A Ph.D. thesis highlights the most notable cases treated in Bilbao hospitals a century ago
Mr José Carrasco, the first Head of Surgery at the Basurto Hospital (Bilbao), took notes on cases treated during his professional career. With these notes, Mr Jesús María Careaga has given us a picture of medicine and illnesses in industrial revolution Bilbao when he defended his PhD thesis at the University of the Basque Country (UPV/EHU).
Jesús María Careaga's PhD is entitled Dr. Carrasco and the surgical clinic in the Bilbao Hospital a century ago. Dr Careaga is currently Head of the Dermatology Service at the Hospital, located in the neighbourhood of Basurto. Doctor José Carrasco was, in fact, the very first Head of Surgery at the Basurto Hospital, and Dr Careaga has investigated his professional career.
Doctor Carrasco arrived in Bilbao in 1884 to work as senior surgeon at the Hospital de los Santos Juanes in the Atxuri neighbourhood of the Basque city and, in 1908 transferred to Basurto Hospital, just when the former closed and the latter began to receive patients. He left the results of his work reflected in four hand-written volumes entitled Thirty years of surgical practice at the Civil Hospital of Bilbao. Gallery of clinical sketches. Dr Careaga has based his PhD thesis mainly on these notes.
Dynamite, one of the worst enemies
According to this researcher and based on 670 cases taken from these volumes of notes, injuries to the limbs, bones and head occupied a considerable part of the medical work at the time. Surgeons at the time carried out trepanation (making a hole in the cranium) and incision in the damaged part of the brain, as well as amputations. As a consequence, a great number of patients ended up as beggars on the street. As Dr Careaga explained, Doctor Carrasco was very affected by the terrible effects of dynamite on miners and quarry workers. Also highlighted in the study is the abundant number of cases of tuberculous processes. In the XIX century it was difficult to make exact diagnoses of this illness, not having access to Roentgen (X) rays. This work of the doctors at Basurto became much easier when radiography was finally implemented - during the final years of Doctor Carrasco's career there. Leg ulcers were also very frequent and not of vascular aetiology, as the PhD thesis shows. In order to cure these ulcers, potassium iodate was administered, followed by Gibert's syrup, given the syphilitic nature of the patients.
However, other, much more currently common illnesses had hardly any recorded incidence a hundred years ago. For example, as Dr Careaga explains, only one case of anthrax and two of melanoma were treated in Doctor Carrasco's time, due to the fact that people were not so exposed to the sun's rays.
The thesis also highlights that the influence of quack healers at the time was very harmful. In fact, operations were delayed due to the trust the public had in quack healers.
Life expectation of 25 years
Apart from outlining the most common illnesses in Bilbao at the end of the XIX century, Dr Careaga specified in his PhD thesis the context in which these developed, in order to better understand why they arose. He has reminded us that, as a result of the industrial revolution of that period, while Bilbao had a prosperous future and an extraordinarily high increase in population and rate of immigration, the average life expectancy was only about 25 years. As a consequence of overcrowding and unsanitary conditions in certain areas, illnesses transmitted through infected water and air were very common, causing mortality rates to soar. Effectively, respiratory affections were the major cause of deaths.
Dr Careaga highlighted this context as conditioning the work of Doctor Carrasco and the other doctors of the period, as well as the decisions of the local authorities. In fact, in his thesis he underlines the fact that high-risk and high-cost decisions had to be made, such as the construction of Basurto Hospital itself.
Provided by Elhuyar Fundazioa
