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9 Unfamiliar Things You’d See in a Hospital in 1900

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Hospital technology has come a long way since the beginning of the 20th century – these former staples of every ward and operating room have all but disappeared.

1. Street Clothes in Operating Rooms

By 1900, doctors understood that cleanliness in operating rooms was an important part of curbing infection and transmission of germs. Unfortunately for patients, they hadn’t quite mastered the art of creating sterile surgical environments. Surgeons performed procedures in their street shoes and clothes topped little more than a butcher’s apron – not to protect the patient, but to keep their threads from getting too bloody.

2. Open Operating Theaters

The surgical team wasn’t alone in tracking contaminants into the operating room. Unlike the scrupulously sterilized modern operating rooms, in the 19th and early 20th centuries many procedures took place in large, open-air operating theaters filled with no barrier between the patient and spectators in street clothes. Since early electric lights didn’t always give off enough light for surgery, these operating theaters often included large windows to let in extra sunlight.

3. Bare Hands and Faces

Although rubber gloves had been invented in the 19th century, their use hadn’t really taken off in 1900. Surgeons would give their hands a thorough pre-procedure scrubbing, then get to work with bare hands. Similarly, the surgical face masks that are a common sight today were still decades away from widespread use.

4. Hand-Cranked Suction

If a surgeon needs a clear blood-free look at the area on which an operation is being performed, he or she can use suction to remove blood from the area. In modern operations, this task is performed by electrically powered vacuum systems, but in 1900 it required elbow grease – one member of the operating team furiously cranked a mechanical suction pump to give the surgeon a clearer view.

5. Inhaled Anesthesia

Being put under for surgery is pretty straightforward for most modern patients – a dose of drugs is administered via IV, and the patient drifts off. In 1900, things weren’t so easy. Inhaled ether was the anesthetic of choice in the early 20th century, and while it did the trick, it soon fell out of favor as more versatile, less flammable intravenous options emerged.

6. Nurses Wearing Caps

Until the 1980s, a small white cap perched atop the head was a part of nursing’s standard uniform. The cap wasn’t just decorative. It kept long hair out of the nurse's way and offered patients a visual cue that the person giving them care was a qualified nurse. However, as nurses transitioned to wearing scrubs rather than formal white uniforms, their signature caps fell by the wayside.

7. Involuntarily Committed Tuberculosis Patients

As tuberculosis tore through New York City during the late 19th century, in 1893 public health officials began an aggressive campaign to curb the spread of the disease. In addition to educating patients on how to prevent further infections, officials could forcibly remove infectious patients from their homes and confine them to hospitals. Although the measure sounds extreme, it worked.

8. Boiling Water Sterilizers

In an early 20th century operating room, you could have spied surgical implements sitting in a pot of boiling water to sterilize them. While this technique was somewhat effective at killing off germs, simple boiling in water can allow some spores to survive. Today, hospitals use a combination of steam and pressure in an autoclave to more thoroughly disinfect implements.

9. Stables

The motorized ambulance made its debut in 1899 when a Chicago hospital adopted an electric version, and the breakthrough found its way to New York City the following year, but the vast majority of emergency patients in 1900 made their way to the hospital in horse-drawn ambulances. Major hospitals had their own specialized stables in which horses’ harnesses dangled from the ceilings. When an emergency call came in, drivers dropped the quick-rigging harnesses onto their team in just seconds and took off for the scene.

Even as automobiles gained in popularity, horse-drawn ambulances persisted. Some of New York’s biggest hospitals were still using them as late as 1923. Public health officials were delighted with the development since it spared them both the hassle of operating stables and the unsanitary conditions that came with quartering livestock in close proximity to patients.

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History
How an Early Female Travel Writer Became an Immunization Pioneer
Lady Mary Wortley Montagu by A. Devéria
Lady Mary Wortley Montagu by A. Devéria

Lady Mary Wortley Montagu was a British aristocrat, feminist, and writer who was famed for her letters. If that were all she did, she would be a slightly obscure example of a travel writer and early feminist. But she was also an important public health advocate who is largely responsible for the adoption of inoculation against smallpox—one of the earliest forms of immunization—in England.

Smallpox was a scourge right up until the mid-20th century. Caused by two strains of Variola virus, the disease had a mortality rate of up to 35 percent. If you lived, you were left with unsightly scars, and possible complications such as severe arthritis and blindness.

Lady Montagu knew smallpox well: Her brother died of it at the age of 20, and in late 1715, she contracted the disease herself. She survived, but her looks did not; she lost her eyelashes and was left with deeply pitted skin on her face.

When Lady Montagu’s husband, Edward Wortley Montagu, was appointed ambassador to Turkey the year after her illness, she accompanied him and took up residence in Constantinople (now Istanbul). The lively letters she wrote home described the world of the Middle East to her English friends and served for many as an introduction to Muslim society.

One of the many things Lady Montagu wrote home about was the practice of variolation, a type of inoculation practiced in Asia and Africa likely starting around the 15th or 16th century. In variolation, a small bit of a pustule from someone with a mild case of smallpox is placed into one or more cuts on someone who has not had the disease. A week or so later, the person comes down with a mild case of smallpox and is immune to the disease ever after.

Lady Montagu described the process in a 1717 letter:

"There is a set of old women, who make it their business to perform the operation, every autumn, in the month of September, when the great heat is abated. People send to one another to know if any of their family has a mind to have the small-pox: they make parties for this purpose, and when they are met (commonly fifteen or sixteen together) the old woman comes with a nuts-hell full of the matter of the best sort of small-pox, and asks what veins you please to have opened. She immediately rips open that you offer to her with a large needle (which gives you no more pain than a common scratch), and puts into the vein as much matter as can lye upon the head of her needle, and after that binds up the little wound with a hollow bit of shell; and in this manner opens four or five veins. . . . The children or young patients play together all the rest of the day, and are in perfect health to the eighth. Then the fever begins to seize them, and they keep their beds two days, very seldom three. They have very rarely above twenty or thirty in their faces, which never mark; and in eight days' time they are as well as before their illness."

So impressed was Lady Montagu by the effectiveness of variolation that she had a Scottish doctor who worked at the embassy, Charles Maitland, variolate her 5-year-old son in 1718 with the help of a local woman. She returned to England later that same year. In 1721, a smallpox epidemic hit London, and Montagu had Maitland (who by then had also returned to England) variolate her 4-year-old daughter in the presence of several prominent doctors. Maitland later ran an early version of a clinical trial of the procedure on six condemned inmates in Newgate Prison, who were promised their freedom if they took part in the experiment. All six lived, and those later exposed to smallpox were immune. Maitland then repeated the experiment on a group of orphaned children with the same results.

A painting of Lady Mary Wortley Montagu with her son, Edward Wortley Montagu, and attendants
Lady Mary Wortley Montagu with her son, Edward Wortley Montagu, and attendants
Jean-Baptiste Vanmour, Art UK // CC BY-NC-ND

But the idea of purposely giving someone a disease was not an easy sell, especially since about 2 or 3 percent of people who were variolated still died of smallpox (either because the procedure didn’t work, or because they caught a different strain than the one they had been variolated with). In addition, variolated people could also spread the disease while they were infectious. Lady Montagu also faced criticism because the procedure was seen as “Oriental,” and because of her gender.

But from the start, Lady Montagu knew that getting variolation accepted would be an uphill battle. In the same letter as her first description of the practice, she wrote:

"I am patriot enough to take pains to bring this useful invention into fashion in England; and I should not fail to write to some of our doctors very particularly about it, if I knew any one of them that I thought had virtue enough to destroy such a considerable branch of their revenue for the good of mankind. But that distemper is too beneficial to them, not to expose to all their resentment the hardy wight that should undertake to put an end to it. Perhaps, if I live to return, I may, however, have courage to war with them."

As promised, Lady Montagu promoted variolation enthusiastically, encouraging the parents in her circle, visiting convalescing patients, and publishing an account of the practice in a London newspaper. Through her influence, many people, including members of the royal family, were inoculated against smallpox, starting with two daughters of the Princess of Wales in 1722. Without her advocacy, scholars say, variolation might never have caught on and smallpox would have been an even greater menace than it was. The famed poet Alexander Pope said that for her, immortality would be "a due reward" for "an action which all posterity may feel the advantage of," namely the "world’s being freed from the future terrors of the small-pox."

Variolation was performed in England for another 70 years, until Edward Jenner introduced vaccination using cowpox in 1796. Vaccination was instrumental in finally stopping smallpox: In 1980, it became the first (and so far, only) human disease to be completely eradicated worldwide.

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Medicine
New Cancer-Fighting Nanobots Can Track Down Tumors and Cut Off Their Blood Supply
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Scientists have developed a new way to cut off the blood flow to cancerous tumors, causing them to eventually shrivel up and die. As Business Insider reports, the new treatment uses a design inspired by origami to infiltrate crucial blood vessels while leaving the rest of the body unharmed.

A team of molecular chemists from Arizona State University and the Chinese Academy of Sciences describe their method in the journal Nature Biotechnology. First, they constructed robots that are 1000 times smaller than a human hair from strands of DNA. These tiny devices contain enzymes called thrombin that encourage blood clotting, and they're rolled up tightly enough to keep the substance contained.

Next, researchers injected the robots into the bloodstreams of mice and small pigs sick with different types of cancer. The DNA sought the tumor in the body while leaving healthy cells alone. The robot knew when it reached the tumor and responded by unfurling and releasing the thrombin into the blood vessel that fed it. A clot started to form, eventually blocking off the tumor's blood supply and causing the cancerous tissues to die.

The treatment has been tested on dozen of animals with breast, lung, skin, and ovarian cancers. In mice, the average life expectancy doubled, and in three of the skin cancer cases tumors regressed completely.

Researchers are optimistic about the therapy's effectiveness on cancers throughout the body. There's not much variation between the blood vessels that supply tumors, whether they're in an ovary in or a prostate. So if triggering a blood clot causes one type of tumor to waste away, the same method holds promise for other cancers.

But before the scientists think too far ahead, they'll need to test the treatments on human patients. Nanobots have been an appealing cancer-fighting option to researchers for years. If effective, the machines can target cancer at the microscopic level without causing harm to healthy cells. But if something goes wrong, the bots could end up attacking the wrong tissue and leave the patient worse off. Study co-author Hao Yan believes this latest method may be the one that gets it right. He said in a statement, "I think we are much closer to real, practical medical applications of the technology."

[h/t Business Insider]

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