1.1 Medicine in the 1800s

In order to better understand some key aspects of modern medicine, we first go back to a time when we did not know much about infectious diseases; a time when an infection that can now be easily treated and cured could kill you.

Activity 2: Living and dying in the 18th century

Watch Video 1, about the death of George Washington in 1799. As you watch, keep the following questions in mind:

  • What did doctors think caused the disease?
  • What treatment was given to George Washington?
  • What might have caused this disease?
  • What kind of treatments are available today?
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Transcript: Video 1

MICHAEL MOSLEY:
On Saturday the 14th of December, 1799, George Washington, one of the founding fathers of the United States of America, lay dying. A couple of days earlier, he'd been out riding in cold and wet weather. He developed a sore throat. Early on the Saturday morning he said to his wife, I'm feeling very ill.
Within hours, his personal physicians had arrived, the finest in the country, the best money could buy. They had all sorts of suggestions as to what was making him ill – his humours were unbalanced, or perhaps he breathed in miasmas, foul air. His doctors gave him the standard medical treatment for someone who was as severely ill as he obviously was.
They took a knife, found a vein, and bled him – repeatedly. They drained him of more than four pints of blood. By nightfall, Washington was fading fast, so his physicians applied even more ‘scientific’ treatments. This Spanish fly, although it's actually a green beetle. They would have ground it up and then applied the paste to his throat. But all that did was blister the skin.
He said to his doctors, I die hard, but I'm not afraid to go. By late that evening, the first president of the United States was dead. Washington probably died from a simple infection. At the end of the 18th century, it made no difference if you were a pauper or the president. What you got was little more than quackery.
The Centers for Disease Control and Prevention in Atlanta is not for those of a nervous disposition. It holds some of the world's most deadly life forms. This facility contains some of the greatest evils ever collected in one place. This bacteria causes the plague. Your flesh dies and rots while you're still alive.
The Black Death of the 14th century killed a quarter of Europe's population. And then there's tuberculosis, a slow and deadly killer, the creator of oozing lung abscesses. The poet Keats, all three Brontë sisters, and Chopin are a few of its more artistic victims. And this is gangrene caused by any number of bacterial infections that lurk unseen in every dirty bullet, scalpel and delivery ward.
Some bacteria don't need a wound to get inside you. They're already there, waiting patiently. Patiently for our defences to drop, and then they pounce. That's probably what did poor George Washington.
DR DRUIN BURCH:
In 1790s America, sudden death was utterly common. And you clustered round people's bedside when they got cold and when they got chills because they could die.
MICHAEL MOSLEY:
Washington's doctors would have laughed in your face if you'd told them that microscopic life was killing him. They still clung to theories passed down from the ancient Greeks.
DR WALTER SNEADER:
They believed that if you had a disease, the humours were out of balance. If you had a fever, you were considered to have an excess of a blood humour– well, you were flushed after all.
End transcript: Video 1
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Answer

  • What did doctors think caused the disease?
    • His humours were unbalanced, or perhaps he breathed in miasma (foul air).
  • What treatment was given to George Washington?
    • They drained his blood (blood-letting).
    • They applied ground-up green beetle on his throat.
  • What do we now know about what might have caused this disease?
    • Microscopic organisms can cause infectious diseases, such as the one that attacked George Washington’s throat. Other examples of diseases caused by microbes are bubonic plague, tuberculosis and gangrene.
  • What kind of treatments are available today for management of infections caused by microbes?
    • We now know that infections are caused by microscopic organisms (microbes), including bacteria. Antibiotics are used to treat infections caused by bacteria. (You will learn more about antibiotics in the next section.)

1 Life before antibiotics

1.2 Discoveries in modern medicine