Charlotte Perkins Gilman

Old medicine vs. new medicine

What are some differences in treatments during Charlotte Perkins Gilman’s time and ours?

When I read “The Yellow Wallpaper” I learned about the treatment for postpartum depression in the 1900’s. It was treated by a popular form of rehabilitation called the rest cure, a regimen consisting of continuous rest and suppression of all thoughts of or actions toward a career (http://www.webster.edu/~woolflm/gilman.html). When I read this I immediately thought this was crazy, and that it was opposite of present day. Postpartum depression is taken very seriously now; any signs of depression should be reported to the doctor immediately. The doctor will prescribe antidepressants and recommend being as social as possible.  I realized that during the 20^th century rest was the cure for almost everything, and a hundred years from now people will probably think some of our treatments were crazy.

In 1900, the three leading causes of death were pneumonia, tuberculosis (TB), and diarrhea and enteritis, which (together with diphtheria) caused one third of all deaths. Sir William Osler, known as "the father of modern medicine," appreciated the morbidity and mortality of pneumonia, describing it as the "captain of the men of death" in 1918, as it had overtaken tuberculosis as one of the leading causes of death in his time (http://www.news-medical.net/health/Pneumonia-History.aspx). There was no known cure for pneumonia until the mid 1900’s. Patients were told to get a lot of rest and usually died. Several developments in the mid 1900s improved the outcome for those with pneumonia. With the introduction of penicillin and other antibiotics, modern surgical techniques, and intensive care in the twentieth century, mortality from pneumonia dropped precipitously in the developed world (http://www.news-medical.net/health/Pneumonia-History.aspx). Today antibiotics are still used to treat bacterial pneumonia. Other medications are also used to help improve breathing and relieve symptoms in bacterial and viral pneumonia.  The second leading cause of death in the 1900’s was tuberculosis. In 1900, 194 of every 100,000 U.S. residents died from TB; most were residents of urban areas. In 1940 (before the introduction of antibiotic therapy), TB remained a leading cause of death, but the crude death rate had decreased to 46 per 100,000 persons. Those infected with tuberculosis were isolated from society and placed in sanatoriums. These self-contained communities became known as "waiting room[s] for death.”



This the abandoned tuberculosis sanitarium Waverly Hills in Kentucky



This shows how close they were put together because there were so many people with TB.

The emphasis on the cure was "Rest in Bed" in the open air on sleeping porches or in well-ventilated rooms. There were strict rules governing coughing in public, spitting on the floor and basically controlling any potential spray that came from the lungs, throat or mouth. Exercise was stressed as speeding up "…the end of many of those now dead from tuberculosis". The patients were instructed to never get out of breath, never exercise when the temperature is above 99.6º, never exercise if sputum was streaked, never run or walk fast, never get tired, and never attempt mountain climbing. The emphasis was placed on the individual and how he/she could facilitate their own cure by following the sanatorium rules. The Piedmont Sanatorium Rules and Information for Patients said, "If you expect to get well you must work for it" (http://www.faculty.virginia.edu/blueridgesanatorium/death.htm). Today in the United States, there are approximately 10 cases of TB per 100,000 people. However, rates vary dramatically by area of residence and socioeconomic status. It is usually treated by antibiotics, and you may need to stay at home or be admitted to a hospital for 2 - 4 weeks to avoid spreading the disease to others until you are no longer contagious.

Many things have changed over the years, and a lot of changes are sure to come in the future.