Doctor's Review: Medicine on the Move

August 21, 2017
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Touch down

Can making contact with a monarch heal scrofula or was that just a 17th-century superstition?

The Middle Ages were a terribly tough time to be a patient. Poultices and prayers were no match for the noxious miasmas and disastrous imbalances of humours blamed for pretty much every disease since Galen put his Roman mind to the mastery of medicine. Plagues and poxes, leprosy and gout, dysentery and syphilis: none were even remotely curable by today’s standards. To be fair, your average medieval Joe didn’t expect to lead a healthy or even a long life; hunger, disease and death were all par for the miserable course. Wealthier folks and royals might have expected a higher standard of care, but the cure rate was about the same for them since even well-regarded doctors were floundering about in the ignorance of the Dark Ages.

Presumably, things should have improved once the whiff of science was in the air, beginning in the mid 16th century. The positive effects of the Italian Renaissance drifted upwards to England and France, and the Protestant Reformation led to a boon in literacy. The dignity of the body and the mind was on the upswing for the first time since Ancient Greece. People began poking beneath the surface in every field from anatomy to zoology. For those suffering from one of the most ubiquitous diseases of the day, hope was on the horizon....

TB or not TB

Before the 17th century, tuberculosis was known by many monikers: phthisis, the white plague, the wasting disease, even the King’s Evil. In 1689, English physician Richard Morton (1637-1698) identified that tubercles were always found in the lungs of sufferers, though it wasn’t until 1829 that German pathologist Johann Lukas Schönlein (1793-1864) coined the term “tuberculosis” to define the constellation of symptoms as belonging to a singular disease. Before that point, scrofula, today known as tuberculous cervical lymphadenitis, was believed to be a unique disease in its own right — and one that had a very particular cure as well.

The symptoms of scrofula were obvious and unpleasant since this infection of the neck’s lymph nodes, almost always associated with TB, would devolve from swelling to chronic sinus drainage and severe dermatological complications. What began as small localized abscesses would grow and become purple, eventually bursting open into gaping wounds that wouldn’t heal. All the other accompanying symptoms — fever, pain, weight loss — are now known to be those associated with the original infection, TB. Scrofula’s name derives from the Latin term for “breeding sow,” perhaps because the puffy, putrid lesions resembled pigs or maybe because a similar disease was seen in swine. Young children were particularly susceptible.

Lay your hands on me

Despite the 16th-century resurgence of reason, however, people still clung to superstition in times of need. Indeed, folks simply hoped for the best while suffering the worst. In the case of tuberculosis and its ugly stepchild scrofula, hapless patients put up with barbaric cures, from cupping to clysters to concoctions so vile that the treatments were often worse than the disease itself. And yet, not all of the medical foibles of yesteryear were crude...

One of the loveliest and most antiquated of them all wasn't found in the bottom of a barber-surgeon’s bag of tricks, but rather in the touch of a monarch. When it came to scrofula, a widely feared condition due to its disfiguring side effects, it was no wonder that people took to the idea that the best cure might be as simple and non-invasive as divine intervention.

Yes, the only known “cure” for scrofula was to be touched by a king or queen. The practice began in the 11th century with Edward the Confessor (1003-1066), the first monarch known to lay hands on his subjects for the purpose of healing. Not to be outdone by the English, France’s King Philip I (1052-1108) hopped on the TB-touching bandwagon soon after. The connection between scrofula and the healing-touch cure might have stemmed from a rumour that there was an increase in scrofula cases at coronations. Whether Edward was racked with guilt at the epidemic he had caused or pressured by his subjects to do something about it, he ingeniously found a way to help them, at least by lifting their spirits for a while.

Johnson gets touched?!

The cure exploded in popularity in the 17th century, when the theory of the divine right of kings came to be. According to one Anglican prayer book dating to 1633, which included the actual prayers and procedures associated with the ceremony, it was also customary for the monarch to give the afflicted patient a coin to be used as a touch piece for additional comfort and curative value. The healing touch became so popular that it seems many French and English monarchs did little else during their reign than wage wars and touch abscesses. England’s most prolific toucher was Charles II (1630-1685) whose grand tally came to 92,000; France’s King Henry IV (1553-1610) was known to lay hands on as many as 1500 people in a single session.

Samuel Johnson (1709-1784), famed essayist and lexicographer, may in fact owe his life to Queen Anne (1665-1714) who is reported to have touched him as a toddler in 1712. Whether he actually had scrofula or whether it was just a nervous mother’s preventative foresight remains unknown. Indeed, at the first sign of a sore throat or a bump in the neck, people would flock to the palace when the doors were opened to the infected masses; the ceremony called “Touching for the King’s Evil” was conducted among much pomp and circumstance, royal guards and nobility. Alas, no records exist as to the number of cures effected, though plenty of eyewitnesses attested to the miracles performed. At the least, sufferers who were simply stricken with boils, mumps or mosquito bites probably fared well.

Some kings and queens enjoyed the tradition, of course, since it affirmed their belief in their own godly nature. On and on it continued, even in times of plague and other contagions, since cancelling the sessions would have destroyed public morale. Interestingly, not all monarchs believed in their hands’ power to heal. William III of England (1650-1702), in particular, felt it was a load of superstition and was once recorded telling a sufferer as he touched him, “God give you better health and more sense.”

A growing issue

Sadly, all those who counted on this God-given blessing for their good health were left to the ravages of the disease when King George I (1660-1727) ascended to the throne. He found the practice of touching scrofula sufferers a little too Catholic and old-fashioned for his taste, and abolished it outright. In France, it continued for a few more generations until Louis XV (1710-1774) also decided he didn’t want to get his hands dirty. Amazingly, French king Charles X (1757-1836) brought back the practice and went on a groping binge in 1825. It didn’t last long; people had grown more sophisticated by then and the entire affair turned into a PR catastrophe. As for patients, the new interest in science didn’t really pan out until the advent of antisepsis, antibiotics and the scientific method.

Today, scrofula remains the most common form of extra-pulmonary TB and has had a resurgence of sorts that can mostly be accounted for by the AIDS epidemic. Most cases are in immunosuppressed patients, most commonly accompanying HIV infection and/or TB. By and large, however, scrofula is not the public-health issue it once was.

Still, even in the face of what could be considered our modern mastery of medicine — at least in comparison to what was practised in the days of the King’s Evil — people continue to cling to some pretty old beliefs when confronted by illness and death. Astrology, mysticism, psychic healing, the laying of hands to cure disease by religious leaders and, of course, the virtual pharmacopoeia of Internet cures and the quacks who purvey them find no shortage of customers in our “sophisticated” society; good news for today’s remaining kings and queens, at least. They might just have something to fall back on in the face of salary cuts or should their office jobs ever be abolished outright.

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