A guest post by Discover Medical London.

Ask people today for the instrument they most associate with the medical profession and almost all answer with the stethoscope. This piece of equipment has become synonymous with the profession of healing, but this wasn’t always the case. From at least the beginning of the 17th century to the end of the 19th, physicians were thought of as inseparable from another accoutrement: their canes.

The practice of using boughs, staves and rods to inspect the sick – specifically those infected with contagious disease – may date back to classical times. And herein lies a clue as to the true purpose of the physician’s stick. For as well as an instrument for the interrogation of the bodies of the infirm, it was intended to play the same role as the extended beaks of the plague doctors’ masks in the protection of the medical practitioner.

According to the prevalent theory of miasmas, contagion was spread by foul-smelling, putrid or ‘bad’ air. A sensible precaution against developing infection was, therefore, to isolate oneself from the source of olfactory pollution. If the bad air could not be smelled, so the logic followed, the contagion could not be caught.

Plague doctors filled their prosthetic proboscises with all manner of fine smelling stuff from camphor to mint, lavender to myrrh. All to little or no effect: the so-called doctors – very few were in fact trained physicians, as they generally fled disease-racked cities – died in their droves.

True physicians could not be doing with the outré outfits of plague doctors and so commissioned elaborate canes with hollow perforated heads wrought in ivory or precious metal in which to contain their protective perfumes. Dr William Munk, writing in 1884, reveals that the favoured fragrance was the so-called ‘vinegar of Marseilles’, an aromatic condiment ‘which, according to the confession of four thieves who had robbed the plague stricken in Marseilles, had prevented them from contracting the disease while pursuing their nefarious occupation.’

By the time the splendid copper-handled cane with malacca shaft on display in the RCP’s current exhibition'This bewitching poison’ was produced in around 1900, some medical types had taken theory and practice to another level.

This stick contains a secret compartment not for fragrance, but for a glass brandy flask. In this slender and beautiful object, two sets of now discredited beliefs – those of the curative properties of alcohol and the spread of contagion by miasmas – came together. Alcohol had long been used by physicians for the purposes of cure, but in the case of this cane the brandy was not to be administered to the ailing patient, but for the consumption of the medical practitioner!

Just as perfumes were thought to prevent the contraction of contagion through the nose so a quick nip of brandy or other suitably sturdy spirit was believed to have similar prophylactic qualities, stopping disease entering by the mouth and throat.

If the date seems surprisingly recent, consider this: London’s National Temperance Hospital was operational until the 1930s. It was so named not because the patients were all abstainers, but because it foreswore the use of alcohol-based treatments deployed so widely elsewhere.

The hidden compartment and secret history of this physician’s cane reveal that the relationship between alcohol and medicine is indeed a long and complicated one in which both temperance and treatment play their part.

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