On flatulence and Darwin

On flatulenceIn 1867 The Medical Press and Circular published a series of articles by the physician Dr John Chapman on a subject in which he was a world authority: flatulence. To be fair to Dr Chapman, he was also an influential publisher and an expert in psychology specialising in ‘neurotics’ – those we would now describe as suffering from anxiety disorders. Two years earlier he was consulted by Charles Darwin and (unsuccessfully) attempted to treat the mysterious digestive symptoms which plagued much of the scientist’s adult life.

Charles Darwin
Charles Darwin in 1867

In his articles, Chapman distinguished between two sorts of flatulence: that caused by disorders of the digestive tract, and another kind which he believed was of nervous origin. This is how he describes the condition:

A lady who is seemingly healthy, and whose abdomen is of normal size, or indeed notably small, receives a mental shock, some bad news, for example, or experiences a distressing and violent emotion of any kind, and suddenly—often instantaneously—her abdomen becomes so swollen that persons previously unacquainted with her, and seeing her then for the first time, look on her, if married, as pregnant, and probably near full term of gestation; if she is not married, they are apt either to draw inferences by no means to the credit of the patient, or, at all events, to conclude that the case is a very mysterious one. 

The cause of this phenomenon, he believed, was ‘reflex action of the nervous excito-motor apparatus’. He offers a few case histories by way of illustration:

No. 1.—A lady who resided in a boarding-house, who enjoyed moderately good health, and whose abdomen was of natural size, had the misfortune to overturn a large basin of water on the feather bed (which happened to be a new one) on which she slept. The mistress of the boarding-house having seen that her new feather-bed was injured, became violently excited, and rushing into the room of the lady, poured upon her a torrent of invectives. The unfortunate and astonished perpetrator of the accident was so agitated by the attack thus suddenly and unexpectedly made upon her, that immediately, and before the storm had ceased, she felt the four strong steel supports of her stays snap asunder by the violence of the great and sudden expansion of her abdomen!

Blimey.

Since that occurrence she has been much more liable than previously to experience great and sudden distension of the abdomen as a consequence of mental emotion, and though as she assures me, she has her stays made especially strong, and never laces them tightly, the steel supports in them have been broken at least five-and-twenty times by the instantaneous swelling of her abdomen in consequence of mental shocks of one kind or another. It has so happened that on several occasions I have been requested to visit this lady immediately after these accidents, and have had my attention especially directed to the wondrously sudden swelling and its surprising consequences, consisting not only of the snapping of the steel supports, but in dragging hooks and buttons off, and tearing, as if only so much tissue paper, the bodice of so-called strong twilled calico which she usually wears.

This sounds quite the spectacle. Here’s another example:

No. 2.—At a large dinner party one of the guests, a lady, was horrified by the housemaid, who ran into the room screaming out, “Mrs., your bedroom is on fire!” The lady, greatly excited, hastened to her room, exerted herself vehemently to save her things and to extinguish the flames, and immediately afterwards (within the space of a few minutes) became exceedingly ill, the chief symptom being an extraordinarily great and dangerous swelling of the abdomen, which compressed the lungs so powerfully as to induce a sense of suffocation, and which so interfered with the circulation of the blood as to cause grave apprehensions concerning the life of the patient. It was judged necessary, instead of losing time in undressing her in the usual way, to give her such immediate relief as was practicable by cutting open her dress with the utmost possible rapidity, and this accordingly was done. The impression made on this lady’s nervous system by the shock she then received is not even yet wholly effaced, although the accident happened fully three years ago.

The next case is a great example of English social awkwardness.

No. 3.—A lady in conversation with a gentleman at an evening party, made a remark the purport of which he misapprehended. Seeing that he did so she felt confused, and being unable to rectify the misapprehension, her vexation so wrought upon her, that in a few minutes afterwards she was immensely swollen, and almost unable to stoop at all: when undressing she experienced great difficulty in taking off her own stockings.

Since female undergarments repeatedly feature in these case histories, I can’t help wondering whether the Victorian fashion for tight stays was the ultimate cause of the abdominal swelling. They have, after all, been blamed for many other medical conditions observed in this era.

As for treatment, this is what Dr Chapman suggests:

There are, fortunately, two plans, both often remarkably successful, of relieving the distress caused by gaseous distension, without resorting to drugs at all, and therefore without submitting to the evils sometimes inseparable from their employment: either the prolonged use of the warm bath, at 100 Fahr., or the judicious application of the spinal ice-bag often operates like a charm in respect to both the rapidity and the completeness with which the gaseous swelling is made to subside… The warm bath usually causes a copious discharge of the pent-up flatus: in many cases of great and extremely distressing intestinal distension I have known it to give wonderfully great and immediate relief. 

One hopes that the patient was left alone at the moment of ‘immediate relief’, which is about as far from the Victorian ideal of social propriety as can be imagined.

Chapman ice bag
Chapman’s ice-bag (click to enlarge)

The spinal ice-bag will, however, as a general rule, accomplish not only all the effects produced by the warm bath, but will prevent the re-formation of gas after that which was distending the alimentary canal has been expelled; that sedative influence on the nervous centres which must be ensured in order to give effectual relief, and which, as I have shown, the warm bath produces by the derivative process, is exerted much more directly and much more powerfully by the application of ice along the spine; and, obviously, it is a much more easily practicable remedy than is the warm bath, for it can be applied without the necessity of undressing the patient, who may even walk about, or attend to business with the ice-bag along his spine.

This was Dr Chapman’s signature treatment – and he even advertised his own brand of ice-bag to his patients. This was indeed what he prescribed for Darwin, who spent months with his spine packed in ice. Alas, it had no effect. You can read more about Darwin’s illness and treatment by Chapman at the Darwin Correspondence Project.

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