Thomas Rowlandson’s The Comforts of Bath
This week My Dear Lady Wife goes into hospital for a hip replacement operation – hopefully it will give her back some of the mobility lost in recent years. Anyway, it got me thinking about 18th century methods of getting broken bones to “knit”. In this context it is worth mentioning that my ancestor Richard Hall broke his leg when he was 22, jumping a ditch and falling awkwardly. The newspaper carried a report of the injury, with an article in the London Evening Penny Post for Monday September 9th 1751 recording:
The resulting injury left Richard in periodic pain for the rest of his life, and caused him to limp. As an old man, he recalls “being follow’d around the village while the boys called out “Hobbledee-Hall”. He doubtless pretended to object and wave his cane at them, since he used a crutch, finding it a hardship to stand still. This is his record of paying out three shillings and sixpence for the “crutch cane”
Richard’s own library gives an interesting insight into the way a broken limb was treated. Rather like someone today buying The Readers Digest Book of Home Medicine, Richard bought Dr Buchan’s Domestic Medicine when the Second Edition came out in 1785. It has the following advice:
“WHEN a large bone is broken, the patient’s diet ought, in all respects, to be the same as in an inflammatory fever. He should likewise be kept quiet and cool, and his body open by emollient clysters, or, if these cannot be conveniently administered, by food that is of an opening quality; as stewed prunes, apples boiled in milk, boiled spinage, and the like.
IT will generally be necessary to bleed the patient immediately after a fracture, especially if he be young, of a full habit, or has, at the same time, received any bruise or contusion. This operation should not only be performed soon after the accident happens, but if the patient be very feverish, it may be repeated next day.
IF any of the large bones which support the body are broken, the patient must keep his bed for several weeks. It is by no means necessary, however, that he should lie all that time upon his back. This situation sinks the spirits, galls and frets the patient’s skin, and renders him very uneasy. After the second week he may be gently raised up, and may sit several hours, supported by a bed-chair, or the like, which will greatly relieve him. Great care, however, must be taken in raising him up, and laying him down, that he make no exertions himself, otherwise the action of the muscles may pull the bone out of its place.
IT is of great importance to keep the patient dry and clean while in this situation. By neglecting this, he is often so galled and excoriated, that he is forced to keep shifting places for ease. I have known a fractured thigh-bone, after it had laid straight for above a fortnight, displaced by this means, and continue bent for life, in spite of all that could be done.
IT has been customary when a bone was broken, to keep the limb for five or six weeks continually upon the stretch, But this is a bad posture. It is both uneasy to the patient, and unfavourable to the cure.
THE best situation is to keep the limb a little bent. This is the posture into which every animal puts its limbs when it goes to rest, and in which fewest muscles are upon the stretch. It is easily effected by either laying the patient upon his side, or making the bed so as to favour this position of the limb.
ALL that art can do towards the cure of a broken bone, is to lay it perfectly straight, and to keep it quite easy. All tight bandages do hurt. They had much better be wanting altogether. A great many of the bad consequences which succeed to fractured bones are owing to tight bandages. This is one of the ways in which the excess of art, or rather the abuse of it, does more mischief than would be occasioned by the want of it. Some of the most sudden cures of broken bones which were ever known, happened where no bandages were applied at all. Some method however must be taken to keep the member steady; but this may be done many ways without bracing it with a tight bandage.
THE best method of retention is by two or more splints made of leather or pasteboard. These, if moistened before they be applied, soon assume the shape of the included member, and are sufficient, by the assistance of a very slight bandage, for all the purposes of retention.”
Anatomia Pathologique du corps Humain, book 2 (1835–1842) by J. Cruveilhier
a representation of a dislocated femur
So, we can assume that Richard was fed his diet of prunes, bled with leeches, made to lie on his side, and wrapped in wet leather and told to lie still for six weeks. Try telling that to a 22 year old! More about Richard can of course be found in The Journal of a Georgian Gentleman.
As for my wife, I am hopeful that she will spend three days in hospital (and this being Spain, I stay in hospital with her) and she should then be able to walk and manage stairs. No wet leather bandages, no prunes, and hopefully no leeches … medicine has certainly progressed over the past 250 years!
I am aware that leeches have made a bit of a comeback in recent years – and I can remember that the old family doctor who looked after me as a child used to tell me stories about how in the 1920s he would prescribe leeches. You got them from the local pharmacy, and you paid according to when they had last been fed. The hungrier they were the more expensive it was to hire them! After use, you would then return them to the pharmacy ready for the next patient….
Image courtesy of Bamfords, auctioneers.