Tag Archives: medicine

Bumbling, Bitchiness and Cruelty at Queen Victoria’s Court

This is dangerously late for my tastes, but a serendipitous choice of podcast to accompany me on a walk the other day (something by Lucy Worsley on Queen Victoria) brought me to a story I had never known. Undoubtedly those who work on the 19th C know all about it, as may others with a better all round general knowledge, but I had not heard of the episode, and, as it happens, it has some relevance to a project I am just finishing (the one on ‘unknowns at the start of life’, inc. bastards and the beginnings of human life).

The episode involved a young(ish) aristocrat, Lady Flora Elizabeth Hastings (b. 1806), who occupied the position of Maid of Honour to the Duchess of Kent (Queen Victoria’s mother). She died in 1839, after something of a scandal, which does not make Queen Victoria and her court look at all good.

Briefly, the problem arose because Flora had a swollen abdomen, and of course it was rumoured that she was pregnant (no doubt euphemistically whilst being – shock – unmarried …. She denied it, but the rumour went round the court, and was enjoyed by those – including the Queen – who were at odds with the faction represented by the Duchess of Kent, and so, by extension, by Flora. A physical examination was insisted upon, and Flora agreed to it, despite the humiliation, because she wished to end the scandal and rumour attached to her name. The examination came back negative (though there is some suggestion that the doctors, despite having certified non-pregnancy, were suggesting to Queen Victoria that Flora might still be pregnant). Flora got very ill and died, however, and public opinion was against Victoria and her doctor. After Flora’s death, it was made clear that she was not pregnant, but had had cancer. The matter was much discussed in the press, and it did nothing for the reputation of court or medical profession.

Using a letter she had written to her uncle, Mr Hamilton Fitzgerald, published in the Morning Post (2) supplemented as to dates from the other sources below, the following timeline can be constructed:

 

  • January 1839. Flora comes to London, and has already ‘been suffering for some weeks from bilious derangement, … pain in the side and swelling of the stomach’
  • 10th January, 1839. she consults Sir James Clark, who, physician to the Duchess of Kent and the Queen. Clark’s treatment is unsuccessful, but Flora’s self-care remedy of ‘walking and porter’ results, she reports, in an increase in strength amd reduction of the abdominal swelling.
  • 16th February 1839. Clark comes to Flora’s room, accuses her of being pregnant and tries to get her to confess that this is the case. His sources are ‘the ladies of the palace’. Flora denies being pregnant. Clark says that the only way Flora can ‘remove the stigma from [her] name’ is to ‘[submit] to a medical examination’. The Queen was in on this plan, and effectively ordered the examination. Flora named some other ladies of the court as having been particularly active in setting this up, though the Duchess of Kent is exonerated.
  • 17th February 1839, the examination went ahead (interestingly, the consent of the Duchess of Kent was required, while Flora ‘submitted’ in order to clear her name.  What followed she described as ‘the most rigid examination’, at the end of which ‘her accuser’, Sir James Clark, and Sir Charles Clark, signed a certificat ‘stating, as strongly as language can state it, that there are no grounds for be[1]lieving that pregnancy does exist, or ever has existed’.
  • 8th March 1839 Flora writes to her uncle, setting out her story.
  • 5th July, 1839. Flora dies. Post mortem examination, at Flora’s request, by Sir Benjamin Brodie and Sir Astley Cooper,  which published its findings officially, and found that she had died of ‘long standing disease of the liver’, and that ‘The uterus and its appendages presented the usual appearance of the healthy virgin state.’ (1)

As the Lancet put it,

 ‘The publication of this post[1]mortem examination is the best reply which could have been given to the slanderers of an illustrious personage, and of a distin]guished physician. No mental emotion could have produced, or even considerably accelerated the progress of the diseaae from which Lady FLORA HASTINGS died ; and if the symptomatic swelling of the abdomen were, by some, mistaken for pregnancy, it could not have been by one who knew that in pregnancy the swelling is developed from below upwards.’ (1)

There were, shall we say, differences of emphasis in terms of whether it was an outrage or a rational scientific thing to insist on examining Flora’s abdomen. Guess which side the Lancet was on … want a clue?

 ‘Had Lady Flora Hastings permitted her physician to have made an accurate external examination of the abdomen, at an eurly stage of her complaint, she would probably have been spared the pain and humttiation to which she was subsequently exposed. Many a female has undermined heutth and compro[1]mised existence, through similar feelings of mistaken delicacy’ (3)

(translation: ‘The ladies, eh – what are they like! It was her own silly fault!’]

 

The resonances this episode has for me, and my projects, concerns detection of pregnancy and the role of medical expertise in this. One of the things which comes out of an examination of the history of pregnancy detection in the more strictly legal context (for deferral of execution, or for the purposes of succession disputes) is that there was quite a difference between England and Wales on the one hand, and the rest of western Europe, on the other, in terms of who was given the task of saying whether a woman was, or was not pregnant. In England and Wales, the use of women – the jury of matrons, or jury de ventre inspiciendo – continued long after it was phased out in other jurisdictions, in favour of (male) medical professionals. Instinctively, we may see the medical professional model as preferable. This case troubles those waters somewhat – since it seems to bring home the questionable nature of medical expertise (and ethics?). It certainly damaged the reputation of Sir James Clark himself. It does make me wonder whether, at that stage in the history of medical research and education, there might have been some over-claiming of expertise.

To somebody coming from a modern Law School, the case also, of course, raises the hackles, in that it seems to amount to the forcing upon a (very sick) woman of an unpleasant and humiliating examination. For all that Flora agreed to the procedure, after her initial horror, this appears very much to have been something she thought she had no real option not to suffer: the rumours and scandal were bad enough, but she was also told that she would not be allowed to attend court functions if not ‘cleared’ of being pregnant (and thus a total, hopeless, sinner …) Neither Flora nor contemporaries seem to have gone down a ‘coerced consent’ line in their objections, but there was certainly outrage at the gossip and the persecution of this poor woman, and the rough, questionably competent and generally unpleasant conduct of the doctor.

Queen Victoria not at all nice – official.

GS

1/1/2022

 

Image – Flora, from source 4, below. Not a very good drawing, I must say.

 

Sources:

  • ‘Lady Flora Hastings’, Lancet, 32, no. 828, 1839, pp. 587–587
  • ‘The Late Lady Flora Hastings’, Lancet, vol. 32, no. 833, 1839, pp. 762–763.
  • ‘Sir James Clark’s Statement of the Case of the Late Lady Flora Hastings’, Lancet, vol. 33, no. 842, 1839, pp. 126–126.
  • Horace Wyndham, The Mayfair Calendar : Some Society Causes Célèbres. (Hutchinson, 1925).
  • D. Reynolds, ‘Hastings, Lady Flora Elizabeth (1806-1839) courtier, ODNB.

Done or in dereliction of duty? A medical dispute in medieval Sussex

Well, looking at this sort of thing during the awful events of the present does make me feel as if my skill-set qualifies me for Golgafrinchan Ark Fleet Ship B* (*If you don’t know what that is, you are not my friend. Read The Hitch-hiker’s Guide to the Galaxy at once!) but I hope it does something for general morale and the gaiety of nations. It’s certainly keeping me going today.

Join me for another little tale from the Plea Rolls and Year Books – this time with a medical theme.

Master Simon of Bredon v. Prior of Lewes (1367)

Back we go to 1367, reign of Edward III (characterised by some terrible sweeps of infectious disease, but that’s not where this is going). England and France at war, off and on, all sorts of chivalrous things happening. Down in Lewes, in Sussex (site of a big 13th C battle, later to be home of a dubious Guy Fawkes parade), there is a house of Cluniac monks. They are much aggrieved to be taken to court by a medical man (or former medical man) called Simon, who claims that they owe him money.

Simon is Master Simon of Bredon, a doctour de physick, and he is bringing an action of annuity. He claims that the monks are in arrears with payment of sums they had undertaken to pay him, to the tune of £30. The prior (who I take to be John de Caroloco) and monks, however, argue that they should not have to pay the money. Both sides accept that there was an agreement to pay Simon some money – £20 per year, in two tranches – but there is disagreement as to whether this came with strings attached. The prior argued that it was a sum in recognition of Simon’s obligation to offer medical assistance to the house and its brethren, and Simon had utterly failed to do so, in the case of a former prior, Gerard (Gerald Rothonis was prior in 1363, according to the Victoria County History entry). Gerard had fallen ill, and Simon, who was at Mayfield (?), not regarded as too distant, had been sent for. He had refused to come.

Simon appears to have tried more than one line of argument for his position that the money should be paid. According to the Plea Roll, he argued that the money had not been conditional on his medical attendance or advice, and that he was, and had been, in poor health, having been struck by an illness called ‘gutta’ (I am tempted to say ‘gout’, but, in current circs, can’t get to a dictionary of medieval medical terms to check that; whatever it was, it made him helpless at some times, but able to function at other times). The same source also shows him claiming that the annuity was not a payment for future medical services, but a ‘reward’ for having given up to the prior the church of which he had previously been parson. The Year Book account includes additional technical pleas (to do with ‘doubleness’ of some of the other side’s pleading, and the wording of the original deal – did it oblige Simon to come in person and give medical advice, or something less than this; did it require medical advice or some more general counsel, since it did not specify). There is more detail on the prior’s pleading, including the idea that what was expected for a private, or internal, ailment like Gerard’s was examination of the urine – a classic medieval diagnostic procedure. There is a lot of interesting debate on the place of medical professionals, and the nature of expertise (of medics and lawyers). Simon gets into difficulties because his case about giving up the church does not have the sort of gold-standard evidence that the priory can produce: it is not mentioned in the parchment-work, while he is described as a doctor of physic in that document, and has not denied that he is one.

There is less difference between plea roll and year book than is sometimes the case, but the vocabulary and detail varies, so that those interested in this sort of arrangement will find it rewarding to look at both.

In the end (and, for once, we do have a result) Simon lost. He did not recover the ‘arrears’, and, what is more, had to pay for having brought a false claim. As ever, it’s impossible to know the truth – was Simon a poor infirm former medic who had given up his church and was supposed to be supported by this annuity, out of which the priory managed to weasel, or was he an arrogant and negligent doctor who would not attend his monastic clients? If he really was old and infirm, and needed to be looked after in his final years, he would probably not have chosen to approach the Priory of St Pancras for charity.

 

GS

22/3/2020

 

References:

Plea Roll: CP 40/426 m. 433, 433d http://aalt.law.uh.edu/AALT4/E3/CP40no426/aCP40no426fronts/IMG_0635.htm

http://aalt.law.uh.edu/AALT4/E3/CP40no426/aCP40no426fronts/IMG_0856.htm

Year Book: see Seipp 1367.014 http://www.bu.edu/phpbin/lawyearbooks/display.php?id=13743 for the case, and a link to the ‘black letter’ report.

On the Priory of Lewes, see https://www.british-history.ac.uk/vch/sussex/vol2/pp64-71#anchorn99

Matrons, medicine and maternity

This morning, I have been listening to a podcast of a late-2017 seminar paper from the Institute of Historical Research Late Medieval seminar:

Zosia Edwards (Royal Holloway), ‘Pregnancy diagnosis in the later Middle Ages: medical methods and courtroom procedures’

https://www.history.ac.uk/podcasts/late-medieval-seminar/pregnancy-diagnosis-later-middle-ages-medical-methods-and-courtroom

This was of interest to me in relation to two projects/areas of on-going research: my monograph on women in the medieval common law and my work on curtesy and live birth/still birth.

Its central focus was the divergence between a rich textual tradition of learned medical writing on techniques of diagnosing pregnancy and the common law’s approach, apparently scorning such learning, or the use of (male) ‘medical experts’ in favour of the judgment of ‘lay persons’: mainly ‘matrons’, though with some involvement of knights (in land cases). It includes some very good examples of both medical diagnosis and common law practice.

The divergence between learned texts and common law practice is striking divergence, and has been commented upon to some extent (e.g. by S.M. Butler). There is much to be said about the common law’s emphasis on jury findings as opposed to those of ‘experts’, not just in the medieval period and not just in medicine. In addition, it seems to me that there are also other particular  explanations for the difference in procedure in relation to pregnancy which would be worth consideration. First, the medical texts and the investigation in common law felony cases were directed at slightly different questions. In the case of the medical texts, the search (however dubious we might find the methods) was for the presence of any pregnancy. At least in the case of the ‘pregnant felon’ cases, it was a search for confirmation of a woman’s claim that she was pregnant with a ‘quick’ child: thus a less ‘expert’ and sensitive test might be thought to suffice. In addition, there does not seem to have been a desire to avoid all possible killings of pregnant women: witness the approach to those claiming a second pregnancy, the possible presence of a foetus not being sufficient to defer execution. Views on the value to be accorded by the law to the foetus at various phases of existence were in a state of development/flux in the medieval period, and trying to bring together the attitudes encapsulated by legal texts and plea rolls relating to foetuses in homicide, abortion, curtesy and other land cases is a task with which I am wrestling. A paper on determinations of live birth in relation to curtesy temp. Edward I is on its way to publication, but I would love to expand into a more general overview of ideas about the foetus/newborn in different categories of legal case. One of these days.

13/1/2019.