Medical Procedures

Medical Procedures Table of Contents:




This page describes various medical procedures, treatments, and medications commonly practiced and used in the past and present. Although several treated physical symptoms, the practices on this page are relevant as treatments for mental disorders.


Artificial Leech
The artificial leech was created roughly near th end of the eighteenth century as a
Courtesy of Random Good Stuff.com
Courtesy of Random Good Stuff.com
way to diminish the usage of real leeches in medical practices. The artificial leech was a prominent tool in blood letting and proved to be a more sterile, an efficient method of bloodletting; however, its gruesome appearance and methods were viewed as being slighty frightentning. The artificial leech was made out of an aluminum tube with small blade on one end and a pump on the other. The leech was then applied to the patient where the blades began bleeding the patient. The pump could be pulled which helped keep blood flowing and which effectively captured the blood.


Sources
:

Oxford English Dictionary
(can somone scale this image? I don't know how to.)

Surgical Technologists.net

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Birth
William Smellie was the first obstetrician to scientifically study the process of child birth. He published the Treatises on the Theory and Practice of Midwifery(1752-64). He gave numerous lectures to midwives and students on childbirth techniques in London. He would offer free births to poor woman as long as they allowed his students to observe. He made many unprecedented observations, such as how the head is adapted as the baby is birthed.
historyworld.net

Birthing Forceps
These forceps were developed in the 18th century to help in childbirth which was much more dangerous to the baby and mother back in the 18th century. This is along the same time in which men started to become midwives as they were professional and education as where female midwives were just in possession of great amount of experience. One such family was the Chamberlen family which was accredited with the development of the forceps to help in child delivery but it is not confirmed as they kept their invention incredibly secret. These forceps are still used today in complicated births.


Blood_and_Guts_Birthing_Forceps.jpg
Source: Porter, Roy. Blood and Guts. London: W.W. Norton and Company, 2002.

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Blistering
Also known as Vesiculation, refers to anything applied to raise a blister or vesicle on the skin. Blistering is a popular treatment for insanity in eighteenth century. Dr.Whytt in Phil. Trans. L. 570, "I advised a blister to be applied". Physicians in eighteenth century believed that blistering was as effective in the management of hypochondriasis and hysteria as it was in other disorders, it had little effect on madness itself.
Sources:
Oxford English Dictionary OED Blistering
The British Journal of Psychiatry (2001) 178: 490-493
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Bloodlettingexternal image bloodletting+america.png
The procedure of withdrawing blood from a patient's vein for therapeutic purposes. Bloodletting was an ancient medical practice used since the ancient Egyptian, Greek, and Roman civilizations and Medieval Europe. Excess animal spirits/pressure were thought to cause physical and mental illness so some would be leaked from the patient. This procedure is no longer exercised as true causes of illness were discovered and bloodletting did not benefit patients; rather it drained them of energy and possibly made them even more ill from excessive blood loss and/or infection. Blood was expelled using bladed tools or leeches and captured with cups or bowls.
Source: [1] PBS.org
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Clysters (Enemas)
According to the Oxford English Dictionary, a clyster, or enema, is when "a medicine injected into the rectum, to empty or cleanse the
Clyster_Syringe.jpg
Clyster Syringe
bowels, to afford nutrition" (Oxford English Dictionary). In other words, stool is manually forced out of the body. This treatment was just one more way to purge the ailment out of the body and mind along with vomiting and bloodletting. Dr. John Woodward, an 18th century British physician, was well known for prescribing this treatment to his patients along with the other methods of purging the body. According to a vivid description by Dr. Woodward, the enema of one hysteric patient "was made of wind and matter, foetid, green, froathy, and sour" (Woodward 64).


Sources:
Oxford English Dictionary: clyster, n.
“Woodward, John (1665-1728).” Patterns of Madness: A Reader. Ed. Allen Ingram. Liverpool: Liverpool University Press, 1998. 63-68.
Source Picture: http://www.nlm.nih.gov/hmd/goya/images/tragala.jpg

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Confinement
In its various forms, confinement was used to treat madness as much as any medication in the eighteenth century. It was believed by many that by removing the patient from the location and circumstances in which they became mad, that the ‘disease’ was treatable. Quoting William Battie, “…repeated experience has convinced me that confinement alone is oftentimes sufficient, but always so necessary, that without it every method hitherto devised for the cure of madness would be ineffectual.” However, in the case of the eighteenth century, there were differing views on the proper way of confining the insane. Some physicians preferred the asylum model, where the patient was removed from friends, family, and all other stresses, such as Battie and St. Luke’s Hospital. This was countered by critics, such as Samuel Tuke, who saw the asylums as harsh and ineffective. They proposed models like the ‘Retreat’, which was based on Quaker ideas of the family unit. This still confined patients from society, but gave them a calm, relaxed atmosphere to cure their ailments.

Sources:
Patterns of Madness: William Battie, Samuel Tuke
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Cold bathing
During the 18th century, cold bathing and cold water was thought to be of use in curing many ailments. One of the most prominent uses of cold bathing is for fever reduction. A differing modern practice requires a tepid bath because a drastic difference in temperature between the body and the bath could cause shock. Other uses of cold bathing are the cessation of convulsions, insanity, plagues, typhoid fever, and drunkenness.
Source: History of Cold Bathing

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Dietary Changes
Changes of diet in the 18th century were thought to be a cure for madness. Often, changing or limiting the amount of wine and water consumed with dinner was thought to have affect as a treatment. Peter Shaw , an 18th century physician and author, "commanded, for his Drink, that Wine shou'd be mix'd in an equal Proportion with Water, wherein a Toast had been first soked; that twice or thrice a-day he shou'd drink a Glass of pure Canary; that an Hour before Dinner he shou'd take a few Spoonsfull of my bitter Stomachick Wine; that his Diet shou'd turn upon Chicken, Veal, or Mutton; that he shou'd eat a little at a time, but often..." (Shaw, 70-71). George Cheyne , an 18th century Scottish physician, stated that his Regimen was "Milk, with Tea, Coffee, Bread and Butter, mild Cheese, Salladin, Fruits, and Seeds of all Kinds, with tender Roots (as Potatoes, Turneps, Carrots) and, in short, every Thing that has not Life, dress'd, or not, as I like it; so that the Stomach need never be cloyed. I drink no Wine, nor any fermented Liquors, and am rarely dry, most of my Food being liquid, moist, or juicy... The thinner my Diet is, the easier, more cheerful and lightsome I find myself; my Sleep is also the sounder..." (Cheyne, 91-92).

Sources:
{1} “Peter Shaw (1694-1763).” Patterns of Madness: A Reader. Ed. Allen Ingram. Liverpool: Liverpool University Press, 1998. 69-75.
{2} “George Cheyne (1671-1743).” Patterns of Madness: A Reader. Ed. Allen Ingram. Liverpool: Liverpool University Press, 1998. 83-92.
{3}
Oldham, Graham. "Peter Shaw". Journal of Chemical Education. 1960. 37 (8) pg. 417.
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Electricitylightning15.jpg
Thought to be a cure for lunacy (Wesley), electricity was an important part of the eighteenth century view of the mind as well as the body. The 1700’s saw major experimentation into the subject of electricity, and in 1791 Luigi Galvani discovered the connection between nerve cells and electricity. He coined the term “animal electricity”, thinking the charge was generated in the body (Kirby, p. 332). As a result of the knowledge gained during this time period, many unique, life-saving devices have been created due to the body’s relationship with electrical charge, such as the defibrillator.


Sources:
Patterns of Madness; John Wesley
Engineering in History; Richard Kirby
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Electrode Stimulation
In numerous experiments, scientists have used electrode stimulation to treat Tourette's Syndrome. A recent study, with 15 patients produced results of a fifty-two percent reduction of ticks and embarrassing statements and/or movements. Some scientists have considered this treatment for people who have attention deficit hyperactivity disorder (ADHD) or obsessive compulsive disorder (OCD), however there are no reports on any actual experiments performed.


Evacuation
Evacuation.jpg
Evacuation

The process of removal or clearing out of the body, any organ or depleting organs of the body by the use of medicine or other anthropogenic means. Dating back to the 18th century, the word was used extensively when we had to refer to “bleeding”. The first use of the word can however be dated back to the 14th century, where again, the use of the word was to do with loss of blood.

Sources:
[1] Oxford English Dictionary, www.nlm.nih.gov/.../ exvotos/images/1927inset.jpg








Frontal Lobotomy
According to the Free Online Medical Dictionary , a frontal lobotomy is:
"A neurosurgical procedure (craniotomy) in which the nerve fibers in the bundle of white matter in the frontal lobe of the brain are severed to interrupt the transmission of various affective responses. Severe intractable depression and pain are among the indications for the operation. It is seldom performed, because it has many unpredictable and undesirable effects, including personality change, aggression, socially unacceptable behavior, incontinence, apathy, and lack of consideration for others. Because lobotomy is simple to perform, it was overused in the treatment of mentally ill patients in the past. A cannula is passed through the bony orbit of the eye, and a wire loop is inserted through the cannula to the cingulum. The nerve fibers are severed with the wire loop."


Homeopathy
According to Thinkquest and wikipedia homeopathy is the idea that a sick person’s symptoms can be cured by giving them something that would give a healthy person the same symptoms that they have. Samuel Hahnemann first proposed this idea in 1796. It started in Germany, and the idea quickly spread across Europe. All of the remedies that are provided are organic or coming from the earth. This form of medicine does not believe in vaccinations or antibiotics. The substances used for treatment were all diluted, and the dilution was done on a three potency scale. Hanhnemann developed the C scale which is one of the levels of potency. Homeopaths believe that the more dilute a remedy is the stronger the potency or power of that remedy. Most scientists will agree though that any positive affect given by homeopathy is from the placebo effect, or the mind believing that it is being cured when it really is not. This seems to be the case when people report significant improvement from ingesting a substance that has been diluted to 10-12, or one part in one trillion of the original substance.

Sources:

from http://library.thinkquest.org/15569/hist-8.html and http://en.wikipedia.org/wiki/Homeopathy

Jugum
The jugum was an instrument used to treat "spermatorrhoea" in the 18th century. Men who were "feeling anxious, tired, and irritable" were diagnosed
hommedia.ashx.png
Jugum
with this condition; the cause was attributed to masturbation.[1] In 1758, doctor Samuel Auguste Tissot published his theory on masturbation stating it was more devastating than smallpox since the act robbed the body of sperm, the "carrier of vital energies."[1] By the late 1700s, the jugum was created to prevent male genitalia from releasing sperm. The release of sperm was considered to be a serious detriment to physical and mental health. Eighteenth-century medical practitioners felt that too much masturbation could cause weakness, loss of vision, and loss of hearing. More importantly, it was also understood to cause insanity, epilepsy, and even mental retardation. The jugum, therefore, was not only a device used to treat a perceived physical ailment, but also one used to prevent and treat mental disorders.

Sources:
1. http://www.sciencemuseum.org.uk/broughttolife/objects/display.aspx?id=5055
2. http://www.afraidtoask.com/masturbate/History.htm

Percussion
According to HistoryofMedicine.com, Percussion is a method still used today, but was invented by Leopold Auenbrugger in the 18th century. As a boy, Auenbrugger would sit in his fathers wine shop and listen to his father tap kegs to determine how much wine was present in a particular keg. Auenbrugger applied this method to patients’ chest to determine how much fluid was present in their lungs. He would tap the patients’ chest with one finger with the hand drawn closed and listen for the different levels of pitches, either high, low, or dull, and determine whether or not that person had fluid in the lungs (historyofmedicine.com). This method of medical examination received little attention early on, but can now be found on any modern day medical website for its effectiveness in today’s medical examination. Medlineplus.com has defined persuccion as “a method of tapping body parts with fingers, hands, or small instruments as part of a physical examinations. The purpose is to evaluate the size, consistency, borders, and presence or absence of fluid in body organs.” The use of percussion in the 18th century eventually led to the development of the stethoscope.

Sources:
http://www.historyworld.net/wrldhis/PlainTextHistories.asp?groupid=479&HistoryID=aa52&gtrack=pthc
http://www.whonamedit.com/doctor.cfm/309.html
http://www.discoveriesinmedicine.com/Ra-Thy/Stethoscope.html


Purging
Removal of one or more of the four humors of the body to cure or prevent illness, madness, or death. By the idea of humorism, the body contained the four humors of yellow bile, black bile, phlegm, and blood. A balance of these humors was essential for health. Doctors used a number of methods to purge patients. Methods included but are not limited to laxatives, consuming various oils, blood-letting, vomiting, consuming poisons (such as mercury), or using opiates.
Sources:
[1] http://www.medicinenet.com/script/main/art.asp?articlekey=6836
[2] http://elane.stanford.edu/wilson/html/chap5/chap5-sect4.html

Restraint
Restraint was perhaps the most widely used "treatment" of madness in the eighteenth century. Restraint entails the use of chains, handcuffs, iron girdles, collars, cages, and straight-waistcoats. Since the insane were not thought of as fully human, restraints were considered entirely moral. Like confinement, restraint was used mostly in the case of violent patients to calm them and decrease their levels of excitement. Moving into the nineteenth century, restraint became less acceptable by society as a moral treatment and was therefore minimized.

Solitary Confinement
According to Stuart Grassian's essay "Psychiatric Effects OF Solitary Confinement", Solitary confinement is a confinement of a prisoner along in a cell for all or nearly all of the day, with minimum environmental stimulation and minimal opportunity for social interaction. This procedure is normally used in the prison as a punishment or separation of dangerous prisoners, but it is always used in psychiatry hospitals paired with straitjacket for dangerous, suicidal patients. When patient is placed in the solitary confinement, the patient is normally using straight jacket, and the cell wall is normally padded. The solitary confinement is used in psychiatry hospitals as a medical procedure, believing it can calm the patients by minimizing all stimulus, but in fact, it can cause severe psychiatric harm. Some specific psychiatric syndrome the the solitary confinement includes hyper-responsitivity to external stimuli, perceptual distortion, illusions, hallucinations, panic attacks, difficulties with thinking, concentration and memory, rove paranoia, noxious, even agitation, self-destructive behavior. In addition, solitary confinement can also result an overt psychotic disorganization and even exacerbation of a previous exiting mental conditions. In 18th century, this procedure was normally used to avoid excitement of the mental patient. It was believed that the absolute solitary confinement without any social contact such as family, even nurse helps patient to regain their calmness.

Sources:
[1] http://www.prisoncommission.org/statements/grassian_stuart_long.pdf


The "Tranquilizing Chair"external image chair.gif
This mechanical chair was devised by Dr. Benjamin Rush, regarded as the "father of American psychiatry," in order to treat or constrain mental patients during treatment. As it was believed that mental illness was caused by abnormalities in the bodily 'humors' or blood, the chair was designed to allow a physician to easily bleed his patient and/or treat the humors themselves by controlling blood flow and pressure. Rush believed that holding the patient in the specially-designed confining chair would control blood flow to the brain and lessen muscular physical activity to lower blood pressure and heart rate. {1}Basically, the mechanics of the chair had the patient restrained so as not to move to force physical relaxation; a patient would sit upright with their arms, legs, and chest bound to the chair while their head was kept in a partially-open box. However, the chair itself neither improved nor harmed his patients and only assisted Rush in bleeding his patients. {2}
Sources:

Sources:
{1} http://www.uphs.upenn.edu/paharc/features/brush.html
{2} http://www.mentalhealthstigma.com/insanecures.html


Treatise of the Operations of Surgeryarticle-1130463-03367D42000005DC-830_224x423.jpg
Written in 1712 by French medical author Joseph Charriere, this pocket-sized book was relied on by many surgeons in the eighteenth century a vital medical guide. The book contains important reference data on various procedures, such as the proper procedures for amputation. For example, the book states that, when performing a leg operation, "cut quick with a crooked knife before covering the stump with the remaining skin.".

Sources:
Revealed: The 18th century guide to amputations, operations and other medical tips









Vaccination

Syringe.jpg
Antique Syringe


Vaccinations, first used in the 18th century, are the “action or practice of inoculating the vaccine matter as a preventive of smallpox”. This practice was carried out to increase the immunity of the person. For instance, the use of vaccines of small pox included introducing cow-pox virus into the body of the person.

Sources:
Oxford English Dictionary
Picture courtesy of: http://antiquescientifica.com/embalming_set_Favre_c._1860_large_syringe.1.jpg



Vomiting
Vomiting was used frequently to purge the patients of anything harmful in their bodies. It did not have any known negative effects. It was used to cure convulsions because they believed that they had too much phlegm in their bodies. John Monro stated that induced vomiting was "infinitely preferable to any other [treatment]".

Waters of Bath
Legend states that the Prince Bladud caught leprosy in 860 BC. He was banished to care after pigs with a skin disease. The pigs rolled in the mud and were cured. When the prince did the same he was also cured. When he became king he founded a city there and named it Bath. Throughout the history, especially in the 18th Century, people came from all of England to bathe in the water and drink it and hopefully be cured. The city of Bath grew in size and popularity during the 18th century mainly because of the many improvements that were made. Countless buildings were erected and the streets were completely cleaned and paved. Rich tourists flooded Bath to play cards and ride horses. By 1801 the city reached a population on 33,000 and had grown into a prosperous town.

Sources:
[1] http://www.localhistories.org/bath.html





Medications



Chamomile: (herbal; Matricaria recutita, Chamaemelum nobile)
chamomile.jpg
Source: http://www.roseoil.in/productdetails.asp?id=31

Chamomile is a flower that has been used for thousands of years as a medical treatment. It has been known to induce a mild sedating effect, as well as an anti-inflammatory. Most might be familiar with the herb as used in tea, which is popular in many European and Asian cultures as a healing herb. Chamomile has been used to treat sleep disorders, anxiety, skin infections/inflammation, and the common cold. Although it has not been scientifically proven to treat these conditions, many believe that herbal remedies are the best for the body's natural healing.

Sources:
[1] Medline Plus, Patterns of Madness (pg. 88-89)







Hiera Picra-
(n.)
meaning “Sacred Bitters,” a purgative drug composed of aloes and canella bark, sometimes mixed with honey and other ingredients. It was administered for nearly any illness and used to help loosen the body and remove ill humors thought to affect the health of mind and body. The word is mentioned in a medicinal use by Mary Delaney in the eighteenth century in the writing of The Autobiography and Correspondence of Mrs. Delaney when she wrote of a friend “He takes nervous droughts and hiera picra. “ It is also mentioned in medical journals and related publications.

Sources:
[1] The Oxford English Dictionary.
[2] The Autobiography and Correspondence of Mrs. Delaney

Opiates
Used to describe the contents of the plant it originates in, the term opiates broadly refers to the various narcotic alkaloid substances acquired naturally through the opium poppy plant. These substances get their name because they are “constituents or derivatives of constituents found in opium, which is processed from the latex sap of the opium poppy, Papaver somniferum.” [2] Discoveries over the years led to the finding that opium contained several useful narcotic alkaloids: morphine, codeine, thebaine, and papaverine. Numerous other substances also exist within opium, but were found to be of little to no medical use, and as such, are typically excluded from the opiate classification. Opiates affect the human central nervous system. In the eighteenth century, opiates were often used as a painkiller; a practice that continues today. [1] The results of opium use is described as a “feeling of euphoria, extreme calm, or well being”, often causing the person to forget about the pain they were experiencing. Opiate usage is extremely addictive, so much so that in the eighteenth century many attempts were made by the Chinese to prohibit cultivation of the crop and its subsequent trade. [3]

Sources:
[1] http://www.opioids.com/pain-management/history.html
[2] http://en.wikipedia.org/wiki/Opiate
[3] http://www.answers4families.org/information-services/substance-abuse/drug-information/other-drugs/opiates


Rough Catharticks
According to the 18th century, a “cathartick”, now known as “cathartic”, is a medicine/substance that has the capability of “evacuating” or purging. A cathartic is a substance that accelerates defecation. It is not necessarily one that eases defecation, for instance a laxative, but is quite the opposite. The first use of the word dates back to the early 1600s, with reference to medical usage of purging. Use of the word then led to its evolution, now being known as “cathartic”. The first use of the new word was in the early 1800s, referring to the use of “cathartic salts” that were used with respect to medical usage.
The use of the word "rough" alongside cathartick refers to only the strength of the substance, and has nothing to do with the meaning of the word "cathartick".

Sources:
[1] Oxford English Dictionary, Wikipedia.

Tea of Carduus
Tea of Carduus is a tea made with Carduus Benedictus, or blessed thistle, also known as milk thistle, lady’s thistle, or holy thistle. It was used to help with stomach ailments and to encourage vomiting if needed. In his eighteenth century publication Domestic Medicine; or A Treatise on the Prevention and Cure of Diseases by Regimen and Simple Medicines, William Buchan explains how to make an infusion of Carduus Benedictus and uses for it.

Sources:
[1] Dictionary.die.net - Blessed Thistle
[2] Richard Buchan's Domestic Medicine






Illegal Drugs and Substances
Not sure if this should go here or somewhere else but a database of illegal drugs and their affects on the brain and why they are illegal. I listed some drugs for people to fill out and put anything else up that you want with some history and the effect it has on people long term and immediate. Make it relevant to the 18th Century