Medical Blistering in the Georgian Era

Medical blistering, also sometimes known as vesiculation, raised a blister on the skin, and was thought by Georgian era 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.

The importance of medical blistering and how doctors thought of it throughout the early to mid Georgian Era is demonstrated by the following description provided in 1895:

“Malignant fevers were then looked up as disease, that unless at once diverted or checked by the most energetic means, were most liable to attack the brain or spinal cord and quickly disorganize their structure. From this view of the case the physician applied blisters to the legs of his unhappy patient, pretty much as one might throw his hat or coat in the path of the pursuing bear in the vain hope that the diversion thus offered might save the more important organ, whilst they totally ignored the retroactive results of the blistering material on the tissues or organs or on the nature of the disease. Yellow fever, putrid fever and all low-grade fevers, then exposed the unfortunate patient to be covered with blisters from head to toe, and even to having his or her head shaved and covered with a blistering wig, the physician being fully confirmed in the conscientious belief that he had sadly neglected his duty if he allowed the patient to die without first disfiguring him from heat to foot with well-raised and rounded and well-filled blisters. When the poor patient was so moribund that his skin would not respond to the action of the blister the physician was disconsolate, and he felt like a solider in battle with an empty cartridge-box.”[1]

To achieve this medical blistering required 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,”[2] 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 medical 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. Often 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 medical blistering operation to drink “copiously of diluent mucilaginous liquids.”[3]

According to at least one Georgian physician, blistering “sometimes [had] a direct stimulation effect on the suffering organ.”[4] 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.”[5]

Medical 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.”[6] Additionally, blistering ointments warmed areas and therefore were used in cases of rheumatism, chilblains, or other similar afflictions.

Many famous people underwent blistering treatments in the Georgian Era. For instance, the husband of Madame Campan, lady-in-waiting to Marie Antoinette, was reported to have been both bled and blistered. His treatment was given by Franz Mesmer, a German doctor who believed in the existence of a natural energy transference occurring between all animated and inanimate objects that he called “animal magnetism.” When his magnetism efforts failed to work, Madame Campan reported that he resorted to the more reliable means of effecting a cure, medical blistering. Another successful recipient of medical blistering was Napoleon Bonaparte. He became seriously ill and began coughing so hard, he coughed up blood. His doctor diagnosed him with lung congestion and prescribed several blisters be applied to chest, which reportedly succeeded in resolving his congestion.

Although Napoleon and Madame Campan’s husband were reported to have been helped by medical blistering, not every case proved successful. For instance, when retired U.S. President George Washington was attacked with “an inflammatory affection” on 13 December 1799 in the upper windpipe, doctors immediately prescribed he be bled and blistered. “Blisters were applied to the extremities, together with a cataplasm of bran and vinegar to the throat.”[7] Unfortunately, in this case, neither bleeding nor blistering helped. Washington died at 11pm the following night. 

By 1827, there was a new invention created by English surgeon Sir Anthony Carlisle that could achieve blistering without using compounds or ointments. It was a piece of polished iron put into boiling water. It remained there for five or six minutes before it was applied to tender skin with an “interposing … piece of wetted silk.”[8] It was claimed to be best used in hospital settings because in private practice there were “prejudices … entertained against instrumental operation — in short, against … the man that meddles with hot iron.”[9]

References:

• [1] Journal of Practical Medicine, Volume 6, 1895, p. 468.
• [2] Lewis, William, etal., An Experimental History of the Materia Medica, 1784, p. 189.
• [3] Forbes, Sir John, etal., The Cyclopaedia of Practical Medicine, Vol. 1,1833, p. 487.
• [4] The London Medical and Surgical Journal, Volume 4, 1834, p. 806.
• [5] Ibid., p. 806.
• [6] Lewis, William, etal., An Experimental History of the Materia Medica, 1784, p. 189.
• [7] Letters on Agriculture from His Excellency, George Washington, President of the United States, to Arthur Young, Esq., F.R.S., and Sir John Sinclair, Bart., M.P., 1847, p. 176.
• [8] The Medico-chirurgical Review,1827, p. 269.
• [9] Ibid.