Key Words: Whistleblower, Maternity
Ignaz Semmelweis was the Hungarian obstetrician and a whistle-blower who spoke out about bad practice in maternity wards. The work done by Semmelweis all but removed puerperal fever, commonly known as Childbed fever, from the maternity wards he worked in. He was not the first to try to change the medical practices of his day and like his predecessors, he was to suffer for his outspokenness.
The son of a tenant farmer from Aberdeen was the first modern doctor to realise how the infection was passed from person to person but he had no proof to back up his findings. Alexander Gordon was born in the hamlet of Milton of Drum, eight miles west of Aberdeen in 1752. His twin brother James went on to contribute to the development of farming introducing the Swedish turnip – the swede to Scotland and improving the diet of the Scottish people. James died at the grand old age of 90; his brother Alexander was not so lucky.
Alexander became a medical student and studied at the medical faculty of the University of Leiden in the Netherlands in March 1776. Teaching at the University took the form of topics rather than through learning the writings of the ancient Greek and Roman treatises on medicine. Students learned to exhibit a caring attitude at the bedside and to take meticulous notes.
After his time in Leiden, there is evidence that Gordon attended physicians’ ward rounds at Aberdeen Infirmary, although the city had no formally established medical school. His notes of lectures by Alexander Monro Secundus in the library of the University of Aberdeen indicate that he studied for a time in Edinburgh. After his time in Edinburgh, Gordon joined the Royal Navy, serving as a surgeon’s mate and ship’s surgeon, a move that would have offered the opportunity for adventure but also funding for further medical training before setting himself up in practice.
In April 1785, he retired from the Navy on half-pay and spent nine months in London, as a resident pupil at the Middlesex Hosptial and Store Street lying-in hospitals, where he heard lectures from leading obstetricians and attended dissections and lectures in surgery at the Westminster Hospital. Early in 1786, with an education gained in prestigious medical centres, he returned to practice in his native Aberdeen.
Gordon became a physician to the city Dispensary in February 1786. Here he saw sick people as outpatients or in their own homes, an activity that continued throughout his time in Aberdeen. The keeping of accurate medical records was a hallmark of the Scottish medical Enlightenment. Gordon was required to maintain a log of the dates of each patient’s attendance, their name, age, address, the presenting condition and its outcome; this discipline was to prove important for his later discovery about the spread of puerperal fever.
There were two major outbreaks of puerperal fever in and around Aberdeen while Gordon was there. From his notes, Gordon noticed that mothers living in the villages developed the fever if they were in the care of midwives from the city, where the infection was rife; village mothers attended by country midwives, who had no previous contact with the fever, avoided the disease.
Secondly, in common with what was becoming part of informed medical inquiry at this time, he created a table and noted the appearance of cases in date order, the maternal place of residence, the outcome and crucially, the name of the person who attended the birth. It was immediately apparent that cases of fever began in date sequence after visits by particular midwives. Furthermore, with impressive scientific objectivity, he implicates himself in the transmission, stating: It is a disagreeable declaration for me to mention, that I myself was the means of carrying the infection to a great number of women. This evidence-based discovery long preceded the findings of Oliver Wendell Holmes in 1843 and Ignaz Semmelweissin 1847, whose names are commonly associated with establishing the mode of transmission of puerperal fever.
Gordon’s advice to any physician who had seen a patient with severe fever was to return home and change and fumigate his clothes. By instituting hygiene measures that included hand washing, fumigation of rooms and burning of infected clothing, Gordon was able to claim, ‘In my practice, of 77 women, who were attacked with the puerperal fever, 28 died; so that very near two-thirds of my patients recovered.’ He goes on to quote contemporary reports of puerperal fever mortalities in the range 68–100%. Alexander Gordon died at the age of 47 in 1799. No one had listened to his advice and he had left the job in loved to work once more as a naval surgeon.
Ignaz Semmelweis suffered a similar fate. Semmelweis was not prepared to accept the belief that poison air was killing his patients in the No. 1 labour ward in the Vienna hospital where he worked. Semmelweis believed that the cause of so many deaths in the maternity ward was the nearby post-mortem room. Ward No. 1 was the preserve of doctors and trainee doctors whereas Ward No 2, where the death rate was lower, was the domain of the midwives who did not perform routine autopsies. Semmelweis believed that there had to be a link between the work done in the post-mortem room and the rate of infection in Ward No 1.
In 1847, a colleague of Semmelweis, Jakob Kolletschka, died from septicaemia. He had been cut with a scalpel during an autopsy. Semmelweis attended his colleague’s autopsy and noticed that the lesions on his body were very similar to those on many of the women who had died in Ward No 1. Semmelweis believed that it had been the scalpel that had transferred the ‘miasma’ from the corpse to his former colleague.
Semmelweis ordered that all medical staff in Ward No 1 had to wash their hands in chlorinated lime before visiting a patient and that the ward itself had to be cleaned with calcium chloride. The mortality rate in Ward No 1 dropped dramatically and by 1849, just 2 years after the death of his colleague Kolletschka, death from ‘miasma’ had all but disappeared.
Semmelweis provided his evidence to the medical elite of Vienna. He stated that cleanliness was the way to defeat ‘poison air’ and backed this up with the statistics he had gathered. His views were not part of the general medical beliefs of the time and he was immediately attacked by most senior medical figures – three did support him but none of them had a background in obstetrics. Semmelweis was dismissed from his position and went to live in Budapest. In Ward No 1, the doctors went back to their old ways and fatality rates immediately increased to their level pre-1847.
Semmelweis gained employment at the St. Rochus Hospital in Budapest and applied his findings there. The death rate in the maternity units there dropped drastically. In 1861, Semmelweis published ‘Die Aetiologie, der Begrif und die Prophylaxis des Kindbettfiebers’ (Etiology, Concept, and Prophylaxis of Childbed Fever) – “which stands as one of the epoch-making books of medical history.” (History of Medicine by Roberto Margotta)
The work was filled with a mass of statistics and proved difficult to read. It was met with hostility by the medical profession and many simply mocked its findings. It took another twenty years before his findings were universally accepted. For years many of Europe’s leading medical practitioners believed that childbed fever was a disease of the bowel and that purging was the best medicine for it.
The years of rejection by his colleagues almost certainly took its toll. Semmelweis suffered from severe depression and may have suffered from premature dementia as he became very absent-minded. After the effective rejection of his 1861 work on puerperal fever he wrote a series of ‘Open Letters’ to his main critics in which he openly called them “ignorant murderers”.
In 1865 he was tricked into visiting a mental asylum. When he tried to leave Semmelweis was forcibly restrained and put in a straitjacket. The injuries were such that they became infected and he died two weeks later.
Ignaz Semmelweis died in 1865. He was buried in Vienna. Very few people attended his funeral. In 1891, his body was transferred to Budapest. A statue was only erected to him and his achievements in 1894, nearly thirty years after his death; Alexander Gordon remains almost entirely unknown.
Image: The Knick—Steven Soderbergh’s riveting Cinemax series, which looks inside the Knickerbocker Hospital in Manhattan at the turn of the last century.
By the 1780s John Hunter was the leading anatomist in Europe and an influential figure in Georgian high society: he had married a beautiful bluestocking poet, Anne Home, and was surgeon extraordinary to King George III.
During the day, the carriages of his wealthy patients blocked Leicester Square, where he lived with his family. In the evening, while Anne entertained London’s literati (“literary debates were decidedly not his idea of fun”), the Resurrectionists, or “Sack ‘Em Up Men”, would deliver corpses from London’s cemeteries to his back door. He was, as historian Wendy Moore says, “the Jekyll and Hyde of the Georgian period”.
At his country house in the “tranquil village” of Earl’s Court, Hunter kept an exotic menagerie: zebras and mountain goats grazed on the front lawn, prompting some to say he was the model for Dr. Dolittle. Hunter would sometimes be seen driving a carriage containing fresh supplies of fruit and vegetables from Earl’s Court to his Leicester Square townhouse, pulled by three Asian buffaloes. On the return journey, it would carry a gory cargo of dissected corpses. It was at Earl’s Court, he conducted experiments on animals of which Dr. Moreau would have been proud. The squealing of pigs and dogs vivisected in the name of science competed with the roar of his lions. In one of his more bizzare experiments he successfully grafted a cockerel’s testicle into the belly of a hen.
The place in British society of a man like John Hunter was rich in contradictions. As a surgeon, he treated some of the prominent men of his age – men like Adam Smith and David Hume (who called him “the greatest anatomist in Europe”), Gainsborough, Hickey, and the baby Byron, possibly James Boswell too. Many of these and other celebrities were personal friends of his and Anne’s – men like Joseph Banks, Joshua Reynolds, and Daniel Solander – highly respected members of civilised society.
Hunter kept a careful record of his surgical operations. This extract from his notebook details an unfortunate patient’s neck tumour:
‘John Burley, a Rigger, thirty-seven years of age, of a middle size, dark complexion, and healthy constitution; about sixteen years ago, fell down, & bruised his cheek on the left side, above the parotid gland. It was attended with a good deal of pain, which in four or five weeks went off, and the part began to swell gradually, and continued increasing for four or five years, attended but with little pain. At this time it was increased to the size of a common head, attended with no other inconvenience than its size and weight. He again fell and received a wound on its side, which gave considerable pain at first, but it got well in eight or nine weeks (This part is marked in the Drawing.) After this, the tumour increased without pain, on the lower part; as also at the basis, extending itself under the chin to the amazing size it now appears. Lately, he had perceived that its increase is much greater than what it was some time ago: he says he can perceive it bigger every month. The tumour is in parts the colour of the Skin, in other parts of a shining purple, where the Skin of the cheek is elongated. The beard grows upon it and is shaved in common. When by accident it is wounded, it heals kindly, because it is only the Skin that is wounded; and has sensation in common with the skin. It is hard to the feel some places, and in others softer, as if containing a fluid. It seems quite loose and unconnected with the skull or lower jaw and may be moved easily without giving Pain.’
Hunter performed the operation to remove this monster of a tumour on Monday, October the 24th, 1785. It lasted twenty-five minutes, and the man did not cry out during the whole of the operation. The Tumour weighed 144 ounces.
John Hunter died on October 16, 1793, after yet another heated argument with the out-dated surgeons at St George’s Hospital. He left huge debts, having spent all his money building up his unique anatomical collection which was opened to the public in 1788 at his Leicester Square home. The 14,000 items collected over 40 years – including Burley’s immense tumour – demonstrated the interrelatedness of all life on Earth. It also proved the originality of Hunter’s thinking. Seventy years before Darwin’s On the Origin of Species, monkey and human skulls were placed together in a series, and he told visitors that “our first parents, Adam and Eve, were indisputably black”.
He had hoped the nation would buy his collection, but William Pitt the Younger exclaimed: “What! Buy preparations! Why I have not got money enough to purchase gunpowder.” Hunter’s wife and children were left with nothing. His brother-in-law seized his unpublished works and plagiarised them ruthlessly to carve out a career for himself as a surgeon. The man whom Hunter had taught the art of anatomy then burnt his priceless research notes.
I gave the eponymous hero of my latest novel, Sinclair, a brush with Hunter at St Georges Hospital. Here are a few of Sinclair’s thoughts on London voluntary hospitals.
“I’ll have to look for a position at one of the voluntary hospitals. I was hoping that I’d never had to go into one of those sanctimonious places again. It’s not the patients that get me down, they can’t help being sick or poor, it’s all the praying and grovelling. Those hospitals are full of the most unpleasant people, Frank. Pompous and incompetent men, self-satisfied arrivistes and simpering clergymen.”
“Oh, life’s full of grovelling and doing what somebody else wants, in my experience. Just try being in the Army.”
“I know it has to be done from time to time, but I’m not good at it. Those poor patients have to pray for their souls and give thanks to their benefactors at least three times a day no matter how sick they are. A lot of them are at death’s door, but they still have to get on their knees and give thanks to God and their wealthy benefactors.”
“But it’s better than being left to die alone and without any care, isn’t it?” said Greenwood.
“Aye, I suppose when you put it like that it’s a small price to pay for a warm bed, medicine and a bowl of broth, but it sticks in my craw. Why should these people be grateful for so little when the undeserving seem to have so much? Besides, this so-called charity work is false. It’s the very thing that enables surgeons like Hunter to build their reputations and make fortunes in the City.”
“So why can’t you be like them, Jamie?”
“Because staff appointments aren’t made on merit, they’re made through connection and patronage, and I won’t prostitute myself for these corrupt men of money. I put my principles aside to join the East India Company. I thought I could make myself happy by getting rich in the colonies, but thankfully I was saved from that folly. I now realise a man must be happy with his conscience if he’s to be happy at all.”
“That’s the trouble with principles; they’re very expensive for a poor man. Most of my father’s friends, who are rich of course, claim to have principles, but somehow they make sure that they never have any that stop them making money or for which they cannot get others to pay.”
“I think you’re an even greater cynic than me, Frank.”
“Oh, that’s quite possible. My whole life has been spent in the company of politicians: I don’t need the newspapers to know how they think.”
Source: The Knife Man: The Extraordinary Life and Times of John Hunter, Father of Modern Surgery by Wendy Moore
Julia Herdman writes historical fiction that puts women to the fore. Her latest book Sinclair, Tales of Tooley Street Vol. 1. is Available on Amazon
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White skin was a must for the most fashionable boys and girls about town in the 18th century. What we would call a healthy sun kissed complexion was a sure sign of being a peasant labouring on the land and not the sign of a lady or gentleman of leisure and so was to be avoided if one could afford it.
Although the 18th century is known as the Age of Enlightenment, most fashionable men and women poisoned themselves with make-up. Unbeknown to these fashionistas the lead based powder they were using to show their class and their wealth contributed to much of the poor health they suffered. It inflamed the eyes, attacked the enamel on the teeth and changed the texture of the skin causing it to blacken; it also made the hair fall out and it became fashionable to shave the front hairline to disguise its worst effects.
Both men and women of fashion applied bright pink rouge in circles and triangles to their powdery white faces in the form of Spanish wool; this was a pad of hair rather like a pan scourer impregnated with pink coloured lead. Lips were painted to appear small with the same pink powder or with carmine [a bright-red pigment obtained from the aluminium salt of carminic acid] to give a bee-sting effect.
Hair was powdered with the same lead based concoction and some women also powdered their shoulders and breasts. A pure white breasts was the vogue and was accentuated by painting veins onto it with blue paint making the bosom a toxic one. The eyes and eyelashes were mostly ignored.
To make white lead powder it was necessary to take plates of lead, and cover them with vinegar in a bowl. The bowl was left in a heap of horse manure – the manure gave off a slow gentle heat as it rotted (if you’ve kept a compost heap you’ll know what I mean). Three weeks later the lead is soft enough to be beaten to a powder and mixed with perfume and dye.
Maria Gunning, Countess of Coventry was the 18th century equivalent of Angelina Jolie; a celebrity who caused men to faint in awe of her beauty.Her beauty regime led to her nasty demise; the same toxic make-up is said to have killed well-known actress Kitty Fisher. Maria entered the social whirl of the Georgian Court in December 1750; within a year, her sister Elizabeth had married the Duke of Hamilton and in March 1752, Maria married the 6th Earl of Coventry and became the Countess of Coventry. For their honeymoon, the Earl and Countess travelled around Europe accompanied by Lady Petersham, but neither lady enjoyed it much, especially Maria who particularly disliked Paris. The Countess’s ignorance of the French language and her husband’s decision not to allow her to wear red powder as make-up (which was fashionable in Paris at the time) intensified her dislike of the city and the trip. On one occasion, her husband saw her arrive at dinner with powder on her face and tried to rub it off with his handkerchief but it was no use she was a make-up addict and it killed her.
Kitty Fisher by Nathaniel Hone
Dressing one’s hair was time consuming and expensive and had to last as long as possible. Rich women rarely wore whole wigs, instead, they hired professional hairdressers (coiffures) who added false hair to their natural hair to big it up and then they added padding, powder, and ornaments, as a women’s hair was supposed to remain “natural” and not have the obvious artificiality of men’s wigs.
Styles sometimes lasted several weeks or months, which could make sleeping difficult, sometimes a wooden block was used as a headrest instead of a pillow to prolong its life. Long scratching sticks were needed when hair became infested with lice. The fashion in France, where all fashions began and were the most extreme, led many men and women to shave their heads for ease and comfort preferring to wear nothing but wigs in public.
Men in particular needed wigs for work and business. There was the Campaign Wig, worn by military men, vicars, lawyers and just about everyone who held a profession or public office needed a wig so the trade was huge and most towns had a thriving trade in wig making. Highly fashionable fops, known as The Macaronis chose elaborate high wigs, sometimes worn up to 18 inches high, they carried men’s fashions and men’s cosmetics to a new extreme. Town and Country Magazine 1764 described them: “They make a most ridiculous figure… it is a puzzle to determine the thing’s sex.”
As the century progressed hair styles and wigs got simpler. The most popular became the Tie Wig where the hair was drawn back from the face and tied at the back of the head with a black ribbon; the tied hair was called a ‘queue’, meaning tail. Men were always clean shaven; beards and moustaches were unpopular, except with the military.
Illustration: Maria Gunning Countess of Coventry, National Trust.
Julia Herdman writes historical fiction that puts women to the fore. Her latest book Sinclair, Tales of Tooley Street Vol. 1. is Available on Amazon – Paperback £10.99 Kindle £2.29 Also available on:
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Throughout her life, Florence Nightingale’s gift for mathematics was often to be a source of frustration for her. This was because many of those she sought to influence simple did not understand numbers. In 1891 she wrote that: “Though the great majority of cabinet ministers, of the army, of the executive, of both Houses of Parliament, have received a university education, what has that university education taught them of the practical application of statistics?”
Nightingale came to prominence while training and managing nurses during the Crimean War, where she organised the tending to wounded soldiers. She gave nursing a highly favourable reputation and became an icon of Victorian culture, especially in the persona of “The Lady with the Lamp” making rounds of wounded soldiers at night. She was revered more as a representative of the female carer than the promoter of scientific medicine.
Florence Nightingale was born on 12 May 1820 into a rich, upper-class, well-connected British family at the Villa Colombaia,in Florence, Italy, and was named after the city of her birth. Florence’s older sister Frances Parthenope had similarly been named after her place of birth, Parthenope, a Greek settlement now part of the city of Naples. The family moved back to England in 1821, with Nightingale being brought up in the family’s homes at Embley, Hampshire and Lea Hurst, Derbyshire.
As a young woman, Nightingale was described as attractive, slender and graceful. While her demeanour was often severe, she was said to be very charming and possess a radiant smile. Her most persistent suitor was the politician and poet Richard Monckton Milnes, but after a nine-year courtship she rejected him, convinced that marriage would interfere with her ability to follow her calling to nursing.
In 1853, Nightingale took the post of superintendent at the Institute for the Care of Sick Gentlewomen in Upper Harley Street, London, a position she held until October 1854. Her father had given her an annual income of £500 (roughly £40,000/US$65,000 in present terms), which allowed her to live comfortably and to pursue her career. A year later, on 21 October 1854, Nightingale and a staff of 38 women volunteer nurses that she trained arrived in Scutari, the base for casualties from the war being waged in Crimea between the British, France, The Ottoman Empire and Sardinia on one side and the Russian Empire on the other.
Immediately, Florence calculated that deaths from disease were seven times those arising in battle and used the information to campaign for better food, hygiene, and clothing for the troops. She persuaded the government to commission Isambard Kingdom Brunel to design a prefabricated hospital to be shipped out to Scutari, though it arrived after hostilities had ceased.
Upon returning to England, Florence continued her work and calculated that, even in times of peace, mortality among supposedly healthy soldiers, aged 25–35 and living in barracks, was double that of the civilian population. She wrote to Sir John McNeill (who was conducting the inquiry into the mismanagement of the Crimean campaign): “It is as criminal to have a mortality of 17, 19 and 20 per thousand in the line, artillery and guards, when that in civil life is only 11 per thousand, as it would be to take 1,100 men out upon Salisbury Plain and shoot them.”
She bombarded the commissioners with questions about the relationship between the death rates in barracks and such factors as the provision of water, sewerage, ventilation, accommodation, and food, using a ‘coxcomb’ chart (a sort of pie chart) to press home her points. She used her contacts to ensure that her views received publicity in newspapers. The commission reported in 1863, accepting most of her recommendations and Florence then used her royal connections to ensure that they were put into effect. Death rates fell by 75 percent.
Florence’s campaigns continued to the end of her life,1891. She didn’t get everything right. Her analysis of the 19th‑century cholera epidemics convinced her that they were caused by foul air, not polluted water and her influence was such that she probably hampered the fight against the disease. But, despite such miscalculations, she was certainly a passionate statistician and reformer.
Sources: Wikipedia, http://www.historyextra.com/article/people-history/florence-nightingale-nursing-numbers
Illustration: A portrait of Florence aged about 20 by August Egg.c. 1840.
Julia Herdman writes historical fiction that puts women to the fore. Her latest book Sinclair, Tales of Tooley Street Vol. 1. is Available on Amazon – Paperback and Kindle. Also available on:
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Anne, The Princess Royal, married the hunchback William of Orange in 1734.
Princess Anne, or the Princess Royal as she was known, was the eldest daughter of George II. The title Princess Royal is a substantive title customarily (but not automatically) awarded by a British monarch to his or her eldest daughter. There have been seven Princesses Royals. The daughter of Queen Elizabeth II is currently holds the title. The title Princess Royal came into existence when Queen Henrietta Maria (1609–1669), daughter of Henry IV, King of France, and wife of King Charles I (1600–1649), wanted to imitate the way the eldest daughter of the King of France was styled “Madame Royale”. Thus Princess Mary (born 1631), the daughter of Henrietta Maria and Charles, became the first Princess Royal in 1642. Anne,the daughter of George II was the second Princess Royal.
Anne was born into what we would call an extremely dysfunctional family in May 1709. George II was the only son of the German prince George Louis, elector of Hanover (King George I of Great Britain from 1714 to 1727), and Sophia Dorothea of Celle. George, I had divorced and locked Sophia Dorothea in a castle in Celle for her adultery with a Swedish cavalry officer and taken their children, which include the boy who would become George II away from her. George II had, of course, never forgiven his father for his cruel treatment of his mother.
George II’s daughter Anne was a remarkable woman in many ways. She was criticised and praised in equal measure by contemporary chroniclers. Some said she was arrogant others that she was accomplished.
Although Anne was an English princess, she was born at Herrenhausen Palace, Hanover. Her mother was Caroline of Ansbach. According to a recent biography of Caroline, The First Iron Lady: A Life of Caroline of Ansbach By Matthew Dennison, she was the real power behind George II. When she arrived in England in 1714, she became the first Princess of Wales since Prince Henry married Catherine of Aragon in 1509. She was blonde, buxom and above all, intelligent. Anne was one of the couple’s four children.
Her parents’ relationship with King George I was a troubled one. Her mother, Caroline of Ansbach, had been brought up in the Prussian Court where she had been treated as a surrogate daughter to the Prussian King and had been well educated.
When she married, she joined the Hanoverian Court, which was by comparison boorish. How much that experience influenced her opposition to George I in England we do not know, but the two did not get on. One wonders if Caroline suspected her father-in-law of having her mother-in-law’s lover killed? There were always rumours surrounding the disappearance of her Swedish lover.
Political differences between George I and his son the Prince of Wales led to factions in the court. The family dispute came to a head following the birth of George and Caroline’s second son, Prince George William in 1717. At the baby’s christening, the Prince of Wales publicly insulted the Duke of Newcastle one of his father’s allies. This so infuriated George I he banished his son and daughter-in-law from St James’s Palace, but he kept their children, including Anne under his guardianship at Leicester House.
The Prince and Princess of Wales were sent packing without their children. George, I kept them separated until 1720 when Anne’s brothers were returned to the care of her parents, but the girls remained the wards of the King.
Smallpox and Variolation
In that year, Anne’s body was ravaged by smallpox; she was 11 years old. The disease killed an estimated 400,000 Europeans a year during the closing years of the 18th century.
Smallpox had no respect for wealth or rank, anyone could catch it. Her own father had suffered from the disease in the first year of his marriage. Her personal near-death experience and the experience and her father led the family to support the introduction of variolation (an early type of immunisation against smallpox), which had been witnessed by Lady Mary Wortley Montague and Charles Maitland in Constantinople.
Variolation or inoculation was the method first used to immunise an individual against smallpox (Variola) with material taken from a patient or a recently variolated individual in the hope that a mild, but the protective infection would result. The procedure was most commonly carried out by inserting/rubbing powdered smallpox scabs or fluid from pustules into superficial scratches made in the skin. The patient would develop pustules identical to those caused by naturally occurring smallpox, usually producing a less severe disease than naturally acquired smallpox. Eventually, after about two to four weeks, these symptoms would subside, indicating successful recovery and immunity.
To test the process, Caroline ordered six prisoners who had been condemned to death to take part in the trial. They were offered the chance to undergo variolation instead of execution. They all agreed, and they all survived, as did the six orphan children who were also part of the test. (There were no medical ethics committees then). The tests convinced Caroline of variolation’s safety, and the Queen had her two younger daughters, Amelia and Caroline, inoculated. Royal patronage of the process was a boon to the doctors who were prescribing the process, and variolation began to spread amongst the upper classes.
On 22 June 1727, George I died making Anne’s father king. The following year, her elder brother, Frederick, who had been educated in Germany, was brought to England to join the court. Father and son had not seen one other in 14 years, and when they did, the fireworks began. Their relationship was even more tempestuous than the one between George I and George II especially after 1733 when Frederick purchased Carlton House and set up what George II considered to be a rival court.
As a daughter of the future British King Anne’s marriage was always going to be a dynastic one. But, as a princess requiring a protestant marriage, her options were limited, most of the continent was ruled by Catholic princes. The government hit on the idea of a union with the rather lowly William, Prince of Orange-Nassau to sure up their anti-French alliance.
George II was not enamoured with the proposal, and Anne was concerned herself. The Dutch Prince William had a well-known physical deformity. Anne wanted to know more about his deformity before she agreed to see him, so she dispatched Lord Hervey, a close confidant, to report on its extent. Hervey said that William was no Adonis. William suffered from a pronounced curvature of the spine, which was probably the result of sclerosis, the same condition suffered by the English King Richard III. or Kyphosis the hunchback disease.
A normal thoracic spine extends from the 1st to the 12th vertebra and should have a slight kyphotic angle, ranging from 20° to 45°. When the “roundness” of the upper spine increases past 45° it is called kyphosis or “hyperkyphosis”. Scheuermann’s kyphosis is the most classic form of hyperkyphosis and is the result of wedged vertebrae that develop during adolescence. The cause is not currently known and the condition appears to be multifactorial and is seen more frequently in males than females. The condition must have made life very hard for William who apart from the problem with his spine was considered an attractive, educated, and accomplished Prince.
Having taken Hervey’s report into consideration and the inferiority of William’s territory, Anne decided she would take him. She was 25 years old, and it seems she did not want to end up an old maid surrounded by her warring relatives. When they married in 1734, her mother and sisters wept through the ceremony, and Lord Hervey described the marriage as more sacrifice than celebration.
As an outsider and British, Anne was not popular in the Netherlands. Her life must have been a lonely one because she did not get along with her mother-in-law, and her husband was frequently on campaign. France was an ever-present threat to William’s protestant country and his power base dependent on his ability to protect the states of the Dutch Republic from its enemies.
In these lonely years, Anne concentrated her efforts on literature and playing the harpsichord; she was an accomplished, artist, musician, and lifelong friend of her music teacher Handel.
Producing the required heir was problematic too. In 1736, she gave birth to a stillborn daughter and another in 1739. Her first live birth came in 1743 with the arrival of Princess Carolina of Orange-Nassau who was followed by another daughter, Princess Anna two years later. Her only son arrived in 1748 when she was 39 years old.
Anne became a widow in 1751 at the age of 40 and was appointed as Regent for her 3-year-old son, Prince William V. She was given all prerogatives usually given a hereditary Stadtholder of the Netherlands, except for the military duties of the office, which were entrusted to Duke Louis Ernest of Brunswick-Lüneburg. To say that she took to the role like a duck to water would not be an exaggeration. Finally free to exercise some power of the own, in true Hanoverian style, Anne used her wit and her determination to secure her personal power base and with it the dominance of her family and the Orange dynasty.
As Regent she was hard-working, but she remained unpopular. The commercial rivalry between the Dutch and the British East India Companies was part of the cause, her Dutch subjects were never entirely sure she was on their side because she pursued a foreign policy, that favoured the British-German alliance over alliance with the French. Another reason was the constitution of the United Provinces. But what made her most unpopular was that she seized the opportunity to centralise power in the office of the hereditary Stadtholder over the traditional rights of the Dutch states, particularly the State of Haarlem.
Ultimately, as a woman, she was reliant on the men around her, and it is fair to say that her husband and her son were fighting a losing battle against the tide of history at the end of the 18th century. Even Anne, with all her skills, could not realise the ambitions of the House of Orange on her own. She ruled the Netherlands for eight years. She died of dropsy (an accumulation of fluid in the body that leads to heart failure) in 1759. Her son was twelve and still too young to take the reins of power.
Anne was replaced as Regent by her mother-in-law, Marie Louise of Hesse-Kassel and when she died in 1765, Anne’s daughter, Carolina, was made Regent until her younger brother William V turned 18 in 1766.
Anne was a remarkable woman in many ways. Her beauty was shredded by smallpox, but she took on the world and won. (I am sure she took the opportunity to show herself in the best light in her self-portrait above.) She accepted and made a success of her marriage, which on the face of it held little prospect for personal happiness. She was an intelligent if haughty woman who endured years of loneliness, the pain of giving birth to two stillborn children and then she was widowed. Anne exercised the role of Stadholder (chief executive of the Dutch Republic) as effectively as any man and the centralisation of power she created laid the foundations of the Dutch state and its royal family. Her grandson, William I became the first king of the Netherlands in 1815.
Picture: Self Portrait
George II: King and Elector By Andrew C. Thompson, 2011, Yale University Press
Julia Herdman writes historical fiction that puts women to the fore. Her latest book Sinclair, Tales of Tooley Street Vol. 1. is Available on Amazon – Paperback £10.99 and on Kindle.
Sinclair is available of Amazon. Click here to get your copy.
Sinclair is set in the London Borough of Southward, the Yorkshire town of Beverley and in Paris and Edinburgh in the late 1780s. Strong female leads include the widow Charlotte Leadam and the farmer’s daughter Lucy Leadam. Sinclair is a story of love, loss and redemption. Prodigal son James Sinclair is transformed by his experience of being shipwrecked on the way to India to make his fortune. Obstacles to love and happiness include ambition, conflict with a God, temptation and betrayal. Remorse brings restitution and recovery. Sinclair is an extraordinary book. It will immerse you in the world of 18th century London where the rich and the poor are treated with kindness and compassion by this passionate Scottish doctor and his widowed landlady, the owner of the apothecary shop in Tooley Street. Sinclair is filled with twists and tragedies, but it will leave you feeling good.
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