Content warning: pregnancy, birth, women’s medicine, disease, COVID-19, death, health and bowel movements.

These days, we all know that it is important to wash your hands regularly.  However, in the early Victorian period people were not quite so convinced that hand washing prevented disease.  Unfortunately without modern microscopes the idea of tiny ‘creatures’ or microorganisms that made you unwell was difficult to believe. In this blog we are going to introduce you to a man who saved lives through good hygiene.

Monster Soup

Credit: Engraving: ‘Monster Soup…” by William Heath. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

When Hungarian doctor Ignaz Semmelweis suggested to his colleagues that they should wash their hands after touching a dead body to reduce maternal deaths, they had him committed to an asylum. In fact most scientists of the 19^th century believed that diseases were spread through ‘Miasma’ .  This was a scientific theory that suggested nasty smells and rotting things caused disease. In general Victorian doctors did not subscribe to the idea that individuals could pass diseases to each other or that it is was important to wash your hands.  Unfortunately for their patients, they worked with dirty hands, rarely wore masks  and didn’t believe coughing or sneezing could harm their patients.

Hygienic doctors

However there were a few doctors, including famed surgeon Joseph Lister, who did  practice good hygiene.  In fact Arnos Vale Cemetery is the last resting place of a less well-known but equally talented 19^th century doctor. His name was Joseph Griffiths Swayne.  Dr Swayne was the author of the wonderfully title ‘Obstetric Aphorisms for the Use of Students’. This book was a vital medical book in the 19^th century for students working with women giving birth.

Front cover of Victorian medical book entitled obstetric aphorism for the use of students

In addition he was involved in cholera prevention in Bristol during epidemics and helped trace the cause of the deadly disease. He was also an accomplished artist and drew images for a sadly unpublished anatomy manual.  In fact the images for the book were drawings he undertook when dissecting cadavers. A medical marvel indeed.

A medical family

Dr Swayne came from a medical family; his father was a doctor and his mother was the daughter of an apothecary.  Therefore it was natural that he followed in his father’s footsteps and he was apprenticed to his obstetrician father.  Thankfully Joseph had great aptitude for the work and studied medicine in Bristol and Paris finally graduating in London.  Whilst in Londn he received Gold Medals for his standard of learning in obstetrics.  After he graduated he took a teaching job in Bristol Royal Infirmary.  He was not only a lecturer in obstetrics, but also held the title of physician accoucheur -a male midwife.

A 19th Century Pandemic

His cholera research was also of great value during the 19^th century and he helped advance the scientific field. Cholera was a terrifying disease which struck poor and rich alike and could kill healthy adults within hours.  In Swayne’s time people didn’t know the cause; which we now know is the bacteria vibrio cholerae.

A man with cholera buried prematurely. Photograph after painting by A. J. Wiertz.. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

Unfortunate victims of cholera were convulsed with pain and suffered violent vomiting and uncontrollable watery diarrhoea resulting in severe dehydration.  The victim eventually turned blue and died.

Death stalked the streets

From 1817 onward pandemics of cholera spread through England , hitting Bristol for the first time in 1831. Many thousands died and cities and towns like Bristol were simply not adequate facilities.  Before the advent of large out of town cemeteries like Arnos Vale they struggled to  bury the dead.  The authorities also struggled to contain the spread, so they set up committees to help. During an outbreak in 1849 the City of Bristol a group of learned men were commissioned to reduce the death toll through scientific means.  Swayne, along with a range of other medical professionals (some of whom will appear in a later blog, looking at you Dr William Budd), set about assessing why the disease spread so fast.

A court for King Cholera. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

A board of experts

This board of medics and administrators went to areas where the outbreaks occurred, at great personal risk to themselves to find answers. One of their number, Mr J Williams caught Cholera whilst compiling the reports and sadly died.  Swayne and his colleagues even examined the diarrhea  of the afflicted and declared there were ‘crescentic bodies’ in their evacuations. It was wasn’t until the 1890’s that the cornerstone of modern medicine: Germ Theory began to fully make sense of this observation.

Credit: F XII, Mucosa ilei, cholera asiatica, Alfred Kast. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

Even today Cholera affects an estimated 3–5 million people worldwide and causes roughly 28,800–130,000 deaths a year.

Saving women’s lives

Swayne’s main area of a research was pregnancy, birth and post-partum support. His obstetrics book was translated into 8 languages and had 10 editions published.  The book was a seminal work for students for many years. Despite practicing medicine pre -Germ Theory,  interestingly Dr Swayne told his students ‘wash your hands’ before examining patients. He also believed that the colleagues that had long hair or beards experienced more sepsis with their patients than clean shaven colleagues.

Beards are bad

Holston Valley Medical Center staff shaved their beards to be able to properly protect themselves and their patients.

One of the interesting outcome of the recent Covid-19 outbreak has been that medical professionals have shaved off facial hair, and even head hair to limit the spread of the highly contagious virus.

Obstetric Aphorisms

Swayne’s book has some truly intriguing images, many a bit too challenging for a public blog but the book can be found for free on google books . Have a look for the pictures with the lovely tailored cuffs in very close proximity!

From Obstetric Aphorisms

In my humble opinion, Dr Swayne deserves better recognition as a pioneer in both women’s medicine and infectious disease control. Swayne’s obituary in the British Medical journal described him as ‘always on the side of advancement in learning ’.  Above all, he was ‘the leading obstetrician in the South West.‘ He died at the ripe old age of 83 in 1903.  Therefore it looks like all the hand washing helped to keep him healthy. Whilst the cemetery is closed if you want to view his grave, take a virtual tour. Take a wander up the path and you will find it is the very last stop. Once our tours program starts again, you can hear more stories on our Medical history tour.

Where next?

If you love blogs about disease, historic medicine and illness, then do also check out the writings of Dr Lindsay Fitzharris and her book about historic surgery ‘ ‘The Butchering Art‘.