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The Practice of Palliative Treatment

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A History of Palliative Care, 1500-1970

Part of the book series: Philosophy and Medicine ((PHME,volume 123))

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Abstract

This chapter offers an in-depth analysis of the various means that physicians and nurses used in order to alleviate the sufferings of dying patients, especially in the first half of the nineteenth century. It shows, in particular, the outstanding place of opium, as a painkiller but also as a drug that reduced the dyspnea of dying consumption but also points out a series of other medicines used to achieve a “euthanasia medica”. It traces the rise of palliative surgery, which could offer welcome relieve, for example in cases of an obstructed esophagus or colon and which continued to thrive while other aspects of palliative care were marginalized. Finally, it highlights the remarkable degree to which good nursing and satisfying the emotional needs of dying patients were appreciated as an essential part of good, professional terminal care.

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Notes

  1. 1.

    Richter, Euthanasia (1841), in German “euthanatisch”; Putz, De euthanasia (1843), p. 9.

  2. 2.

    Nolte, Ärztliche Praxis (2010a), esp. pp. 46–55; eadem, Todkrank (2016); Schilling, “Ach gib mir doch nur etwas Luft” (2011).

  3. 3.

    Th. A. R. Figulus, De opio, ejusque in quibusdam morbis abusu, Berlin: Nietack 1837 (“quum per periodos alia interponenda sint, ne consuetudine dosium opii mediocrium vis frangatur.”)

  4. 4.

    Hufeland, Enchiridion medicum (1837), p. 854.

  5. 5.

    On the curative uses of opium see Samuel Crumpe, An inquiry into the nature and properties of opium, wherein its component principles, mode of operation, and use or abuse in particular diseases are experimentally investigated, London: Robinson 1793.

  6. 6.

    Similarly Ziemssen, De euthanasia medica (1845), pp. 45–6.

  7. 7.

    Hufeland, Enchiridion medicum (1837), p. 853.

  8. 8.

    Ibid.

  9. 9.

    Albrecht von Haller, Commentatio de opii in corpus humanum efficacia, in: Novi commentarii Societatis Regiae Scientiarum Gottingensis 7 (1777), pp. 1–16, here p. 10; see also Jalland, Death (1996), pp. 86–7.

  10. 10.

    Haller, Briefe (1923), pp. 490–1 (December 12, 1773).

  11. 11.

    William Heberden, Commentarii de morborum historia et curatione, Frankfurt: apud Varrentrapp et Wenner 1804, pp. 200–1.

  12. 12.

    Spender, Therapeutic means (1874), p. 62.

  13. 13.

    Bullar, Opium (1856), pp. 268–9.

  14. 14.

    Snow, Palliative treatment (1890), pp. 46–7; in addition, Snow assumed a direct positive effect on the cancer.

  15. 15.

    Berridge and Edwards, Opium (1987), pp. 135–41.

  16. 16.

    John Kent Spender, The hypodermic action of morphia, in: British medical journal (1860), pp. 436–7.

  17. 17.

    Eduard Levinstein, Die Morphiumsucht. Eine Monographie nach eigenen Beobachtungen, Berlin: Hirschwald 1877, p. 3.

  18. 18.

    Albrecht Erlenmeyer, Die Morphiumsucht und ihre Behandlung, Neuwied−Leipzig: Heuser’s Verlag 1883; on the French situation see Szabo, Incurable (2009), pp. 142–51.

  19. 19.

    Capellmann, Pastoral-Medicin (1895), p. 41.

  20. 20.

    The same warning was already voiced by Jentink, De promovenda euthanasia (1840), p. 24.

  21. 21.

    Nolte, Pflege (2010b), p. 102.

  22. 22.

    Oscar C. Young, On the use of opiates, especially morphine, in: Medical news 80 (1902), pp. 154–7, cit. in David T. Courtwright, Dark paradise. Opiate addiction in America before 1940, Cambridge, Mass.: Harvard University Press 1982, p. 54.

  23. 23.

    Franck, Moderne Therapie (1926), p. 530, on cancer treatment; B. Bandelier and O. Roepke, Die Klinik der Tuberkulose. Handbuch der gesamten Tuberkulose, 2nd edn, Würzburg: Kabitzsch 1912 (orig. 1910), p. 183.

  24. 24.

    For a useful contemporary survey see Spender, Therapeutic means (1874); on pain relief in cancer of the uterus see Wilhelm Schrader, De carcinomate uteri, med. diss., Berlin: Nietack 1842, pp. 29–30.

  25. 25.

    Putz, De euthanasia (1843), p. 15.

  26. 26.

    Jalland, Death (1996), p. 89; on the history of the medicinal uses of cannabis in Western medicine in general see Manfred Fankhauser, Haschisch als Medikament. Zur Bedeutung von Cannabis sativa in der westlichen Medizin, Liebefeld: SGGP/SSHP 2002.

  27. 27.

    Augustus B. Granville, An historical and practical treatise on the internal use of the hydrocyanic (prussic) acid in pulmonary consumption and other diseases of the chest, London: Longman et alii 1820, pp. 60–1.

  28. 28.

    Vogel, Euthanasia (1834), p. 601.

  29. 29.

    Schaffrath, Euthanasie (1869), p. 15.

  30. 30.

    Spender, Therapeutic means (1874), pp. 147–52.

  31. 31.

    J. Heitzmann, Die palliative Behandlung der inoperablen Uteruscarcinome, in: Centralblatt für die gesammte Therapie 17 (1899), pp. 705–18; Max Berl, Zur palliativen Behandlung des inoperablen Uteruscarcinoms, med. diss., Munich: Gerstenberg [1910], p. 8.

  32. 32.

    Spender, Therapeutic means (1874), p. 62 and pp. 71–2; Snow, Palliative treatment (1890), p. 34.

  33. 33.

    Snow, Palliative treatment (1890), pp. 34–5, on the case of a patient with breast cancer.

  34. 34.

    Goldin, A protohospice (1981), p. 384; Saunders, Evolution (1988), p. 170.

  35. 35.

    See the contemporary survey in Franck, Moderne Therapie (1926), pp. 419–26; see also Hans Auler, Über die Wartung und Behandlung Krebskranker (offprint from Monatsschrift für Krebsbekämpfung), Munich: Lehmann 1933.

  36. 36.

    Ibid., p. 424; F. G. Chandler, Cocaine for euthanasia (letter to the editor), in: Lancet 207 (1924), p. 629; Sabine Fellner and Katrin Unterreiner, Morphium, Cannabis und Cocain. Medizin und Rezepte des Kaiserhauses, Vienna: Amalthea Signum 2008, pp. 142–3.

  37. 37.

    Callegari, Cura palliativa (1828), pp. 4–5.

  38. 38.

    Historical survey in Christina Koßobutzki, Die Geschichte der inhalativen Sauerstofftherapie in Deutschland, med. diss., Lübeck: urn:nbn:de:gbv:841-20090420356 2009.

  39. 39.

    Norbert Ortner, Die Sauerstofftherapie in der inneren Medizin, in: Max Michaelis (ed.), Handbuch der Sauerstofftherapie, Berlin: Hirschwald 1906, pp. 535–41, cit. p. 539.

  40. 40.

    Mann, Magic mountain (1929), p. 137.

  41. 41.

    Ibid., pp. 369–70.

  42. 42.

    Brodie, Vorlesungen (1847), p. 73.

  43. 43.

    Ibid., p. 66.

  44. 44.

    Ibid., p. 75.

  45. 45.

    Ibid.

  46. 46.

    Cf. Capellmann, Pastoral-Medicin (1895), p. 46.

  47. 47.

    Snow, Palliative treatment (1890), p. 18.

  48. 48.

    Lund, Palliative medicine (1880), pp. 21–2.

  49. 49.

    The term derives from the biblical expression “Miserere mei, Deus”, “have mercy on me, God”; when their neighbour died in this manner, vomiting feces, Georg Handsch’s teacher, Ulrich Lehner, around 1550, still told him in fact that this was called “Miserere mei deus” (ÖNB, Cod. 11240, fol. 37r).

  50. 50.

    Maurice Recouly, De la valeur de l’anus iliaque comme opération palliative dans le cancer de la partie terminale du gros intestin (S[igma] iliaque, rectum), med. diss., Paris: Henri Jouve 1902; Linkenheld, Palliative Operationen (1894), pp. 416–9.

  51. 51.

    “To live with an artificial anus and a cancer in the area of the rectum and anus”, Finet quoted M. Beaudoin, “that means just not being dead” (Prosper Finet, De la valeur curative et palliative de l’exérèse dans le cancer du rectum, med. diss., Paris: G. Steinheil 1896, p. 75).

  52. 52.

    Ibid.

  53. 53.

    Linkenheld, Palliative Operationen (1894), p. 419.

  54. 54.

    Edward Lund, On the removal of the entire tongue by the Walter Whitehead method, with full details of the operation and after-treatment, London−Manchester: Churchill and Cornish 1880; Snow, Palliative treatment (1890), pp. 18–9.

  55. 55.

    Max Berl, Zur palliativen Behandlung des inoperablen Uteruscarcinoms, med. diss., Munich: Gerstenberg [1910], pp. 8–9; Gabriel-Adolphe-Léon Planque, De la ligature palliative, atrophique, de l’artère linguale dans les tumeurs malignes de la langue, med. diss., Bordeaux: Barthélemy et Clèdes 1912.

  56. 56.

    M. Kirschner, Zur Bekämpfung der Krebskrankheit, in: Der Chirurg 12 (1940), pp. 177–92, hier pp. 191–2.

  57. 57.

    Jean-Auguste Schneyder, De la ponction lombaire comme thérapeutique palliative dans les tumeurs de l’encéphale, med. diss., Bordeaux: Imprimerie du Midi, E. Trénit 1908; Francis Trocmé, De la thérapeutique palliative dans les tumeurs de l’encéphale, méthodes décompressives (ponction lombaire et trépanation palliative), med. diss., Paris: Henri Jouve 1909.

  58. 58.

    Hans-Joachim Ahrens, Die palliative Trepanation bei Gehirndruck, med. diss., Marburg: Hamel 1935, p. 23.

  59. 59.

    Max Berl, Zur palliativen Behandlung des inoperablen Uteruscarcinoms, med. diss., Munich: Gerstenberg [1910], pp. 14–6; John V. Pickstone, Contested cumulations. Configurations of cancer treatments through the twentieth century, in: David Cantor (ed.), Cancer in the twentieth century, Baltimore: Johns Hopkins University Press 2008, pp. 164–96.

  60. 60.

    Snow, Palliative treatment (1890), pp. 24–5.

  61. 61.

    Oetheus, Gründtlicher Bericht (1574), fols 126r-v and fol. 131r.

  62. 62.

    On nursing care for dying patients in the nineteenth century see Nolte, Pflege (2010b), eadem, Umgang (2006a), pp. 165–74 and eadem, Todkrank (2016); for general introductions into the history of nursing see Sylvelyn Hähner-Rombach (ed.), Quellen zur Geschichte der Krankenpflege, mit Einführungen und Kommentaren, Frankfurt: Mabuse 2008; Birgit Panke-Kochinke, Die Geschichte der Krankenpflege (1679–2000). Ein Quellenbuch, Frankfurt: Mabuse 2003; dated but still useful is Adelaide Nutting and Lavinia L. Dock, A history of nursing (orig. 1907), Tokyo−Bristol: Synapse/Thoemmes 2000.

  63. 63.

    Zach, De cura (1792); on Zach’s treatise see the medical dissertation by Philipp Feldle, Palliativpflege im 18. Jahrhundert. Ignatius Zachs “De cura, quam moribundis debent, qui aegrotis sunt a ministerio” (1792), Duisburg-Cologne: WiKu-Verlag 2013.

  64. 64.

    Lebrecht, Arzt (1821), p. 104.

  65. 65.

    Vogel, Euthanasia (1834), p. 600.

  66. 66.

    Richter, Euthanasia (1841), p. 365.

  67. 67.

    Jahn, De euthanasia (1839), p. 19.

  68. 68.

    Paradys, Rede (1796), p. 570.

  69. 69.

    Jahn, De euthanasia (1839), p. 18.

  70. 70.

    Paradys, Rede (1796), p. 570.

  71. 71.

    Puchelt, Umriss (1826), p. 522; Jahn, De euthanasia (1839), p. 21; E[rnst F.] Gurlt, Krankenpflege, in: Albert Eulenburg (ed.), Real-Encyclopädie der gesammten Heilkunde, Vienna−Leipzig: Urban & Schwarzenberg 1887, pp. 239–318, here pp. 317–8.

  72. 72.

    Percival, Medical ethics (1803), p. 9.

  73. 73.

    Ibid., p. 11.

  74. 74.

    Jahn, De euthanasia (1839), p. 24; Baltes, De euthanasia (1842), p. 22.

  75. 75.

    Wolfart, Betragen am Sterbebette (1819), p. 62.

  76. 76.

    Richter, Euthanasia (1841), p. 367.

  77. 77.

    Scholand, Menschenfreund (1837), pp. 1–13 (“Von der Behandlung der Sterbenden”).

  78. 78.

    Krügelstein, Handbuch (1807), pp. 424–5.

  79. 79.

    Salzburg Museum, Salzburg, Hs 2194, handwritten lessons for nurses; I have not been able to consult Schmidt’s—possibly largely identical—printed work Unterricht für Krankenwärter , Vienna 1831.

  80. 80.

    Capellmann, Pastoral-Medicin (1895), pp. 277–8.

  81. 81.

    Stadtarchiv Nürnberg, C11/I, 124.

  82. 82.

    Munk, Euthanasia (1887), pp. 88–93, cit. p. 93.

  83. 83.

    Browne, Care of the dying (1894).

  84. 84.

    Mendelsohn, Ueber die Euthanasie (1897), pp. 37–8; similarly already Richter, Euthanasia (1841), p. 365.

Selected Bibliography

  • Baltes, Wilhelm. 1842. De euthanasia. Berlin: Nietack.

    Google Scholar 

  • Berridge, Virginia, and G. Edwards. 1987. Opium and the people. Opiate use in nineteenth-century England. 2nd ed. New Haven/London: Yale University Press.

    Google Scholar 

  • Brodie, B.C. 1847. Vorlesungen über wichtige Gegenstände der therapeutischen und operativen Chirurgie, ed. Friedrich J. Behrend. Leipzig: Kollmann.

    Google Scholar 

  • Browne, Oswald. 1894. On the care of the dying. A lecture to nurses. London: George Allen.

    Google Scholar 

  • Bullar, Joseph. 1856. On the use of small doses of opium in the act of dying from phthisis. Association Medical Journal 4 (new series): 268–269.

    Google Scholar 

  • Callegari, Paulus. 1828. De cura palliativa. Padua: Typis Seminarii.

    Google Scholar 

  • Capellmann, C[arl]. 1895. Pastoral-Medicin. 10th ed. Aachen: Barth.

    Google Scholar 

  • Franck, Rudolf. 1926. Moderne Therapie in innerer Medizin und Allgemeinpraxis. I. und II. Teil. Leipzig: Vogel.

    Google Scholar 

  • Goldin, Grace. 1981. A protohospice at the turn of the century. St. Luke’s House, London, from 1893 to 1921. Journal of the History of Medicine and Allied Sciences 3: 383–413.

    Article  Google Scholar 

  • Hufeland, Christoph Wilhelm. 1837. Enchiridion medicum oder Anleitung zur medizinischen Praxis. 3rd ed. Berlin: Jonas.

    Google Scholar 

  • Jahn, Jakob Dietrich Ludwig. 1839. De euthanasia. Diss. med. Kiel: Mohr.

    Google Scholar 

  • Jalland, Pat. 1996. Death in the Victorian family. Oxford: Oxford University Press.

    Book  Google Scholar 

  • Jentink, Andreas. 1840. De promovenda euthanasia. Utrecht: Ex Officina Paddenburgii.

    Google Scholar 

  • Krügelstein, Franz Christian Karl. 1807. Handbuch der allgemeinen Krankenpflege. Zum Gebrauch für Aerzte und Familienväter. Erfurt: Henningssche Buchhandlung.

    Google Scholar 

  • Lebrecht, Leo. 1821. Der Arzt im Verhältnisse zur Natur, zur Menschheit und zur Kunst. Mainz: Kupferberg.

    Google Scholar 

  • Linkenheld, J. 1894. Palliative Operationen. In Fünfzig Beiträge aus dem Gebiete der gesammten Medicin. Festschrift zur Feier des fünfzigjährigen Jubiläums des Vereins der Ärzte des Regierungsbezirks Düsseldorf, 416–419. Wiesbaden: J. F. Bergmann.

    Google Scholar 

  • Lund, Edward. 1880. Palliative medicine and palliative treatment in surgical cases. Address delivered at the meeting held in Manchester. London/Manchester: J. & A. Churchill/J. E. Cornish.

    Google Scholar 

  • Mann, Thomas. 1929. The Magic Mountain. Trans. H. T. Lowe-Porter. London: Martin Secker.

    Google Scholar 

  • Mendelsohn, Martin. 1897. Ueber die Euthanasie. Zeitschrift für Krankenpflege 19: 1–7, 36–39.

    Google Scholar 

  • Munk, William. 1887. Euthanasia: Or, medical treatment in aid of an easy death. London: Longmans, Green, and Co.

    Google Scholar 

  • Nolte, Karen. 2006a. Vom Umgang mit Tod und Sterben in der klinischen und häuslichen Krankenpflege des 19. Jahrhunderts. In Pflege – Räume, Macht und Alltag. Beiträge zur Geschichte der Pflege, ed. Sabine Braunschweig, 165–174. Zürich: Chronos.

    Google Scholar 

  • ———. 2010a. Ärztliche Praxis am Sterbebett in der ersten Hälfte des 19. Jahrhunderts. In Ärztliches Ethos im Kontext. Historische, phänomenologische und didaktische Analysen, ed. Walter Bruchhausen and Hans-Georg Hofer, 39–57. Bonn: Bonn University Press.

    Google Scholar 

  • ———. 2010b. Pflege von Sterbenden im 19. Jahrhundert. Eine ethikgeschichtliche Annäherung. In Transformationen pflegerischen Handelns. Institutionelle Kontexte und soziale Praxis vom 19. bis zum 21. Jahrhundert, ed. Susanne Kreutzer, 87–107. Osnabrück: V&R unipress.

    Google Scholar 

  • ———. 2016. Todkrank. Sterbebegleitung im 19. Jahrhundert. Medizin, Krankenpflege und Religion. Göttingen: Wallstein.

    Google Scholar 

  • Oetheus, Jakob. 1574. Gründtlicher Bericht, Lehr unnd Instruction von rechtem und nutzlichem brauch der Artzney, den Gesunden Krancken und Kranckenpflegern […]. Dillingen: Sebald Mayer.

    Google Scholar 

  • Paradys, Nikolaus. 1796. Rede von Nikolaus Paradys, Professor in Leyden, über das, was die Arzneiwissenschaft vermag, den Tod leicht und schmerzlos zu machen. Neues Magazin für Aerzte 18: 560–72. (orig.: Oratio de euthanasia naturali et quid ad eam conciliandam medicina valeat, Leiden: H. Mostert 1794)

    Google Scholar 

  • Percival, Thomas. 1803. Medical ethics, or, a code of institutes and precepts, adapted to the professional conduct of physicians and surgeons. Manchester: J. Johnson/R. Bickenstaff.

    Google Scholar 

  • Puchelt, Friedrich August Benjamin. 1826. Umriss der allgemeinen Gesundheits-Krankheits- und Heilungslehre. Part 1. Heidelberg: Mohr.

    Google Scholar 

  • Putz, Franz Xaver. 1843. De euthanasia. Diss. med. Vienna: Überreuter.

    Google Scholar 

  • Richter, H.E. 1841. Euthanasia. In Encyklopädie der gesammten Medicin, ed. Carl Christian Schmidt, vol. 2, 363–367. Leipzig: Wigand.

    Google Scholar 

  • Saunders, Cicely. 1988. The evolution of the hospices. In The history of the management of pain: From early principles to present practice, ed. Ronald D. Mann, 167–178. London: Parthenon.

    Google Scholar 

  • Schaffrath, Heinrich Daniel. 1869. Die Euthanasie. Diss. med. Bonn: J. F. Carthaus.

    Google Scholar 

  • Schilling, Katharina. 2011. „Ach gib mir doch nur etwas Luft, Du hast der Luft so viel!” Pallativmedizin im frühen 19 . Jahrhundert. Cologne: WiKu-Verlag (= Diss. med., Würzburg 2010).

    Google Scholar 

  • Scholand, J.M. 1837. Der Menschenfreund, oder Anleitung zur zweckmäßigen Pflege und Behandlung der Kranken. Sterbenden, Todten und Scheintodten, sowie auch Gedanken zur Besiegung der Todesfurcht und des Schmerzes beim Ableben der Unsrigen. Part 2: Anleitung zur zweckmäßigen Pflege und Behandlung der Sterbenden, Gestorbenen u. Scheintodten. Magdeburg: W. Heinrichshofen.

    Google Scholar 

  • Snow, Herbert. 1890. The palliative treatment of incurable cancer. With an appendix on the use of the opium-pipe. Being a lecture delivered at the cancer hospital. London: Baillière, Tindall and Cox.

    Google Scholar 

  • Spender, John Kent. 1874. Therapeutic means for the relief of pain. London: Macmillan.

    Google Scholar 

  • Szabo, Jason. 2009. Incurable and intolerable. Chronic disease and slow death in 19th-century France. New Brunswick: Rutgers University Press.

    Google Scholar 

  • Vogel, [Dr.] […] von. 1834. Euthanasia. In Encyclopädisches Wörterbuch der medicinischen Wissenschaften, ed. D.W.H. Busch et al., vol. 11, 598–603. Berlin: Veit & Co.

    Google Scholar 

  • von Haller, Albrecht. 1923. Albrecht von Hallers Briefe an Johannes Gesner (1728−1777), ed. Henry E. Sigerist. Berlin: Weidmann.

    Google Scholar 

  • Wolfart, K. Chr. 1819. Betragen am Sterbebette. Jahrbücher für den Lebens-Magnetismus oder Neues Askläpieion 1 n 2: 59–63.

    Google Scholar 

  • Zach, Ignatius. 1792. De cura, quam moribundis debent, qui aegrotis sunt a ministerio. Apitz: Frankfurt an der Oder.

    Google Scholar 

  • Ziemssen, Wilhelm Ludwig. 1845. De euthanasia medica. Diss. med. Greifswald.

    Google Scholar 

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Stolberg, M. (2017). The Practice of Palliative Treatment. In: A History of Palliative Care, 1500-1970. Philosophy and Medicine, vol 123. Springer, Cham. https://doi.org/10.1007/978-3-319-54178-5_6

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