The Left Atrium · De l'Oreille Gauche

CMAJ 1999;160:1743-6

• The vulgar pushing scions of a new science
• Two thousand words
• Bos bovis
• Against wisdom

Viewed in the rearview mirror of history, Victorian Britain looks as bleak a house as there could be. Yet in Mesmerized: Powers of Mind in Victorian Britain, Alison Winter draws back the heavy curtains to reveal a vortex of change that remodelled human interaction and social power. An assistant professor of history at the California Institute of Technology, Winter takes mesmerism from the lunatic fringes of society and places it at the epicentre of a cultural earthquake, where, she argues, it exerted a deeply subversive and seductive appeal. People of intelligence and good breeding as well as "that vulgar pushing woman," as Robert Browning described Fanny Trollope, were drawn to the animal-eyed followers of Dr. Franz Anton Mesmer, whose technique for controlling another's mind and body reached Britain in the 1830s. According to Mesmer, an invisible "vital principle" linked cosmic phenomena with life on earth. By spreading this force evenly over the subject's body, a magnetizer could cure physical and mental disease.

When mesmerism arrived in England it landed in the middle of a philosophical debate about what constituted "science." This debate is in many ways familiar to us, given modern controversies over levels of evidence and alternative treatments. In Victorian England there was no medical orthodoxy to police what doctors did. The line between quack and professor of medicine was very thin indeed. Experiments took the form of private or public demonstrations. However, as the century wore on, reforms in education and laboratory investigation left less room for the type of investigation Mesmer's devotees needed. After the Medical Regulation Act of 1858, medicine became increasingly regulated. What we now consider the basic sciences of physiology, chemistry, biology and physics were just beginning to come into their own, emerging from the less defined field of natural philosophy with its metaphysical roots. One of the perplexing epistemological questions facing Victorian scientists was the role of the "self" in descriptions of reality. Charles Babbage's "thinking machines" appeared to offer a way to interpret nature without human bias. But how could nature be "known" in any branch of science when the recording instrument — the human brain and mind — was the thing under study?

Amid this scientific debate, mesmerism became the cause célèbre of social reform. The observation that people shared, regardless of their colour, the same psychic abilities and experiences pointed to common bonds that transcended race. In Winter's view, mesmerism wasn't an innocent parlour game; it was a potent symbol of a political and scientific Zeitgeist that threatened to shake the social order. The writer Fanny Trollope, mother of the more famous Victorian novelist Anthony Trollope, is best remembered for her fictional diatribes against the abuse of working children in England's industrial north. In one episode she described how during a mesmeric seance a factory owner is haunted by the ghosts of child labourers he worked to death; thus she captured the convergence of a revolution in science with an emerging, vocal working class seeking revenge.

Mesmerism caught on partly because it could be conducted by anyone who had acquired the technique. Travelling lecturers demonstrated the power of animal magnetism to public audiences and in private parlours. Primarily involving female subjects who were put in a trance by the mesmeric "pass" of hands along the body, these sessions often evoked paranormal phenomena, the suspension of pain and psychic clairvoyance.

Mesmerists claimed to diagnose and treat disease. A hospital ward was set up at University College Hospital in London where experiments were conducted to investigate the healing effects of mesmerism. Public displays of the surgical removal of limbs and tumours in the pre-anesthetic era lent powerful evidence of the metaphysical forces at work. These in turn led to further research in pain and the subsequent development of anesthetics such as ether.

Although some physicians took up mesmerism, it was primarily lay practitioners who popularized it. It required no special education, and anyone with the talent could mesmerize a patient. This challenged many of the reforms that doctors were introducing. But this medical reform, including the physical examination of the patient, threatened Victorian Britain's habits and sensibilities. Patients were unused to being poked and prodded while naked. Medical reform and the fervour of the hygiene movement diminished privacy and personal freedom. Medical manuals called for the purchase of special equipment for the sickroom, changing a patient's bedroom into a barren, hospital-style ward. In some ways the current popularity of home care is a return to an era of patient control over the care environment. Another effect of medical reforms was the licensing and regulation of medical practitioners; before this, just about anyone could treat sick people. Medicine, after all, didn't have a great success rate.

Medical reforms such as these made mesmerism seem conservative. Its mode of diagnosis and treatment was, to many, "more proper" than hospital practice. Now that invasive medicine is the standard for the investigation and treatment of many conditions, it can be hard for today's physicians to appreciate how auscultation and percussion were cultural shocks to the Victorian patient. The professionalization of medicine required patients to learn new ways of being sick. Winter argues that mesmerism was a countercurrent to these changes in medical practice, one that empowered patients — especially several prominent women such as Ada Lovelace, Elizabeth Barrett and Harriet Martineau, who publicized their cures.

Winter's book will appeal to physicians interested in the history of medicine and to anyone practising clinical hypnosis. Mesmerized is an entertaining exploration of a neglected subject, even if in the end it reads like a feverishly overwritten doctoral thesis.

Peter Vaughan, MD, MPH
Secretary General of the CMA.

[Contents]

Send a letter to the editor Envoyez une lettre à la rédaction

William James Topley / National Archives of Canada / PA-42373

William James Topley / National Archives of Canada / PA-42374

Men's and women's sitting rooms, Perley Home for Incurables, Ottawa, January 1904

[Contents]

If you have not been to Nova Scotia during the first week of October, you have yet to see one of the wonders of the world. The forest is alive with colour, and when, as often happens, the sunlight ignites the scene, the red leaves of the maples become a canopy of flame and the huckleberry bushes glow like embers below. Despite the nip of autumn you feel a warmth and breathe a perfume that intoxicates the soul. Apparently Longfellow wrote Evangeline, his epic poem of Acadia, without ever experiencing this "forest primeval." What a pity.

Such a light and such a fire of the woods comes to mind as I recall the day I drove along a forest road to a small farm adjacent to a marsh, where lived Hubert and Ottie Williams in some isolation from the world. On a small rise stood a little wooden house with faded green siding and a grey roof. I suspect that the trim around the windows and doors had once been white, but now it was faded to a dusty yellow. Behind the house was a barn; in front was the wild marsh that stretched down some distance to the ocean.

In the doorway stood Hubert, a tall, upright, healthy octogenarian whose eyes were watery blue, perhaps from gazing for so many years at the sea. He had once been as far as 16 miles from this spot, this house where he was born, and his sister Ottie had once been invited to tea in a small village 12 miles up the shore. This was the extent of their travels in 80 years, but they expressed no regret on this point. If anything, they seemed proud of having lived all their lives so close to this one place.

Ottie was two years younger than her brother. Her grey hair was combed into a tidy bun on top of her head, and she wore a grey dress with a white pinafore. She stood behind Hubert as he invited me into their spotless house, on the floors of which were carefully laid newspapers in the place of carpets. They had no electricity or telephone; their water came from a well. With shining faces they showed me a recent extravagance: a hand pump, newly installed in the kitchen so that they wouldn't have to go out to the well in the winter.

"We saved our pension money," said Ottie, "and look what we bought. I told Hubert that they give us the money to spend and it's meant to be circulated so that others get a chance to use it."

A neighbour had called from her telephone asking me to "please visit Hubert and Ottie if I was in the area." The nature of the problem was not stated, and seeing them for myself I thought they both looked very healthy. I waited for them to volunteer an explanation.

"It's the bossies, Doctor," Hubert finally said.

I racked my brains. I didn't know the expression, but the meaning became clear when they showed me to the barn. The previous night their cow had calved. There she stood in her stall, with two sturdy little offspring sitting on their haunches beside her. Alas, my training had only included Homo sapiens. Bos bovis was a mystery to me. They all looked fine as far as I could see.

"Is something wrong with them?" I asked gently.

"Oh no, Doctor, it's just the afterbirth. It should have come out by now."

"Ahh," said I. "You know I don't know much about cows, or how long it takes."

"Yes I know, Doctor, but the vet's on holiday and we thought you would be able to help. We've got a book."

"Go and get the book, Hubert," said Ottie.

We followed him back to the house. He produced a heavy book wrapped in newspaper and placed it on the kitchen table. He then went to the sink, pumped the new pump, and washed his hands with soap and water like a surgeon, drying them on a small clean towel with extreme care. He then unwrapped the book. It had a black cover and appeared to be new in condition, though turn-of-the-century in content. It was a volume on animal husbandry, printed on thick creamy paper in heavy blurred type of a font no longer used. It had been set by hand and was sparingly illustrated with original woodcuts. Hubert had been consulting it earlier, and he now opened the cover and turned the pages one by one until he reached the relevant advice. "If the placenta is not delivered naturally, after twenty-four hours from the birth, the following should be undertaken," I read in awe. "After careful washing of the hands and arms up to the shoulder, one should carefully separate the cotyledons from the uterus and deliver the placenta." There was a slightly blurred woodcut of the cotyledons, which looked to me unlike anything I had ever seen. I read it a few times in the glow of the kerosene lamp that Ottie had thoughtfully lit to illuminate our deliberations.

"How long has it been?" I asked hopefully.

"About thirty hours," came the reply.

We all looked at each other. I knew what it meant. The cow's uterus was obviously large enough to contain two calves and an appropriate amount of placenta. The operator had to strip to the waist and wash his hands and arms up to the shoulder. Then he had to insert his hand and arm deep into the uterus and, as the book said, "gently separate the cotyledons." These I assumed must be extensions of the placenta that joined it to the inner wall of the uterus. The problem was that an inexperienced hand might perforate the soft uterine wall, which in these circumstances would mean a painful death for the cow.

"Hmmm," I said, trying to at least appear impressed, or perhaps wise. "Hmmm, let's have a look at her."

The barn was poorly lit but as our eyes adjusted it assumed a nobility of its own, like a Christmas scene.

I circled the cow a couple of times trying to size her up. The risk of leaving the placenta was that puerperal sepsis could set in and kill her. I ventured closer. The cow was eating contentedly and had a wet nose; it didn't look as though she had a fever. Neither Hubert nor I had a thermometer suitable for cows and I didn't know the normal temperature anyway, so this avenue was left unexplored.

"How do you think she looks, Hubert?"

"She looks pretty good to me, Doctor."

"And to me, Hubert."

In those days there was a medical principle called "masterly inactivity." I felt that this was the moment for such a time-honoured course.

By this time evening had fallen. The sun was setting, and as I drove home streaks of sunlit clouds hovered over the golden ripples on the distant sea.

In the early morning again I found Hubert at his front door. His smile told all.

"I don't know how to thank you, Doctor."

"Oh, it was the book, Hubert."

This time I drove home pondering the simplicity of Hubert and Ottie's lives and the complexity of my own.

The money was meant to be circulated so that others get a chance to use it. I had never quite seen it that way but I think Ottie was right.

Alan J. Lupin, MD
Honorary Professor
Department of Surgery
University of British Columbia
Vancouver

[Contents]

1.  Corpus

Post-autopsy, the returned convexity of skull reshapes the scalp.
The chest and belly, baseball-stitched, hold in one green garbage bag
a mess of unmatched guts, the viscera dissected to detect
the-thing-that-did-it.
The autopsy technician sacrificed a step
to tie off the jugular veins
keeping colour in the face,
a gesture to this man or courtesy to his last beauticians.

"Corpses are more fit to be cast out than dung."

I wash excrement from skin that holds no mystery,
slice and weigh the organs, warm and turning cold and stiff as turds.
The clues are not available to idiots with knives.

2.  Breath

Your garden in November,
this moment dragging remnants of itself.

Unharvested summer squash as fat as watermelons, soft
hope grown into vegetables, and then inedible.

A pumpkin too long after Halloween.
The slow deflation of a red balloon saved from a birthday party.

A breath not yet let out
hopes too much to breathe.

3.  Skin

Humans have the ocean in them,
but a body can be light
   in dance,
   when fear lifts mud feet into air,
   or when the heavy ocean floats it.

Socrates is dead.
What dances on the last extent of flesh
is flesh extended into laughter,
   the hollow at the base of neck
   pulled taut between a swallow and a breath.

Robert Maunder, MD
Department of Psychiatry
Mount Sinai Hospital, Toronto

Send a letter to the editor Envoyez une lettre à la rédaction

© 1999 Canadian Medical Association