19th Century medicine: what’s with the blood-letting?

Anyone who reads pre-Twentieth Century literature or watches period films has come across an episode in which a character is ill and they are bled by their doctor.  I have been asked many times if doctors really did this, why they did it, and what it was supposed to do.  Indeed, bleeding, either by opening a vein or using leeches to suck out the blood, was a major treatment for a number of disorders before the second half of the 19th Century, when a massive wave of medical scientific discoveries completely changed the practice of medicine and the practice of bleeding gradually died out.  I posted a similar article on The Book Rat in June, 2011.

Medical science in England before the modern era was based on concepts first delineated by ancient Greek physicians, such as Hippocrates and Galen. These principles were distilled into the holistic medicine (treatment of the entire body or constitution) practiced in the Georgian and Regency Eras. Human health was a situation where the patient’s constitution was balanced between “weakness” and “plethora.” In modern use, the word plethora means “a large amount, or many,” but in medical terminology it meant an excess of  heat, blood, body fluids, etc.  Plethora was diagnosed in conditions where the patient became more red, warm or swollen,  and might include fevers, localized infections such as cellulitis (where affected areas of skin become red and swollen), inflammatory arthritis (such as gout), and pregnancy (where the skin is typically more pink and warm than usual because of the increased blood volume during pregnancy).  Weakness, on the other hand, was any condition that would make the patient paler, thinner or weaker: blood loss, fainting, chills, or wasting diseases.  Because physicians in the 18th and 19th Centuries did not do any surgical procedures (you could not be a gentleman if you worked with your hands), the actual blood-letting was done by surgeons.

The treatment of plethora included changes in diet to avoid anything which was thought to be “heating”, and generally meant anything red, rich or fatty, or stimulating. Foods to be avoided included red meat, eggs, spices, and “stimulants” such as wine, coffee, and tea. “Cooling” foods were encouraged, such as fruits and vegetables, and simply prepared white meats, such as chicken and fish, and bland foods such as gruel (a sort of runny cereal made by boiling oats or other grain in milk or water). In addition, physicians would take blood from patients to directly remove the “excess” blood that was engorging their bodies and causing them to be red and hot.  This treatment would be likely to help patients with gout, where there is an excess of uric acid in the blood (see my post on Gout).  This results in red, hot joints, most commonly in the big toe and the knee.

Fever was a common medical problem because of the lack of antibiotics and vaccinations (except for smallpox vaccination, which was widespread by the Regency Era).  With this theory of health and disease states, bleeding a patient who was hot and feverish to decrease the fever made perfect sense to pre-modern practitioners.  Ironically, blood-letting was often used after gunshot wounds to prevent a fever from the almost inevitable wound infection which resulted from having the ball and bits of clothing fibers implanted in the body.  One wonders how many gunshot accidents resulted in death because the surgeon finished off the patient after the bleeding from the wound stopped.

Pregnancy was considered to be a plethoric condition and women in this “interesting condition” were often given “cooling” diets to promote health. Because these would include plenty of fruits and vegetables, it would often improve constipation, which is common in pregnancy, and this  was taken as encouragement that the diet was working as it should.  Fortunately for the health of the patients and their infants, most women did not follow these diets as strictly as their physicians would have liked. Women who had a history of miscarriage or infertility would be more likely to rigorously follow the suggestions of their physician, and to change physicians if their condition did not improve to find one whose care they liked better.

Patients who were pale and weak, such those who were having chills in the early stages of a cold or who had wasting diseases such as tuberculosis, were encouraged to have a “heating” diet and could eat as much red meat and drink as much wine, especially red wine, as they wished to warm an overly cool and weakened constitution.  They would also be treated with heating treatments, such as mustard foot baths or mustard plasters to the chest. In this case, of course, blood-letting was not used.

So, infections such as malaria, bacterial wound infections, or influenza (all of which are characterized by fever) would be treated as plethora, while infections such as tuberculosis, which causes chronic cough and gradual wasting, would be treated as weakness.  People who were weakened by blood loss might be treated with blood-letting and fed with gruel rather than with red meat, which would help restore their iron stores needed to replace their blood loss.  Today, blood-letting is used to treat hemochromatosis (an inherited problem which causes the storage of too much iron, damaging the liver), polycythemia vera (excess red blood cell production, which can increase the risk of stroke), and porphyria.

Blood-letting shown in medieval illuminated manuscript

An interesting historical side note to this treatment was the condition of the Prince Regent and his father, King George III. The king is well known for the periods of insanity from which he suffered, which eventually became permanent and required that the Prince of Wales become Regent.  A number of medical historians believe that King George III suffered from a form of porphyria, an inherited disease in which the patient lacks one of the enzymes required to break down hemoglobin into smaller molecules which can then be excreted by the kidneys. The major symptoms of hereditary porphyrias are abdominal pain and psychiatric symptoms.  The treatment for porphyria, still used today, is to remove blood from patients on a regular basis until they are slightly anemic and thereby decrease the number of porphyrins in their blood.  This treatment is done at blood center and is just like donating blood, except that the blood removed is discarded. The Prince Regent had a long history of various types of illness, including frequent abdominal pain, and he was a great believer in blood-letting, having it done whenever he felt unwell. His symptoms might have been from his unrestrained eating and drinking, but if they were an indication of porphyria, his enthusiasm for having his blood let might have prevented him from developing the severe mental symptoms from which his father suffered.

The Dog Days of Summer

Muzzy and Mommy

Until a few years ago, my husband and I had always had small dogs, all of them less than 20 lbs. Over the years we discussed getting a large dog, but we were undecided what kind. We liked labs, but they seemed, somehow, very ordinary. We decided, finally, that what we would really like is a Newfoundland. If we were to go large, let us go GIANT! Besides, we like hairy dogs and what could be hairier than a dog which looks like a bear?

Then, six years ago an acquaintance had a litter of Newf puppies. We decided the time was right- we have a big fenced yard and a house with enough room to move around, even with a dog as big as a full-grown human. I picked out a black male from the litter and brought him home July third of 2005. He was 10 weeks old and as big as a cocker spaniel. We decided to name him Muzzy after a gigantic, hairy alien in the BBC Language Course (he introduces himself by saying, “Hi, I’m Muzzy…BIG Muzzy”) When we arrive home I put him in the back yard and went in the house for a few minutes. When I returned, he was lying underneath the sprinkler, letting the water flow back and forth across him. Yep. He was definitely a Newf.

My three beasts...

Our other dog, a Yorkie named Kai, was used to being in a multi-pet family and had no problem adding to the pack. However, Kai, who is definitely the leader of the dog pack, gradually began to realize that this newcomer was going to be a problem. Muzzy is a very submissive dog and he accepted that Kai was the boss, but as the disparity in their sizes became greater and greater their relationship altered a little. Muzzy would lay flat on the floor so Kai could stand on his hind legs and put his paws on the top of Muzzy’s head and lick his face, showing that he was the boss. However, when Muzzy, still a puppy, wanted to play, he could easily knock Kai over in his exuberance and physically Kai could not dominate him. One time, he playfully picked up Kai by the long hair on his back (needless to say, we jumped in to rescue him!). Kai made good use of hidey-holes such as behind the couch to escape when Muzzy got too carried away when playing.

During the first two years of his life, we kept Muzzy gated into our kitchen/family room area to prevent chewing and housebreaking problems (which didn’t occur…) and Kai would take advantage of this and show his power by stealing Muzzy’s chewbones, jumping over the gate and then hiding them in the living room. He also ate Muzzy’s food, even though he had to stand up on his hind legs as high as he could to reach his head into the raised dish where the food was. (He still does this). In general, Muzzy will politely sit there and wait for him to finish. On a few rare occasions he has become annoyed with the little pipsqueak for stealing his food and lets out what can only be described as a roar and goes after him, sending the humans in the room into scrambling mode.

Don’t get the idea that Kai was just a “taker” in this relationship. He taught Muzzy to bark at animals outside in the woods. First, Kai would bark like a maniac at a deer. Next time, Muzzy would run up an look at Kai when he barked. The time after that, Muzzy ran up and started barking at Kai. Finally, Muzzy realized that Kai was barking at something and looked out the window so he could bark too. We were so appreciative of Kai for this help training his brother!

Muzzy and Mommy

Last year I thought I would take some more author photos while my photographer friend was visiting and I thought it would be fun to put the dogs in the photo. The entire time of the shoot Kai was racing around, jumping up to lick Muzzy’s face, leaping off my lap, jumping in the air to look at the camera…well, you get the idea. Finally, I clamped Kai between my ankles and we got a great photo with Muzzy (160 lbs) lying nobly with his gigantic paws crossed next to me. When you see this serene photo, think of Kai, all 8 lbs of him, wiggling to get free from between my clamped ankles while the photo was shot.

Why Jane Austen?

Welcome visitors to Austenesque Extravaganza Touring Thursday!

I began my journey as an Austenesque writer in 2006 when my eldest child left for college. No more swim meets, no more tennis tournaments, no more musicals, no more plays, no more Debate tournaments…well, you get the idea! I still had one child at home but he is severely autistic and was not in all the extracurricular activities that my eldest was, and he also went to bed very early (still does…). I had been leery about buying Austen sequels and retellings because I did not know which ones to choose- there were so many! I finally decided to buy Pamela Aiden’s Fitzwilliam Darcy Trilogy and promptly sank into the joy of learning more about my favorite Austen hero.

After reading this now classic work a couple of times I realized that I had my own ideas about where the story would go after the end of Pride and Prejudice and they had been release by reading Ms. Aiden’s book. I took my laptop into my elder son’s now unused bedroom and started writing. I didn’t tell anyone that I was doing this- I did not want to talk about it until I was sure that I would be able to hang on writing until the end of the story. My husband is a fanatical tennis player and plays almost every day, and I work part-time, so I would only write when he was at work or tennis and I would stop when I heard the garage door open. Yes, it is rather like the behavior of an addict hiding her needles!

I finally neared the end of the manuscript and had discussed publishing options with my friend Lauren Small (author of Choke Creek) and decided that self-publishing was my best option. I looked at the self-publishing houses and picked iUniverse because it is a subsidiary of Barnes and Noble so I thought that it would probably not go into bankruptcy while I was working with them. At this point I was going to commit to paying some significant money for publication, so I thought I should tell my husband.

We have a regular “date” on Tuesday evenings, so after we finished eating dinner I cleared my throat and said, “There is something I need to tell you.” His eyebrows rose at this (I don’t even want to know what his first thoughts might have been at this statement!). I told him that I had written a sequel to Pride and Prejudice and was going to publish it. For about 30 seconds he stared at me with his mouth slightly agape, then he said, “You know, you just might be able to sell that.” He has had more reminders than he would ever choose to have about the popularity of Jane Austen, so the topic was not a surprise to him, but I was pleased to see that I had succeeded in taking him aback- not an easy thing to do with an eye surgeon who has seen pretty much everything.

I went on to publish with iUniverse, buying the editing services that I thought I needed with this first attempt. I titled it And This Our Life: Chronicles of the Darcy Family from one of my favorite Shakespeare quotations and had a photographer friend take the cover photo. The cover model is the daughter of my minister, who I saw in church one day (when I should have been listening to the sermon…) with her hair up, and I realized that she was the epitome of Georgiana Darcy in my mind. I called her to see if she would model for the cover and, at the end of the call, said, “Don’t worry about the clothes.” Fortunately, she knows me well enough to trust that I was not wanting nude or porn pictures…I sewed a Regency gown and the photographer and I did her hair and accessories and took about 300 pictures with a black background. We picked one with her looking down and holding a fan I brought back from a trip to China and iUniverse used it for the cover. Apparently they liked the black background because they kept it and I loved the look, however, I later noticed that just about every new book I saw had a black cover…oh, well.

Several months later I was contacted by an agent who was looking for Jane Austen-related titles and I signed with him and sold the book to Sourcebooks. They wanted a rewrite to change the point-of-view to Georgiana’s and I liked the idea, so spent 3 weeks completely rewriting the book, recycling some scenes and creating new ones for the rest, while I waited for them to decide if they wanted to buy it. They took the rewrite without significant further changes, and Mr. Darcy’s Little Sister was born.

The future? Well, I have several more Austen related stories I would like to tell, as well as some other historical fiction and a modern suspense series. I confess that I still love the Regency Era as it is unique and not well known, in spite of the amazing things that happened during that short period in history. So many books and so little time…

Interview with Jennifer Becton

Author Jennifer Becton

Today I am interviewing Jennifer Becton, hot new author, whose latest book, Absolute Liability, is now in the top 100 in sales on Amazon’s Kindle Store.

Carey:   Jennifer, I know you have also published a Jane Austen sequel about Charlotte Collins, what else have you written?

Jennifer:  Until I published Charlotte Collins, I had written primarily nonfiction articles for various regional publications. These articles fell into one of two categories: Southern lifestyle or equestrian. So writing an Austen sequel was a big departure from my other published work. In addition to Charlotte, I have also attempted one piece of literary fiction, which is in dire need of major rewrites or perhaps dynamite, and I have completed two other novels: Absolute Liability (A Southern Fraud Thriller) and Caroline Bingley, another Austen sequel that will be out in early September 2011. I also have one short story available: “Maria Lucas.”

Carey: Dynamite, now that’s something I have never tried when my plot was struggling!  Tell me, why did you start your own publishing company?

Charlotte Collins, 2010

Jennifer:  I have worked for thirteen years in the traditional publishing industry as a proofreader and editor, so when I decided to pursue publication of Charlotte Collins, I went the traditional route: querying agents and publishers. One publisher liked the book, but said she thought the market for Austen’s minor characters was too small. I disagreed, of course, and she said that if I could prove there was a market by selling 1,000 copies, she would reconsider. So I began my own publishing company—Whiteley Press—and published my own book using the traditional methods I’d learned through my work. Charlotte sold the required number of copies in slightly more than four months, but the publisher still declined on the basis of market size. This rejection turned out to be a great benefit to me because I loved publishing so much that I decided to continue with Whiteley Press and have since sold more than 10,000 books, and in the future, I plan to add anthologies and nonfiction to my self-published catalogue.

Carey:   You are the goddess of internet promotion. How much time do you spend online everyday promoting your books?

Jennifer:  Goddess of internet promotion? I don’t know about that, but depending on my writing schedule, I devote between two and eight hours each day to marketing. This includes social media, interviews, website creation, and blogging. My techniques don’t resemble traditional marketing. I do not use any print ads, bookmarks, or commercials; I do buy ad space at pertinent websites occasionally. Most of my marketing is done simply by making friends through social media, like Facebook, Twitter, and Google+. I don’t get out there and sell, sell, sell; I talk to people and hope they become interested in my books.

Absolute Liability, 2011

Carey:   Why did you set Absolute Liability in the area of insurance fraud?  Do you have experience in the insurance industry that you were able to use?

Jennifer:  Insurance fraud is not exactly a popular topic, is it? But when I contemplated writing a mystery, I neither wanted to write a cozy, in which a non-police person has to solve a crime, nor a police procedural, in which I was required to follow law enforcement protocols to the letter. My main character had to be a professional law enforcement official, but not one of the usual type; I wanted her to be unique. In addition, I wanted to incorporate funny criminals with my more dangerous ones. And in my research, some of the most ridiculous crimes were insurance-fraud related. I do not have professional insurance experience, but my in-laws do run an independent insurance agency, so I have sources to consult on the minutia of the industry.

Carey:  That’s a clever idea- it is hard to reinvent the wheel when it comes to mystery/suspense books.  What other types of books are you interested in writing?

Jennifer:  I’ve always wanted to write a spy novel, and I’m in the research phases now. And of course that’s a difficulty in itself. How does one learn about secret organizations? I’m spying on spies.

Carey:  Hope we are not going to be seeing you on CNN for stalking CIA agents…What do you like to read?

Jennifer:  I go through phases. For a while, I read a lot of Regency novels, especially Jane Austen. Then, I read vampire novels and comedic mysteries, but I’ve moved on and am currently reading The Fountainhead by Ayn Rand. I may try sci-fi or fantasy next.

Carey:  That’s quite an eclectic mix!  Do you prefer to read paper or electronic books?

Maria Lucas, 2011

Jennifer:  I enjoy both. I own a Kindle and love it more than I expected. The e-ink screen is non-reflective and easy on the eyes, and the device is convenient and effortless to hold. I still buy paperbacks and enjoy those too. I’ve never been a fan of hardcover books because they are so difficult to keep open, hold, and transport, so I’d probably buy an e-book over a hardback, but it’s a toss-up between paperbacks and e-books for me.

Carey:  That sounds exactly like my feelings about my Kindle- I like it more than I expect.  I never thought I would be and electronic reader, but it is easy on the eyes…and when you get to be my age mass market paperbacks have print that is way too small!    Any advice for those promoting their own books?

Jennifer:   Make friends. That’s the best advice I can give on the subject of social media marketing. A great deal of what I do online looks like I’m wasting time and chatting with people. I am chatting, but it’s not a waste of time. It’s marketing. Social media marketing is about developing relationships, not putting the hard-sell on people. I try to make 80 percent of my social media posts personal and only 20 percent direct marketing. This results in the cultivation of a passionate group of friends and fans who will tell their friends about your books and whose books (or products) you will want to promote in return. And it’s just plain fun.

Carey:  Sounds like great advice, Jennifer.  Thanks for coming and sharing your insights with us, and I hope Absolute Liability keeps going to number 1!

You can find out more about Jennifer Becton at her blog,   or at Austen Authors.   She is also on Twitter, Facebook, and Google +

Words of the day: fichu, chemisette and fraise

Elizabeth Huntington wearing a fichu, by Simon Fitch (Huntington Museum)

Fichu:  (French) From the past participle of ficher, to fix.  Indicates a light-weight kerchief folded into a triangle and fixed either with a knot or pin in the front (think a very small, triangular shawl).  Alternatively, it could be tucked into the bodice of the gown.  Used to hide excessive décolleté  in day gowns and to keep the neck and chest warm in cold weather as well as for decorative purposes.  Fichus were made of linen, silk or lace and could be decorated with lace or embroidery.  In Pride and Prejudice 1995 Jane Bennet (played by Susannah Harker) frequently wore fichus.

Countess Bucquoi wearing a chemisette, 1793, by Marie Louise Elisabeth Vigée-LeBrun

A similar article of clothing would be the chemisette (French, diminutive for shirt, “little shirt”), a partial shirt (with or without a collar) worn under a gown and tied under the bodice (at the waistline of Regency and Empire gowns) to keep it in place.  Also known as a tucker in England.  This article of clothing served the same purpose as the fichu: to fill in a low bodice for a more modest or decorative daytime look.

The chemisette was not the same as a chemise (French: shirt), which was an article of underclothing; a loose shirt worn under stays.  The purpose of the chemise was comfort and to keep the outer clothing free of perspiration.   It was a simple garment shaped like a T with short sleeves, underarm gussets for free movement, and a simple drawstring neckline which could be adjusted as needed for the bodice of the outer gown.

Lady Elgin wearing a fraise over a chemisette, 1804, by François Gérard

The last neckline decoration worn in the 18th and 19th Centuries which I want to mention was the fraise (French (archaic): neck ruff).  The modern meaning of fraise is “strawberry” but the original meaning was an embankment for protection from attack (i.e. rampart).  The same term would have been used for the rigid ruffs worn in the 16th Century, but the Georgian and Regency version was made of several soft layers of lace which came up high on the neck.  They were most popular with older women, who liked the way the fraise would disguise a double chin.

Teamwork: Part II

Today I welcome back Erica McFarland and Jennifer DeWoody, better known to Twitter followers as “Regency Ladies.”

Carey:   Let’s go into some of your inspirations for your writing…Are you fans of Jane Austen?  Georgette Heyer? Other Regency historical fiction?

Erica: My Jane Austen addiction started in ninth grade, on a summer vacation to Florida (my current residence).  I found Emma in a bookstore, and from there on, I was hooked.  I’ve slowly made my way through almost all her works, with only Mansfield Park still outstanding.  For me, Austen has come to mean a quiet, comfortable place, almost like home.  I know that when I read her books, there will not be graphic details, that the stories will be poignant and romantic.  There’s something about the simplicity of her writing that really resonates with me.

Inspired by Austen, I studied British literature when getting my undergrad in writing.  I read Eliot, Collins, Dickens, and then studied the Romantic poets with avidity.  I started to read Georgette Heyer when I embarked on my first regency writing project.  She had come up in so many of my reference materials as the undisputed “Queen of Regency.”  I’ve only read about six of her novels so far, but I’m absolutely in love.  She has definitely been formative for me in my writing of regency.

Jenny:Yes, yes and yes.  I am an Anglophile at heart.  I have recently finished Regency Buck by Georgette Heyer, an author that Erica actually introduced me to, encouraging me to read several of her works.  I find that I really enjoy immersing myself in Heyer’s style and wit.  She has a way of setting a scene that paints it so vividly in the reader’s mind that it almost feels as if you are in the room with her characters.  Her attention to detail, I think is something that Erica and I are really striving to emulate in our own writing.

As for Jane Austen, she is and always will be one of my favorites.  Pride and Prejudice is the novel I credit with introducing me to my love of reading and for that reason alone it will always hold a position of great import in my heart.  Austen’s style, like Heyer’s after her, is very entrenching, and I think her characters and the way she portrayed societal interactions is something any self-respecting lover of the genre and the historical era would cherish.

Carey:   Do you have a timeline for your current collaboration?

Jenny: I think we have bandied about the idea of trying to get a working draft, that is a fully functioning, readable draft completed in a year and considering the progress we’ve made in just a few short months I think even this goal may prove to be conservative.

Erica: While this is not my first attempt at historical fiction, it’s the first time I’ve really embarked on a project of this magnitude.  My first novel attempt was simply that, an attempt.  We both come from a freewriting background with historical fiction, so this has been a learning experience for us to try and formalize our thoughts in a coherent book.

We are about half-way through our first draft now.  We’ve gotten to the point now where we’ve become so familiar with these characters that they are second nature, and I think that’s starting to really show in our prose.  Chapters are becoming longer, and we’re tweaking our basic outline as we continue to find new ways to make the story more effective.  We hope that by next July we would be able to have a marketable product, either to send to agents in hopes of going the traditional route, or for self-publishing.

Carey:   What other writing have each of you done?

Erica: Since about the fourth grade, I’ve known that I wanted to be a writer.  I went to school for writing, so during that time I wrote for the University of Tampa’s newspaper and their literary journal.  Post-graduation, I’ve been a prize winner in a few local writing contests for fiction.  My most recent foray into journalism has been with a magazine in my town called Pulse, which focuses on creative nonfiction with an upbeat take.  Most of my experience outside of fiction comes from opinion pieces, so this new brush with magazine writing has been interesting.  I also run a blog called Hello Writer, and do some freelancing.

Jenny: I am still somewhat of a novice when it comes to writing.  For the past two years or so I have been heavily involved in a play-by-post, Victorian Era game called Era of Elegance.  Most of my writing has been done within the construct of that game, as it has been a great exercise in the creation and development of characters, which for me are always the heart of every story.

Carey:  What do you do in “real life” and how long have you known each other?

Erica: For the past three years, I have been employed as a secretary for a Trust Department.  I take down dictation and format business correspondence, while dabbling in basic graphic design for our marketing materials.  I’ve learned a lot about technical writing through this job, and I do appreciate the opportunities it presents to refine my style.  But I consider myself to be most importantly, a writer. Jenny and I have known each other since about April of 2011, but it feels like much longer.

Jenny: In real life I am a barista at Caribou Coffee, where I have worked for almost a year now and before that I worked as a bookseller and barista for Books-A-Million.  I have only recently begun to identify myself as a writer and this new way of thinking has lent me a great purpose to my life, for which I am eternally indebted to Erica as she is the one that really made me realize that being a writer is something that I very seriously wanted to pursue.

Carey:   So, Jenny, I assume that your writing is fueled by coffee!  Diet Mountain Dew is my stimulant of choice.  Where can we see more of you? Facebook? Twitter? Blog? Website?

Jenny: Together, we have a twitter account: we are Erica and Jenny @Regencyladies.  We also have just started a blog which can be found at: http://hellowriter.org/rl/.

Erica: I can also be reached through Facebook at http://facebook.com/HelloWriterCo and through my website of hellowriter.org, which features my personal blog as well. Jenny and I are in constant contact, so we send any information we receive to each other.

Thanks Ladies!  I think I would be more productive if I had a writing partner waiting for me to finish my part, although it would be important to find the right (write?) person.  Best of luck, Regency Ladies!

Teamwork: an interview with Regency Ladies, Part I

Today I am interviewing Erica McFarland and Jennifer DeWoody, a pair of writers who have joined forces to write their first Regency novel, styling themselves “Regency Ladies” on Twitter.  Although they have not yet published together, I think their story is interesting for writers (and wannabe writers).

Carey: How long have the two of you been Regency Ladies?

Erica: We have been writing together since about mid-April, when I finally relented and joined a friend’s historical game.  I liked Jenny’s writing style, so I hunted her down on the game and from there, we started to develop different storylines.  When we started to develop the plotline for the characters used now in our novel, I realized that it had a lot of potential and could become something more.  I petitioned Jenny and asked if she’d want to start this project with me, terribly hopeful of course that she’d say yes.  She did, and the rest as they say, is history.

Jenny: I believe the Regency Ladies moniker got its start as early as the beginning of July when we opened up our joint twitter account, which Erica then promptly ran away with, but in our hearts I believe we have always been Regency Ladies, or if not with the capital letters at the very least, Regency ladies.

Carey:    What made you decide to write together?

Jenny: I think, at the heart of the matter is our shared love of the history of the era, our love of reading the works produced both in that era and of that era.  It also helps that we met on a Victorian Era role playing game and hit it off famously from the start, I believe. We found, through the process of plotting and writing in that game that our styles complimented each other nicely and that we worked well together, our temperaments suiting in such a way that it almost seemed destined that we embark on such a journey together.

Erica: As Jenny said, we bounce off each other very well. She’s pretty mellow, while I’m an extrovert with a tendency toward sap.  We’ve managed to achieve a balance in our working relationship that really helps us to keep up the fast pace we’ve set for this first draft.  I think one of the most important things in doing a project like this with someone else is that there is an element of trust.  With Jenny, I know that I can always count on her; not only to carry through with the writing in a timely manner, but to support me as a person and give me her honest opinion.  It’s that faith we have in each other, I think, that makes us such good partners.

Carey:   Why did you pick the Regency Era?

Jenny: I think a large part of why we picked the Regency Era is that it is a time period so rich in culture and beauty and decadence as well as intrigue and politics that there is a wealth of topics that as a writer it is fun to explore.  The way the people related to each other and the strict societal paradigms that were constructed have always been fascinating to me. And it has always been a point of interest to me to analyze and pick apart the way people interacted with each other whether it be member of the ton at a grand society ball or the interaction between a nobleman and a servant, as a surveyor of human nature in general the era lends itself to some very interesting as well as entertaining and thought provoking study.  Plus, Erica had already done an obscene amount of research on the era and is a veritable history buff when it comes to all things Regency.  That, and as Erica will attest, the dresses were pretty.

Erica: The dresses are pretty, indeed!  I am a self-confessed fashion addict, and so I gravitated toward the regency era because of the real elegance to the costumes and just the entire style of being.  The concept of dandies and debutantes fascinates me, and I love the idea of being able to make those kinds of characters come to live for a generation of readers entrenched in the twenty-first century.  Like Jenny, I enjoy dissecting the different interactions between the  social spectrums; we cover this a lot in our novel, as our hero is a commoner and our heroine the daughter of a Baroness.  While my fondness for this era stemmed from my love for Jane Austen, I’ve found that I truly enjoy researching all the different aspects of life.  I think the constrictions of the period help to give me structure in writing, in contrast to my previous work in science fiction and fantasy where the world was entirely of my creation.  The dialogue of this era has always felt very rich to me, and as a writer I aim to mimic that.

Carey:  Besides, you don’t have to wear a corset in the Regency…always a plus!  Thanks Jennifer and Erica and we will see the rest of the interview tomorrow!

Word of the Day: aigrette

Snowy egret (photo courtesy Karen Gallagher)Aigrette: (French) egret or silver heron

Aigrette: (French) egret or silver heron

An aigrette was a popular ornament for hats (men’s and women’s) or women’s hair in the 19th Century.  Often fashioned with a lace or ribbon piece attached to a fastener to hold the egret plume to the hat or hairdo, the term aigrette later was used to also refer to a similar decorative piece of jewelry, often set with diamonds or other gemstones.

Egret is a general term used for a number of species of white heron, and egrets can be found in tropical climates all over the world.  Like other herons, egrets have an s-curved neck and fly with their head pulled back onto their back (rather than “craned” out straight like a crane).  They live near water and catch their food by standing and wading in the water, spearing their prey with their beaks.  They will eat any type of fish, or other water-dwelling animals which are small enough to swallow whole.

Great Egret contour feather (top) and breeding plume (bottom). Photo courtesy of Karen Gallagher

Unfortunately for the egret, during the breeding season they develop long, wispy feathers in a crest on their head and neck, and it is these feathers that were considered desirable for decoration.  During the second half of the 19th Century and early 20th Century hunters by the thousands invaded the wetlands of the southern US for these birds and egrets were hunted to the brink of extinction to obtain these fashionable accessories.  Stringent protection has brought the egret back and is one of the great success stories of the Endangered Species Act.

GF Handel: a Georgian anecdote

George Friedrich Handel, 1749

George Friederich Handel (1685-1759) was a Baroque composer contemporary with Bach and Scarlatti.  He was of German extraction and in 1710 was named Kapellmeister (basically, court composer) to Prince George, the Elector of Hanover.  He worked for the Elector two years and then asked his sponsor if he would allow him to go to London.  The prince said yes, but that he must return after his visit.  Instead of returning, Handel stayed in England and became the court composer for Queen Anne.

Two years later, Prince George became King George I of England.  Handel was in a serious quandary.  Fortunately for his career, he wrote the beautiful Water Music and George forgave him.

King George I, 1706

George I ruled both England and the Electorate of Hanover until his death in 1727, spending about half of his time in each of his kingdoms.  He never learned to speak English, but began the Georgian Era which continued until 1811, when the Regency Era began with the Regency of Prince George, later George IV.  The descendants of the house of Hanover continue to rule England.

This tale is from an audio course on How to Listen to and Understand Great Music, taught by the lively and funny Robert Greenberg and sold by The Teaching Company, which I highly recommend for anyone with an interest in music.

Gout: From the 19th Century to the 21st Century

1799 caricature of gout by James Gillray

Gout is a metabolic problem that was very common throughout history and is mentioned in many historical novels (it is a great excuse for a grouchy personality if needed in a story).  The first known description was in Egypt in 2,600 BC, and it was well described by Hippocrates in ancient Greece, about 400 BC.  The uric acid crystals which are the cause of gout were first seen in 1679 by Dutch scientist Antonie van Leeuwenhoek.

This painful disease is caused by the buildup of uric acid crystals in  a joint, the base of the big toe (called podagra) being involved more than 50% of the time.  Other joints may also be affected, such as in the hands, elbows and knees, and other tissues can also be affected.  Uric acid crystals can deposit in the skin (gouty tophi), kidneys, tendons and other tissues.  High fever can also be associated with this problem.  The uric acid build up is caused by decrease in the breakdown of uric acid because of an enzyme deficiency, or increase in production because of dietary factors; in fact genetics and diet are both important factors for most people with clinical gout.  It has been known through history as “rich man’s disease” and “the king’s disease” because until the Twentieth Century only the wealthy ate enough of the foods that cause it.

Very simply, when uric acid crystallizes in joints, an immune response occurs and the subsequent inflammation makes for a hot, red joint.  Cold seems to be one of the precipitating factors, which might explain why it tends to involve the extremities such as toes and fingers and tends to begin at night.  The most common mimic of gout is septic arthritic (and infected joint), which a physician would suspect if the presumed gout does not respond to treatment.

In the Regency Era:

Physicians were aware that gout was caused by over-indulgence in elderly men and it was thought that red meat, rich food, and red wine, especially port wine, caused flares of gout.  Treatment of an acute gout attack included keeping the painful foot bandaged and elevated.  Bleeding or leeching would be used to decrease the inflammation and laudanum (tincture of opium) would be used for pain.  Various other treatments, such as soaking in mineral baths at spas such as those in Bath, England, as well as drinking the mineral water in the Pump Room were held to be helpful.  An acute attack of gout will resolve on its own in 5 to 7 days, so every physician has his own regimen that he felt worked, but none of these treatments, except dietary restriction, made a difference in the long term incidence of recurrent arthritis.

In the 21st century:

Modern medical science has learned that the precipitating factors for people predisposed to gout (which is most common in those with metabolic syndrome:  abdominal fat, type  diabetes, high blood lipids, and high blood pressure). The incidence of gout has doubled in the past twenty years, along with an increase in obesity and metabolic syndrome.  It is still more common in older men as well as post-menopausal women.

A patient who comes in with a red, hot joint will be evaluated with a blood test for blood uric acid levels.  If the patient clinically fits the diagnosis of gout, and the blood level of uric acid is high, then the diagnosis is made.  Unfortunately, half of patients with gout have normal uric acid levels, and other blood tests, such as the white blood cell count and sedimentation rate will be elevated for both gout and septic arthritis.  In these cases, a sample of synovial fluid (the fluid inside the joint space) is removed and examined microscopically for uric acid crystals (gout) or for bacteria (septic arthritis).

Treatment for the acute attack of gout is geared towards decreasing inflammation with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, corticosteroids such as prednisone, or colchicine.  Pain relievers may be used to help get the patient through the acute attack.

Prevention is the crux of treatment for gout, because a patient who has had an episode has a high risk of having it recur, as well as having the risks of kidney and skin problems.  Patients should avoid drugs which can precipitate gout, such as aspirin, hydrochlorothiazide (a diuretic commonly used for hypertension), and long-term immunosuppressive drugs such as cyclosporine and tacrolimus (commonly used to prevent rejection after organ transplant).  Diet should avoid meat, fish, fructose, and alcohol.

Long-term drug treatment for those who have recurrent gout attacks include medications which inhibit the enzyme xanthine oxidase and thus decrease uric acid levels, or those which increase the amount of uric acid excreted by the kidneys. The choice of medications depends on how much uric acid the kidneys are removing, determined by a 24-your urine collection.  These drugs are generally not started until 2 weeks after the last acute attack because of a risk of worsening the attack.