E.S. Thomson looks back on the gruesome history of Scottish medicine

[This article by E.S. Thomson previously appeared on 03 September 2016 in the Daily Record]

White-coated doctors, anti-bacterial hand-wipes and bleach-rinsed floors are what we expect in hospital today. But medicine hasn’t always been so sparkling clean. Grave-robbing, blood-letting and even murder were once everyday parts of medical practice.

Writing my crime novel, Beloved Poison, I learned a lot about the dark history of Scottish medicine. Rather than being places of hope and cure, hospitals were once dark, forbidding places. If you went in before 1850, there was every chance you’d not come out. Wards were filthy, crowded and unventilated. Doctors might go from the mortuary to the wards without washing their hands, transferring death to all they touched.

Operations would take place without anaesthetic, the patient often sedated only with alcohol. Surgeons prided themselves on how quickly they performed complex procedures. Early 19th-century pioneer James Syme was first to remove a hip joint, upper jaw, lower jaw and ankle – all without anaesthetic. His speed and skill were legendary.

Chloroform was eventually pioneered by Scots doctor James Young Simpson, who tried it on himself and his pals at a dinner party in 1847. Surgeons worked without antiseptic as well as anaesthetic. Wounds and instruments went unsterilised until Joseph Lister, professor of surgery at Glasgow University, pioneered antiseptic in the late 1860s.

[James Young Simpson]

There were no white coats either until Scot William Macewen developed his theories on fighting infection in the 1870s. Before then, surgeons wore their own clothes. Many had a favourite coat which got soaked in gore over the years.

Scots have contributed greatly to our understanding of anatomy, but the way they got their knowledge is the stuff of nightmares.

John Hunter, born near East Kilbride in 1728, was once the most famous anatomist in the world and amassed a huge collection of specimens – along the way testing the idea that gonorrhoea and syphilis had the same origins by smearing infected pus onto his own penis. But he was also in cahoots with the grave-robbers (or resurrectionists), taking in bodies at the back door of his home-based anatomy school while his wife opened the front door to society ladies. Once the corpses were dissected and the samples pickled in formaldehyde, Hunter boiled up the bodies in a great copper cauldron until the bones were clean. He was hugely proud of his collection – which included the skeletons of 14,000 preparations of birds and animals and the bones of 2,31 meter Irish giant Charles Byrne.

Byrne had wanted to be buried at sea, but Hunter bribed the undertaker with £500, filled the coffin with rocks and snatched the corpse. Hunter insisted all the senses were used when performing a post mortem – including taste.

And more alarming still was his practice of pulling poor children’s new teeth and transplanting them in the mouths of 'quality' patients.

Many others loom large in medicine’s macabre history. Victorian toxicologist Robert Christison was a professor of medicine at Edinburgh University for more than 50 years. He did much of his research by testing poisons on himself, with a glass of salt water handy so he could make himself vomit after noting down the symptoms.

Dr James Barry studied medicine at Edinburgh from 1809 to 1812 and served in the Army around the Empire. But on his death, it emerged 'he' was a woman who had hidden her identity to become a doctor.

Joseph Bell, who worked at the Edinburgh Royal Infirmary in the 1870s, pioneered forensic pathology and inspired fellow-Scot Arthur Conan Doyle to create Sherlock Holmes. He was used by Scotland Yard in 1888 to analyse the Ripper murders. Of course, this story isn’t just about the people at the top. It also gives a unique view of those at the bottom – the patients. Their minds and bodies were riddled with diseases doctors could not cure. Cholera, smallpox, plague and typhus destroyed whole communities, and both the pox (syphilis) and the clap (gonorrhoea) were incurable until the 20th century.

Before Scot Alexander Fleming discovered antibiotics in 1923, patients were often as likely to be killed by their medicine as their disease. Doctors treated venereal disease with mercury – a poison. Patients’ teeth and hair fell out and they produced copious amounts of black saliva. Opium, often in the form of liquid laudanum, was prescribed for numerous complaints from insomnia to toothache. Overdose or addiction were common. Leeches were widely used up to the 1860s, with Scotland’s large infirmaries going through thousands every year.

It was also commonplace to cut patients to 'bleed' them. When Edinburgh suffered an epidemic of 'relapsing fever' in 1826 and 1829, one student noted that the hospital floors were 'running with blood… it was difficult to cross the hall without fear of slipping'.

Consider too what we might call the 'ancillary services'. The grave-robbers were the most notorious, digging up the newly dead to provide subjects for anatomists and their students. William Burke and William Hare worked for Dr Robert Knox at Edinburgh University. And when new corpses grew scarce, they took matters into their own hands. In 1828, they murdered between 16 and 30 men and women over just 10 months. When they were caught, Hare turned Kings evidence and escaped the gallows. But Burke was hanged and his body dissected by the surgeons he had supplied. His skeleton is still in the anatomy museum at Edinburgh University Medical School.