Hektoen International

A Journal of Medical Humanities

Looking back 175 years

Biji T. Kurien
Oklahoma, USA

Louis Pasteur in his laboratory, 1885
Albert Edelfelt

It was a time when surgery was performed in the raw. Obviously a horrendous nightmare for both patient and surgeon, it was performed only in do-or-die situations. The odor of pus in various stages of decomposition pervaded hospitals. Deaths from various diseases and surgery were common. Treatment of ailments with mercury vapor baths was commonplace. Weights and measures were in minims, grains, drachms, scruples, and stones. It was customary to dry clothes before the fire. Doctors paid house visits, bled people copiously by venesection or with leeches (local or imported) and prescribed weird medicines such as python’s excreta. In journals authors glibly published statements, like—“She was seventeen years of age, unmarried, of a healthily disposition, short and corpulent, I opened the veins in both arms; she was a fat subject.  . .”, “ a spinster aged 40, of huge proportion, fat and plethoric”, “a motherly old dame”, or “As the breasts of many women and girls, particularly in countries abroad, are inclined to be too much developed . . . even when not abnormally developed they may be so mobile as to cause serious inconvenience . . .”

Some things do not change

Space in medical journals was scarce even in the 1840’s and it was very hard to get published, but people loved to do so. Oliver Wendell Holmes Sr., celebrated author and doctor, stated that he “first tasted the intoxicating pleasures of authorship while at college” and that “there is no form of lead poisoning which more rapidly and thorough pervades the blood and bones and marrow than that which reaches the young author through mental contact with type metal.”

Some things did change

Medical, scientific, engineering, and electronic knowledge grew by leaps and bounds. Newton, Dalton, Koch, and Osler, in spite of their brilliance, would never have imagined people using computers, iPods, cell phones, and radios to communicate, or MRIs.

Electricity, telephones, cars, airplanes, rockets, and other modern amenities have transformed life. A lot of “–less” stuff are in place now—wireless, topless, cloth less and even penniless. Toilets are no longer the garden soil/pail kind. Excreta from airplanes are no longer discarded over sea or land. One author wrote about “Parasites Lost and Regained,” protesting against the use of human excreta as manure for cultivating lettuce.

Important doctor and scientist discoveries

According to Goethe, “all productivity of the highest kind, every significant piece of insight, every discovery, every great thought that proves fruitful and leads to further consequences, stand in the power of no one, and are beyond all earthly might. A human being has to regard them as unhoped-for gifts from above which he has to receive and revere with joyful thanks.”

Louis Pasteur

In 1874 Lister wrote a letter to Pasteur, the founder of microbiology “Allow me to take this opportunity of thanking you most heartily for having shown me, by your brilliant investigations, the truth of the germ theory of putrefaction, and for having thus acquainted me with one principle which can lead the antiseptic system to final success.” Some of Pasteur’s major achievements included pasteurization, conquest of anthrax and rabies, and disproving spontaneous generation.

Lord Lister

Joseph Lister, as a direct result of Pasteur’s publications, created a revolution by introducing antiseptic surgery. Prior to this all operation wounds tended to be septic and many became gangrenous. Lister sterilized his hands, his instruments, and his dressings as far as he could with carbolic acid and other antiseptics. He even sterilized the air with carbolic spray. Thus he was instrumental in saving much life and suffering.

James Young Simpson

James Simpson lost his parents in his youth. Even though very poor and friendless he completed his MD. The horror that he felt while assisting a surgery without anaesthesia built in him a resolve to find a way to relieve pain rather than run away from it. Several people thought that he was too young when he decided to apply for the chair of mid-wifery. On hearing this, “on an impulse” he decided that he would be young indeed and signed his application as James Young Simpson.

In January, 1847, he became the first to use ether in obstetric practice. Soon he found that ether was not the ideal anaesthetic. Keith and Matthews Duncan, his assistants, and himself would meet after work in Simpson’s dining room for several months before the discovery to inhale, from “simple tumblers” all kinds of “likely and unlikely vapours,” Prof. James Miller, Simpson’s neighbor would often peep in at breakfast-time just to inquire if everyone was still alive. Finally, one evening in November 1847, they stumbled on chloroform retrieved from a waste-paper basket.

John Dalton

Dalton, himself color blind, wrote the most important paper on color blindness and was responsible for the atomic theory. He led a temperate, simple, frugal, unmarried life. He said that his head was “too full of triangles, chymical processes, and electrical experiments, etc., to think much of marriage.”

Robert Koch

Robert Koch, famous for the Koch postulates, isolated the bacteria causing anthrax, tuberculosis, and cholera. There was almost a fanatical opposition of the true etiology of cholera set by Koch. The third International Sanitary Conference at Constantinople, held in 1866, lasted seven months and this meeting was “dominated by Pettenkofer’s fallacious a priori reasoning and voted unanimously that air was the main vehicle of the generative principle of cholera.”

Alexander Fleming

Young Alexander went to school barefoot as his family was poor. As a researcher, he returned from his holiday to observe some mold growing in one of his discarded staphylococcus culture plates. “That’s funny,” he said as he observed that around the mold, staphylococci had been killed. His work identifying penicillin as the substance secreted by the mold as responsible for killing bacteria, changed forever the treatment of bacterial infections.

Other discoveries

The first successful human transplant (cornea) was in 1905. Kidney transplantation started in 1954, liver and heart in 1967, and bone marrow in 1968.

Sir Ronald Ross, in 1897, discovered the transmission of malaria by mosquitoes. Quinine was discovered for treating malaria in the sixteenth century but malaria’s cause and nature had remained a mystery. Paul Ehrlich laid the foundation for the modern science of hematology as well as introducing chemotherapy. Emil von Behring discovered antitoxin against diphtheria. Sigmund Freud’s pioneer work established the theory and practice of psycho-analysis. Jenner’s smallpox vaccine, and Sabin and Salk’s polio vaccine saved innumerable lives.


Around 1840 nurses performed all the duties that servants did, waiting upon and cleaning patients, furniture, beds, stairs, and wards. As wages, they received 7s weekly from the steward. In addition they received two gowns and a cap/year, half a loaf, a pint of beer, and meat from the hospital broth daily as well a dinner on Sunday.

A quack advertisement in the “Times” newspaper

Manhood; the Causes of its premature Decline, &c. By Messrs. Curtis and Co.


Ever since Roentgen discovered X-rays in 1896, they were indiscriminately used to treat wounds, lupus, rashes, and even ringworm on the head. It was no small wonder that people lost hair.

Air travel

In 1949, it took six days to travel from London to Hong Kong, while stopping at Augusta, Alexandria, Bahrein, Karachi, Calcutta, Rangoon, and Bangkok. Excreta was first disposed of over sea and land and planes were heated with exhaust from engine.


A review on cars in 1909 recommended drivers to buy speedometers. Cars got about 60 km/gallon, [37 mph] were fitted with dual ignition and acetylene lamps. One car had the fuel tank under the driver’s seat to provide space for luggage at the back.

Queen Victoria

She reigned sixty-three years. For forty years (after she was widowed) she wore black. She came out of mourning after her death, as she lay in state robed, “in a blaze of color-purple and scarlet and crimson and white and gold . . . to set a good example, that in our dealings with death we should drop once and for ever the use of the hideous catafalque, the shut hearse, the black pall, the idiotic black feathers and horses, all the ugly and cowardly side of our thoughts.”

Weird case

Fishes have not been heard to cast bait for humans, especially coming via the commode to catch someone by the “back passage.” A lady went to defecate and felt a tearing in her “back passage.” She placed her hand to her anus and gave a little tug and got a small fish-hook.

Laboratory space

Pasteur’s laboratory space during his early days, when he carried out his famous experiments was his attic. Fleming’s laboratory was described as the backroom of an old fashioned drug store. Fleming states that it only showed that contemporary laboratories are quite secondary to the brain of the worker and that the grandeur of the scientist matters more than the grandeur of the laboratory.


Mankind’s eventful journey through the last 175 years has been memorable.


  1. Walker, Edward D. and Boulger, Edward “Case of Salivation excited through the Lungs,” Prov Med Surg J s1-3 (1842): 371-72.
  2. Brightwell, Thomas “On the Medicinal Leech: (Sanguisuga Officinalis, Sav.),”
    Prov Med Surg J s1-10 (1846): 428-30.
  3. The Journal’s Centenary. Br Med J 2 (1940): 454.
  4. Scarbrough, John L. “Case of Glanders:Produced by the absorption of matter from a horse,” Prov. Med. Surg. J s1-4 (1842): 458.
  5. Esser J.F.S. “Skin of Female Breast in Plastic Surgery,” Br Med J 2 (1938): 1256-74.
  6. Obituary. Oliver Wendell Holmes, M.D. Br Med J 2 (1894): 839–41
  7. Jones, Ernest, “The Nature of Genius,” Br Med J 2 (1956): 257– 62.
  8. Kurien, Biji T. “Serendipity is “divinipitous,” but “divinipity” is not serendipitous,”
    BMJ 328 (2004): E284.
  9. Fleming, Alexander, “Louis Pasteur,” Br Med J 1 (1947): 517-22.
  10. Guthrie, Douglas, “Centenary of chloroform anaesthesia,” Br Med J 2 (1947): 701 – 3.
  11. The Centenary of the Atomic Theory: gleanings from the life and work of John Dalton. Br Med J 1 (1903): 1171–76.
  12. Howard-Jones N. “Gelsenkirchen Typhoid Epidemic of 1901, Robert Koch, and the Dead Hand of Max von Pettenkofer,” Br Med J 1 (1973): 103–5.
  13.  Dosani, S. “Penicillin Man: Alexander Fleming and the Antibiotic Revolution,” BMJ 330 (2005): 50.
  14.  Terplan, M. “Centenary of first successful human transplant,” BMJ 331 (2005): 891.
  15. Bruce-Chwatt L. J. “Transmission of malaria. 75th anniversary of Ronald Ross’s great discovery,” Br Med J 3 (1972): 464–66.
  16. Ehrlich and von Behring Centenaries. Br Med J 1 (1954): 691–92.
  17. Hospital Evolution in the Victorian Era. Br Med J 1 (1897): 1659–64.
  18. 18. Health of London:-Week ending May 19th 1855. Prov. Med. Surg. J. S3-3 (1855): 520.
  19. Curiosities of Medical Literature: The Quack’s Corner. Prov Med Surg J s1-2 (1841): 99– 100.
  20. Schultz,Weijmar W., van Andel, P, Sabelis, I, and Mooyaart, E. “Magnetic resonance imaging of male and female genitals during coitus and female sexual arousal,” BMJ 319 (1999): 1596 – 1600.
  21.  Editor Br Med J 1 (1949): 682.
  22. Barrett R.H. “Health Regulations for Air Travel,” Br Med J 2 (1947): 741-43.
  23.  Massey, A. “Public health problems attendant on air travel,” BMJ 2 (1931): 296-97.
  24. The Olympia car show. BMJ, 2 (1909): 1556-60 BMJ 2 (1909):1481-82.
  25. The Death of Queen Victoria. Br Med J 1 (1901): 360.
  26. Glanvill, M. “Kiss of Life,” Br Med J 2 (1965): 483.
  27. Strauss E.B. “Psychiatric Aspects of Impotence,” Br Med J 1 (1950): 697–99.
  28. Kurien, Biji T., Gross, T., and Scofield Robert, H. “Barbering in mice: a model for trichotillomania,” BMJ 331 (2005): 1503–05.

BIJI T. KURIEN, PhD, completed his studies in 1989 at the University of Madras, India. Currently, he works as Associate Professor of Research at the University of Oklahoma Health Sciences Center, Oklahoma City. His research interests include the study of free radical-mediated damage in systemic lupus erythematosus and Sjögren’s syndrome as well as the role of the nutraceutical curcumin in autoimmune diseases. His publication record includes numerous publications in national and international peer-reviewed journals. In addition, he co-edited four volumes in the Methods in Molecular Biology series.

Highlighted in Frontispiece Volume 8, Issue 4 – Spring 2017

Spring 2015



Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.