Academic Physiologies

In the second half of the century two particular scientific developments had greatly strengthened the impact of hygiene, and given the European—and American—public a whole new set of medical words to play with. Firstly, physiology took a turn towards the social sciences, towards seeing the human body en masse, observing the effects of personal hygiene from a distance. Secondly, a new phase of physiology opened up through the mid-century discovery of the nervous system, which ultimately led to the softening of the 'heroic' form of cold hygienic regimen. The first development opened up the public mind;the other appealed to more private sensibilities.

In the new 'Westernized' world that was now so closely interconnected by science on both sides of the Atlantic, health advice book publications rose steeply from c.1770 to 1800. Most of them were now written by university-trained medical professionals.45 During the first half of the century, hundreds of university graduate theses had begun to focus on the Hippocratic relationship between human disease and the physical environment, including the social environment. While some were attempting to systematize the classification of diseases through theory, others were empirically searching for disease causus elsewhere. Study of the air had led to study of the climate and 'emanations' from foul waters and places, without dislodging earlier theories of direct contagion through touch, bites, or poisons.46 Epidemic quarantine had long been imposed for leprosy and plague, but the full political apparatus of quarantine in Europe is generally held to have emerged with the mercantile plague regulations of the early modern Italian city-states; and for similar commercial reasons, increasingly elaborate pan-European quarantine regulations were gradually adopted during the seventeenth and eighteenth centuries.47 But the hardest-hitting proofs of environmental impact in the eighteenth century, and which ultimately led to the revision of European quarantine legislation in the nineteenth century, came from the neoclassical revival of military hygiene—the old Roman classical category of 'ships, camps, and armies'.

The key experiments were those of the Scottish physician Dr John Pringle (1707-82), physician-general of the British Army from 1742 to 1758, who used his position to study the effects of mass crowding on disease and fevers and, especially, the means of 'antisepsis' (as elsewhere, Dr James Lind was experimenting with 'antiscorbutic' fruit—limes—to stem appalling naval losses due to scurvy). Pringle's influential Observations on the Diseases of the Army (1752) described how he had applied Sydenham's cooling regime to his soldiers, and found that it worked, including bathing them in the sea. Mortality fell, and rates of casual infection fell. He also found that a systematic regime of cleanliness was of utmost importance in preserving the gains. His subsequent chemical and mechanical analysis of putrefaction, infection, and contagious particles was also persuasive: 'It was never imagined, until Dr Pringle shewed it, that the Antiseptic Power is so extensive.'48 Specific antiseptic matter could be found, according to Pringle, in mineral salts and in the fluids of most vegetables, which could be used in the form of good antiseptic odours or fumes (sulphur), or astringent washes (vinegar). More generally, coolness on its own could retard and prevent putrescence: cold water and cold air both had antiseptic properties, but the air was most antiseptic because it also dried. The diseases that responded to hygiene best were the 'low' enteric diseases, and diseases of the skin, all of which were prevalent in overcrowded conditions. The remedies were the ancient ones: personal cleanliness and clean clothes, exercise and fresh air, and constant vigilance to eradicate all sources of dirt.

The next generation carried on testing, and took Pringle's 'gospel of cleanliness' into all sorts of places. Captain James Cook used full hygienic principles on board his zealously scrubbed ship, with its equally scoured crew (taking Lind's fruit with him as an extra onboard experiment) in his first voyage round the globe in 1770, returning triumphantly with only one man lost and all the rest in good health. Other naval officers followed suit, and late eighteenth-century British naval hygiene became a thorough exercise in the health management of men and resources—carrying antiscorbutic oranges, lemons and limes, and fresh vegetables;enforcing drill, swimming, and athletics;cleaning linen and inspecting quarters, and detecting early signs of fevers, all of which revolutionized morale on board ship. By the end of the century the army officers were demanding full-scale hygienic reforms too. The civilian hospital movement was also spurred on by naval hygiene; mainly by Pringle's reformed naval hospitals, but also by the success of Dr John Haygarth's antiseptic regime at his fever hospital at Chester in the 1770s—especially his investigations into actively infectious 'zones' around the patient (which he concluded was roughly one yard).49 In the 1780s the long campaign to hygien-ically reform the British and European prison systems began, started by the philanthropist John Howard and the Quaker reformer Elizabeth Fry.

The 'animal' nervous system was first clearly described by Albrecht von Haller in 1752, and turned into the central physiological problem of the eighteenth century. By the second half of the century it was widely assumed that 'nervous' energy was one of the key agencies through which the human animal interpreted the environment, via the nerves connected to the senses: it was what made humans 'sensible'—or 'sensate', as we would now call it. Moral feeling ran high over potential implications. A whole new nervous pathology was required, and with it a new sensate interpretation of personal hygiene and regimen. As always, excess was blamed. Overwrought nerves, or nervous 'sensibilities', were now the cause of a new range of 'diseases of civilization'—nervous havoc caused by over-sensuous, luxurious, and 'artificial' modes of urban life (later called 'asthenia').50 In 1780s London, quack 'sensualist' doctors adroitly took money off sensitive well-off 'New Age' readers whose health interests included the occult, herbalism, primitive diet, balneology, pneumatics, magnetism, and electricity. The medical showman James Graham, 'the Hygienist', treated the sexual disorders of the aristocracy on, and in, his famous electric 'galvanized' bed (surrounded by flashing lights) in his Electrical Temple of Health and Hymen in London's fashionable West End. He also guaranteed total cure for nervous prostration from a hectic, overheated social life with other elemental purifications, such as vegetarian foods, water bathing, sun and air bathing—and his unique therapy of earth bathing (being buried up to the neck in earth to absorb its goodness).51 Deep below this urban health faddery, however, lay the many different 'proofs' and debates that had originally encouraged Jean-Jacques Rousseau to dream of a new relationship with nature.

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