery is aseptic and childbirth becomes
aseptic too. Women are given twilight sleep (asleep, dont
remember it, fears it is too sterile, no love/soul). In 20 th-21st C,
Australia and NZ lead the way in ante-natal (before birth) support.
There was improved nutrition for mothers, examinations, tests and
scans, return to birthing stool, and choice between home and
hospitals. However, there are high standards in developed countries
(back to blaming for deformities), and it isnt available in all parts of
the world, and it should be.

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Oliver Bogdanovski