Medical Blistering in the Georgian Era

Thomas Rowlandson's Death and THe Apothecary or the Quack Doctor, Medical Blistering

Thomas Rowlandson’s Death and THe Apothecary or the Quack Doctor, Courtesy of Wellcome Images

Medical blistering, also sometimes known as vesiculation, raised a blister on the skin, and was thought by Georgian doctors to be an effective tool to deal with certain medical issues. Among the issues and problems blistering was thought to correct or aid was hysteria, hypochonriasis, gout, certain types of simple inflammation, and fevers, as well as cases of insanity.

Blistering was achieved with applications of a fine powder usually composed of cantharides (a powerful-blistering substance often obtained from blister beetles, sometimes called Spanish Fly). Sometimes other stimulant ingredients, such as “pepper, mustard-seed, and verdigris,” were also added. The fine powder and stimulants were then mixed with plasters or other compositions of the same consistency and spread on the skin’s surface to produce a blister. This concoction was left on the skin from a few hours to many hours, depending on the extent of blistering required.

When the blister was fully raised, it was often “snipped” or opened. Sometimes the blister was  dressed with a healing ointment on a linen rag. More often than not patients were advised to abstain from bulk liquids because it was thought drinking liquids would reduce the effectiveness of the blistering agents. However, in certain cases patients were advised during the blistering operation to drink “copiously of diluent mucilaginous liquids.”

According to at least one Georgian physician, blistering “sometimes [had] a direct stimulation effect on the suffering organ.” However, physicians had to be careful or they could cause damage as blistering could not be applied too long as it was claimed it would over excite the organ. To ensure that an organ was not overexcited, it was recommended a piece of silver paper, thin gauze, or muslin (moistened with oil) be put next to the skin and that the compound applied be left on only until “a decided sense of smarting [was] produced.”

Blistering ointments were also sometimes used to create perpetual blisters so that there was a “constant drain of ferous humours.” Ointments were generally prepared by apothecary shops as needed. They could also be diluted “one twenty-sixth part of the whole compound.” Additionally, blistering ointments warmed areas and therefore were used in cases of rheumatism, chilblains, or other similar afflictions.

By 1827, there was a new invention by Sir Anthony Carlisle that could achieve blistering without using compounds or ointments. His invention was a piece of polished iron put into boiling water. It remained there for five or six minutes before it was applied with an “interposing … piece of wetted silk.” It was claimed to be best used in hospitals because in private practice there were “prejudices … entertained against instrumental operation — in short, against … the man that meddles with hot iron.”

References:

  • Forbes, Sir John, etal., The Cyclopaedia of Practical Medicine, Vol. 1,1833
  • Lewis, William, etal., An Experimental History of the Materia Medica, 1784
  • Stokes, William, Lectures on the Theory and Practice of Physic, 1837
  • The Medico-chirurgical Review,1827

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