Category Archives: medical history

Red Poppies, Blue Poppies

Nearly 3 years ago, the British Prime Minister David Cameron made his first official visit to China. It was early November, so like most British (or European) politicians, he was wearing a red poppy in his lapel to mark Remembrance Day.

The British Embassy staff in Beijing advised him not to wear it while he was in China. Poppies have a loaded message for Chinese, which has nothing to do with the bloodstains of Flanders fields. Poppies mean opium.

The opium poppy, Papaver somniferum, has flowers that are usually blue, although they can also be red, white, or somewhere in between. After they finish flowering, the seedpods swell. Left alone, they will eventually dry and crack to release a mass of tiny poppy seeds, but to produce opium, the poppy farmer carefully slashes the green seedpods. Over a day or so these wounds bleed raw opium, which is collected daily.

Traditionally the sticky resin was dried into cakes of opium, which could be used in many ways. It could be chewed or smoked – there’s an excellent description of the process of preparing an opium pipe in Graham Green’s The Quiet American. Dissolved in alcohol, opium became laudanum, which was used widely as a painkiller or soporific in the 18th and 19th centuries.

1024px-Illustration_Papaver_somniferum0

Purified into heroin, it was used by doctors well into the 20th century. I once gave a talk on the history of opium to a group of elderly women. Most of them had had their babies during the 1950s. One woman told me afterwards that the births she experienced using heroin were much less painful than the ones after it became illegal in 1952.

The Chinese prohibited opium much earlier than the rest of the world – but without success. There were edicts against it during the 18th century, and in 1799 the Chinese government banned its importation in any form. The British East India Company was the main supplier, and while the EIC officially withdrew from the opium trade in 1809, a mere 10 years after they were asked to do so, they didn’t stop making the stuff. Most of the illegal opium produced today comes from the same Golden Triangle first set up by EIC traders in the 18th century.

The trade really took off in the 19th century. Free traders, mainly British but also some Americans, smuggled it into Canton/Guangzhou, where it had a devastating effect – not just on individual users, but on the economy as well. One of the key figures in the trade was my old friend Walter S Davidson, who went to China as an opium trader in 1812. By the time he left in 1822, two firms dominated the smuggling trade, Jardine, Matheson & Co (still alive and kicking in 2015) and Dent & Co, WSD’s old firm.

In 1839 the Chinese renewed their efforts to keep out the opium traders. The Emperor sent his own picked official, Commissioner Lin, to Canton to crack down on the trade. In a grand public gesture, he seized the stockpiles of opium from the British merchants and destroyed the ‘foreign mud’ by mixing it with salt and lime and throwing it into the sea.

It was a grand public gesture, but it failed completely. Britain declared war, and China was defeated in the First Opium War (1839-42). In a humiliating peace treaty, the Chinese were forced to hand over Hong Kong Island, and open 5 Treaty Ports to foreign trade. When land sales opened on Hong Kong, Dent & Co bought the first block of land. They were also among the first to open in Shanghai.

The opium trade continued to flourish and foreign trade and foreign ideas steadily weakened in Chinese Imperial Court’s grip on authority. A second Anglo-Chinese War (1858-60) saw British and French forces reach Beijing, where amongst other things, they looted and destroyed the Summer Palace. Amongst the many items looted was a Pekingese dog that was given to Queen Victoria. Without so much as a blush, she named him Looty. There’s a good account of the affair here.

China is very much in the news at the moment. The Australian Government is passing a China-Australia Free Trade Agreement. An American warship has deliberately sailed within 12 nautical miles – the distance that marks the extent of territorial waters – of the Spratly Islands.

And President Xi Jinping has just been on a state visit to Britain. This has inevitably led to talk about human rights in China. Reporters at the BBC in particular have been effortlessly sanctimonious, and there is no doubt that in some matters, China’s record is dodgy – but then, as our ex-PM Tony Abbott so effortlessly demonstrated yesterday, nobody is perfect.

Wearing poppies, David Cameron, George Osborne, Vince Cable and Michael Gove drink a toast at a contract signing in China, The Guardian, 10 November 2012

Wearing poppies, David Cameron, George Osborne, Vince Cable and Michael Gove drink a toast at a contract signing in China, The Guardian, 10 November 2012

On his 2012 visit to China, David Cameron didn’t take his embassy’s advice, and wore his red poppy regardless, because he refused to kowtow to Chinese sensibilities. The word kowtow is Cantonese. It refers to a stylized prostration before the Emperor, where the subject kneeled, then knocked his head on the ground a specified number of times. It came into English usage following Lord Macartney’s 1793 Embassy to China. Britain wanted trade concessions, but Macartney failed to get them – allegedly because he refused to perform the kowtow.

Personally I think it might be a good idea to cut China some slack. In a culture that famously thinks that it is still ‘too early to tell’ what will be the impact of the French Revolution of 1789, the humiliations of the 19th century are still quite raw.

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Dealing with our Waste

In this world where there is a day for everything, today, 19 November, is International Toilet Day. Basic sanitation is still a luxury in many parts of the world – as this BBC photo spread shows.

The Redback on the Toilet Seat

Some dangers are specifically Australian. Record cover of the single released by Slim Newton, June 1972

Human waste disposal is a problem. A contaminated water supply can lead to cholera, dysentery and other infectious diseases, while parasites such as hookworm or schistosomiasis are picked up walking through contaminated soil or water in bare feet. Women in particular are at risk for other reasons, because finding a private place for their ablutions is difficult and potentially dangerous.

Australian cities have not always had clean and reliable sewerage. Continue reading

Ebola – lessons from the past

The Four Horsemen – War, Famine, Pestilence and Death* – tend to work as a team. War brings famine (and famine, or at least land shortage, brings war). Hunger makes people vulnerable to infectious diseases – and pestilence, famine and war all bring death.

Durer Four Horsement

Albrecht Durer , The Four Horsemen of the Apocalypse (1497-8)

But sometimes a new disease turns up unexpectedly, like Ebola in West Africa right now, or smallpox in the Aztec Empire in the 16th century, or the Plague of Justinian in 541AD, the first recorded pandemic caused by the bacterium Yersinia pestis, better known from its second appearance in 1347 as the Black Death.

Historians are good are looking back and finding explanations, and epidemic diseases are most deadly when certain preconditions exist: poverty, poor hygiene, poor nutrition and over-population all make things worse. But sometimes, there are no preconditions, and it doesn’t do to blame the victims: the Aztecs were doing just fine until the Spanish arrived, bringing smallpox to a population that had no immunity to the disease. Continue reading

Bioethics in Historical Perspective

During the last month Australia and Thailand have had to confront the implications of a terrible medical dilemma, when news broke of ‘Baby Gammy’, the Downs syndrome twin left behind by an Australian couple who paid a Thai woman to carry their child. When the mother found she was having twins, she allegedly refused to abort the pregnancy because of her Buddhist beliefs. The genetic parents subsequently took the ‘good twin’, a girl, back to Australia with them, leaving the boy behind with a mother too poor to pay for his medical treatment. A lot of this is still ‘alleged’ – but just when it seemed the story couldn’t get any worse, it turned out that the new father had formerly been convicted of child abuse. Both Thailand and Australia have been hastily rushing through new regulations on child surrogacy.

Many medical issues have an ethical dimension. Some, like surrogacy, are self-evidently vexed. Others are subtler.

In the current Ebola epidemic, for instance, why does an American patient get flown home for treatment that is not available for Africans? What are the ethics of administering treatment that is still experimental? And why is the language in which the disease is discussed so charged? There has been a lot of talk about how uneducated Africans don’t obey the scientists when they are told to abandon their traditional burial rites and not touch Ebola victims, or wash the bodies of their dead relatives. Yet the said American patient subsequently credited Jesus, not the scientists, for his recovery.

Sarah Ferber, Bioethics in Historical Perspective

It is against this background that I’ve recently been reading Sarah Ferber’s Bioethics in Historical Perspective (Palgrave, 2013). Continue reading

When is Old Age?

In 1555* Charles V abdicated. He was the greatest European ruler of his day, Emperor of Germany, Duke of Burgundy, King of Aragon (including chunks of southern Italy and Sicily) and Castile (including new conquests in the Americas), and various territories along the Danube and in North Africa.

He was born in 1500 – and when I taught European history to first year students, I used to say that he retired at 55 because at that age he could access his superannuation. As I got closer to the same milestone, I think my lecture became increasingly heartfelt, though sadly only the mature aged students ever really got the joke.

Not many rulers willingly abdicate. It usually takes a revolution of some sort, or a particularly sexy American divorcée, before they can be dragged off kicking and screaming. It was a particularly unusual act in the early modern era, when the sacral nature of a crowned king, ordained by God, was taken very seriously – and Charles was a serious and religious man.

Charles V by Titian (1548)

Charles V looks considerably older than 48 in this portrait by Titian from 1548

But he was also an exhausted man, and by the standards of his day already an old man. Continue reading

What’s for breakfast?

I’m currently reading the journal of Thomas Otho Travers. He worked for the East India Company in the early 19th century, at one time as private secretary to Sir Stamford Raffles when he was in Java. Raffles is best remembered because he later founded Singapore. The journal is rather frustrating, to be honest, because Tom seems to have written it up only once a month, just giving a summary of any important events during that time. It lacks the immediacy of a daily journal.

The reasons why we keep a diary are very different from the reasons later historians may want to read it. A diary may be a memoir or an aide memoire, a chance to sound off about the boss, or a spiritual solace.

What it never tells you, in my experience, is what the writer had for breakfast. Why should it? Travers’ diary was where he noted down significant or unusual events he needed to remember, or wanted to think through. He had no need to jot down details about his own daily life.

Old Bencoolen 1799

Joseph Constantine Stadler, Fort Marlborough from Old Bencoolen, Sumatra (1799)

And yet I would love to know more about what East India Company servants, and other British traders in the Far East, were having for breakfast in the early 19th century. Continue reading

Kakadu and Sickness Country

There has been a spill of contaminated material at the Ranger uranium mine in Kakadu. It’s still not clear how bad it is (or if it’s the only one) but Energy Resources of Australia (ERA) assures us that no one was injured and no uranium leaked from the site. Who knows? As always, there are many conflicting interests, but everyone will no doubt be on high alert, especially now, during the wet season.

wetlands kakadu

I visited Kakabu in the 1990s, so these photos are nearly 20 years old, but there is – or should be – something timeless about this beautiful place.  But of course the environment is vulnerable.   Nothing stands still, and this is an area already affected by various environmental catastrophes. Continue reading