Did They Have Germs Back Then? - Spanish Military Hospital 1784

[Music] we are here today at the spanish military hospital museum in saint augustine florida and i have with me one of the wonderful docents kim and she's going to tell us about this location what happens in it tell me about this particular building though all right this building is just one of three buildings that made up the hospital complex this was hospital east recuperation building now across the street we had hospital west the surgical building it was the largest of the three unfortunately we can't show you that one it burned down in 1818. now this one burned down also in 1885 but it was rebuilt actually only two-thirds of it because the building next door was already a historical building they wouldn't let us tear it down but it is the original foundation now the hospital was actually called the royal hospital of our lady of guadalupe and it was here from 1784 to 1821. this was um still pre-germ theory so they were working on the golonic theory of the four humors of the body this was developed by three greeks galen aristotle and hippocrates the father of medicine basically they thought that our health was governed by those four fluids phlegm black bile yellow bile and of course blood so if you were ill they thought you had either too much or not enough of one of them if somebody was feverish and grumpy they thought they had too much blood so they would do a bloodletting and of course that person did quickly become calm we all do when you take out a bunch of blood if they thought you didn't have enough of a fluid that wasn't too bad for you because they would use diet to make you healthy again and the spanish were big believers in a healthy diet that's why the patients at this hospital they vary well yes back the average diet had a base daily ration of chicken beef pork lard bacon bread chickpeas and the seasonal fresh fruits and vegetables doesn't sound that bad to me no today we call that the ketogenic diet my favorite now the time period 1784 to 1821 even though it was pre-germ theory the spanish were very medically advanced in fact they were the most advanced in all of europe and england this is because they were influenced very early on by the moors the moors had occupied spain for over 700 years during this time they were advanced in all the sciences and mathematics they had saved the teachings of the greeks the romans and the egyptians now the moors were islamic and so they were very holy and according to their religion it is unholy to be dirty so they were hygienic this included washing their hands and their medical tools they washed their medical tools yes they washed them in vinegar water wow which today we know kills germs they didn't know about them but they were killing them in 1492 spain told the moors they had to go but maintained those medical practices and grew them and in 1563 they were the very first country to require a formal education and a license to be a physician you have to actually know what you're doing to be a doctor well in spain anyway not here necessarily now they required eight years of university followed by two years of residency yes sound familiar yes now um this is where we get ours from but the spanish took it a step further once you had your license you were required to undergo a competency hearing every five years this was to make sure you were maintaining that knowledge here in america though we did not have any requirements of any kind till 1910 before then anybody who wanted to be a doctor could hang up his shingle and start practicing which is probably why the average american hospital during this period only had a 30 to 35 percent survival rate what about this one this one 70 to 75 percent very close to the hospitals of today and we do think it is because of the good hygiene the diet and of course that education that's amazing i'm ready to start surgery if you are they were very medically advanced but there was one thing they didn't know how to do and that's fix broken bones yes a simple break that you don't fix it you just immobilize it and it heals itself but if somebody had a compound fracture or shattered bones those just don't heal themselves and they did not have the skills we have today they did know however what was going to happen to that patient if they didn't amputate he was going to lose the use of that limb he was going to be in great pain he was going to die because that's right that's what was going to happen next yes so this was a life-saving surgery unfortunately it was also pre-anesthesia we did not discover the anesthetic effect of ether till 1846 but it wasn't a problem at this hospital those patients didn't suffer much at all because here they used a couple of herbs and laudanum to make him quite comfortable okay now they added the herbs because this gave them a patient who was not only highly euphoric but calm sedate and drowsy they would doze in and out of sleep during the surgery the physicians knew that even though he was quite comfortable he was still conscious that meant pain could still send him into shock and kill him so in addition to being skilled they were fast they could do an arm amputation in three to four minutes a leg amputation in four to six minutes pretty good huh so show me the saw here okay well this is our bone saw it's really just a hacksaw and they could use this saw and cut through both bones in only 30 to 60 seconds now there were a couple of things they had to do before they could get to that cutting the first thing they're going to have to do of course is make him comfortable i almost forgot then they applied the petite screw tourniquet it was invented in 1710 by a frenchman jean-louis petty and actually it was the first one to completely cut off the circulation and we still use this same design today more than 300 years later now once that was on he would grab his capital knife now you'll notice that it's uniquely shaped and they designed it for a specialized cut called the single flap angled incision the first of its kind now how it worked the surgeon would start as far below the cutting area as he could then he would cut up on an angle as high as he could he came across and then reversed that angle now this gave him a nice flap of muscle fat and skin that was separated from the bone except the muscles they're still attached to the bones by tendons so he grabs his catlin blade he gets it underneath the muscle and then runs it right down those bones this um severs the tendons and frees that flap so he grabs a leather strap peels the flap back and then ties it down safely away from the cutting area so nothing will happen to it and of course he cuts off the saw off with the saw now he's cut off those shattered bones but he's also cut arteries veins and capillaries yes so big problem yes he's going to quickly grab his tuniculum then he reached down between the bones gently pulled up those cut arteries then quickly tied them closed with a strong silk ligature and this is similar to how we still do it in amputations today then he reaches into the fireplace and grabs a cottering iron he used that red hot tip to run across the cut and seal the veins and capillaries shut the next thing he did was pack in a linton mixture now this was just ground cotton and flour but it did the same three things the hemostatic linton does in surgery today it absorbed excess fluids coagulated the blood and promoted proper drainage unlike the hemostatic linton he did not have to remove it it was all natural so it would get absorbed by the body after it was broken up now once he's done that he quickly removes the leather strap and he puts that flap of muscle fat and skin right back where it was but thanks to that special cut he's got more flap than arm so he folds it over on top of the cut bones to protect and cushion them now once he's done that he's got to sew it back together right yeah but here's the problem they didn't like to sew see they practice something that's still practiced in medicine today evidence-based care they would write down everything they did if something was working they continued if not they quickly stopped well they had noticed something there was a much higher incidence of infection during recovery when they sewed so instead he's going to super glue it that's amazing no they didn't have superman [Laughter] but they did have eyes and glass okay now eisenglass is the purified air bladders of fish it's very sticky almost as sticky as super glue they would take the eyes and glass put it in a bowl then they took their bandages dipped them in it and then wrapped them nice and snuggly all the way around that glued everything right back into place and when they did that the surgery was over okay now we're going to do my favorite okay the guillotine amputation well it was fun for the surgeon i don't know how fun it was for the soldier okay now um he would use this one when his patient only had an infected finger or toe this made it possible to just take that digit now what he would do is place that digit on a block of steel called a medical anvil put the digit on the block of steel then he picked up his osteotome now it's just a curved chisel it was razor sharp on the bottom don't worry mine's not now we would place it over that very last knuckle and then the orderly over there would drop something he'd make a big noise when that patient turned his head to look off that puppy came then he would reach into the fireplace and grab his flat cottering iron he cauterized that knuckle he packed in some linton mixture wrapped a bandage around it and he was done seconds later seconds later yes now they did not get a nice soft bed for this one it was considered outpatient surgery and they sent him straight home sure off you go okay now the next one up is bullet removal now the good news is they just had little round balls of lead for their bullets they did not penetrate as deeply or do quite as much damage but they also didn't have x-ray machines or decent lighting now the surgeons here they relied on their tools to find the bullet and get it out the first one he always used his finger if he felt that bullet he pulled it out now this was the second tool he would use it is his probe a metal stick and the tip was coated in porcelain that's because when lead touches porcelain it always leaves a mark so he would stick it in and wiggle it around hoping to find the bullet he would know because when he hit something hard and pulled it out there's gonna be a mark there yes now once that was done he grabbed his concave forceps now these are cool see how they're indented sure he would stick them in wrap them around that bullet get a good tight grip now once it was out they would pour vinegar water in they knew that along with the bullet had gone pieces of his clothing dust dirt maybe even a leaf or a twig they were hygienic so they flushed it and that helped them to keep infection out because vinegar water kills germs all right let's see the next one is the treponation now this one was used when somebody had injured their head and was exhibiting symptoms nausea disorientation lack of balance and unequal dilation of their pupils they knew what this meant do you know what it means there's pressure on your brain no yes very good perfect yes they knew that fluid was building up and making pressure now in order to relieve that pressure you have to drill yeah you gotta drill hole in your hand yes of course now i know what you're thinking that this was very painful but it wasn't that's because while we have billions of nerves everywhere else in our body we don't have any in our skull so you could drill all day long he's not going to feel a thing once you've got a hole in your head yeah they've relieved the pressure but he does have the hole in his head now the spanish they would use a silver coin to fold it i mean to close it up sure that's because they used it for two reasons the first is silver was their number one export so this was cheap and readily available second evidence-based care they noticed very little mostly no infection when they used it today we know why it's antimicrobial here comes the fascinating part before they put it on they drilled small holes all the way around it then over the next few months the soldier's skull would grow bone right through those holes making this a permanent part of his head that is amazing isn't it and we still do that today as well wow alrighty now during this time we already know they didn't know about germs yet but they did know something was spreading disease they didn't know it was germs but they thought it was miasmas noxious gases or odors in the air so to prevent that spread of disease they did three things they kept the windows open during the day to let fresh air in they kept plenty of space between their beds check it out social distancing amazing and finally each room would burn their escaphetta three times a day the escapetta is a cast iron bowl with a bed of sand in the bottom to it they added burning hot coals from the fireplace and lavender believing it would smoke the miasmas away now it didn't do that because there's no such thing as miasmas there were people who thought about germs they just got laughed out of the business every time they tried to bring it up exactly especially hand washing i mean what the heck yeah why would they want to wash their hands little dirt doesn't hurt anybody that's right now when they burn their escaphetta they noticed something their patients always became much calmer and today we know why lavender is a calming aromatherapy now they didn't know it but it was preventing the spread of disease that's because when you burn lavender or sage or rosemary they give off carbolic acid and it destroys viruses and bacteria right in the air a little fun fact the very first doctor who used um killed germs during surgeries lister the scot and he used carbolic acid wow same acid that they were using here they just didn't know it so we're in the recovery ward is that what we've got here that's what we've got here now there was some special things that they did with their beds first of all you're going to be surprised but they were soft that's because they stuffed those mattresses with spanish moss this yes it doesn't look like spanish moss it looks like somebody's hair that's because they would boil it first okay to kill the bugs that like to live in it we call them chiggers i didn't know chiggers lived in spanish moss yes that's where they like to live i know every summer i made forts and every summer i got chiggers because i used that spanish monster stuff terrible yes so yeah you definitely want to get rid of them so it's a it's nice and spongy and soft it is very fill this tick up uh-huh you could just fill it up yeah now the other thing about it was it was free they just had to pull it out of the trees and boil it which was very handy because of their hygiene every time they discharged a patient they burned all his moss laundered the outer covering then re-stuffed it with fresh clean moths for their next patient so not only was that bed soft it was hygienic as well when a patient was given a bed he was also given clothing linens and utensils that had the same number this way when they were taken out to be cleaned they were brought back to the same patient thus preventing cross-contamination now the final bed is that one over there okay you'll notice there's a hole in the middle what's going on with that well underneath that is a chamber pot okay this was for leg amputees or any other patient who was too ill to go outside and use the latrine okay that was the invalid bit today we call it the bedpan yeah and they have separate yes they would uh well we just did this to separate the two this would have been done um in the isolation ward and also because of those beds to give that person privacy yeah it's uh amazingly modern in all these conveniences we you know you do some reading in other medical situations other cultures and it doesn't seem like it's anything close to this none of them were doing any of this there was no there was no cleansing there was no hygiene and that's probably why they had such a high survival rate here what about the i mean you mentioned the idea of the priest coming along are who are the people who are actually taking care of these folks the orderlies these are the orderlies now everybody in here would have been in the military it was a military hospital it would have been all men i am an anomaly i would not have been here because first of all it's military and second these are catholics it was completely unseemly for a woman to see a man in his underclothes and vice versa sure thank you so much kim for your uh amazing quantity of information it feels like i could ask any question about you know spanish military hospital and you're going to have the answer to it so thank you so much for that if you're ever in the saint augustine florida area and you want a a wonderful experience learning about medicine in the 18th century come to this spot you will get the information you want again thank you kim it's amazing and thank you for coming along on this amazing medical journey as we discover what it's like and actually walk in the footsteps of people in the 18th century they were in this very building more than 200 years ago so thank you so much for coming and have a great day

Channel: Townsends

Views: 179,493

Keywords: townsends, jas townsend and son, reenacting, history, 18th century, 19th century, jon townsend, 18th century cooking

Id: BqxHXB6_Ggk

Length: 20min 41sec (1241 seconds)

Published: Mon Apr 05 2021