Love Letters

Like my hero Sinclair, the Romantic poet John Keats (1795-1821) studied to become doctor but unlike Sinclair’s his heart was not really in it. . Keats’s letters to Fanny Brawne are among the most famous love letters ever written. As next-door neighbours, they exchanged numerous short notes, and occasionally more passionate letters.

Keats trained as an apothecary at Guy's Hospital from 1815 to 1816 and attended lectures on the principles and practice of surgery by the famous surgeon Sir Astley Cooper who also makes a brief appearance in my novel. In 1816, Keats received his apothecary's licence, which made him eligible to practise as an apothecary, physician, and surgeon.

Poet and surgeon John Keats

Keats's desire to become a poet led him to abandon medicine soon after he completed his training. In his 'Ode to a Nightingale' recalls his experience of caring for the dying:

The weariness, the fever and the fret

Here, where men sit and hear each other groan;

Where palsy shakes a few, sad, last grey hairs,

Where youth grows spectre-thin, and dies.

Ironically, it was his medical training that made him such a good carer for his brother Tom when he died from tuberculosis. In giving that care Keats became infected with the disease himself; there was no inoculation at the time, the now well-know BCG vaccine was first used in humans in 1921. Infection for Keats meant certain death but not before, he fell in love and wrote some of the world’s greatest poetry and love letters. Here is one of them.

“25 College Street, London

My dearest Girl,

This moment I have set myself to copy some verses out fair. I cannot proceed with any degree of content. I must write you a line or two and see if that will assist in dismissing you from my Mind for ever so short a time. Upon my Soul I can think of nothing else – The time is passed when I had power to advise and warn you again[s]t the unpromising morning of my Life – My love has made me selfish. I cannot exist without you – I am forgetful of every thing but seeing you again – my Life seems to stop there – I see no further. You have absorb’d me. I have a sensation at the present moment as though I was dissolving – I should be exquisitely miserable without the hope of soon seeing you. I should be afraid to separate myself far from you. My sweet Fanny, will your heart never change? My love, will it? I have no limit now to my love – You note came in just here – I cannot be happier away from you – ‘T is richer than an Argosy of Pearles. Do not threat me even in jest. I have been astonished that Men could die Martyrs for religion – I have shudder’d at it – I shudder no more – I could be martyr’d for my Religion – Love is my religion – I could die for that – I could die for you. My Creed is Love and you are its only tenet – You have ravish’d me away by a Power I cannot resist: and yet I could resist till I saw you; and even since I have seen you I have endeavoured often “to reason against the reasons of my Love.” I can do that no more – the pain would be too great – My Love is selfish – I cannot breathe without you.

Yours for ever

John Keats

Fanny, John Keat's great love

For more see:

http://englishhistory.net/keats/letters/love-letter-to-fanny-brawne-13-october-1819/

Outlander's Clair Fraser has jumped from second world war nurse, to eighteenth century healer cum witch to surgeon and that's what's great about fiction but the real story of female doctors, in Britain at least, is one of profound struggle and individual persistence. 

When Charlotte Leadam, in my up coming novel Sinclair, a story based on the real Leadam family who lived and worked as apothecary surgeons in Tooley Street from the late 18th century to the mid nineteenth century, inherits her husband's apothecary shop she was not allowed to run the shop on her own account - only men were allowed to be licensed as apothecaries.

Elizabeth Garrett Anderson (1836 – 1917) was the first woman in Britain who qualified as a physician and surgeon and she did this when in 1865, she finally obtained a licence (LSA) from the Society of Apothecaries.

Garrett's life's work was opening the medical profession to women. She started her quest by working as a surgery nurse at Middlesex Hospital, In 1860 she attempted to enrol in the hospital's Medical School. She was not accepted but was allowed to attend private tuition in Latin, Greek and materia medica with the hospital's apothecary, while continuing her work as a nurse.

She employed a tutor to study anatomy and physiology three evenings a week. Eventually she was allowed into the dissecting room and the chemistry lectures.

Gradually, Garrett became an unwelcome presence among the male students, who in 1861 presented a memorial to the school against her admittance as a fellow student, despite the support she enjoyed from the administration.

She was obliged to leave the Middlesex Hospital but she did so with an honours certificate in chemistry and materia medica.

Garrett then applied to several medical schools, including Oxford, Cambridge, Glasgow, Edinburgh, St Andrews and the Royal College of Surgeons, all of which refused her admittance.

Having privately obtained a certificate in anatomy and physiology and in 1862, she was finally admitted by the Society of Apothecaries who, as a condition of their charter, could not legally exclude her on account of her sex.

She continued her battle to qualify by studying privately with various professors, including some at the University of St Andrews, the Edinburgh Royal Maternity and the London Hospital Medical School.

She co-founded the first hospital staffed by women, was the first female dean of a British medical school, the first female doctor of medicine in France.

She was the first woman in Britain to be elected to a school board and, as Mayor of Aldeburgh, she was the first female mayor and magistrate in Britain.

Pictures: 1. Claire Randall (Caitriona Balfe) in Outlander Season Two Finale "Dragonfly in Amber"
2. Elizabeth Garrett Anderson

Imagining life without antibiotics

Mary Woolstonecraft, author of the Vindication of the Rights of Women fell victim to Childbed fever in 1797 having given birth to her daughter Mary Shelly the author of Frankenstein

The discovery of antibiotics has transformed all of our lives but it was found quite by accident when Professor Alexander Fleming discovered that one of the plates which had previously been coated with staphyloccus bacteria had mould on it in 1928. The mould was penicillium notatum but it was not used on a human being until 1941 when an Oxford doctor, Charles Fletcher, tried it on a patient dying from an infected wound. The patient unfortunately died, not because the drug did not work but simply because Fletcher did not have enough to kill all the bacteria. Having proved its effectiveness in reducing bacterial infection in people the drug went into production and was available to treat patients from the end of World War II. In 1945 Fleming, and the US drug company that manufactured the new ‘Wonder Drug’ Chain and Florey were awarded the Nobel Prize for Medicine.

Staphylococcus has many strains and causes a wide variety of diseases in humans and animals. About 20% people are long-term carriers of staphyloccus  aureus on the skin or in the nostrils and it lurks quite inertly in the healthy lower reproductive tract of women. It can cause a range of illnesses, from minor skin infections, such as pimples, impetigo, boils, cellulitis, folliculitis, carbuncles, scalded skin syndrome, and abscesses, to life-threatening diseases such as pneumonia, meningitis, osteomyelitis, endocarditis, toxic shock syndrome, bacteremia, and sepsis. It is still one of the five most common causes of hospital-acquired infections. When it gets into the bloodstream your chances of surviving without antibiotics is about 20% for a healthy adult for the frail and the very young it is much lower so it is not surprising that many people in the past died of what we consider to be relatively minor illnesses e.g.:infected wounds, rotten teeth, septic throats, leg ulcers and abscesses.

Puerperal or childbed fever was a common infection in the past. It is an infection of the uterus and surrounding tissues. Infection can be caused by a number of factors: premature rupture of membranes, vaginal examinations, manual removal of the placenta, and prolonged labour. In chapter II of 'Feavers and Acute Diseases in Women in Childbed' Nicholas Culpepper discusses puerperal fever (though not by this name) and attributes it to the “…stoppage of the afterflux… or the foul humours that were gathered at the time of being with child and stirred in travel” i.e. labour. In addition to this, getting up too soon after childbirth, too rapid a delivery, changes in the weather, strong drink, spices, metastasizing milk, and obstructed perspiration were all suggested as possible causes but the most popular was that it arose from poisons in the atmosphere or miasma.

The epidemic of childbed fever that struck the city of Aberdeen, Scotland, between December 1789 and March 1792 was unusual. It occurred not in the dirty, crowded and ill-ventilated wards of lying-in hospitals, but throughout the city and surrounding villages. Alexander Gordon, physician to the Aberdeen Dispensary found that "this disease seized such women only as were visited or delivered by a practitioner or taken care of by a nurse who had previously attended patients affected by the disease."  He admitted, "I myself was the means of carrying the infection to a great number of women." He went on to recommend in his report of 1795 that, "Nurses and physicians who have attended patients afflicted with the puerperal fever ought carefully to wash themselves and get their apparel properly fumigated before it be put on again." Unfortunately his advice was rejected by the medical establishment of the time, he died a broken man a few years later and the carnage in the the lying-in wards continued unabated.

One famous victim of puerperal fever was Mary Wollstonecraft, mother of Frankenstein author Mary Shelley. In 1797 she gave birth to her daughter Mary with the assistance of a midwife but then a doctor was called to help remove the placenta. He came quickly and with unwashed hands removed it. Wollstonecraft died a painful but typical death a week later. Today, as I know myself these infections are treated with antibiotics. Antibiotics saved my life twice in childbirth so I am very grateful that I was born after their discovery.

In the 1790s, Gordon stressed that the disease was spread from one patient to another. In 1842, Thomas Watson recommended that physicians and birth attendants wash their hands and use chlorine between patients. In 1847, Ignaz Semmelweis reduced the rate of fever in his obstetric ward by ordering hand washing, but the idea was still rejected by the medical industry at large and it was not until the late 1850s when the work of Louis Pasteur and Robert Koch provided convincing evidence of what we now call 'germ theory' that the idea of human transmission of infection started to be accepted. Indeed in 1880 the miasma theory was still competing with the germ theory of disease. Eventually, a "golden era" of bacteriology ensued, in which the theory quickly led to the identification of the actual organisms that cause many diseases.

Antibiotics are precious and we should use them wisely. If we look at what life was like before we had them I am sure we would not take them for granted.

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References:

Porter  Ian A. Alexander Gordon MD of Aberdeen 1752-1799.  University of Aberdeen:Oliver and Boyd (Edinburgh), 1958.

Gordon, Alexander. A Treatise on the Epidemic of Puerperal Fever of Aberdeen.London:GG and J Robinson,1795.

http://www.hektoeninternational.org/index.php?option=com_content&view=article&id=889&catid=65&Itemid=435 

https://en.wikipedia.org/wiki/Germ_theory_of_disease (01.05.2016)

A Directory of Midwives or a Guide for Women” by Nicholas Culpepper (London, 1681).

The Unfortunate Captain Peirce: When is a Hero not a Hero?

The wreck of the 'Halsewell', Indiaman, 1786, Thomas Stothard

Two and twenty years ago the merchant marine got its first hero; Captain Richard Peirce of the ill-fated East Indiaman the Halsewell. The ship which left Gravesend docks on the first day of January 1786 with a manifest of 240 people and was wrecked six days later of the Dorset coast with the loss of over 170 lives. The tragedy rocked the nation to its core and the ship’s captain became a national hero with stories and eulogies[1] appearing the London press and magazines like The Gentleman and The European praising his self-sacrifice for the sake of his family. The ship was not the first to go down and it certainly was not the last but this wreck captured the nation’s imagination for some reason.

Built by Wells of Blackwall in 1778 the 758 ton ship was on route to Madras armed with 12 cannon and carrying a cargo of 53 chests of small arms, 25 tons of copper plate, 500 tons of lead for shot, and general merchandise including pitch, grindstones, tar, chains and bellows but the main consignment was the men of the 2^nd Battalion and the 42^nd Regiment of the East India Company’s army who were being sent to replace men lost in Company’s war with the last mogul emperor with any clout, Hydra Ali, three years earlier.

 In addition to these soldiers the Haleswell has civilian passengers, including the two daughters Eliza and Mary-Ann; and two nieces of the captain Amy and Mary Paul, a Miss Elizabeth Blackburn,a  Miss Mary Haggard, a Miss Ann Mansell and a Mr John Shultz. The first mate, Thomas Burston, was a member of the Peirce family and was also lost in the incident. None of the women were able to escape and were among about 170 who died in the ship, which disintegrated within two hours of striking the rocky promontory. 

The Loss of the Haleswell, J.M.W Turner.

Accounts[2] given by two surviving officers Meriton and Rogers said that Peirce heroically remained with them and is shown on the right of the painting above, seated between and comforting his daughters. Meriton and Rogers stand on the left, on the point of departure, as calm observers of the group.

During the eighteenth century a number of men achieved the status of national hero, the most famous of them being the legendary Captain James Cook (1728-1779), the man who spent his life exploring and mapping; Newfoundland, Australia, the Hawaiian Islands and New Zealand for the British Crown.

During the Seven Years' War, Cook served in North America as master of Pembroke (1757) In 1758 he took part in the major amphibious assault that captured the Fortress of Louisbourg from the French, after which he participated in the siege of Quebec City and then the Battle of the Plains of Abraham in 1759. He showed a talent for surveying and cartography, and was responsible for mapping much of the entrance to the Saint Lawrence River during the siege, thus allowing General Wolfe to make his famous stealth attack on the Plains of Abraham.

In 1766, Admiralty engaged Cook to command a scientific voyage to the Pacific Ocean. The purpose of the voyage was to observe and record the transit of Venus across the Sun for the benefit of Royal Society inquiry into a means of determining longitude. Once the observations were completed, Cook opened his sealed orders and started the second part of his voyage: to search the south Pacific for signs of the postulated rich southern continent of Terra Australis. He sailed around New Zealand and landed on Australian soil on 19 April 1770, and in doing so his expedition became the first recorded Europeans to have encountered its eastern coastline. 

Two years later as the commander of HMS Resolution with his companion ship HMS Adventure he circumnavigated the globe at an extreme southern latitude, becoming one of the first to cross the Antarctic Circle on 17 January 1773.

On his last great voyage Cook was charged with looking for a north-west passage around the American continent. He sailed via Cape Horne and into the Pacific Ocean stopping off at Hawaii and the Sandwich Islands. Cook sailed as far north as Vancouver Island than turned back and was killed in an altercation with the local Hawaiian chief on 14 February 1779.

The Death of Captain James Cook,  Johann Zoffany, circa 1795.

So, how was it that Captain Peirce of the East India Company could be compared with the heroic Cook? 

In the latter part of the eighteenth century as tariffs were lowered on tea, brandy and other luxury goods the amount of smuggling along the coast was at last beginning to fall. Wrecks too were becoming less attractive to looters. The rescuers of the survivors were hailed by the King and the Company provided a reward of 50 guineas for their efforts. The survivors who were mainly crew had to walk all the way back to London through snow and rain, there was no reward for them. In fact the crew were lambasted[3] in some sections of the London press for failing to do their duty and for disobeying their captain and it became a commonly held view that the reason for the disaster was the lax attitude of the crew and their failure to follow their captain’s orders.

Thompson[4] argues that placing Peirce in the company of a man like Cook elevated him to an example of the national character, the embodiment of British courage and virtue in war. But Pierce was not at war and neither was he a servant of the state like Cook and other heroes such as Wolfe and Andre he was engaged in trade and a lucrative one at that. On a successful voyage a captain like Pierce could expect to make £10,000, and extra-ordinary amount of money compared to his pay which would have been something in the order of £300 a year and he was hoping to marry his daughters and nieces to rich officers or merchants along the way. But for a nation hungry for commercial success and wealth Pierce was their man, a jewel in their social crown and an example of familial loyalty and enterprise in the area of the world they were most interested in, India. “In death, Peirce becomes implicitly iconic not only for British courage and manly virtue but also the East India Company’s paternalism and its mission to form stronger bonds of affection and sociability both within British society and between Britain and its colonial dominions.

However, the legal implications of the commonly held view that the crew was the chief cause of the disaster were to have lasting significance for seamen who found themselves under the control of brutal officers, as both commercial owners and the British Crown were able to cite the example of the Halsewell as a reason for the maintenance of strict order, by force if necessary by officers on the lower orders.

The story of the Haleswell (renamed the Sherwell) inspired the beginning of my up- coming novel, Sinclair which will be available later this year.

[]] Monody, On the death of Captain Peirce, 1786.

[2] A circumstantial narrative of the loss of the Halsewell, East-Indiaman .Henry Meriton (second mate of the Halsewell.), John Rogers (third mate of the alsewell.)http://www.responsites.co.uk/halsewell/

[3]The London Recorder, January 15^th, 1786.

[4] Ship Wreck in Art and Literature, Carl Thompson, Routledge, 2013