Regency-era doctors threw all sorts of treatments at their patients with scarlet fever: gargles made with hydrochloric acid; gentle potions made with antimony—a compound used to promote perspiration (today antimony is used mainly in industrial processes); and caustic blisters applied to the neck or throat, which surely made the patient miserable both inside and out. “Early, powerful and repeated vomits” were used with enthusiasm.1 Dietary treatments, described below, were popular as well.
General Dietary PrinciplesDr. William Withering—best known for identifying the actions of digitalis, a compound obtained from the foxglove plant—advised his patients with a mild case of scarlet fever to avoid animal food and fermented liquors. Those who were worse off (presumably patients having the malignant form of the disease) were allowed tea, coffee, chocolate, milk, gruel, barley water, and occasionally weak wine whey. The best remedy was plain, fresh-drawn spring water. Patients were allowed to indulge themselves with cool water during “every exacerbation of heat, restlessness, or delirium.” The cool water was thought to help diminish painful symptoms.2
Dr. William Buchan, my go-to physician for all things related to Regency-era medicine, believed in treating scarlet fever as a putrid fever, such that only a few medicines could be depended upon—specifically, Peruvian bark, wine, and snakeroot. He advised his patients to add acids like oranges, lemons, and vinegar to their food. Their food should be light and not weigh on the stomach: panada, for example, and water gruel were appropriate. Fresh, ripe fruits such as roasted apples, currants, plums and cherries, along with gooseberry tarts could be eaten freely.3
Wine and Diluting Drinks
Dr. Withering instructed his patients to go to bed and drink wine whey with spirit of hartshorn in plentiful amounts.4 In general, Withering believed it was important to give scarlet fever patients a quantity of wine in proportion to their degree of debility.5 Dr. Benjamin Rush likewise recommended diluting drinks “impregnated with wine,”6Dr. Buchan advised his patients suffering from scarlet fever to drink freely of cool and diluting liquors and to avoid strong liquors and cordials.3
What is a diluting liquor? We think of liquor today as a spiritous beverage made from grain—say, whiskey or brandy. During the Regency era, the word liquor had a different meaning in medical practice. Dr. Hamilton, for example, gave his scarlet fever patients liquors, particularly water-gruel, barley-water, chicken-water, sage tea, rosemary tea, or baum tea.7 Any of these could be drunk freely, either chilled or at room temperature, and none contained a spiritous liquor.
Dr. Bateman was a dissenter when it came to wine, for he stated emphatically: “Wine, cinchona [Peruvian bark], and other cordials and tonics, are not only useless, but injurious, until after the efflorescence has declined, together with the febrile symptoms.”8 The efflorescence mentioned by Dr. Bateman refers to the pockets of pus that appear at the back of the throat or the fauces.
Dr. Buchan advised refraining from flesh, meaning meats.3 The idea must have been to provide refreshing foods and drinks that did not weigh heavily on the stomach. Dr. Withering, on the other hand, allowed his patients to eat animal food in whatever form it could best be consumed. He observed that his patients usually wanted cold meat, especially cold chicken.9
Of course, there was a dissenter! In this case it was Dr. Bateman, who restricted his patients to eating a light diet without animal food.10
A Case Study
Dr. Withering’s book, published in 1793, includes descriptions of several case studies. This one seems fairly typical:11
Case Study I. A young lady 12 years of age, was suddenly seized in the evening with weariness, sickness, sore throat, and head ache. A vomit was given the following day, and afterwards the bark [Peruvian bark]. The third day the nausea still continuing, and the strength being greatly impaired, the vomit was repeated, the bark continued, and port wine negus directed for common drink.
Note his direction to partake of port wine negus. Jane Austen had a recipe for negus. And here is Mrs. Beeton’s recipe for negus, which I made one evening for a dinner party. It was a winter evening and the warm negus was the perfect party warm-up.
1Withering, William. An Account of the Scarlet Fever and Sore Throat; or Scarlatina Anginosa: Particularly as It Appeared at Birmingham in the Year 1778, 2nd ed. (London: G.G. & J. Robinson, 1793), p. 10 (PDF p. 15).
2Ibid., p. 96 (PDF p. 101).
3Buchan, William. Domestic Medicine. (Boston, 1811), p. 189.
4Withering, pp. 65-66 (PDF pp. 70-71).
5Ibid., p. 11 (PDF p. 16).
6Rush, Benjamin. Medical Inquiries and Observations, Vol. I, 2nd ed. (Philadelphia, 1805), p. 145 (PDF p. 162).
7Hamilton, James. Observations on the Utility and Administration of Purgative Medicines in Several Diseases. (Edinburgh, 1819), p. 69 (PDF p. 108).
8Bateman, Thomas. A Practical Synopsis of Cutaneous Diseases. (London: 1814), p. 83 (PDF p. 120).
9Withering, p. 11 (PDF p. 15) and p. 96 (PDF p. 101).
10Bateman, p. 72 (PDF p. 109).
11Withering, p. 104 (PDF p. 109).