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| Fig 1: The title page of a paper presented to the Royal Medical & Chirurgical Society May 1835 |
We often wish we could see into the minds of our
ancestors. To understand them better. To comprehend what was important to them and to
examine what they believed and why. Well
we can’t. We must avoid the temptation to indulge in too much sentimental mush.
All we can do is speculate and try and
build a little evidence in the hope of opening a small window into the
past.
Although the mind is out of bounds we do have a very rare opportunity
to have a bit of insight into the brain of one of my ancestors. I am indebted to Chris TRENDALL of Ontario
who some years ago shared an extract from a medical paper he had found. I have since been able to download the whole
of Volume 16 of the London Medical Gazette 1835 and interesting reading it
makes.
The volume contains the transactions of the Royal Medical
and Chirurgical Society, including a paper presented in May and June 1835 by Dr
John SIMS MD (1792-1838) of the St Marylebone Infirmary. Dr SIMMS was interested in Hypertrophy and
Atrophy of the brain and the connection between the state of the brain and what
we would call mental illness. His paper
is a long one. With hindsight we can see
that his research was bound to fail given the limited options open for
scientific examination and a lack of understanding of the functions of the most
complicated organ in the human body. His
work was before its time.
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| Fig 2: Chart showing relationship between the author and Joseph TRENDALL (1811-1833) |
It wasn’t just medical science that was in its infancy. Ideas of medical confidentiality and ‘data protection’
were non existent. For this fortuitous reason
the patients in his case studies are named.
The patient we are interested in is Joseph TRENDALL (1811-1833). He was my Great Great Great Uncle, the son of
Joseph TRENDALL (c1770-1838) and Ann TRENDALL (BARTLETT 1789-1829). He was born in St Marylebone, Westminster on
27th December 1811 and was baptised a couple of weeks later. The register bears the word ‘POOR’ indicating
the status of the family and the fact that they could not afford a fee. His father was a baker who went on to do
quite well for himself. Joseph was one
of 11 children. Two of them called Joseph. It was not that unusual at the time to use a
name twice if the first named died very young.
But, in this case this subject, Joseph (1811-1833) was still alive when
another was baptised – although there is a big gap between them. The second Joseph was one of the youngest
children in the family and was born in 1827 and lived until 1903. Why would you have two children of the same
name? This oddity was enough to make me
check the records very carefully to make sure that I am not attributing a child
to the wrong parents and it seems not. So
it is speculation time. When the youngest
Joseph was born in 1827 his elder brother Joseph was 16. It is possible that by that time he was
estranged from his parents. His parents
had moved up the Great North Road to Whetstone while their son remained in
Marylebone. Perhaps they assumed that he
had died. Perhaps they regarded him as
not being a member of the family any longer having given up on him because of
his lifestyle or mental illness. As we shall
see he clearly had his share of medical problems and at the time of his death his
address was given as the Marylebone workhouse (of which the infirmary was part).
We lack evidence.
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| Fig 3: Baptism Record for Joseph TRENDALL (1811-1833). St Marylebone. Note the annotation: POOR |
Joseph TRENDALL (1811-1833) was admitted to the St Marylebone
Infirmary on 6th March 1833.
In the paper he is listed as Joseph TRENDAL aged 22. On his burial record his name is TRENDLE. Spelling was a lot more casual in an age
where literacy was a luxury (1).
Dr Sims describes the case history:
“A short time ago he had taken
a large quantity of mercury for the cure of syphilis……He was reported insane,
but when visited he was quite rational, although unable to control the
spasmodic motions of the muscles of his extremities, which were thrown about,
and much distorted. Cupping, and other
depleting measures, brought him into a quiet state. On the evening of the 9th he was
suddenly seized with a fit resembling epilepsy, which soon however assumed a
confirmed apoplectic character , attended with complete insensibility,
stertorous breathing, and general convulsions.
He died the following evening” (Sims, 1835 p333) (2)
Joseph was clearly very ill at the time of his admission but
it is hard to know the causes of his ailments and the effect of his treatment.
To us the idea of ‘cupping’, the placing of heated cups to
raise the skin, seems odd given the description of his symptoms. However the process has reappeared in the
world of ‘alternative’ medicine in recent years, but still without any
scientific proof of its efficacy. I
dread to think what other ‘depleting measures’ might have included.
The one solid thing we know about his medical history is
that he had syphilis (or at least was thought to have had the disease) and had
consumed mercury as a cure. Many of his symptoms
and the idea that he may have been insane fit a diagnosis of the last stages of
syphilis but Joseph was only 22 at the time and one would normally expect the
disease to have been present for many years to reach this stage but who knows
when he may have contracted it, and how quickly it progressed.
We all know that mercury is a poison but its use for the treatment
of numerous afflictions was almost universal for a period of at least 400
years. It was the preferred treatment
for syphilis until the late Victorian
period. It probably killed many patients
in search of a cure and the symptoms of the poisoning are similar to (at least to
the observations of a layman) to the diseases that led to the ingestion of the ‘medicine’. Depression, mood changes, physical tremors,
memory problems and lack of motor skills are part of a long list of effects
leading to death. In Joseph’s case Dr SIMS
could be describing the effects of the treatment rather than the disease.
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| Fig 4: Hogarth's famous image depicting a man with his young wife visiting a quack doctor for mercury. Note the pitted skull on the table, the pox marks on the man and the figure of death in the background. |
The effects of mercury can be seen in skeletons that have
skulls with a pocked and flaking bone structure. Because of the association between this sexually
transmitted disease and its treatment a joke arose: ‘Spend one night with Venus and eternity with
Mercury’. Oh, for a classical education!
As an aside, mercury was also used as a cure for
constipation. A rather extreme cure. It is said the route taken by the explorers
Lewis and Clark through the western United States can still be traced by the
mercury deposits left behind by expedition members who imbibed Dr Rush’s ‘Thunderclappers’
pills. This mercury based medicine was
used to tackle the side effects of eating an expedition diet that contained
little roughage and no fresh fruit.
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| Fig 5: A purgative of explosive power! Mercury tablets used for the treatment of 'syphilis, pleurisy, ague and other ailments' |
A post mortem examination of Joseph was carried out and his
brain carefully examined. The brain was described
thus:
“….the
convolutions were much flattened, and closely pressed together. The blood vessels were almost entirely empty. The membranes were quite dry and the
ventricles appeared to be almost obliterated….it weighed 3lb 9oz” (Ibid) (3)
The heart was said to be ‘natural’ and the lungs full of
pus.
Dr Sims concluded that this was a case of Brain Hypertrophy,
ie that it was an enlarged brain with excess growth of tissue, that caused
Joseph’s death. We can’t tell if this
was in fact the case. The detailed
description he provides of the brain means little without a full clinical
context. For example we don’t know when Joseph
contracted syphilis or how long he had been taking mercury or what the other
symptoms of his supposed insanity were. Death certificates were not issued in
England until 1837 so we don’t know what would have been recorded.
Dr Sims continued his study of the brain but lived for only
three more years and died in 1838. He
had suffered a serious infection contracted during his post mortem work but it
was typhoid that saw him off. It is
believed that he contracted the infection at the Marylebone Infirmary.
So, we have glimpse of one aspect of the life of Joseph TRENDALL
(1811-1833) but as always this generates many new questions, the answers to
which are lost. It is impossible not to
dwell on the survival of some records and the loss of others. The technology that allows us to search into
an obscure journal from long ago and find a relative may yet generate other
clues – and more questions.
Philip Trendall
Bramfield
15th May 2020
(1)
At this
time male literacy is said to have been around 63%, but this is likely to include
basic reading and writing only https://www.researchgate.net/figure/Literacy-in-England-1580-1920_fig3_228553349 (accessed 15th May 2020)
(2)
Sims, John. On Hypertrophy and Atrophy of the
Brain: Royal Medical and Chirurgical
Society 26 May 1835 and 9th June 1835 London Medical Gazette, Vol
16: 456. Accessed via Google Books 15th
May 2020: https://books.googleusercontent.com/books/content?req=AKW5Qad6oHm9z_YrbO4gHy7L43rIU_oEbzXmW05fnJ5q4tpaBa2e5w1RKLkvNt1YnGPni9vGnFB5xZdbzLgKXJOPwFZUtjzAP3tlxCSOQTrCmv1ZTl0WrxspC7GRci6j6UPeCcwXLPbXzHHy6uFVZbt34QGYQjrd1WLhTe_S_hAuD0Yt5nWEg3sSPV5vZdwOpCd7Cmx16j16L_L2JjoR7v8IfvFUvMx6rQqCKbz8w7oZf-XvOFK2NVxCt7d0VwOD5VmFB150t8CBm77nB825drw3wWxA3wJ2Rw
(3)
The average male brain weighs around 3lb.
.JPG)
Very good research. What will you do after "lockdown" has ended I would hate for you to stop blogging if this is a verb.
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