By Barbara Barrett

Tuberculosis Operations

On December 5, 1935, REH wrote to H. P. Lovecraft about his mother’s condition:

About the middle of November my mother’s health became so poor we took her to the Torbett Sanatorium in Marlin, Texas, where more than a gallon of fluid was drawn off her pleura. She stayed at Marlin two weeks. (Roehm REH Letters 3-388)

Just a few months later, in another letter to HPL, dated February 11, 1936, REH again discusses his mother’s illness and her trips to the hospital.

After our return from Marlin we stayed at home for about two weeks, and then my mother’s pleura filled again, and we took her to a hospital in San Angelo, 105 miles southwest of Cross Plains… Her condition is very bad and she requires frequent aspirations, which are painful, weakening and dangerous. (Roehm REH Letters 3-415)

The difficulties of removing fluid from the pleura is confirmed when Novalyne asks REH if the operation on his mother was successful.

He shook his head. “She’s suffered so much…and she has tried to keep it from interfering with my life. She’s very brave.” (Price Ellis 194)

From the descriptions given by REH in his letters, the types of operations that Hester underwent were the painful aspirations and perhaps the Artificial Pneumothorax (Lung Collapse Therapy) which by the mid-1930s had become a more popular solution for pulmonary TB. And, if the symptoms of tuberculosis were difficult to read, some of the procedures performed on TB patients are straight out of one of REH’s horror stories.


The aspirator, a needle and pump-syringe device for drawing off fluid or gas by suction, was also popular. According to a sarcastic observer in the Medical Record, “The aspirator replaced the stethoscope as the medical novelty of the day.” (Ott 26) With aspiration, physicians cautiously began to explore treatments actually inside body cavities. The limitation of thoracentesis (a procedure to remove fluid from the space between the lining of the outside of the lungs—pleura—and the wall of the chest) was that it was directed at the secondary effects of already established disease processes. Thoracentesis was not preventive; it was a fix but not a cure. There were interesting ethical debates about when and how often to aspirate the chest…By the 1890s advocates of thoracentesis generally agreed that in cases of empyema (inflammation with pus) one should aspirate as early as possible…(Ott 66)

Artificial Pneumothorax (Lung Collapse Therapy)

This procedure was based on the work of Robert Koch whose research concluded that the “tubercle bacillus was a strict aerobe: it could survive but not grow and multiply without a generous supply of oxygen. Operations were aimed at resting the affected lung or lungs by reducing the patient’s ability to take a full breath” (Ryan 28):

Because the two pleural sacs enclosing the two lungs do not communicate with each other, one whole lung can be collapsed, without affecting the other, by repeatedly injecting air into the potential cavity between the lungs and the chest wall. (Dormandy 250) This was the oldest and most common of the operations. Some patients promptly felt better, lost their fever and coughed less and the tubercle bacilli disappeared from their sputum. No longer a hazard, the patient could recover at home or return to work. The lung was kept in semi-collapsed position by weekly or biweekly refills. This procedure was not for patients with scar tissue that prevented the collapse. Complications included infection, coughing up blood, and even sudden death. (Bates 286) The rationale for this operation is that if rest benefited the patient, it would also benefit the lung. (Ott 95)

The Artificial Pneumothorax procedure required weekly or biweekly refills and hospitals equipped to do this were quite a distance away. However, Hester could have undergone these treatments during one of her hospital or sanitarium stays.

In the letters above, REH mentions taking his mother to Marlin for aspirations and then when she needed another in two weeks, they took her to San Angelo where she stayed for six weeks.

If she was receiving the Artificial Pneumothorax procedure, this would have been the routine Hester endured. Patients were given morphine the night before.

[T]heir chest was pierced under local anesthesia, usually Novocain. In Hungary, Arpad Toth, the consumptive poet who had the treatment in the early 1930s wrote that though the needle prick in the skin did not hurt and the morphine had in any case induced a happily drowsy state, the needle entering the pleura felt like being kicked by a mule: “There was a crunch, a stab and a prayer, O God, let me die quickly. The real pain began a few hours later (after the anesthetic had worn off and the operator had departed.) It was sharp and unresponsive to drugs and kept patients awake. (Dormandy 261)

And if the pain and suffering from one of these treatments wasn’t enough, according to REH’s letters Hester had several aspirations done over a period of two or more weeks.

Although aspirations became a common procedure for TB, they weren’t without risks

The technique was both dangerous and painful. Many things could go wrong including perforation of the lung, stomach, heart or liver, or in the case of an accidental puncture of the pulmonary vein, instant death. The procedure could be frightening as well as exhausting for a patient. Some had adverse reactions such as horrible pain, fever and hallucinations (Ott 97-98).…By the turn of the century, putting a needle into the chest under local anesthesia to aspirate an effusion or pus from the pleural cavity had become well established as a useful and sometimes even life-saving procedure but the intervention was not without risk. The main difficulty lay in distinguishing the location of the pleural cavity. This was done by tapping on the chest to find the pleural cavity or the areas in the lung where the breath was absent. (Dormandy 205)

By 1921 good x-ray machines were available to make the location of the pleural cavity more accurate; however, not many tuberculosis centers or doctor offices had access to x-ray facilities.

In 1949, Gosta Birath of Sweden wrote one of the last comprehensive reviews of the Collapse Theory: “The pneumothorax needle was the most dangerous weapon ever placed in the hands of a physician.” (Dormandy 351) By the 1930’s, artificial pneumothoraces were being performed, often in incompetent operations in tens of thousands of unsuitable cases and the results were predictably dismal.” It might be thought that the patients or their families would rebel, but the opposite was true. Almost anything active was better than just waiting and hoping. (352)

And survival of these procedures and the disappearance of symptoms did not mean the tuberculosis was cured.

Pain and Suffering

Pain was a constant companion to all those who suffered from tuberculosis. Hester Howard was no exception. In a letter to Lovecraft dated May 13, 1936 REH wrote:

She seemed to be improving a little when she had an attack of acute pleurisy on her right side, which until then hadn’t been affected. (Roehm REH Letters 3-459)

Pleurisy was a much feared complication. Every breath was so painful that not even morphine or laudanum could entirely cope with it. REH’s letter to Lovecraft dated February 11, 1936 reflects his own pain at watching his mother suffer.

Some times we have to be up all night with her. There seems to be little we or anyone can do to help her, though God knows I’d make any sacrifice, including my own life, if it could purchase her any relief. (Roehm REH Letters, 3-415)

The aspirations for pulmonary tuberculosis were agonizingly painful. Watching his mother suffer gives a deeper understanding to REH’s vehement defenses of his mother’s illness and his insistence of her bravery. Knowing the details regarding this procedure gives more insight into another of his conversations with Novalyne.

She never complains, even though her little body is wracked with pain. She’s had a hell of a life. And I think it’s a damn shame that she’s been such a wonderful person and now she has to suffer all the pain and heartache she has to. By God, don’t tell me about bravery, for she’s the bravest. (Price Ellis 168)

REH wasn’t the only one who noted Hester’s bravery and that she bore the pain with great courage.

It’s wonderful with what fortitude she endures her afflictions; in every hospital she has been, the doctors and nurses speak of her cheerfulness, her nerve and her steadiness in the highest terms. (Roehm REH Letters 3-459)

Not only did the hospital staff and REH admire Hester, in a 1944 letter to E. Hoffmann Price, Dr. Howard also mentioned her bravery.

She was the bravest woman I’ve ever seen. During the months and years of intense suffering, no word of complaint was ever heard more than this (Oh dear). (Roehm IMH Letters 205)

Painful operations were not the only option for tuberculars looking for a remission. There was also bed rest in a sanitarium and this “cure” came with its own brand of misery.


The sanitariums mentioned in relation to Hester Howard in the letters of both Dr. Howard and REH are:

  1. Torbett Sanitorium and Hot Wells Pavilion in Marlin, 170 miles southeast of Cross Plains. According to their advertising, “the Bethesda Bathhouse and Infirmary is equipped for the treatment of chronic diseases.”; This facility was mentioned several times in REH’s letters starting in 1923. Young Thurston Torbett was a friend of his. There is no mention which treatments Hester received during her stays: whether it was for TB or for the mineral waters in not known.

  2. Kings Daughters Hospital in Temple (150 miles southeast) is one of two hospitals in Temple. The other, the Temple Sanitarium, has a notation on their advertising “No infectious or contagious diseases allowed.” According to Dr. Howard’s letters, Hester was at Kings Daughters in March 1935. REH confirms this telling Farnsworth Wright she had her gall bladder out. (Roehm REH Letters 3-306)

  3. The Sanitorium in San Angelo 100 miles southwest of Cross Plains) was located in Sanatorium, TX. It was never an incorporated town, instead, it was a relatively self-sufficient tuberculosis sanatorium. The first institution of its kind in Texas, the colony provided the isolation to calm the fears of the public, as well as rest and clean air, the only known cure for TB sufferers. Admission was restricted to patients between the ages of six and sixty for a period not to exceed six months. Hester was there from approximately the middle of December 1935 to the end of January 1936. Note that according to Hester’s real birth date in 1970 (Louinet 1), she would have been too old for admission. The 1876 birthday that REH gives (Louinet 1) would have barely made her eligible for the upper age limit.

Although sanitariums were a thriving business in the 1920s, 30s and 40s, tuberculars found them strict and uncompromising and Hester Howard’s family agreed. According to REH’s letter to Lovecraft dated May 13, 1936 (Roehm REH Letters 3-458-9):

Then in the latter part of February, in desperation, we took her to a sanitarium in East Texas, [Temple? Marlin?] where in times past we have got good service. But the head of the place left for Detroit just after we got there, leaving his conceited jackass of a son in charge, who was fresh from study in Baltimore or Boston, or some place, and full of his own importance, and authority, and the usual theories — theories — theories — my God, I’ve had my belly-full of theories in the past few months. (Roehm REH Letters 3-458)

How many times Hester was in a sanitarium and how long she stayed in the East Texas facility are unknown. We do know that from approximately the middle of December 1935 until the end of January 1936 Hester spent six weeks in a sanitarium at San Angelo.

After a few days then we put her in a sanatorium about seventeen miles northwest of San Angelo, where she stayed for six weeks, when her condition got so bad, we put her back in the hospital at San Angelo. (Roehm REH Letters 3-415)

Six weeks in a sanitarium was not a typical stay. San Angelo limited their patients to six months. Other sanitariums had no such rule and patient stays were usually much, much longer.

In the 1920’s and 30’s, when institutions had numerous technologies and protocols upon which to draw, patients typically stayed on their backs for one and a half to two years and sometimes more than five. (Ott 148)

Unless it was compulsory, not all people who entered sanitariums stayed. “From ten to thirty percent of the sanitarium patients left within a month of arrival.” (Rothman 245)

Entering the Sanitarium

Sanitariums were built to house the many thousands of TB patients.

The single most important achievement of sanitarium institutions was the isolation of the infected from other potential victims. Another benefit was the improved nutrition which bolstered the immune defenses. (Ryan 28)

While society saw sanitariums as a benefit, most patients did not view them that way. There is no way of knowing how Hester felt when she walked through the entranceway at San Angelo or even why she was there. Perhaps it was for treatments that needed to be given often and in a hospital environment. Admissions for new patients was pretty much the same in all TB facilities. First, Hester would have gone through the entry process.

On entering the sanitarium, each patient was handed an official rule book and most institutions required the patient to sign it. (Rothman 231) Patients learned to control their coughs and spit, and to maintain vigilance over their thoughts so as not to dwell upon sad or melancholic sentiments. Long lists of rules imposing quiet hours when no one could talk or move about, prohibitions on reading and music; strict schedules for sleeping, eating and bathing contributed to the pervasive sense of discipline. Sanitariums were known for having a thousand rules and for enforcing every one of them. “Everything that is not expressly allowed is forbidden.“ (Ott 150)

If it was the standard practice for patients to sign a rule book in San Angelo, Marlin and Temple sanitariums, then Hester Jane Ervin Howard has probably written her name in at least one of those and was given a copy of it. It’s an oppressing and depressing thought that “Everything that is not expressly allowed is forbidden.”

If the rule book signing was the first ritual, the second – one that the patients found equally demeaning – was the way many sanitariums washed and scrubbed the newcomers. To the staff, it was an appropriate procedure for the new arrivals at a hospital; to the patients, it was further evidence that they were unclean. (Rothman 232)

This scrubbing also protected the current patients so Hester’s age probably didn’t excuse her from the cleansing but it is to be hoped that she wasn’t roughly handled.

And the anger and bitterness were not the only emotions brought about by sanitarium staff. There was also humiliation and denigration. One had to give up a personal identity and become an inmate. It was like making a pact with the devil, sacrificing dignity in return for health. (Rothman 227)

Patient emotions were especially controlled because the sanitariums insisted on maintaining a positive attitude and rewarding those who did. Crying in public was practically prohibited. “Only when alone in bed could patients release pent-up emotions.” One woman, determined to be a model patient, observed all the rules and maintained cheerfulness in order to get well. Only at night did she give into her fear and frustration. “In the darkness of night you lay aside the garment of well-being and give up to the deepest anguish, smothering sobs under the pillow. The uppermost thought in your mind is that others must not hear you.” (Rothman 240)

REH and Dr. Howard spoke of Hester’s bravery in the face of great pain. REH also mentions her courage in a letter to Lovecraft (Roehm REH Letters. 3-359) According to a note in the Collected Letters, a freak windstorm struck Cross Plains just after 5:00 p.m. on July 12, 1935. Here is REH’s description:

It was just a gust, the single buffet of a giant’s fist, and that was all. To me, standing at the open window, it was like a breath-taking slap in the face. The wind, roaring from the northeast, whipped around the house and rushed against the south windows with a terrific impact. It slapped me full in the face and nearly knocked me down. A thick stack of papers and letters on my typewriter table went spiraling to the ceiling and rained to the floor in confusion. I don’t remember getting the windows down, but I must have done it in something less than a second. The house was wide open and the wind filled it with a roar. I had a fleeting, momentary sensation of feeling the house expand, as the wind forced the ceiling and walls outward, and I remember yelling: “Shut the doors! This is a storm!” If it had been a real bad one, it would have torn the house apart, for it was wide open. Before I could get out of my room, my mother had shut the outer doors, and the blow had passed before I could get the inner doors closed. I went into the kitchen to close the west windows, but my mother had already closed one and the cook was trying to close the other. She was scared so her hands were shaking and she couldn’t get it down, so I closed it for her. No need to ask if my mother was frightened; there’s nothing in this universe that can frighten her. [emphasis mine] (Roehm REH Letters 3-359-60)

Her strength of character must have helped her to cope at San Angelo. Still courage against a windstorm is one thing. Bed rest for endless day after day with nothing to do but lie there would take another kind. With few exceptions, sanitarium stays meant rest. This was absolute–no reading, visitors, talking or exercise was allowed. Weeks of lying quietly without reading, or visitors or any kind of distraction would have been very difficult for an intelligent woman. Perhaps the reams of poetry she had memorized kept her sane.

Rothman in her book Living in the Shadow of Death, states:

The dreariness of a sanitarium stay is described by one patient “as lying in bed day after day, week after week, month after month, engaged in pursuits such as listening to the split, splat splat of the rain hitting the gutter outside my window.” She lost track of the days of the week. “I only knew them as bath day, fluoroscope day, visiting day, supply day or store day.” (237)

The close ties between the patients were based on their shared experiences as tuberculosis patients, as well as their own sense of unworthiness, the stigma imposed on them by outsiders, and to a degree, by the rule book-minded staff…Even those who tried to keep a distance from other patients initially were eventually overcome by the lengthy alienation from family and friends and a sense of isolation. (Rothman 234)

And the isolation was acute. In fact, the sanitarium staffs did little to alleviate it. Visiting was discouraged so it was probably the separation from her family that was the worst for Hester. Sanitarium life itself wasn’t easy. As shown in the photo above, sanitarium beds were lined up close to one another with no chance for privacy.

In the closed world of the patients, privacy and even private ownership practically disappeared. Clothing, radios, letters, even love letters were community property. Incoming patients were regarded closely for their size and the quality of their clothing and possessions. Letters were steamed open and read before they were delivered to the patients. Some of the news within them was posted in the gossip newspapers. (235)

The biggest complaint was that staff in most sanitariums would not provide any information to the patient regarding his or her discharge from the hospital. The silence was unbearable for most of the them. The only way they could tell whether they were getting along or dying was by the privileges they were granted.

If we were progressing satisfactorily at the end of one month we were given the bathroom privilege and fifteen minutes a day reading and writing time. At the end of two months, if we continued to progress, our reading and writing time was increased to half an hour, we were allowed to read books and were given ten minutes a day occupational therapy time. At the end of three months we were given a chest examination, along with the other tests and if all was well, we were given three hours’ of time out of bed, one hour occupational therapy time and could go to the movies. (Rothman 244)

Weekly movies were one of the privileges for those patients whose health showed some improvement.

For those who had permission to attend, the movies were a weekly highlight and women spent hours primping, putting on makeup and curling their hair. Men shaved and if street clothes were allowed, they were worn, if not, clean pajamas and robe. (Rothman 237)

But even then, patients were not told when they would be allowed to go home.

Basically, doctors were reluctant to be truthful with patients. One school of medicine told its students, “Your patient has no more right to all the truth you know, than he has to all the medicine in your saddlebags…” Physicians were ready to tell patients the truth in the last stages of the disease when they knew death was imminent and the patient had religious duties to perform. There were two reasons for their attitude regarding the truth. (1) Doctors believed the medical profession had the duty to give comfort and (2) they were unsure about the specific course of the disease. (Rothman 112)

Perhaps the most unkindest cut of all was when patients discovered following the rules didn’t guarantee a cure.

When death and not a cure came, the patients were left confused and angry. One patient, commenting on the death of a fellow patient, “He followed the rules better than anyone in the whole place. And some of these guys that chase around and get drunk, play the women, sneak out late at night – they get along all right. It makes you wonder.” (Rothman 241)

Hester was at San Angelo approximately six weeks. Did she progress enough to receive bathroom privileges and fifteen minutes a day reading and writing time? REH describes the treatment his mother was receiving so it is doubtful that her evaluation resulted in any privileges. In fact her stay at San Angelo sanitarium was cut short.

The Howards to the Rescue

In a May 13, 1936 letter to Lovecraft, REH describes Hester’s circumstances at San Angelo.

We put my mother in a sanatorium, expecting that she would get better treatment than we were able to give her. I went there in January and found that they were not only neglecting her, but that such treatment as she was getting was so little suited to her case that even a layman like myself could see it. She would not have lived much longer in their hands. They, like so many moderns, thought only of their blasted routine—my father and I knocked their God-damned routine into a cocked hat and they ran around like a bunch of neurotic old women holding up their hands in helpless bewilderment. He [my father] saved my mother’s life when they were helpless and we put her in a hospital where at least she’d get good care. But though they were good, honest, willing people, they couldn’t understand her case and we brought her home. Then in the latter part of February, in desperation, we took her to a sanitarium in East Texas [Temple? Marlin?] where in times past we have got good service. But the head of the place left for Detroit just after we got there, leaving his conceited jackass of a son in charge, who was fresh from study in Baltimore or Boston or some place and full of his own importance, and authority and the usual theories. To show his authority, he neglected my mother—or tried to—trying to refuse to do things for her even I knew she needed. But before we got through with him he was damned glad to do everything my father suggested—suggested hell, ordered. …One of the most sincere and best natured was a man [staff member] from Maine, but he too was full of theories he couldn’t prove and like most of them, inclined to regard a human being as a guinea pig for experiments. No man’s going to experiment with any of my folks while I can stand on my feet and hold up my hands. (Roehm REH Letters 3-458-59)

It’s easy to picture the impression that Dr. Howard and REH, with their forceful personalities, must have made in those sanitariums and we can only imagine Hester’s look of sheer delight and relief to see them. But how did their intervention affect Hester’s health.

The Efficacy of Sanitariums

Later evaluations that were done regarding sanitarium stays noted that in mild or early cases, it seems likely life could be prolonged and the course of the disease slowed down allowing the body’s natural defenses a better chance of healing. There is indirect evidence to suggest that sanitariums would not cure a patient who was seriously infected. (Ryan 26)

According to Rusty Burke, Howard scholar and president of the Robert E. Howard Foundation, “By 1935 and 1936, Hester Howard’s health was deteriorating rapidly.” (Burke) By late 1935 and early 1936 Howard’s letters mention his mother was already receiving frequent aspirations and experiencing the stage 2 night sweats.

In view of the opinion that sanitariums would not cure a patient who was seriously infected, it is doubtful that a continued stay could have prolonged her life, especially if the care was of a type that didn’t help her.

Seeing we could expect nothing from specialists or hospitals, we brought her home, in the early part of March and we’ve been here ever since. (Roehm REH Letters 3-459)

In a letter to W. J. Proctor (son of William J. Proctor and Mary Frances Henry, who was one of Robert Howard’s grand-aunts) dated July 11, 1936, Dr. Howard’s description of Hester’s condition is more detailed:

We placed her in many hospitals and under the best medical skill in the state, but she never received any benefit whatever from any of them. We brought her home from San Angelo the first of February this year because she had been given up by all physicians who had had her in charge, so we brought her home to die. Since February 1, 1936 we had stood over her day and night doing what we could to make her comfortable. Near June 1, 1936 she began to sink rapidly and on the 10th day of June she went into coma. (Roehm IMH Letters 76)

Hester’s TB was too far advanced for sanitarium care. And, it would be another eleven or twelve years before the only known cure, streptomycin was available to the general population.

Home Cures.

There were other options available besides operations and sanitariums. Home cures were preferred by many families when it was allowed by state law. Dr. Howard states they brought Hester home when the sanitarium and hospitals were unable to help her. The rules for home rest were also very restrictive.

There were other options available besides operations and sanitariums. Home cures were preferred by many families when it was allowed by state law. Dr. Howard states they brought Hester home when the sanitarium and hospitals were unable to help her. The rules for home rest were also very restrictive.

Complete rest and hygiene were top priorities. According to medical principles of the day, the sick room must be cheerful and clean, flooded with sunshine and fresh air and only cheerful, clever or amusing stories were told to the patient. Recreation was very limited. Little or no mental concentration, exertion or emotional strain. The list of forbidden activities included card playing, music unless it was light music for a very short period, letter writing, or receiving visitors if the fever was high. An occasional fluffy novel, a lot of temperature taking, weighing in, staring at clouds and of course, eating were all allowed. Diet was also well regimented: six to eight eggs each day, meat and meat juice, and all the milk a patient could keep down. Forbidden foods included rich sauces, spices, and often, tea and coffee. (Ott 72) Books, as possible germ carriers, were kept to a minimum and burned after the death of the patient. (Ott 81-82)

However, until the tuberculin cattle were eliminated in the 1930s, it wasn’t always safe to drink cow’s milk. In an effort to follow the recommended diet, many people, including the Howard’s, turned to goat milk. In a May 13, 1936 letter to Lovecraft, REH states:

We got goats and for weeks she lived mainly on their milk. She seemed to be improving a little when she had an attack of acute pleurisy on her right side. (Roehm REH Letters 3-459)

Educational classes offered public information that if followed prevented infection. Dissemination of this information might explain why REH, Dr. Howard and others caring for Mrs. Howard did not contract TB:

These programs taught new lessons of hygiene based on how the disease is transmitted. New York City Department of Health in 1894 issued a pamphlet “Information for Consumptives and Those Living With Them.” (Rothman 186) Among the information offered is that consumption is usually caused by germs which enter the body with the air breathed. It is not dangerous for other persons to live with a consumptive if the matter coughed up by the consumptive is destroyed at once. Sound health habits included avoiding spitting, cough only into handkerchiefs, let in sunlight, prepare nutritious meals and discourage alcohol consumption. (Rothman 186-87)

Tuberculosis was also big business. Newspapers and magazines were filled with advertisements for TB cures and especially devices for its prevention however ineffective they were.

The racket looks pretty small for ping pong and the article doesn’t say what the antiseptic was. If it worked, why not apply it to the lips directly and eliminate the “middle man.” But this ad was only one of hundreds of “cures” offered.

Morphine, Laudanum and Patent Medicines — or — REH Gave His Mother what Medicine?

Especially profitable were the patent medicines sold to “cure” TB. On their first date, REH stops by his house to give his mother her medicine explaining to Novalyne:

“It’s my job. My dad is gone a lot of the time. When he’s home, he has to try to get some sleep. No telling when somebody will knock on the door for him to get up and go take care of a sick baby, man, or woman.” (Price Ellis 54)

The medicine he gave her could have been laudanum or perhaps morphine if she was in a lot of pain but both of those were addicting and would have affected those times she was in remission. It could also have been a prescription made by Dr. Howard or a patent medicine to make her more comfortable. At any rate, she was on her feet and with REH’s help was able to do some Christmas shopping with him.

Patent medicines for curing tuberculosis and many other diseases were big business. And, they were often prescribed by doctors. Dr. Lawrence Flick (1856-1938), who was one of the most innovative leaders against tuberculosis, promoted europhen.

Dr. Flick maintained the belief that the europhen or the iodeform was the most important factor in the treatment of the cases reported. He has long been convinced that Iodin is the best remedy for the treatment of tuberculosis and better results are obtained from inunction of europhen or of Iodoform or any other Iodin compound that gives off Iodin readily…It is the Iodin and not the creosote that gives the results…In advanced cases the creosote is an important factor. The farther the case is advanced the more freely is the creosote to be used. (Flick)

Creosote is a wood preservative that is used to treat telephone poles. However, that was not the problem with europhen. One of its major obstacles was its extremely offensive odor.

Bargaining for Life describes some of the medicines prescribed to TB patients. “Often though patients took more than one medicine and some of them a deadly poison. One man was ‘being treated with Europhen as well as 1/20 gr. three times a day of strychnia’ (a form of strychnine) plus the doctor was bleeding him. Nothing is noted whether or not he survives either the medicine or the TB.” (Bates 37)

Another patient tells Dr. Flick she is “taking Tablets of Iron, Strychnine and Arsenic and drinking Porter” and wants to know if she is taking all she should. (Bates 38)

Her array of medicines gives a whole new meaning to chemo-therapy.

The Porter she refers to is Dr. Porter’s Healing Oil. A patent medicine in the early 1900s. The medicine was investigated under the Federal Food and Drugs Act of 1907.

In 1915 Dr. Porter’s Healing Oil was reported by federal chemists to be “essentially a solution of camphor and carbolic acid in cotton-seed oil,” and many of its curative claims were characterized as knowingly false and fraudulent, perhaps especially the company’s claim that “the use of Dr. Porter’s Antiseptic Healing Oil is a wise precaution against serious infectious diseases, such as Whooping Cough, Diphtheria and Tuberculosis.” (Nickell)

Ultimately, a fine of $25 was levied against Dr. Porter, but the medicine continued to be sold for years to come. (Nickell)

Medical staff and non-medical workers were never backward in claiming credit for the occasional cure but the credit almost always belonged to the patient’s natural resistance and the recuperative power of nature. While medicine could do little on its own, it could help to promote this power by wholesome rest and graduated exercise and at least insure that the healing processes of the body were not impeded.

Although operations, sanitariums and home therapies and even medicines might bring on a remission, none of them could guarantee the tuberculosis would not return. The death rate had declined significantly by the time of Hester Jane Ervin Howard’s death, but the discovery of an antibiotic cure came too late to save her.

Streptomycin was the first effective bio-medical treatment for tuberculosis. It was found in 1944, when Albert Schatz, working under Selman Waksman, discovered it through his work with soil samples. (Ott 7-8) But it was only in January 1946 that it was reported the majority had responded favorably with a drop in temperature, weight gain and general improvement. (Dormandy 366)

Ironically, in 1929 Rene Dubos discovered that a previously unknown bacterium, the Cranberry Bog Bacillus destroyed the pneumococcal capsule. However further research was abandoned. Selman Waksman stated “Had the scientific world fully appreciated at that time the significance of the discovery (the Cranberry Bog Bacillus enzyme), the practical development of antibiotics might have occurred so much earlier.” (Ryan 70)

And, if it had, perhaps Hester’s life might have been spared, and, also that of her son, Robert E. Howard. In June 1936, Hester Jane Ervin Howard was one of 90,000 people to die of TB that year.

Article taken from the closed down website REH: Two-Gun Raconteur. Date of the article: September 24, 2015.