Farewell To The East End

and it has been said that many consumptives who could afford it were addicted to opium. Many drugs are hallucinogenic, but not all arouse creativity as opium does.

    Dwellers in the cold North assumed that grey skies, foggy winters and biting winds caused tuberculosis. Therefore the consumptive rich flocked in droves to Southern climates, trying to escape the cold North, but to little avail. They carried the seed of death with them and spread it amongst their hosts. In the South of France, Nice, once a pretty fishing village, suddenly became fashionable. Hotels were built, and filled with cadaverous consumptives, ghostly pale, with sunken features and haunted eyes. It was said that performances at the Opera House could not be heard above the sound of coughing and spitting! Rich Americans fled south to Florida and New Mexico to beg of the sun a last ray of hope. But the sun had no healing powers to cure advanced galloping consumption; in fact, exposure to the sun could have a negative effect.
    Medical advice changed. Mountain air was prescribed – desert air, sea air, tropical air, moist air, dry air, gentle winds, fierce winds, no wind. Consumptives who could afford to do so journeyed hither and thither in vain. By the end of the eighteenth century it was obvious to everyone that tuberculosis did not respond to any climatic conditions, and respected no geographical boundaries.
    Medical science was in its infancy, and treatments were rudimentary. The unpredictability of the course and outcome of tuberculosis had always baffled doctors – some consumptives died within months of contracting the disease, others recovered spontaneously with no treatment, whilst some lived a long and active life with intermittent bouts of debility. The sick begged for treatment; anything that might offer a glimmer of hope was clutched with shaking hands. But the outcome of the treatment was as unpredictable as the disease itself, and probably had little effect upon the course of the illness anyway. Despite that, one fashionable treatment followed another. Bleeding and blistering were common, as were leeches, plasters and poultices, cuppings and inhalations. Lifestyle was tackled, and various courses advised: vigorous exercise, such as skiing, riding, walking, or sea bathing sometimes helped. Deep breathing was advocated, also flute playing and singing. Other physicians insisted that rest was essential – total bed rest for months or years on end, often in an enclosed, heated room in which it was forbidden to open a window. Elizabeth Barrett lay in bed for years until Robert Browning romantically carried her off to Italy, where she spontaneously recovered!
    Diet is important in any illness, and dietary fads followed each other with bewildering speed. Some physicians advised extreme abstention – a starvation diet we would call it today – and the Bronẗ sisters almost certainly suffered from malnutrition, imposed by their father and his medical advisers. Others went for diets rich in meat, offal, warm animal blood, fat, cream, fish, eggs and milk – asses’ milk, goat’s milk, camel milk, sheep’s milk and human milk (still favoured in the United States in 1900). All have had their day.
    Drug therapy was almost non-existent. Ancient herbal remedies existed in every culture or tribe from time immemorial, some of which would ease symptoms, but none of which could destroy the tubercle bacillus. In the eighteenth and nineteenth centuries digitalis, quinine and mercury were used, although the universal balm and comforter was opium.
    The great flaw in all treatments was the fact that the highly contagious nature of tuberculosis was not recognised. No special precautions in the care of a dying consumptive were advised by physicians. Quite the contrary, a hot stuffy room, with windows never opened, was favoured. Many are the testimonies of a loving parent or sibling who spent whole days and nights in the same room, and often in the same bed, as the sufferer. Millions of people who showed no signs of disease were carriers.
    If all the money in the world could not protect the rich from the ravages of tuberculosis, what became of the labouring poor? Not for them the luxury of hotels in southern France or Alpine Switzerland, or even the cost of a doctor. They could barely afford an aspirin, or a day off work. Loss of work could spell destitution, so they laboured on until they died.
    In industrial cities, firstly in England and later