Masks in the 1800s for Safety and Health

Just like we are wearing masks today to prevent the spread of covid-19, in the 1800s people wore masks but they did not necessarily wear them to protect against infection. Most masks in the 1800s were designed to protect people against eye or facial injuries. However, that would change by the end of the 1800s when the first surgical masks would be worn by doctors.

An 1827 book titled Chemical Manipulation: Being Instructions to Students in Chemistry, on the Methods of Performing Experiments of Demonstration Or of Research, with Accuracy and Success noted that masks should be worn to protect chemists and lab workers against injury. It stated that “screens and masks” should be worn because chemists and lab workers used dangerous or explosive substances such as gases, “chloride of nitrogen,” and other similar things. It was therefore important that these workers protect their faces and eyes from any harm or injury and to help them, certain masks in the 1800s were recommended. These workers were also advised that it was “worse than thoughtless to neglect the proper means of preserving the eyes [and face from injury].”[1] Moreover, the masks suggested for them were described in the following fashion:

“A very excellent mask for the defence of eyes and face, may be made of a piece of wire gauze, sufficiently large to cover the visage. It may be attached at the upper edge to a spring band, which, passing round the head, will retain it in its place. This mask is flexible, consequently not liable to be shattered like one of glass, and is free from the inconvenience of producing dimness, which is often occasioned by masks of glass, owing to the condensation of moisture from the breath. But it is objectionable for all experiments which require close observation, because of the interference of the wire gauze with perfect distinctness of vision; and as it allows the passage of fluids through its meshes it is inefficient in explosive experiments, made with corrosive liquids, as for instance, those upon the chloride of nitrogen by acids.”[2]

By 1882, masks of mica were being used by workmen who performed duties related to grinding and polishing, such as glass melters, stone masons, and so forth. These workers were “liable to be injured by heat, dust or noxious vapors … [and flying fragments]”[3] and many mica masks were being produced by a well-known German manufacturer, Herr Raphael of Breslau. The masks were said to be “quite transparent, very light, and affected neither by heat nor acids.”[4] They were also described as follows:

“[Mica] plates are fixed in a metallic frame, which is well isolated by means of asbestos, so as not to be attacked by heat or acid. These masks allow the turning of the eyes in any direction; and, as against mica spectacles, they afford the advantage of protection to the whole face. In certain cases the neck and shoulders may also be guarded by a sheet of cloth impregnated with fire-proof material, or by an asbestos sheet attached to the mask. The interval between the mica and the eyes allows workmen who have poor eyesight wearing spectacles, and of workers with fire or in melting operations wearing colored glass spectacles under the mask without fear of breakage of glass, being such a bad conductor heat. Where the masks have to be long worn, it is found desirable to add a caoutchouc tube, with a mouthpiece for admission of fresh air; the tube passes out to the shoulders, where its funnel-shaped end (sometimes holding a moistened sponge) is supported. The masks have a sort of cap attached to it for fixture on the head.”[5]  

By the late nineteenth century people were no longer wearing masks just to protect a person’s face and eyes. It had become obvious during the Georgian Era that there was bad air and by the late 1800s people understood that health problems or physical injuries could result from workers breathing in particles that floated in the air. Suggestive of this was what one book on health and occupation cited as “evils” resulting from “dusts”:

“The dusts, however fine and impalpable they may be, admit of being filtered from the air readily enough, so that the person who is exposed, if he should wear, with care and judgement, a simply constructed filtering mask, would be saved from danger.”[6]

Many different types masks in the 1800s were invented to filter dust particles. Among them was the “feather mask” said to be “light, as easy to put on as spectacles, and so cheap that the poorest might have it.” [7] Its inventor claimed that the mask was “so perfect in its action that the finest flour will not pass through its meshes, although the air traverses it with complete facility.”[8]

Other types of masks in the 1800s that were worn by workers for protection against dust particles were invented by a factory inspector named Baker. His invention was a “crape mask” and was supposedly worn by those working in Ireland’s flax-spinning factories. It supposedly was of “much benefit” to the workers although Sir Benjamin Ward Richardson, a British physician, anesthetist, physiologist, sanitarian, and prolific writer on medical history, countered that assertion after he visited flax-spinning factories:

“I never once saw the mask in use and from what I could learn the objection against masks of all kinds almost prevent the hope of an acceptance of the most simple and most perfect that could be designed.”[9]

Masks in the 1800s were sometimes applied in medical settings but not necessarily to prevent contamination and not necessarily for doctors. One mask, the “Ring’s ocular mask,” devised by American doctor Frank W. Ring was promoted in 1893 for patients who underwent “cataract extraction.” It was worn by patients over their eyes and functioned more as shield to protect patients from touching or disturbing their eyes after surgery.

Ring’s mask was made from papier-maché and lined on the outside with silk and inside with linen. Ring suggested that a new mask be used for each patient and supposedly patients were “anxious” to wear it at night to protect themselves against any accidents. Moreover, Ring suggested doctors apply it to their patients immediately after surgery and that if a doctor desired “to give the patient light, a perforation may be easily made with a penknife in front of the unoperated eye.”[10]

Other types of masks in the 1800s that were used by patients included the “ether mask.” It was applied to ensure that ether, an anesthesia that was pleasant-smelling and colorless, would put a patient under so that surgery could be performed. One of the best of the ether masks was the “Juillard of Geneva.” A description of it stated:

“A metal or wire basket, large enough to cover the entire face, is covered with oiled silk, and at its vertex contains a tuft of flannel upon which the ether is poured. The mask is then held down on the face, and, as a rule, is much less than half a minute, pressed down so as to exclude the external air as much as possible, surrounding the edge of the mask with a towel, and the struggling patient is restrained by assistants. The mask is removed [only enough] … to pour on more ether.”[11]

Doctors and surgeons did not initially understand that masks could protect against infection. That didn’t happen until French surgeon Paul Berger became the first doctor to wear a cloth facemask during an operation in Paris in October 1897.

“Berger’s suspicions had been aroused by the association of a short series of cases of suppuration in clean operations with an assistant who was suffering from an alveolar abscess. The same mishaps occurred several months later, when he himself was suffering from a dental peritonitis. His attention directed to the point led him to notice that drops of saliva were projected from the lips of the operator or his assistant even when isolated words, orders in monosyllables, were given. Aware of [Carl] Flügge’s discovery of the presence of pathogenic bacteria in the saliva, he had set to work to find a means of ‘shielding his operation wounds from this cause of contamination.’”[12]

Berger decided there should be something to shield incisions in order to prevent postoperative infection because he knew that speaking, coughing, and sneezing could spread secretions from a person’s nose and mouth. So, he became the first doctor to wear a mask when he performed surgery.* Of the type of mask he used, it was reported:

“[H]e began to wear a rectangular compress of six layers of gauze, sewn at its lower edge to his sterilized linen apron (he had a beard to safeguard) and the upper border held against the root of the nose by strings tied behind the neck.”[13]

Berger then tracked the results of wearing a mask during surgery and discovered over a 15-month period that the incidences of infections were reduced. Thus, on 22 February 1899, he read before the Surgical Society of Paris a paper titled, “On the Use of a Mask in Operating.” He touted the use of masks in surgery and noted how they safeguarded against infections. He ended his paper stating:

“It is exactly because I realize that perfection in the carrying out of operations aseptically must not concern itself with any one point but with all, and must neglect no detail, that I have been so anxious to insist on a precaution, the use of which has contributed not a little to improve my operative results.”[14]

Others in the medical community, such as Berkeley Moynihan, a noted British abdominal doctor, also supported wearing masks in the 1800s when performing surgical operations:

“Experiment work … has shewn that particles of saliva are ejected during conversation to a considerable distance … ‘worse than the worst London sewage.’ Unless the operator and his assistant and all those nearly engaged in the operation, can preserve absolute silence during an operation, they should wear gauze masks. I have had a sort of spectacle frame made for me to which the gauze is fixed. The frame is fixed, by bent sides, behind the ears, so that there no fear of the gauze slipping or becoming displaced during an operation. It is the custom among the unenlightened to scoff at the necessary precautions taken by those who practise aseptic surgery; the meaning of the word ‘aseptic’ is forgotten.”[15]

Despite Flügge, Berger, and Moynihan being convinced of the efficacy of wearing surgical masks, many surgeons believed that their mouths or noses could not be the source of infection. This was demonstrated by a Monsieur Terrier who scoffed, “I have never wore a mask, and quite certainly I never shall do so.”[16] Thus, because the medical community was still unsure about the value of masks in the 1800s, they “did not come into general use for many years, as some surgeons incorrectly believed that silence would be enough to prevent droplet infections.”[17]**

—
*In July 1897, Dr. Jan Mikulicz-Radecki, a pioneer of antiseptics and aseptic techniques, was the first to wear what he called a “mouth bandage.” It covered only his mouth.
**The facemasks that are now commonly found in medical settings and used by surgeons, did not come into use until the 1960s, when cloth facemasks fell out of fashion.

References:

• [1] M. Faraday, Chemical Manipulation: Being Instructions to Students in Chemistry, on the Methods of Performing Experiments of Demonstration Or of Research, with Accuracy and Success (London: W. Phillips, 1827), p. 581.
• [2] Ibid.
• [3] Southern Medical Record (Atlanta: A.M. Bergstrom, 1882), p. 391.
• [4] Ibid.
• [5] Ibid.
• [6] B. W. Richardson, On Health and Occupation (London: Society for Promoting Christian Knowledge, 1879), p. 125–26.
• [7] Ibid., p. 126
• [8] Ibid.
• [9] Ibid.
• [10] G. F. Shrady and T. L. Stedman, Medical Record (New York: William Wood & Company, 1893), p. .
• [11] G. B. Shatttuck, ed., The Boston Medical and Surgical Journal (Boston: Cupples, Upham & Company, 1895), p. 591.
• [12] Miles H. Phillips, “History of the Prevention of Puerperal Fever*,” British Medical Journal 1, no. 4017 (1938),  p. 4.
• [13] Ibid.
• [14] Ibid.
• [15] B.M.B. Moynihan, Abdominal Operations (Philadelphia: W.B. Saunders Company, 1906), p. 27.
• [16] M. H. Phillips, p. 4.
• [17] L. K. Groah, Operating Room Nursing: Perioperative Practice (New York: Appleton & Lange, 1990), p. 142.