334Chapter 18
an artery), shows the state of learned medicine. A team
of a dozen physicians first drew a pint of blood from
his right arm. They then cut open his right shoulder
and cupped it with a vacuum jar to draw more blood.
Charles then received an emetic to induce vomiting,
followed by a purgative, then a second purgative. Next
came an enema of antimony and herbs, followed by a
second enema and a third purgative. Physicians then
shaved the king’s head, blistered it with heated glass,
intentionally broke the blisters, and smeared a powder
into the wounds (to “strengthen his brain”). Next came
a plaster of pitch and pigeon excrement. Death was
probably a relief to the tortured patient.
Hospitals were also scarce in the Old Regime.
Nearly half of the counties of England contained no
hospital in 1710; by 1800, there were still only four
thousand hospital beds in the entire country, half of
them in London. Avoiding hospitals was generally safer
in any case (see illustration 18.2). These institutions
had typically been founded by monastic orders as
refuges for the destitute sick, and most of them were
still operated by churches in the eighteenth century.
There were a few specialized hospitals (the first chil-
dren’s clinic was founded at London in 1779), and most
hospitals typically mixed together poor patients with
a variety of diseases that spread inside the hospital. Pa-
tients received a minimal diet and rudimentary care but
little medical treatment. The history of surgery is even
more frightening. In many regions, surgeons were still
members of the barbers’ guild. Because eighteenth-
century physicians did not believe in the germ theory
of disease transmission, surgeons often cut people in
squalid surroundings with no thought for basic cleanli-
ness of their hands or their instruments. Without anti-
sepsis, gangrene (then called hospital putrefaction) was
a common result of surgery. No general anesthetics
were available, so surgeons operated upon a fully con-
scious patient.
In these circumstances, opium became a favorite
medication of well-to-do patients. It was typically taken
as a tincture with alcohol known as laudanum, and it was
available from apothecaries without a prescription. Lau-
danum drugged the patient, and it often addicted sur-
vivors to opium, but it reduced suffering. Many famous
figures of the eighteenth and nineteenth centuries died,
as did the artist Sir Joshua Reynolds in 1792, “all but
speechless from laudanum.”Subsistence Diet and the Biological
Old Regime
The second critical feature of the biological old regime
was a dangerously inadequate food supply. In all re-
gions of Europe, much of the population lived with
chronic undernourishment, dreading the possibility of
famine. A subsistence diet (one that barely met the
minimum needed to sustain life) weakened the immune
system, making people more vulnerable to contracting
diseases and less able to withstand their ravages. Diet
was thus a major factor in the Old Regime’s high mor-
tality rates and short life expectancies.Illustration 18.2
An Eighteenth-Century Hospital.
This scene of a German hospital ward in
Hamburg depicts many aspects of pre-
modern medicine. Note the mixture of
patients with all afflictions, the nonster-
ile conditions, the amputation of a leg
on a conscious patient, the arrival of a
daily ration of bread, and the administra-
tion of the last rites to a patient.