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The Editor’s Eye

July 15, 2014

Focusing on the stories of the medical humanities – by Elizabeth T Hurren

Elizabeth Hurren.

Elizabeth Hurren.

“It’s marvellous the workings of a wheelbarrow.” This was my Irish Grannie’s favourite piece of homespun wisdom – it covered everything that life could throw at you and a lot of surprises that made life really worth living. A district nurse and midwife, married to a man originally born in India, she knew all about the amazing uses a wheelbarrow could be put to in modern medicine: taking clean laundry deliveries to surgical wards, wheeling pregnant women to theatre, carrying clean water from village wells and food from the fields to nourish countless millions – in a global health economy the wheelbarrow has surely been one of the most versatile and underrated pieces of medical equipment. Did I mention that it covered sex education too? My Grannie would whisper that with the birds and the bees, “so much depends on the wheelbarrow”. I never worked out the precise mechanics of wheelbarrow reproduction, but I did learn that for many of the poorest a wheelbarrow was their mobile home – a pram for precious babies – a trusted family heirloom. In this summer 2014 issue all our contributors invite us to see human creativity and medical diversity in humdrum things and outwardly familiar predicaments. Read more…

Dialogue with pain

July 14, 2014

How and when we give meaning to bodily pain – by Louise Hide

Etching of a man in pain. By W Hebert, c.1770, after C le Brun. Wellcome Library

Etching of a man in pain. By W Hebert, c.1770, after C le Brun. Wellcome Library

Pain destroys lives. Most of us will do almost anything to avoid or at least to mitigate it. We pop a pill for a headache, welcome the anaesthetist when the surgeon’s knife threatens, and find solace in the prospect of an expanding cornucopia of powerful analgesics. As Jo Shapcott’s poem ‘P’ (excerpted at the bottom of this piece) highlights, we dread being in pain. Yet everyone will experience it at some time in their medical life story. Getting it is very worrying; not sensing it doesn’t dull the anguish.

‘Pain and its Meanings’ convened in early December 2012, hosted by the Birkbeck Pain Project in collaboration with Wellcome Collection. It was a two-day interdisciplinary symposium that asked crucial questions about our dialogues with pain, our historical and contemporary attitudes towards understanding and treating it, and – crucially – what happens when we do not feel pain? During the symposium, Joanna Zakrzewska, an NHS consultant who leads a multidisciplinary facial pain unit at University College London Hospitals (UCLH), described how people who are congenitally insensitive to pain might fall asleep on hot water bottles, iron their hands, or run on a broken leg until it collapses. Pain does, therefore, have its uses. It warns us of danger and damage to the body. It also has meaning. Read more…

A culinary challenge

July 14, 2014

From early modern recipe books to MasterChef – by the Wellcome History team

In 1897 Henry Wellcome purchased his first domestic recipe book at a London saleroom. He went on to collect many more, giving unique insights into the history of food and domestic medicine. Today, the Wellcome Library has digitised these fascinating sources, making them freely available online for the first time to every budding masterchef. This unrivalled collection of nearly 300 volumes spans from the early 16th century to the late 19th century.

Recipe book, 1680-c.1725. Wellcome Library

Recipe book, 1680-c.1725. Wellcome Library

So this summer we have a culinary challenge for all the readers of Wellcome History who love to cook. Here we reproduce five recipes from a book written by unknown authors between 1680 and c.1725; it seems to have later been owned by Henry Stopes (father of Marie Stopes). Cook them if you dare!

Do let us know how you get on in the kitchen – though please note that the Wellcome Trust accepts no legal responsibility for any aches, pains, wind, indigestion, stomach upsets, bowel complaints or deaths that may occur as a result of using these recipes.

To Make Almond Cakes

Take half a pound of sugar sieved as much as Almonds [same weight of each] beaten very fine with 3 spoonfuls of orange water – then ye whits [whites] of 15 eggs beaten – take the froth of the eggs and set with ye almonds [stirred in together] on a chafing dish [oven ready] when hot cook well and then let it go cold – roll it up and make it into almond cakes.

To Make Roseberry Cakes

Take 2 pounds of flour and one pound of butter, rub it into the flour with one pound of sugar – let ye butter be [first] steeped [soaked] in rose water all night well – 4 eggs and 4 spoonfuls of rose water work well – and then [taking all the ingredients, sugar, flour, rosewater and eggs] make ye cakes round and thin, and bake them in a quick hot oven.

To Make China Ale

Take 15 gallons of ale when it hath done working, put it into 4 ounces of coriander seeds bruised and 2 penny worth of cloves – let it stand a week or 9 days – to every three dozen bottles put a pound of sugar and if you will have it very sweet you must have half a spoonful of sack [sweet syrup] put into every bottle.

To Make Lemon Cream

Take 6 egg wits [whites] & yolks and beate them very well with a spoonful of rose water, but six hours before you beat the eggs pare of the peel of 4 lemons as thick as you can and put it in half a pint of faire water. Bruise the peel that the water may taste of it well, then take it out and put in the juice of the lemons & the eggs that was beat – stir it well together and serve it in half a pound of fine sugar & then straine it and set it on the fire until it be as thick as good cream – then take it off the fire & stir it still it be cold then put it in a dish you will save it in – you must stir it all the while it is on the fire.
[Sadly there are no details of how hot the fire should be or how long to cook it for.]

To Boil Mackerel

Take ye mackerel and draw it [removethe guts] as ye would herring and wash it very clean and dry it – Ye then take parsley and thyme and work it with butter and a little salt to fill up the belly of the mackerel – ye then take a sheet of white paper [greaseproof] and dip it in [more] melted butter and wrap ye mackerel upon it and put it on a and slow fire until all the flesh is cooked – serve.

Happy cooking and summer picnics!

Sun and surgery

July 13, 2014

Voices of medical tourism in high-tech Indian hospitals – by Orla Mulrooney

Forty years ago conditions and facilities at most Indian hospitals generally compelled rich Indian citizens to travel abroad for advanced surgeries where possible, while the poor simply did without. Today, however, quite the reverse is widely reported. Patients now travel from around the world to undergo advanced surgeries at high-tech hospitals in India. How did this happen? What has changed, who has driven these changes, and what is this burgeoning medical industry?

The term ‘medical tourism’ is, arguably, an oxymoron – even the name of the phenomenon my research explores is contested. As a concept in modern medical care it certainly remains hotly disputed. Yet since the expression first appeared in the last quarter of the 20th century, medical tourism has grown into a lucrative, increasingly organised, yet largely unregulated industry. Also referred to as ‘value medical travel’, it is a phenomenon associated with unprecedented changes in healthcare delivery. Social, political and economic factors – including access to travel, information and technologies, endorsements from states and insurance companies, promotion by various individuals and interest groups, and changed consumer behaviours – have all fuelled increased cross-border and international travel for health. Read more…

Soaking up the sun’s rays

July 12, 2014

Light therapeutics and the belief in a healthy tan – by Tania Anne Woloshyn

In a 1936 leaflet, a ‘Vi-Tan’ UV-rich mercury vapour lamp shines down on a jubilant woman. She is dressed for the beach but wrapped in an electrical cord. The manufacturers of the device, the Thermal Syndicate Ltd, promise that their UV lamp would bring “summer in winter” to the “sun starved, restoring everyone to a healthy colour”. Like the woman’s smiling face and her swimsuit body displaying delectable contours, the promise was that everyone could have a deeply tanned body. Through an overtly contrived composition, the Vi-Tan acted as the technologically advanced substitute for a radiant and radiating sun. The lamp was thus stationed in the advertising as though taking its ‘natural’ place, embedded within the sun itself.

Vi-Tan leaflet, 1936. Wellcome Library

Vi-Tan leaflet, 1936. Wellcome Library

I am exploring the reception of a whole range of light therapeutics in Britain from the turn of the 20th century until just before World War II (1899–1938). The overall aim of the three-year research project is to investigate light therapy, through not just its literature but its images and objects: photographs, posters, postcards, illustrations, films, goggles, and sun lamps too. Read more…

Women and cycling

July 11, 2014

A ‘hobby-horse to destruction’ and ‘healthful exertion’ in late-Victorian Britain – by Hilary Marland

“Maidens with a disregard for convention” by William Gordan Davis, 1895. National Cycle Archive, Modern Records Centre, University of Warwick

“Maidens with a disregard for convention” by William Gordan Davis, 1895. National Cycle Archive, Modern Records Centre, University of Warwick

Cycling is nowadays widely and enthusiastically promoted as a means of improving fitness, reducing stress and aiding weight loss for men and women of all ages. The positive vision of female cycling highlighted during the London 2012 Olympics has, though, also revealed the stresses of competitive cycling for young women and the physical and emotional pressures placed on young female bodies and minds.

Today, tucked away in medical journals and on cycling websites, a variety of concerns about the potential medical risks of cycling for women and men have been voiced: ‘cyclists’ nipples’, skin problems, erectile dysfunction. For women, poor posture or excessive cycling has been associated with numbness, soreness and decreased sensation in the pelvic floor, the bacterial infection vaginitis, and ‘bicyclists’ vulva’. This unpleasant swelling of the labia is caused or exacerbated by intensive cycling – perhaps predictable, given that one recent survey found the average female athletic cyclist to be doing 462.5 miles a week! It is nevertheless striking that this association between cycling and gynaecological troubles is historically nothing new. Read more…

Boiled baby bees for tea

July 9, 2014

Recovering Mizo medicine’s endangered archives – by Kyle Jackson

Kyle Jackson (far right) and colleagues in Mizoram. Kyle Jackson

Kyle Jackson (far right) and colleagues in Mizoram. Kyle Jackson

A big bowl of boiled baby bees was being pushed towards me. It was the generous honour afforded to dinner guests in a village home in Mizoram, the tribal state at the southernmost tip of India’s easternmost frontier. I wished that my hosts were less generous. I wished that the honour were less larvae-related. I cursed the British Library under my breath, and grabbed a grub.

I was in Mizoram, one of the ‘Seven Sister States’ of India’s northeast, sharing borders with Bangladesh and Myanmar. I travelled out as part of a four-member pilot project under the Endangered Archives Programme (EAP), a global rescue mission for the world’s most endangered historical documents.

The scheme is administered by the British Library and funded by Arcadia. EAP researchers have in the past eight years fanned out across the globe. Team members travel to the remotest places, armed with little more than high-resolution digital cameras and strong stomachs, as I did in India.

Read more…

A whole realm of unregulated healing

July 9, 2014

Subaltern therapeutics in Indian medical history – by David Hardiman and Projit Bihari Mukharji

In India, government health facilities have been notorious for their inadequacy, whether in British colonial times or under subsequent independence. State hospitals are frequently overcrowded, offering a much poorer service than private hospitals. Local public health centres are run by staff who lack commitment to their work and indeed are often absent. Money is often demanded for treatment that should be free of charge. These limitations provide the conditions for a large and flourishing healthcare sector that is entirely unregulated. This ranges from modern medicine provided by unqualified or inappropriately qualified people who style themselves ‘doctors’ to popular remedies and spiritual cures. Their care is usually cheap and easily available, though its quality is highly variable and often questionable. In the absence of regulation, the sector is wide open to malpractice.

While medical historians of India have in recent years studied biomedicine and the systematised and regulated indigenous systems, such as Ayurveda, in some depth, the unregulated sphere has been largely ignored. We know of it mainly through the work of medical anthropologists, and however fine their studies may be, they are usually of contemporary times and not the past. ‘Folk’ therapies appear in their writing as timeless and unchanging; history, if visible, appears as a benign background rather than a dynamic site of analyses. Moreover, the vast majority of these anthropological works study ‘folk medicine’ without any reference to the vernacularised biomedicine that is practised so widely by unqualified ‘doctors’. As historians, we are not satisfied with this state of affairs, as it excludes from the history books any adequate recognition and analysis of large areas of healthcare in South Asia. The challenge for us has been to construct a history of this whole realm of unregulated healing, and to situate it in relation to the histories of the better-known and better-researched spheres of regulated practice.

Read more…