Minor infections in the days before anti-biotics or anti-fungals?
December 4, 2015 8:06 AM Subscribe
What happened when someone in the Middle Ages got pink eye, or someone in Elizabethan England got athlete's foot or crotch rot? Did the infections just hang around forever? Was everyone just infected with this type of stuff? (It's pretty well-known that basically everyone had lice and fleas, I believe.)
There was a lot of it that was half-assed but even back centuries earlier people would treat infections with "molds" they just didn't know why it worked only that it did. This story zipped around earlier this year and specifically talks about eye infections and here's a great article talking about how people used to treat UTIs. posted by jessamyn at 8:20 AM on December 4, 2015 [4 favorites]
RadioLab just did a podcast on medieval remedies for staph infections (specifically pinkeye). I'm in my phone, so no link, but there were remedies that seem to have some benefits even today.
posted by mrfuga0 at 8:26 AM on December 4, 2015 [2 favorites]
posted by mrfuga0 at 8:26 AM on December 4, 2015 [2 favorites]
It's funny you mention pinkeye, because I remember hearing a story recently about the rediscovery of an old antibiotic. I don't remember where I heard it, but based on my podcast proclivities, probably Radiolab, This American Life, or Snap Judgement.
The idea is, someone found an ancient english recipe for a treatment for a sty in your eye (I think, an infection of your eyelash follicle?). They made it and it turned out to be a reasonably potent unknown antibacterial agent.
It's easy to laugh off most ancient medicine as old wives tales, but they basically threw everything at the wall and saw what stuck. Not all of it was nonsense.
posted by RustyBrooks at 8:27 AM on December 4, 2015 [16 favorites]
The idea is, someone found an ancient english recipe for a treatment for a sty in your eye (I think, an infection of your eyelash follicle?). They made it and it turned out to be a reasonably potent unknown antibacterial agent.
It's easy to laugh off most ancient medicine as old wives tales, but they basically threw everything at the wall and saw what stuck. Not all of it was nonsense.
posted by RustyBrooks at 8:27 AM on December 4, 2015 [16 favorites]
Link to Radiolab podcast: Staph Retreat
posted by tuesdayschild at 8:38 AM on December 4, 2015 [2 favorites]
posted by tuesdayschild at 8:38 AM on December 4, 2015 [2 favorites]
RustyBrooks, this story?
"Take cropleek and garlic, of both equal quantities, pound them well together… take wine and bullocks gall, mix with the leek… let it stand nine days in the brass vessel…"
posted by rhamphorhynchus at 8:39 AM on December 4, 2015 [2 favorites]
"Take cropleek and garlic, of both equal quantities, pound them well together… take wine and bullocks gall, mix with the leek… let it stand nine days in the brass vessel…"
posted by rhamphorhynchus at 8:39 AM on December 4, 2015 [2 favorites]
Healing with Breastmilk (KellyMom is research-based and has citations for all of it's statements)
posted by jillithd at 8:41 AM on December 4, 2015 [4 favorites]
posted by jillithd at 8:41 AM on December 4, 2015 [4 favorites]
It's wonderful to recognize that some traditional treatments have plausible clinical effects, but many do not. Also, one doesn't have to look back hundreds of years to see what happens to untreated illness, either. It's very common today for people to avoid or lack access to medical care. Chronic infectious diseases are common. Athlete's foot / crotch rot / tinea will clear on its own--after several months--if one's body is in decent health and can mount an immune response. The same goes for many infections, but not all. What's more, just as today, people can carry infections while being asymptomatic.
This is a common topic in public health education. Here's a good starter paper that touches on a few of these ideas if you're curious. But you can also search through the literature yourself, with terms like "burden chronic undiagnosed infectious disease" (which will turn up papers like this).
posted by late afternoon dreaming hotel at 8:42 AM on December 4, 2015 [5 favorites]
This is a common topic in public health education. Here's a good starter paper that touches on a few of these ideas if you're curious. But you can also search through the literature yourself, with terms like "burden chronic undiagnosed infectious disease" (which will turn up papers like this).
posted by late afternoon dreaming hotel at 8:42 AM on December 4, 2015 [5 favorites]
People died from what we think of as "minor" infections in relatively recent times. My great uncle died of a sinus infection in the late 20s and my grandfather died of an infection after having his tonsils removed in the early 1930's (he was working at a mining operation in Bolivia--there is a letter from his manager saying that they had sent for a "serum" but it didn't arrive in time--I don't know what the serum would have been).
posted by agatha_magatha at 8:53 AM on December 4, 2015 [3 favorites]
posted by agatha_magatha at 8:53 AM on December 4, 2015 [3 favorites]
In the case of pinkeye, almost all cases of conjunctivitis *will* clear up on their own - in the case of viral conjunctivitis (probably the most common infectious conjunctivitis), we don't really have any drug treatments even today. Even most bacterial conjunctivitis infections will clear up on their own; they just clear up faster and are less uncomfortable if treated with antibiotics.
So, some infections were treated with remedies that may or may not have actually worked, some infections cleared up (with or without help from the remedies), and some got worse and caused serious illness/blindness/death/what have you.
As late afternoon dreaming hotel points out, there are still populations all over the world where various infectious diseases are endemic and untreated, and they don't necessarily cause death directly but they have a lot of impact on quality of life. You can live with a lot of chronic infectious diseases, they just make you sick and miserable and make it hard for you to get stuff done.
posted by mskyle at 9:08 AM on December 4, 2015 [11 favorites]
So, some infections were treated with remedies that may or may not have actually worked, some infections cleared up (with or without help from the remedies), and some got worse and caused serious illness/blindness/death/what have you.
As late afternoon dreaming hotel points out, there are still populations all over the world where various infectious diseases are endemic and untreated, and they don't necessarily cause death directly but they have a lot of impact on quality of life. You can live with a lot of chronic infectious diseases, they just make you sick and miserable and make it hard for you to get stuff done.
posted by mskyle at 9:08 AM on December 4, 2015 [11 favorites]
Some things that we think of as "minor" today could be fatal back then. The two boys who would have been my uncles died of rheumatic heart disease, one in the late 20s and one in the late 30s. My mother said that losing her brother was the worst thing that ever happened to her. Rheumatic heart disease is damage caused by a variety of strep.
When my kids got strep throat and scarlet fever it meant a round of antibiotics and couple of days at home and my son learning to belch at will. Minor.
posted by SLC Mom at 9:38 AM on December 4, 2015
When my kids got strep throat and scarlet fever it meant a round of antibiotics and couple of days at home and my son learning to belch at will. Minor.
posted by SLC Mom at 9:38 AM on December 4, 2015
I wonder too, about the state of teeth back then. I suspect many of us middle aged people would be toothless today, and have suffered a lot of pain in the process, were it not for modern dentistry and antibiotics.
posted by SLC Mom at 9:39 AM on December 4, 2015
posted by SLC Mom at 9:39 AM on December 4, 2015
Hot and cold treatments have been around a long time, thus the historical popularity of "baths" -- in other words, going someplace with hot springs, basically. Hot and cold treastments can effectively kill infection.
Hydrogen peroxide has been around for centuries and effectively kills things.
Historically, they had a more holistic view of health. Old recipe books typically had commentary on what kinds of things to feed a sick person. Cooking and feeding people were viewed more as health related in some important way than most people see it today.
But, as others have said, a lot of stuff we see today as "minor" killed people. For rxample, it took a long time for them to figure out what caused scurvy. The slang term "Limey" is related to early practices of using limes to prevent scurvy (vitamin C deficiency) by...the navy or something.
posted by Michele in California at 10:01 AM on December 4, 2015 [1 favorite]
Hydrogen peroxide has been around for centuries and effectively kills things.
Historically, they had a more holistic view of health. Old recipe books typically had commentary on what kinds of things to feed a sick person. Cooking and feeding people were viewed more as health related in some important way than most people see it today.
But, as others have said, a lot of stuff we see today as "minor" killed people. For rxample, it took a long time for them to figure out what caused scurvy. The slang term "Limey" is related to early practices of using limes to prevent scurvy (vitamin C deficiency) by...the navy or something.
posted by Michele in California at 10:01 AM on December 4, 2015 [1 favorite]
The author of Waiting for Snow in Havana writes about how his parents wouldn't let them lick envelopes because one of his grandfathers licked carelessly, got a paper cut on his tongue, got it infected, and died a week or two later. From an envelope-related papercut. That would have been around 1910 to 1930, I think, based on the author's age.
posted by Eyebrows McGee at 10:04 AM on December 4, 2015 [10 favorites]
posted by Eyebrows McGee at 10:04 AM on December 4, 2015 [10 favorites]
My parents were born before antibiotics and then ended up being allergic to penicillin and sulfa drugs. There are a lot of home remedies that I learned from them as a kid. Vinegar is s good cure all for fungal things. Makes for good soak for athlete's foot and even ringworm. We used cranberry juice and it has been proven to keep bacteria from thriving in UTI's. I even soaked the crap out of my toe in hot salt water when I got an ingrown toenail. It was an all day thing with a change of water each time it cooled, but the next day, no infected toe! Back in the day were all grades of herbal medicines that seemed to provide relief. Remember, even aspirin had its beginnings in willow tree bark.
posted by PJMoore at 11:41 AM on December 4, 2015 [8 favorites]
posted by PJMoore at 11:41 AM on December 4, 2015 [8 favorites]
My grandmother kept a diary for years; when I was a kid, we read the whole thing in order. I remember how shocking it was when one of the neighbor boys, in the 1930s, got his toe cut off by the spokes of a bicycle wheel, riding fast, sitting behind the kid on the bicycle seat who was pedaling. Over the days following he got sick, seemed to get better, got worse, and died. From an infection following the loss of a toe.
posted by artistic verisimilitude at 12:08 PM on December 4, 2015 [6 favorites]
posted by artistic verisimilitude at 12:08 PM on December 4, 2015 [6 favorites]
Strep throat is the same bacteria as scarlet fever. You know, the disease that made Mary Ingalls blind? It can also cause quinsey, which supposedly killed Queen Elizabeth and is apparently one of the bacteria that can cause impetigo.
posted by fiercekitten at 8:45 AM on December 5, 2015 [2 favorites]
posted by fiercekitten at 8:45 AM on December 5, 2015 [2 favorites]
A 30-something musician from New Orleans died recently of an infected molar that went septic. It happened quickly, but it's also fair to say that he was from a social class that puts off visiting the dentist because of the cost. It still happens.
Ear infections and pinkeye (as mentioned above) generally will clear up on their own, but it takes much longer. Breast milk will absolutely cure pinkeye (I've seen it in action) but I'm not sure that that was widely known. Honey is also an effective topical antibiotic for wounds, and was used as a dressing in Egypt and some parts of Europe (especially in monasteries, which generally kept bees).
But yeah, often people just died. When I got an impacted wisdom tooth pulled, I asked the oral surgeon, "If this was the 1800s, could I die of this?" because I'm morbid like that. And he was also morbid like that, so he said, "Yes, absolutely," and told me that he'd studied the skulls of Victorians who died from impacted wisdom teeth.
posted by Nibbly Fang at 8:40 AM on December 6, 2015 [3 favorites]
Ear infections and pinkeye (as mentioned above) generally will clear up on their own, but it takes much longer. Breast milk will absolutely cure pinkeye (I've seen it in action) but I'm not sure that that was widely known. Honey is also an effective topical antibiotic for wounds, and was used as a dressing in Egypt and some parts of Europe (especially in monasteries, which generally kept bees).
But yeah, often people just died. When I got an impacted wisdom tooth pulled, I asked the oral surgeon, "If this was the 1800s, could I die of this?" because I'm morbid like that. And he was also morbid like that, so he said, "Yes, absolutely," and told me that he'd studied the skulls of Victorians who died from impacted wisdom teeth.
posted by Nibbly Fang at 8:40 AM on December 6, 2015 [3 favorites]
Dental problems are not actually minor problems. Perhaps because teeth are the only part of your skeletal system that is exposed and, among other things, white blood cells originate in bone marrow, infected teeth continue to be potentially life threatening, even with excellent modern care. This is something I have firsthand personal experience with. I have been frighteningly ill from dental problems and had emergency dental surgery more than once. I was a military wife at the time and all my medical care was either free or low cost. I got unusually good care for a middle class American and, after having too many teeth go septic and need one surgery after another while I was prescribed both antibiotics and strong oral rinses, I just began going "Pull it. Today." when new teeth began having the same problem. Elderly people who would need to go off certain maintenance drugs, like heart medication, and be put under general anesthesia to get, for example, bridge work, sometimes choose to not get certain dental problems fixed because the risk of death is too high for something they view as primarily cosmetic.
But, yes, there are plenty of home remedies, like breast milk, that actually work. As a child, I witnessed my mother put her saliva in the eye of a baby with pinkeye for a few days and it cleared up. She delivered babies in her teens and, under other circumstances, might have become a doctor. So I grew up seeing a lot of old fashioned home remedies used effectively.
posted by Michele in California at 12:34 PM on December 6, 2015 [4 favorites]
But, yes, there are plenty of home remedies, like breast milk, that actually work. As a child, I witnessed my mother put her saliva in the eye of a baby with pinkeye for a few days and it cleared up. She delivered babies in her teens and, under other circumstances, might have become a doctor. So I grew up seeing a lot of old fashioned home remedies used effectively.
posted by Michele in California at 12:34 PM on December 6, 2015 [4 favorites]
Best answer: Trigger warning for icky description
The big thing that changed our life expectancy, way more than antibiotics was drains. The horrifying death rate was led by the dysenteric disease. Our ancestors used to die of diarrhea with depressing frequency. Sure, if you got a wound you might die, but if you ate a raw apple, or if you ate a slice of bread and butter after some flies had landed on it, or if you had a drink of water, or if you cleaned your feet, or you drank beer out of a mug that had previously been used for milk, or if you shook hands on an agreement, or if you used a door knocker, or any one of a million actions that could get the wrong kind of bacteria into your mouth, you were looking at a good two weeks of liquid shooting out of your butt, dehydration, exhaustion and violent cramping. Worse yet, you ran a decent chance of doing this several times a year. Oh, and if you had ever walked around barefoot, you quite likely had hookworm, which meant you were debilitated before you started your next go around of flux.
Once they realised that if they kept all their poo strictly sealed into glazed clay piping, away from flies and strictly out of the water and the soil, they could avoid the tummy bugs, it was a major game changer. They went from assuming that any babies born in the spring would die of diarrhea, and hoping for babies to be born in the fall so the poor infant would hopefully have gained enough weight over the winter to be strong enough to survive the inevitable dysentery that was endemic in the summer, to getting to keep just about every baby that was adequately nursed.
A rule of thumb about illnesses such as infections is that eighty percent of them get better on their own. The remaining twenty percent don't always kill; they often become chronic. There were a lot of our ancestors who picked up something like a UTI when they were fifteen and had it right up until they died in their fifties, the itching, the burning, the pain, the infertility, the difficulty peeing... Never got better but it never killed them either.
It's a lot more dramatic to talk about how somebody got this wee little puncture wound... and they were dead in three days! Than it is to talk about how somebody got this wee little puncture wound and it turned into a nasty disfiguring scar and six months later they lost their sight in one eye because the infection got into the wound and it was four years before the wound was finally scar tissue and not oozing any more.
The original anecdote about antibiotics is how this person got sick, with, you know, that awful thing, frequently fatal, nasty, long, disfiguring... and they took something called a "sulfa drug" and they were well in three days! Just three days. That was the miracle, not that they survived, as many did, but that you didn't have to wait weeks to find out if they would live or not.
So there were a lot more chronic conditions. Boneyards are full of skeletons that show evidence that some pour sufferer had an abscess on the jaw for the last decade of their life, or that some infection was so bad there is scarring on the bone.
Our ancestors had LOTS of antiseptics: Vinegar. Rum. Salt. Fire. Quicklime. Saliva. Boiling water. Mustard. Lye. Onion juice. Soap. Bleach. And they all worked, more or less, although for most of them the biggest problem was that they not only killed the germs but often any living tissue for a considerable distance around the site of a wound or of an infection. My own mother, born before antibiotics were regularly available, felt that the appropriate treatment for any small wound we got in childhood such as a grazed knee was to scrub it thoroughly with soap and water - and I mean, thoroughly. She was old fashioned and knew the meaning of elbow grease. My father used iodine. It was far cry from a kiss on the boo-boo and a Hello Kitty band-aid. That stuff burned. First aid in our household involved shrieks of pain. The treatment was invariably more painful than the actual injury.
It could be tempting to not treat a minor injury. If you treated it too aggressively you could turn a minor cut into a festering sore, contaminated with caustic. And it might get better on its own. Things usually do....
When someone took an injury there were several questions to ask. How deep is the wound? What made the puncture? Where did the injury occur? How much did it bleed? And were there any horses around?
Presented with some hapless person gushing blood the first instinct was not necessarily to staunch the flow of life's vital fluid. The more the wound bled the more likely it was to avoid going septic. Freshly flowing blood could remove particles of rocks and straw and rust and earth that might otherwise have stayed in the wound. They had to decide if they would let the blood keep flowing or try to stop it. When should you stop it? One guideline was to allow it to bleed until the patient swooned.
They knew that deep injuries, and injuries that occurred around a stable or in a street were the bad ones. They didn't know why. But they knew that that was the kind of injury that could turn into lockjaw - tetanus by its familiar name. Someone who contracts tetanus suffers from tetanic convulsions - muscular spasms where the patient's body locks up tighter and tighter inflexible, until their body weight can be supported entirely on their head and their heels. It also locks the jaw so the patient can't speak, and the throat, so they die painfully of suffocation. (Mem. to self: Check if my tetanus shot is up to date)
So if you accidentally got stuck with a pitch fork while working in the stable, a wound that was deep, created by rusty metal and had occurred in the vicinity of horses, it was time to bring the hot iron out and cauterize that wound... It was less terrible than death by tetanus.
If your peritoneum was punctured, everyone agreed you were a goner. That is, if you got a belly wound and it went into the abdominal cavity infection was inevitable. Of course it wasn't always easy to tell how deep the wound was, what with the guarding reflex causing your abdominal muscles to clamp up hard, and what with gummy blood clots and all that. And they didn't want to start probing to see how deep it went or they could make it deeper and turn a non fatal injury into a ghastly death, as they did with President McKinley. The Vikings knew how to figure this one out. They would feed the sufferer a bowl of onion soup - eye wateringly strong onion soup. Shortly after the patient had finished his supper the healing woman would put her nose down close to the injured person's tummy and start sniffing. If she could smell the onion soup that meant the digestive tract had been punctured and it was time to start preparing for the funeral.
Trachoma was a chronic eye disease which produced pus and a sore eye. After some years of repeated reinfections the eyelid would turn partway inside out and blindness would result. Trachoma is basically unheard of now. A single dab of soothing antibiotic goo and the germs are dead. But left alone Trachoma runs its course in a few days. The problem is the reinfection which can't be prevented by antibiotics alone. What it requires is a clean pillowcase each night, and washing the hands several times during the day. As soon as mothers learned that mopping a child's crusty eye with the corner of an apron wasn't helping, the reinfection rate dropped like a stone. Germ theory is what has saved so many lives, with the wonder drugs playing a supporting role, not winning the war single-handedly.
Another interesting line of defense that our ancestors used with a suppurating wound was maggots. Flies often carry horrible germs as they like to get nourishment from putrid food matter and feces. But they also like to get their nourishment from dead tissue, not living tissue. If you had a nasty infected hole in your body that was oozing pus they might drop a few clean white maggots into the hole. The maggots would be happy. They would have landed in a banquet. And you would be happy because compared to over-proof vodka, or boiling oil maggots aren't traumatic at all. In fact they don't even hurt. They just eat up all that pus and scab and dead tissue that is rotting way on you, stopping with insect scale precision at the edge of the healthy tissue. Using maggots was the neatest, most precise way of cleaning a wound that you can imagine - much better than trying to scrape all the dead tissue out.
Many of our ancestors used to practice rigorous cleaning, on a scale we don't imitate. We may have vacuum cleaners and Lysol and rubber scrub brushes and special dryer vent cleaning brushes but we don't drag our mattresses out into the yard and burn them, and boil everything fabric that we want to keep and then burn the house down for good measure, or at least abandon it despite it being in perfectly good repair and go move into a new one. But this was quite common. One example are the first peoples on the West Coast of North America. One fine summer day they would load up anything they wanted to keep, like their babies, abandon everything, travel a few miles up or down the coast and start building their village over again, houses and all. This was in part in order to get within reach of new shellfish beds and new foraging grounds, but it was also for hygenic reasons. They just felt you wouldn't want to go on living in the same grubby old house after five years or so.
Similarly, feudal villages in England and Normandy used to kind of wander. At the centre of the village was usually a fish pond, frequently dug by hand. Once the houses got full of fleas and the barn smelt of that barrel of apples that had fermented and the fields were getting unproductive from too much cultivation, one by one the villagers would go build new houses, and new byres and dig a new fishpond. Aerial photography shows the foundations of the houses, the way the villages might wander a mile north, then a mile west, then to the other side of the coppice, then up to the east side of the valley. Somethings stayed stationary, such as the cross roads, or an important and nearly indestructible stone building like the church, but the majority of houses were made of wattle and daub and the village boundaries would pulse like a wandering amoeba as the decades went on.
This is shown in English place names. A village might be known as Muddington. But in its peregrinations it would end up with a different name for each location where it ended up: High Muddington, Muddington Dell, Little Muddington, Muddington Stone Cross, Muddington-by-the-Marsh...
One of the very important things this moving about did was ensure that people got away from sites that were getting too un-hygenic. Fleas and lice they had. But they also had treatments for fleas and for lice. There is not an insect that can survive hidden in bedding which is being vigorously boiled. Head lice drown if your head is saturated in oil. The cleaner your scalp the more hospitable your head is to a louse. A nice oil treatment left in for a few hours will drown all the hatched lice. Repeat the treatment a week later and the nits are taken care of too. Wooden articles of furniture were one of a households cheapest possessions; metal and cloth items were much more valuable. If you thought you had bedbugs in your bedstead you burned it.
So people who had enough resources to replace the straw in their bed tick could often make their lives flea and louse free, at least temporarily. Everyone did get fleas, or bedbugs, or lice, or all three at some point or another but only someone who was really struggling gave up and just lived with them. Having lice or other insect infestations was not considered shameful. It was just one of those things that a good householder took care of constantly, the way we take care of our teeth nowadays and nobody is ashamed to buy toothpaste.
posted by Jane the Brown at 9:27 PM on December 6, 2015 [269 favorites]
The big thing that changed our life expectancy, way more than antibiotics was drains. The horrifying death rate was led by the dysenteric disease. Our ancestors used to die of diarrhea with depressing frequency. Sure, if you got a wound you might die, but if you ate a raw apple, or if you ate a slice of bread and butter after some flies had landed on it, or if you had a drink of water, or if you cleaned your feet, or you drank beer out of a mug that had previously been used for milk, or if you shook hands on an agreement, or if you used a door knocker, or any one of a million actions that could get the wrong kind of bacteria into your mouth, you were looking at a good two weeks of liquid shooting out of your butt, dehydration, exhaustion and violent cramping. Worse yet, you ran a decent chance of doing this several times a year. Oh, and if you had ever walked around barefoot, you quite likely had hookworm, which meant you were debilitated before you started your next go around of flux.
Once they realised that if they kept all their poo strictly sealed into glazed clay piping, away from flies and strictly out of the water and the soil, they could avoid the tummy bugs, it was a major game changer. They went from assuming that any babies born in the spring would die of diarrhea, and hoping for babies to be born in the fall so the poor infant would hopefully have gained enough weight over the winter to be strong enough to survive the inevitable dysentery that was endemic in the summer, to getting to keep just about every baby that was adequately nursed.
A rule of thumb about illnesses such as infections is that eighty percent of them get better on their own. The remaining twenty percent don't always kill; they often become chronic. There were a lot of our ancestors who picked up something like a UTI when they were fifteen and had it right up until they died in their fifties, the itching, the burning, the pain, the infertility, the difficulty peeing... Never got better but it never killed them either.
It's a lot more dramatic to talk about how somebody got this wee little puncture wound... and they were dead in three days! Than it is to talk about how somebody got this wee little puncture wound and it turned into a nasty disfiguring scar and six months later they lost their sight in one eye because the infection got into the wound and it was four years before the wound was finally scar tissue and not oozing any more.
The original anecdote about antibiotics is how this person got sick, with, you know, that awful thing, frequently fatal, nasty, long, disfiguring... and they took something called a "sulfa drug" and they were well in three days! Just three days. That was the miracle, not that they survived, as many did, but that you didn't have to wait weeks to find out if they would live or not.
So there were a lot more chronic conditions. Boneyards are full of skeletons that show evidence that some pour sufferer had an abscess on the jaw for the last decade of their life, or that some infection was so bad there is scarring on the bone.
Our ancestors had LOTS of antiseptics: Vinegar. Rum. Salt. Fire. Quicklime. Saliva. Boiling water. Mustard. Lye. Onion juice. Soap. Bleach. And they all worked, more or less, although for most of them the biggest problem was that they not only killed the germs but often any living tissue for a considerable distance around the site of a wound or of an infection. My own mother, born before antibiotics were regularly available, felt that the appropriate treatment for any small wound we got in childhood such as a grazed knee was to scrub it thoroughly with soap and water - and I mean, thoroughly. She was old fashioned and knew the meaning of elbow grease. My father used iodine. It was far cry from a kiss on the boo-boo and a Hello Kitty band-aid. That stuff burned. First aid in our household involved shrieks of pain. The treatment was invariably more painful than the actual injury.
It could be tempting to not treat a minor injury. If you treated it too aggressively you could turn a minor cut into a festering sore, contaminated with caustic. And it might get better on its own. Things usually do....
When someone took an injury there were several questions to ask. How deep is the wound? What made the puncture? Where did the injury occur? How much did it bleed? And were there any horses around?
Presented with some hapless person gushing blood the first instinct was not necessarily to staunch the flow of life's vital fluid. The more the wound bled the more likely it was to avoid going septic. Freshly flowing blood could remove particles of rocks and straw and rust and earth that might otherwise have stayed in the wound. They had to decide if they would let the blood keep flowing or try to stop it. When should you stop it? One guideline was to allow it to bleed until the patient swooned.
They knew that deep injuries, and injuries that occurred around a stable or in a street were the bad ones. They didn't know why. But they knew that that was the kind of injury that could turn into lockjaw - tetanus by its familiar name. Someone who contracts tetanus suffers from tetanic convulsions - muscular spasms where the patient's body locks up tighter and tighter inflexible, until their body weight can be supported entirely on their head and their heels. It also locks the jaw so the patient can't speak, and the throat, so they die painfully of suffocation. (Mem. to self: Check if my tetanus shot is up to date)
So if you accidentally got stuck with a pitch fork while working in the stable, a wound that was deep, created by rusty metal and had occurred in the vicinity of horses, it was time to bring the hot iron out and cauterize that wound... It was less terrible than death by tetanus.
If your peritoneum was punctured, everyone agreed you were a goner. That is, if you got a belly wound and it went into the abdominal cavity infection was inevitable. Of course it wasn't always easy to tell how deep the wound was, what with the guarding reflex causing your abdominal muscles to clamp up hard, and what with gummy blood clots and all that. And they didn't want to start probing to see how deep it went or they could make it deeper and turn a non fatal injury into a ghastly death, as they did with President McKinley. The Vikings knew how to figure this one out. They would feed the sufferer a bowl of onion soup - eye wateringly strong onion soup. Shortly after the patient had finished his supper the healing woman would put her nose down close to the injured person's tummy and start sniffing. If she could smell the onion soup that meant the digestive tract had been punctured and it was time to start preparing for the funeral.
Trachoma was a chronic eye disease which produced pus and a sore eye. After some years of repeated reinfections the eyelid would turn partway inside out and blindness would result. Trachoma is basically unheard of now. A single dab of soothing antibiotic goo and the germs are dead. But left alone Trachoma runs its course in a few days. The problem is the reinfection which can't be prevented by antibiotics alone. What it requires is a clean pillowcase each night, and washing the hands several times during the day. As soon as mothers learned that mopping a child's crusty eye with the corner of an apron wasn't helping, the reinfection rate dropped like a stone. Germ theory is what has saved so many lives, with the wonder drugs playing a supporting role, not winning the war single-handedly.
Another interesting line of defense that our ancestors used with a suppurating wound was maggots. Flies often carry horrible germs as they like to get nourishment from putrid food matter and feces. But they also like to get their nourishment from dead tissue, not living tissue. If you had a nasty infected hole in your body that was oozing pus they might drop a few clean white maggots into the hole. The maggots would be happy. They would have landed in a banquet. And you would be happy because compared to over-proof vodka, or boiling oil maggots aren't traumatic at all. In fact they don't even hurt. They just eat up all that pus and scab and dead tissue that is rotting way on you, stopping with insect scale precision at the edge of the healthy tissue. Using maggots was the neatest, most precise way of cleaning a wound that you can imagine - much better than trying to scrape all the dead tissue out.
Many of our ancestors used to practice rigorous cleaning, on a scale we don't imitate. We may have vacuum cleaners and Lysol and rubber scrub brushes and special dryer vent cleaning brushes but we don't drag our mattresses out into the yard and burn them, and boil everything fabric that we want to keep and then burn the house down for good measure, or at least abandon it despite it being in perfectly good repair and go move into a new one. But this was quite common. One example are the first peoples on the West Coast of North America. One fine summer day they would load up anything they wanted to keep, like their babies, abandon everything, travel a few miles up or down the coast and start building their village over again, houses and all. This was in part in order to get within reach of new shellfish beds and new foraging grounds, but it was also for hygenic reasons. They just felt you wouldn't want to go on living in the same grubby old house after five years or so.
Similarly, feudal villages in England and Normandy used to kind of wander. At the centre of the village was usually a fish pond, frequently dug by hand. Once the houses got full of fleas and the barn smelt of that barrel of apples that had fermented and the fields were getting unproductive from too much cultivation, one by one the villagers would go build new houses, and new byres and dig a new fishpond. Aerial photography shows the foundations of the houses, the way the villages might wander a mile north, then a mile west, then to the other side of the coppice, then up to the east side of the valley. Somethings stayed stationary, such as the cross roads, or an important and nearly indestructible stone building like the church, but the majority of houses were made of wattle and daub and the village boundaries would pulse like a wandering amoeba as the decades went on.
This is shown in English place names. A village might be known as Muddington. But in its peregrinations it would end up with a different name for each location where it ended up: High Muddington, Muddington Dell, Little Muddington, Muddington Stone Cross, Muddington-by-the-Marsh...
One of the very important things this moving about did was ensure that people got away from sites that were getting too un-hygenic. Fleas and lice they had. But they also had treatments for fleas and for lice. There is not an insect that can survive hidden in bedding which is being vigorously boiled. Head lice drown if your head is saturated in oil. The cleaner your scalp the more hospitable your head is to a louse. A nice oil treatment left in for a few hours will drown all the hatched lice. Repeat the treatment a week later and the nits are taken care of too. Wooden articles of furniture were one of a households cheapest possessions; metal and cloth items were much more valuable. If you thought you had bedbugs in your bedstead you burned it.
So people who had enough resources to replace the straw in their bed tick could often make their lives flea and louse free, at least temporarily. Everyone did get fleas, or bedbugs, or lice, or all three at some point or another but only someone who was really struggling gave up and just lived with them. Having lice or other insect infestations was not considered shameful. It was just one of those things that a good householder took care of constantly, the way we take care of our teeth nowadays and nobody is ashamed to buy toothpaste.
posted by Jane the Brown at 9:27 PM on December 6, 2015 [269 favorites]
Athletes foot is often exacerbated by a diet high in sugar or refined starches. Some of our ancestors never got any of that. Athletes foot is often reinfected from a pair of sneakers that contain the fungus spores. People who run around barefoot rarely have anything like athletes foot because the fungus needs to be enclosed in a warm damp location to grow.
In the medieval period shoes were often made of fairly thin leather rather like ballet shoes; they wore our incredibly quickly. Six or so pairs of shoes a year was not uncommon just from wearing them out.
As a result in certain periods and for certain people athletes foot would almost certainly not have been a problem.
But let's say your are a Late Georgian era factory worker. You might live pretty much on a diet of white bread and jam. He might wear a pair of sturdy hobnailed boots that would enclose your feet in the same unwashed pair of stockings for twelve hours a day. And you might not have access to vinegar or anything else that you could treat the condition with. So it might get bad enough that you developed trench foot, but most likely it wouldn't, so you would just have appallingly nasty feet for years.
posted by Jane the Brown at 9:51 PM on December 6, 2015 [28 favorites]
In the medieval period shoes were often made of fairly thin leather rather like ballet shoes; they wore our incredibly quickly. Six or so pairs of shoes a year was not uncommon just from wearing them out.
As a result in certain periods and for certain people athletes foot would almost certainly not have been a problem.
But let's say your are a Late Georgian era factory worker. You might live pretty much on a diet of white bread and jam. He might wear a pair of sturdy hobnailed boots that would enclose your feet in the same unwashed pair of stockings for twelve hours a day. And you might not have access to vinegar or anything else that you could treat the condition with. So it might get bad enough that you developed trench foot, but most likely it wouldn't, so you would just have appallingly nasty feet for years.
posted by Jane the Brown at 9:51 PM on December 6, 2015 [28 favorites]
It has been mentioned up thread, but very often, even in the 20th century, you just died. Even if your father was the president.
posted by TedW at 9:14 AM on December 8, 2015 [2 favorites]
posted by TedW at 9:14 AM on December 8, 2015 [2 favorites]
Hydrogen peroxide has been around for centuries and effectively kills things.
It was first discovered in 1818, so not quite two centuries. It certainly wasn't around in the Elizabethan era or the Middle Ages.
posted by jedicus at 9:22 AM on December 8, 2015 [4 favorites]
It was first discovered in 1818, so not quite two centuries. It certainly wasn't around in the Elizabethan era or the Middle Ages.
posted by jedicus at 9:22 AM on December 8, 2015 [4 favorites]
Jim Henson died of an infection at age 53, in 1990, so, people still die of infections.
Pasteurization - raising milk to oiling point - was huge in preventing TB. People got TB a lot, many lived, many didn't. There are old TB sanitariums in lots of places - you went away for a rest, ideally in clean air, but also in a place where you got good nutrition, and maybe you got better. Now, you take a regimen of antibiotics, for quite a while, and hope you don't have a resistant variety. I know someone who had TB, and my Dad had antibodies, so had been exposed. Pretty recent.
Lister promoted sterile surgical practice not all that long ago, and good practice is still critical - better to not get an infection than to take antibiotics.
posted by theora55 at 3:05 PM on December 8, 2015
Pasteurization - raising milk to oiling point - was huge in preventing TB. People got TB a lot, many lived, many didn't. There are old TB sanitariums in lots of places - you went away for a rest, ideally in clean air, but also in a place where you got good nutrition, and maybe you got better. Now, you take a regimen of antibiotics, for quite a while, and hope you don't have a resistant variety. I know someone who had TB, and my Dad had antibodies, so had been exposed. Pretty recent.
Lister promoted sterile surgical practice not all that long ago, and good practice is still critical - better to not get an infection than to take antibiotics.
posted by theora55 at 3:05 PM on December 8, 2015
The horrifying death rate was led by the dysenteric disease.
Thanks to half a decade living and working in far flung 3rd world countries, I ended up with the delightful big-D at least on 3 (more memorable) occasions.
The first time was in Lilongwe, Malawi. Had been there for a few months at that point. Pretty sure I got it from a tomato or some other fresh vegetable I made the mistake of washing in sink water rather than bottled. I was getting sick of safe food (anything that had been fried or baked into oblivion) and the general lack of fiber in my diet and not having a decent bowel movement on the regular, so I got careless.
Solved the bowel movement problem right quick.
I'm writing this not for your enjoyment so much as the fact that "a good two weeks of liquid shooting out of your butt, dehydration, exhaustion and violent cramping" doesn't quite do it justice.
It's really the first week that's a doozy. If you can manage to stay out of the hospital (more on that in a minute), you better stock up on all the ginger ale you can find if the country you happen to be in has it, because it's quickly going to become the only thing you can ingest. No food - you aren't going to be hungry - no juices, none of the sharper tasting sodas, and at least in my case - even water was hard to keep down. Everything else you try to put in gets promptly returned up the pipes in 30 minutes or less.
Meanwhile the other end of you is hard at work vacating you of everything else that got in before the bug settled. You'd be surprised how much there was in there to start with. A good few days worth before it's just the sitting there in agony with nothing left to give. You're losing fluids from the puking, you're losing it from the shits, and you're even losing it from the sweating of the feverish state you're in. The only question is whether you can possibly ingest enough to keep you in your hotel room.
It's a great way to lose 10 pounds.
The next time I got it was in Lubumbashi, DRC. Man that one was scary bad. No idea how I got it, could have been from a handshake out on the field project site, who knows. Carry more Purell next time.
Ended up in the best thing they had that passed for a hospital, with a French-speaking co-worker helping me try to describe to the doctor what was wrong. Didn't help that I had flu-like symptoms at the same time and woke up with breathing problems that night. The fever got so bad that I had to sit in a tub full of cold water for hours on end just trying to get my body temp down. Get up, towel off, toilet, get back in.
Obviously it's hard to sleep in this state, hence the exhaustion. Eventually you get so exhausted you can't stay awake though, but I don't recommend trying it. You can feel your body not healing.
The last and worst time was in Arusha, Tanzania. I made the mistake of trying the local burger place popular with the tourist transit crowd headed between Ngorongoro and Kilimanjaro. What could go wrong?
After 3 straight days completely laid up in the hotel room, and fighting a losing battle to keep the Ginger Ale in, I ended up being forced to head to the clinic, basically for fear of dying otherwise. In places like this it's important to see them unwrap the hypodermic needle if you don't happen to have your own with you - some people carry them. Hence the reticence with being treated, but death isn't an attractive alternative. I couldn't really sit with the doctor for 3 minutes without running to the loo to violently dry heave for the whole clinic to hear, and when I nearly passed out in there, we agreed I needed an IV to re-hydrate.
You've never been truly dehydrated until you can literally feel the life coursing back into your body from the bag of fluids. Didn't clear up the symptoms for another week, but bought my body the space to do it that I wouldn't have otherwise had. Without something as simple as a bag of fluids, a hypodermic needle, and some rubber tubing, I could have died from eating a bad burger.
Point is, this still happens to kids in our day and age who have the misfortune of being born in rural Zambia. This isn't just a middle ages thing.
posted by allkindsoftime at 3:42 PM on December 8, 2015 [49 favorites]
Thanks to half a decade living and working in far flung 3rd world countries, I ended up with the delightful big-D at least on 3 (more memorable) occasions.
The first time was in Lilongwe, Malawi. Had been there for a few months at that point. Pretty sure I got it from a tomato or some other fresh vegetable I made the mistake of washing in sink water rather than bottled. I was getting sick of safe food (anything that had been fried or baked into oblivion) and the general lack of fiber in my diet and not having a decent bowel movement on the regular, so I got careless.
Solved the bowel movement problem right quick.
I'm writing this not for your enjoyment so much as the fact that "a good two weeks of liquid shooting out of your butt, dehydration, exhaustion and violent cramping" doesn't quite do it justice.
It's really the first week that's a doozy. If you can manage to stay out of the hospital (more on that in a minute), you better stock up on all the ginger ale you can find if the country you happen to be in has it, because it's quickly going to become the only thing you can ingest. No food - you aren't going to be hungry - no juices, none of the sharper tasting sodas, and at least in my case - even water was hard to keep down. Everything else you try to put in gets promptly returned up the pipes in 30 minutes or less.
Meanwhile the other end of you is hard at work vacating you of everything else that got in before the bug settled. You'd be surprised how much there was in there to start with. A good few days worth before it's just the sitting there in agony with nothing left to give. You're losing fluids from the puking, you're losing it from the shits, and you're even losing it from the sweating of the feverish state you're in. The only question is whether you can possibly ingest enough to keep you in your hotel room.
It's a great way to lose 10 pounds.
The next time I got it was in Lubumbashi, DRC. Man that one was scary bad. No idea how I got it, could have been from a handshake out on the field project site, who knows. Carry more Purell next time.
Ended up in the best thing they had that passed for a hospital, with a French-speaking co-worker helping me try to describe to the doctor what was wrong. Didn't help that I had flu-like symptoms at the same time and woke up with breathing problems that night. The fever got so bad that I had to sit in a tub full of cold water for hours on end just trying to get my body temp down. Get up, towel off, toilet, get back in.
Obviously it's hard to sleep in this state, hence the exhaustion. Eventually you get so exhausted you can't stay awake though, but I don't recommend trying it. You can feel your body not healing.
The last and worst time was in Arusha, Tanzania. I made the mistake of trying the local burger place popular with the tourist transit crowd headed between Ngorongoro and Kilimanjaro. What could go wrong?
After 3 straight days completely laid up in the hotel room, and fighting a losing battle to keep the Ginger Ale in, I ended up being forced to head to the clinic, basically for fear of dying otherwise. In places like this it's important to see them unwrap the hypodermic needle if you don't happen to have your own with you - some people carry them. Hence the reticence with being treated, but death isn't an attractive alternative. I couldn't really sit with the doctor for 3 minutes without running to the loo to violently dry heave for the whole clinic to hear, and when I nearly passed out in there, we agreed I needed an IV to re-hydrate.
You've never been truly dehydrated until you can literally feel the life coursing back into your body from the bag of fluids. Didn't clear up the symptoms for another week, but bought my body the space to do it that I wouldn't have otherwise had. Without something as simple as a bag of fluids, a hypodermic needle, and some rubber tubing, I could have died from eating a bad burger.
Point is, this still happens to kids in our day and age who have the misfortune of being born in rural Zambia. This isn't just a middle ages thing.
posted by allkindsoftime at 3:42 PM on December 8, 2015 [49 favorites]
My Dad was born in 1938, in New Zealand, so his childhood was near over before antibiotics were a thing. He told me once, it was a thing that after every school term, when they got back from the holiday, a child would have died from an infection.
posted by i_am_joe's_spleen at 5:25 PM on December 8, 2015 [6 favorites]
posted by i_am_joe's_spleen at 5:25 PM on December 8, 2015 [6 favorites]
Response by poster: Point is, this still happens to kids in our day and age who have the misfortune of being born in rural Zambia. This isn't just a middle ages thing.
That's a really good point, and a check on my unexamined cultural privilege, although I would not consider Dysentery one of the kinds of minor infections I was talking about.
posted by OmieWise at 7:06 AM on December 9, 2015 [1 favorite]
That's a really good point, and a check on my unexamined cultural privilege, although I would not consider Dysentery one of the kinds of minor infections I was talking about.
posted by OmieWise at 7:06 AM on December 9, 2015 [1 favorite]
"Take cropleek and garlic, of both equal quantities, pound them well together… take wine and bullocks gall, mix with the leek… let it stand nine days in the brass vessel…"
Incidentally, that one ingredient there? The one that probably made you go, "Thanks, but I think I'll let the infection sort itself out"?
Red Bull's full of it.
posted by Sys Rq at 9:17 PM on December 9, 2015 [4 favorites]
Incidentally, that one ingredient there? The one that probably made you go, "Thanks, but I think I'll let the infection sort itself out"?
Red Bull's full of it.
posted by Sys Rq at 9:17 PM on December 9, 2015 [4 favorites]
That's a really good point, and a check on my unexamined cultural privilege, although I would not consider Dysentery one of the kinds of minor infections I was talking about.
As was mentioned above, people will often get a low-grade, lingering case of something instead of just an acute case that is then fully resolved. Diarrhoeal diseases work that way, and as long as your health is good you can just deal with it, but as soon as your health suffers (immune compromisation, lack of food, etc) than all of a sudden the somewhat unpleasant chronic issue becomes acute and deadly.
And dysentery is not a specific infection -- it is the outcome (bloody diarrhea and inflamed intestinal lining) that can come from a wide variety of sources (wikipedia lists "a number of types of infection such as bacteria, viruses, parasitic worms, or protozoa"). All of those sources of dysentery can also present in much more mild forms, only becoming acute when health or circumstances change. (And of course babies and the elderly are at high risk and will often die from things that do not trouble a healthy adult.)
So absent modern sanitary sewage and other public health measures, and absent availability of antibiotics and other medicines, most people would have had on and off symptoms of that same list of causes. They would have treated with both effective and ineffective folk medicine (such as purges and other deworming techniques), and when chronic cases became acute people would have died.
posted by Dip Flash at 1:01 AM on December 10, 2015 [3 favorites]
As was mentioned above, people will often get a low-grade, lingering case of something instead of just an acute case that is then fully resolved. Diarrhoeal diseases work that way, and as long as your health is good you can just deal with it, but as soon as your health suffers (immune compromisation, lack of food, etc) than all of a sudden the somewhat unpleasant chronic issue becomes acute and deadly.
And dysentery is not a specific infection -- it is the outcome (bloody diarrhea and inflamed intestinal lining) that can come from a wide variety of sources (wikipedia lists "a number of types of infection such as bacteria, viruses, parasitic worms, or protozoa"). All of those sources of dysentery can also present in much more mild forms, only becoming acute when health or circumstances change. (And of course babies and the elderly are at high risk and will often die from things that do not trouble a healthy adult.)
So absent modern sanitary sewage and other public health measures, and absent availability of antibiotics and other medicines, most people would have had on and off symptoms of that same list of causes. They would have treated with both effective and ineffective folk medicine (such as purges and other deworming techniques), and when chronic cases became acute people would have died.
posted by Dip Flash at 1:01 AM on December 10, 2015 [3 favorites]
Trachoma is very much still around today, just not in the West. It remains the leading cause of preventable blindness in the world.
posted by ghostpony at 4:19 PM on December 10, 2015 [3 favorites]
posted by ghostpony at 4:19 PM on December 10, 2015 [3 favorites]
Someone above wondered about teeth. Our prehistoric ancestors had better, whiter teeth than we do generally, because no sugar. The Victorians on the other hand had black rotted teeth, because sugar no toothpaste....
posted by xammerboy at 5:44 PM on December 17, 2015
posted by xammerboy at 5:44 PM on December 17, 2015
Somewhere in one of the first couple of This Week in Microbiology podcasts one of the hosts (a micro prof...) says "before antibiotics the death rate from strep throat was 80%". Does that make sense? It seems like a lot, but I can't find a useful reference.
posted by sneebler at 7:19 PM on December 18, 2015
posted by sneebler at 7:19 PM on December 18, 2015
Strep throat, left untreated, leads to rheumatic fever, which can definitely be fatal. The current rate of rheumatic fever deaths is something like 12% in the developing world.
posted by Sys Rq at 10:40 PM on December 18, 2015 [1 favorite]
posted by Sys Rq at 10:40 PM on December 18, 2015 [1 favorite]
Point is, this still happens to kids in our day and age who have the misfortune of being born in rural Zambia. This isn't just a middle ages thing.
Or born in the US if you are poor
posted by TedW at 5:59 AM on December 19, 2015 [4 favorites]
Or born in the US if you are poor
posted by TedW at 5:59 AM on December 19, 2015 [4 favorites]
This thread is closed to new comments.