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By Leslie Lynne Ryan, Oakville, Ontario

Source: The Avonlea Traditions Chronicle, Issue No. 26, Winter 1998/9.

L. M. Montgomery's lifetime (1874 - 1942) is an interesting period with respect to medicine. Her journals and literature provide us with a wealth of information about medical practices, diseases that were prevalent during her time, common notions, and home remedies that were used.

In looking at the evolution of medicine during this period, it is valuable to also explore the period preceding it. Medicine of the early 1800s bore little resemblance to that of today. Surgery, performed without the aid of antiseptics or anaesthetics (except alcohol), was limited to tooth extraction and amputation. In 1788 an ordinance was passed that required all members of the medical establishment to take an examination to obtain a license to practise medicine. Women were excluded and did not gain entry into Medical schools until the 1850s, though female nurses and midwives continued to practice and were regularly called upon, especially if the doctor's own wife was in labour.

Influenza, typhoid fever, smallpox, and cholera were common and deadly diseases. Thousands died during the cholera epidemic of the 1830s. L. M. Montgomery wrote that her Aunt Elizabeth Campbell Montgomery's four children had died of "the black cholera." Doctors didn't know the disease was caused by bacteria and contaminated water supplies or that it was contagious.

Theories were that it was caused from too much oxygen in the air, the sun, moon or comets, or simply by being afraid of it. Treatments doctors gave to people suffering from cholera included bleedings, opium, cauterization of the spine, blistering, and massive doses of calomel, a medicine based on mercury that caused one's gums to bleed.

Electric shock therapy, experimental injections of various liquids, turpentine enemas, and leeches were also used. These brutal treatments did nothing to cure the patient and further devastated those already weakened by disease.

As a result of the medical profession's failure to explain or deal effectively with cholera, many people lost faith in conventional medicine and turned to treatments which had little or no basis in science but that were less barbaric. Home medical guides promoted alternative treatments which could be applied at home. Plant therapy and homeopathic medicine, based on very tiny doses of drugs, became enormously popular. Many people chose unlicensed practitioners, referred to by the medical profession as "quacks and root doctors," until the late 1860s and beyond.

Few advances were made in medical science or medical education in Canada during this time due to the public's lack of support. The medical profession's claim to scientific expertise was not taken seriously until the 1880s when cholera ceased to be a threat in Canada.

There were, however, some important advances in the 1800s. The first anaesthetics, chloroform and ether, were introduced in the 1840s and made invasive types of surgery possible. Nitrous oxide also found its place in clinical dentistry and is still in use today.

Antiseptic surgery arrived in 1865 when Joseph Lister, after studying the earlier germ research done by Louis Pasteur, became convinced that germs caused the death of most surgical patients. He began to use carbolic acid, a strong disinfectant, to sterilize surgical wounds. Preventing infection saved the lives of many patients and led to the development of aseptic surgery.

By the time L. M. Montgomery was born in 1874, considerable progress had been made. Bloodletting had gone out of style. The germ theory of disease had been developed and accepted. Women had entered the largely male-dominated medical profession and were beginning to gain support. In spite of these advances, there were many diseases that often resulted in death. Sometimes the actual cause of death was unknown.

In L. M. Montgomery's most famous work of fiction, Anne of Green Gables, we see evidence of this. Anne's young parents both died of "the fever." Nowadays, a fever itself is not thought to be fatal, but merely the immune system's reaction to another illness and a symptom that we in 1999 often eliminate with Tylenol.

The common cold too, or at least complications arising from it, could prove fatal. L. M. Montgomery's former beau, Herman Leard, died in 1899. His obituary reads "He contracted a severe cold not long since and never recovered from its effects." We think of a cold as an uncomfortable but relatively minor illness that affects the upper respiratory tract and lasts only a week. The cold in L. M. Montgomery's time was something to be feared. In Emily Climbs, Aunt Ruth is afraid Emily will "catch a cold and go into consumption." Consumption, now called tuberculosis, was a constant in L. M. Montgomery's journals and literature. Her own mother (1876, SELECTED JOURNALS VOL. I), her childhood friend Penzie Macneill (1906, SJ VOL. I) and several other of L. M. Montgomery's relatives, friends and acquaintances, died of consumption. It was a common cause of death for the characters in her literature: Douglas Starr (EMILY OF NEW MOON), Hester Gray (ANNE OF AVONLEA), Davy and Dora Keith's father (ANNE OF AVONLEA) and Ruby Gillis (ANNE OF THE ISLAND), to name a few. In Emily of New Moon, Aunt Elizabeth believes the "night air is poison" and that Emily's father died of consumption from leaving the window open at night.

Typhoid, rarely seen in North America today, was more common then. It is now believed that typhoid is transmitted through poor sanitation. People may carry the disease and show no symptoms, but can transmit it to others. At age 5 or 6 L. M. Montgomery almost died of typhoid fever. She accidentally picked up a "red hot poker" and burned her hand severely. The household was in a flurry trying every home remedy they could think of to soothe her poor burned hand, finally immersing it in a pail of ice cold water.

The next morning L. M. Montgomery became very ill. It seems possible that one of the home remedies may have introduced the salmonella typhii bacteria through the wound caused by the burn. The doctor who was called in to treat her advised cutting off her long hair, as a common belief during those times was that long hair sapped strength from the patient. In 1915, L. M. Montgomery's dear cousin, friend and confidante Frederica Campbell narrowly survived typhoid too, and unfortunately succumbed to flu-pneumonia in February of 1919.

The influenza epidemic of 1918/1919 was responsible for the deaths of thousands of people. In L. M. Montgomery's journal entry of December 1, 1918, L. M. Montgomery wrote: "Toronto was then beginning to be panic stricken over the outbreak of the terrible 'Spanish Flu.' The drug counters were besieged with frantic people seeking remedies and safeguards." A few days after writing this, L. M. Montgomery came down with flu and almost died. A week later, cousin George Campbell and little Georgie died of flu-pneumonia. Most of the other members of the Campbell household contracted the flu but survived. Pneumonia, a complicating factor in influenza cases, remained a major cause of death until the 1930s, by which time the first antibiotic-penicillin, became available.

Scores of interesting home remedies were in use during L. M. Montgomery's lifetime and she described many of them in her journals and fiction. In The Story Girl she referred several times to Mexican tea, described as a great blood-purifier and cure-all. It seems Mexican tea was made of a pungent herb called epizote. Epizote, popular in Mexico and the Southwestern U.S., has a flavour similar to cilantro. Its main use is as an ingredient in bean dishes, to counteract the gas-producing effect of the beans. It sounds like an alternative to Beano!

Other remedies are described in L. M. Montgomery's literature. In Anne of Green Gables ipecac is used as an expectorant. Today, syrup of ipecac is used mainly to induce vomiting in the case of accidental poisoning. Although ipecac is not currently popular as an expectorant, it can act as such if it is given in low doses. In Emily Climbs, cod liver oil is given as a general tonic, Aunt Ruth gives Emily hot milk and cayenne pepper for a cold, and whiskey is Perry's Aunt Tom's remedy for an upset stomach.

In Anne of the Island a remedy for sore throat is to place turpentine and goose grease in a red flannel poultice to be wrapped around one's neck. In The Story Girl, liver pills are a cure-all recommended by Elder Frewen, and whiskey is rubbed on for a pain. The liver pills might have been considered a "patent" medicine. The majority of patent medicines, common before the early 1900s, were not patented at all. Often advertised as "cure-alls," many contained large amounts of alcohol, and sometimes opium or cocaine. The manufacturers were not required by law to list any ingredients and could keep their formulae secret.

L. M. Montgomery used herbal preparations too. She wrote in her journals of taking "hop tea" as a natural sleep aid while pregnant (FEB 25, 1918), and of brewing flaxseed tea for Ewan's bronchitis (FEB 9, 1916). Sleep-inducing herbal teas, containing 70% hops, are being sold in health food stores today. L. M. Montgomery also wrote of using preparations containing elements that are poisonous: strychnine for her heart after her flu illness, and an "old time remedy of Bland's iron and arsenic pills" when her ear was bothering her. (SJ II, JAN. 27, 1930)

Other ailments existed then that still plague people today but are thought of much differently. In 1910, L. M. Montgomery discovered a "kernel" in her breast and feared cancer. To avoid gossip, instead of going to the local doctor, she wrote to a doctor in charge of a newspaper medical column to ask his opinion. Without examining her, he wrote her that it was not cancer and to leave it alone. She accepted his opinion without question and worried no longer. If one were to find the same thing today, an examination, a mammogram, and perhaps a biopsy would be done.

L. M. Montgomery also complained of recurrent bouts of cystitis which first started when she was in Halifax. Even though she was in great discomfort, she does not mention receiving any medical treatment.

L. M. Montgomery suffered from nightly attacks of coughing in the late 1920s to early 1930s, and was diagnosed with asthma. On a few occasions it became so bad that the doctor was called in, and promptly gave her a "hypodermic." She did not name the contents of the hypodermic, but it was likely adrenaline or epinephrine. The doctor told her she had a bad form of asthmatic hayfever. She wrote in her journal (JULY 30, 1930) that she did not feel he knew what he was talking about, and instead attributed this to eating tomatoes! (AUG. 30, 1930). Months later, (it seemed avoiding tomatoes didn't help) L. M. Montgomery theorized that strawberries were the cause! The concept of allergy was in its infancy during that period. If she were alive today it is very likely that she would have been sent for a battery of allergy tests, prescribed bronchodilators and inhaled steroids for asthma, and advised to eliminate the offending allergens-dust mites, moulds, and possibly her beloved cats-from her home!

Chloroform was still in use as an anaesthetic in 1929. L. M. Montgomery was justifiably worried when her son, Stuart, went "under" chloroform to have his tonsils removed. Her journal entry of September 2, 1929 reads: "Ordinarily an operation for taking out tonsils is not a very serious thing. But in the past two months six children have died in Toronto under the chloroform while having tonsils out and there has been much talk about an impure anaesthetic and much newspaper discussion. So I was very cold and sick of soul until I knew Stuart had come out to the ether safely." L. M. Montgomery confuses chloroform and ether here. These two distinctly different compounds, now known to cause liver and kidney damage, are no longer in use as anaesthetics. L. M. Montgomery's writings provide a rich source of information and contain much more than can be covered by this article. Today we benefit from medical discoveries that were made during her lifetime and beyond.

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