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Book-It Repertory Theatre

The following post was written by Treasure Island Assistant Director and Dramaturg Rebecca Fredrickson.

“I don’t know about treasure, but I’ll stake my wig there’s fever.” —Dr. Livesey

Treasure Island is known to be a story of pirates, treasure, and swashbuckling adventure. However, there is another thread running through the plot: sickness and disease. At the opening, we are told that Jim Hawkins’s father is bedridden of an unnamed illness, and other characters experience various maladies, including stroke, fever, and malaria. Fortunately, Dr. Livesey is on hand to treat Treasure Island‘s various sufferers. Unfortunately, medical understanding and methods at this point in history were almost totally unrecognizable compared to the sophisticated treatment we experience today.

Diagnostic methods were relatively primitive during the 18th century. For one thing, not all doctors were even trained at university; many were simply apprentices to apothecaries whose training consisted of packaging medicines for sale. For another, the stethoscope and other crucial diagnostic instruments were not invented until the 1850s. Doctoral diagnoses were based largely on the patient’s description of their own symptoms, which would only sometimes be supplemented by the doctor’s cursory observations of the patient’s eyes, pulse, and bodily excrements.

Even if an ailment was correctly diagnosed, treatment was not always effective. One common treatment method was bloodletting, a process during which a doctor would open a vein or artery and drain blood from a patient. According to 18th century medical theory, illness was a result of an internal imbalance or loss of harmony of bodily fluids. Bloodletting was an attempt to restore the internal equilibrium of the body. Unfortunately, being such an inexact science, bloodletting often left patients weaker and sicker than they were before.

Bloodletting was used as a treatment for a variety of ailments, including stroke. In the 18th century, ‘stroke’ was still considered an alternate word for ‘apoplexy,’ a term that was used to describe any sudden paralysis or loss of consciousness. The concept of a brain blockage was still half a century away, so stroke had to be explained by alternative means. Among the average lay citizen, stroke could be explained as an act of God’s displeasure. At the time, the explanation offered by doctors was hardly any more scientific. Medical writings of the time attribute stroke to excessive consumption of meat or alcohol, the sexual act, and even straining too hard while constipated. Toward the end of the 18th century, autopsies of stroke patients revealed bleeding in the brain, which led to the idea that high blood pressure could be a cause of stroke. Then, bloodletting was used by some doctors as a means of alleviating high blood pressure and treating stroke.

Even with these advances, the prognosis was not good for stroke patients. Without intervention to remove blockages and/or stop bleeds in the brain, the root causes of strokes were generally left untreated and untreatable. Furthermore, even if a patient did survive a stroke, there was the possibility of institutionalization because stroke patients were often regarded as mad. The same was true for other ailments. Because medical understanding was so limited, patients often died of diseases that are now considered completely treatable. Patients who survived ailments such as stroke, fever, or malaria would often live the rest of their lives in poor health or in madhouses. It is safe to say that being a patient of a doctor in the 1760s was not nearly as safe or hopeful as it is today.

Our thrilling adaptation of Treasure Island runs Nov 22-Dec 24. Click here for more information and tickets.