Maria Theresa's Medical Legacy (with Matt Kaplan)

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Manky, listener discretion advised. Welcome to this very special episode of Noble Blood. I am so thrilled to be joined by Matt Kaplan, the science correspondent at the Economist. He's written about everything from paleontology and parasites to verology. He's a paleoclimatologist by training I've just heard of written for the National Geographic

New Scientist, Nature, New York Times. But more relevant to this audience, his new book, I told you, so scientists who are ridiculed exiled and imprisoned for being right is out February 24th. It has been such a roller coaster working on the book too. I mean, I set out to look at scientists who had been screwed by the system, scientists

who had had great ideas and then their ideas didn't make it even though they were right. And what I stumbled upon as I uncovered the history of science and looked at the underbelly a lot of these relationships, it was unbelievable to me how often monarchs in particular in Europe got involved in all of this stuff. I mean, and top, top, like the cream of the crop was Empress Maria Terace of Austria.

I mean, she's just such an incredible personality.

Well, that's really who I'm very excited to talk to about because the very first chapter in your book, you start the story with Maria Terace, who, as listeners of the show might know, was the 18th century leader of the only soul female monarch of the Habsburg monarchy in Austria, an incredibly interesting and powerful woman, the mother of Marie Antoinette, who sort of a marquee figure.

Yeah, she was also the mother of 16 children, 16 kids.

“I mean, like, I understand biologically how that works, but wow, really?”

Yeah, I've managed one, and I consider that a real pet on the back, doing 16 feels and also running an empire. Yeah, and I mean, the thing is, and she wasn't, I mean, okay, aside from being a baby machine, which clearly she was, because I mean, she was really pop in the mouth, but there was also the fact that she, I mean, she, it wasn't just Austria, she was ruling

right? She had territory all the way deep into Italy. She controlled Milan. She had sort of an arrangement where she had partial control of Florence, but she was also up in Croatia and into Transylvania and big chunks of Romania.

I mean, she had so much control and her sister was the governor of Netherlands and really, Marie Theresa is such an interesting character because she wasn't just a ruler, because

of all her kids, she had an incredible soft spot for the overwhelmingly impoverished women

of her empire. There were swarms and swarms of women in her empire who got pregnant, because I mean, there was no birth control back then.

horrible stuff. As well as relationships where they just had sex and didn't know what was going to happen next. I guess they didn't know what was going to happen next and just let it go. But women were having babies all the time and could not feed them.

So their only option was to go to a bridge in the dark of night and throw the baby over the bridge into the river when no one was looking. And I mean, I'm taking it back by that, and I mean, I worked in the emergency services in the university as an emergency medic and that kind of stuff chills my blood. And then it turns out it chilled noble blood, too, because Marie and Teresa really cared.

She really wanted that to come to an end.

And one of her first moves as Empress was the installation of Dropboxes.

“Now Dropboxes, you're familiar with them at libraries, right?”

You have them in the United States style, I hope. We have them when I was drawing up in California, we have them in the UK, I'm sure you still have them. You know, you can, oh man, you forgot to drop off the book. You can drop it off in the box and the library will deal with it when they have opening

hours. They installed these at all the hospitals in Austria so that women who were going to throw their baby in the river could put their baby in the box, turn the box around, and hope that the state could give their child better care. Better life.

Could.

Yeah, I mean, the state did not have a lot, so this was really a great option.

But they were, you know, she was trying. She also had a vision, as you mentioned in your book, for a hospital that would be able to take care of impoverished people and these underprivileged women, these women who are forced into situations where they have to give birth, but don't have their resources to actually do so safely.

This hospital, Murray and Theresa would die in 1780, but her vision would actually be fulfilled. Yeah, it was a huge deal too. So, Murray and Theresa met up with Gerard von Sweeten. Gerard von Sweeten was the physician who looked after her sister, who was the governor of Netherlands.

She had a stillborn child, stillborn children, often initiated bacterial infections in the mother, and Gerard von Sweeten was unable to save Murray and Theresa's sister, the governor of Netherlands. But Murray, Theresa was so taken aback by his professionalism that she brought him into her empire and started up a friendship with him.

Now, that's sweeten.

“You have to, we have to backtrack here for a second because Ben Sweeten is a really interesting”

character in his own right. So, going way back in time for a moment, we have hypocrite, during the age of the Greeks who believed in the humors. Now, hypocrite, he did say, you know, as a physician, you should help or at least do no harm.

But he also believed that you had blood, bile, flem, and all of this stuff in perfect balance, and that when you became ill, it was because one of the humors was out of balance. So if you had too much fever, the solution was well, you've got too much blood in you, drain them of blood. If you have too much flem in you, you know, I'm not such bad thing, put them in a hot

room, have them cough up the flem. There's actual benefits to that, right? You get a chest infection, go on the steam room, or the sauna. So, I mean, like, he wasn't totally wrong, but his ideas weren't real great either for medicine.

And he existed in the first place.

“I think as you've been here in your book, hypocrite, he might have existed, but we're”

kind of going on plateaus word on that. Yeah, we don't really know a whole lot about hypocrisy, but what we do know, for sure, is that a British physician named Toddness Sidneym, who was really active, like 1650s, he rediscovered hepatitis ideas, whether if I already existed or not, and he adopted them and there was a huge renaissance in medicine, which was not really a renaissance,

because people started bleeding patients again, which wasn't good. And Sidneym taught his ideas widely, and one of the people who really picked him up was Gerard Van Sweeten, and Gerard Van Sweeten ended up really convincing Maria Teresa, that her hospital needed to have these ideas in her hospital. And one of the possibly most disastrous things he did was he ended up hiring a guy named Anton

De Hayen, and I mean, De Hayen was a real piece of work. De Hayen believed in the devil and believed that vampires caused certain diseases, and any doctor, who said, "I think they're ill for some reason other than God being angry at them than He would not have it." No, no, they're ill because God has made them ill and a story.

Of course. Yeah, right? So, in the midst of all of this, you've got this hospital being built, and this hospital would eventually house a man named Agnaz Semelweiss. Agnaz Semelweiss was an obstetrician who was really deeply bothered by a disease that

It was called "Prepareal fever," and if you got it, you died. That was the end of story.

It was only second to tuberculosis and killing people off.

The reason no one really cared about it was because it only killed women off, and who cared about women back in that day. I mean, really can you believe this? And so, but Agnaz Semelweiss saw all these women dying, there was nothing he could do.

“He started running experiments to kind of explore why do they get this?”

How does this happen? But he was operating in a hospital that had been established by DeHan, who believed that you only got ill if God made it so. Well, one point that you make in your book that I find very interesting is someone like DeHan believes, "Well, your illness has to do with the weather and the temperature and

the position of the stars and the position of the moon." And sort of if you're thinking scientifically, it wouldn't really make sense that one woman in a ward when the weather is a certain way gets sick. And the other, right next to her, with the weather the exact same way and the moon in the same position, wouldn't get sick.

Well, yeah, that's the thing. I mean, with that said, when "Prepareal fever" happened, it tended to happen in waves. So the women in the ward, many women in the ward were all died at the same time for "Prepareal fever." So that's where they got this idea that it was the sun, the moon, and the stars.

But here's the catch, and this is what really got some a wise thinking, and it didn't work in the hospital because the hospital was founded by people like DeHan and it's on Sweden, but at some a wise said, "Wait a minute, there's this ward that is mostly managed by doctors, and there's this ward mostly managed by women, not women, by nurses who were women." And fascinating, the ward that gets all of the "Prepareal fever" cases

are most of them, is the ward, with the doctors. The people tended to buy the nurses don't get it. So like the weather's the same, around the buildings, the same, what the hell's going on. One of the things I write about in the book is he noticed that the priest, who was working

at the hospital, would come and ring his bell and smoke the incense in the room where the doctors were present far more often, because we're more people dying, and he thought it's the priest, the priest is causing this. So he banned the priest from, and of course that had no effect, but hey, you know, good on him for checking that out, and in the meantime, everyone's rolling their eyes like

"What is this guy doing? Why is he trying this stuff?"

But ultimately, he really had huge breakthroughs and demonstrated that it was the doctors

going to the morgue in the morning and examining their patients from the previous day. They were washing their hands with soap and water, but because corpse material was getting under their fingernails and because soap and water is just not up to the task of getting rid of corpse bacteria, which is rampant. They were then going, and when women were giving labor, going into labor, they would palpate

to feel if they could feel the babies had to find out if the adult court was around the

“neck or whether or not the baby was going to be a breach, these were important things”

to know, and they were introducing corpse material into the babies, and into the women, and the women were getting this infection in dying. I mean, it was a giant discovery and some of why created this antiseptic solution that neutralized it, unfortunately, the hospital was just not ready to accept what he discovered in his peers ended up throwing him into an insane asylum for all of his hard work.

Because imagine, I mean, for these doctors, I'm sure it seems like a personal insult saying, like, your hands aren't clean enough to be treating these women. Yeah, I mean, in fact, actually, his ideas got out to some sections of Germany, the city of Kiel.

There was a doctor, surname, Mikhali, so I can't remember his first name, but Mikhali initially

they accepted some of the wife's ideas, and said, we've had tremendous success with this chlorine wash, and then it dawned on Mikhali's, oh, the thousands of women who have died in his hospital because of me. And so he threw himself onto the railroad tracks and committed suicide outside of the city because he couldn't take the belief, the understanding, he understood what he had

done in his life, and obviously, that's not good, but actually the vitriol that some of wise received, you look at what these people were writing to them and what they were saying to him, share part of it was believed they believed that God drove disease, and it

“was a son of an insert, but I think deep in their heart of hearts, many of these doctors”

who engaged in character assassination, it was really all about the knowing deep inside today, actually were responsible and couldn't cope with that.

and co-hosts, Tamara Judge and Dolores Katanya, the three of us have been watching the

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“Out of curiosity, what was in the antiseptic handwash that some of my life came up with?”

Yeah, that's a great question. So, at the time, people were having, you know, cities were getting bigger and bigger. The sewers were getting stinkier and stinkier, and the folks of Europe worked out, hey,

if we take this chloride of lime, basically chlorine, which you throw in swimming pools,

and we throw it in vast quantities into the sewer. It makes the sewer a lot less stinky. And some of why swine, when he was running his experiments, to try to assess like what the heck is responsible for preparing fever. He noticed that even after with washing was soap and water,

he could still smell more of odor on his hands. And he thought he had no understanding of microbes. Bacteria would not be identified for another 40 years by Louis Pasteur. There's another really interesting character who rubbed elbows with royalty, and engaged in all kinds of interesting behavior.

But he worked out, it's got to be the scent. The smell is the reason for the infection. So I want to eradicate the odor. So he got one of his friends who worked at the local sewage facility to give him a whole bunch of chlorine, and he created a mild chlorine solution.

And what? I did my hands in this, and the smell goes away.

I wonder if this will work, and it was incredible.

The effect of using the chlorine solution within three months, the he had an 18% death rate from prepareal fever in the doctor's ward before running the experiment at the end of three months, it dropped to zero. I mean, why? Unbelievable.

Yeah, I mean, it was a coup, and the fact that the other doctors went, "Sir, how dare you tell us our hands or dirty? We are gentlemen." And in many cases, they were nobleman. He was-- I mean, and this is where the noble blood site of this really comes into it because civil life was Hungarian. Hungary was a vassal state of Austria.

So he was-- even though he was a very successful obstetrician,

he was a second-class citizen in Vienna, and these nobles who had become doctors in the Vienna hospital,

they had all this clouded over him just because of their blood. And there was, of course, on top of all of this, Hungary rose up against Austria.

Joseph? Yeah, Joseph the second?

“He was not the sharpest tool in the box.”

His favorite activities involved rolling around in the waste paper bin and trying to swat flies with his hands. Oh, yeah. Yeah, that inbreeding. It didn't do him a lot of good. And I mean, he had very serious mental deficits, and he should not have been ruler of that absolute empire. Really?

You're sort of coming down to the thesis of this podcast, really, as when you just decide who's in charge of these wildly powerful

empires based on who's born first. It doesn't always work out.

No, no, definitely not. And so when the people of Hungary rose up and said, "We don't like being vassals to the hub's break-up. By the way, we would like to determine our own destiny." He went, "Okay." And of course, all of the nobles who were of Austrian blood ruling Hungary went, "Hang on. Can we have a say in this somewhere along the way?"

And several of why he's actually made a huge mistake because Hungary rose up against Austria, and there was a fierce war between them. And in the midst of this, I mean, he's he's working as a Hungarian in the Vienna hospital. He started donning the uniform of Hungarian soldiers while working in the operating theater. I mean, like he's running people against him. Yeah, it was, I understood that he cared,

but he was reporting to a guy named Johan Klein who was not a good doctor. He wasn't a bad doctor, but he wasn't a very good one. And he was a shining example of what privilege and power would get you if you're raised in upper class Vienna society. And he, to his credit, when some wise brought out the chlorine wash, he did try it. I mean, he did give it a shot. He did not like some wise. They did not get along well. And ultimately, the uniform thing and supporting the Hungarian

rebels really created a clash. And this is, I think, a huge part of why some wise lost the battle with the aristocracy and the doctors in the Vienna hospital. He was a mess.

It's not always the message. It's sometimes is the messenger. Oh, yeah. I mean, and I compare him in

the book to Joseph Lister and Lee Pestor because Joseph Lister also got just trashed by the aristocracy in London as he was coming up with his theories demonstrating that when you're conducting surgery,

“you need to use anesthetic on your knives, right? I mean, before Joseph Lister came along,”

you, if you were a surgeon, the more entrusted your blade was with Dorian Guts, the better a surgeon you were, because it showed how many bodies you had cut open. Oh, God. Yeah. And it, I mean, it was, it was bad. And people wouldn't die during the surgery. They died as post-operative infection all the time. And Lister was the one who said, you know, I think we got a problem here. And similar to to similar mice, they were throwing carbolic at carbonic acid in, in the sewers in Britain.

And he got some of that stuff and started using the acid on patients to treat them after cutting them open. And he received tons of pushback and aggressive attacks. He didn't get thrown in an insane asylum like similar mice, but he was forced into academic retreat for decades. And during that time, he just quietly taught what he knew and eventually his students got everywhere. They were known as Listerians. And they spread the word and demonstrated through deed that Joseph Lister was

right. And thank goodness for that because it was an alternative approach that similar mice never

managed. And fortunately, ultimately, did lead to understanding of how to engage in surgery and treat people properly. Ironically, ironically, I don't know about it. It's just astoundingly, the day that Lister had his big breakthrough by treating a patient on the surgery table and not having them die of a postoperative infection that would have been certain as a kid who had got run over by a wagon in Scotland. The bones were sticking out of the wound. It was really bad.

“He would have died. Was the same day that Ignos civilized died in the Insan asylum in home?”

Oh, my God. So it was Ignos civilized who had this really amazing breakthrough, which is that doctor should be washing their hands with the strong stuff before treating women, giving birth, had this tragic end of dying in Insan asylum, which I think just sums up some of the interesting stories and sort of fascinating ideas that you present in your book, which are a number of these stories, which is sometimes people, science reports to be this this field that is completely

the right idea will win out, but that is absolutely not always the case as you make very clear.

“Oh, yeah. I mean, I just look at Galileo. I mean Galileo had his ideas about the earth,”

not, you know, about the sun not rotating around the earth and had all these observations of comments to demonstrate as such, but the people in power, I mean, the up hope said, well, you know, if you speak that, that's heresy and we'll send you before the inquisition, Galileo had to engage in such careful PR. I mean, he used pseudonyms to hide his identity and to protect himself from being eviscerated by the inquisition and it was all political. I mean, going back to Tuscany in the city of

Florence, which, you know, would be ruled many years later by Maria Teresa through her relationships with the grand Duke there. I mean, when Galileo was being challenged by the inquisition, it was his relationship with Archdu Ferdnando, the leader of Florence and Tuscany.

“It was his relationship with that man that protected Galileo from ultimately being killed off”

for imprisoned themselves and Ferdnando, it wasn't revealed at the time, but hundreds of years later, letters emerged revealing that Ferdnando had directed his ambassador to Rome to intervene on Galileo's bat behalf, which reveals that all of this mythology of Galileo being tortured at the hands of the

inquisition was actually alive. It's an incredible Galileo had to go to to be able to endure the

political society of the age. -Absolutely. Although sometimes things do, have been flow and come around, I know that now without getting too political, there are challenges to things that I had considered done science, but I do want to celebrate Maria Teresa for openly celebrating and realizing that smallpox inoculation really does help people,

“and she publicly inoculated her own children in 1768. -Yeah, yeah, she herself was inoculated.”

I mean, and she was right up there with Louis XVI and Catherine II of Russia and Frederick II of Russia. I mean, but you want to talk about, I suppose it's not so much noble blood, as it is just American politics, but George Washington, so during the American War of Independence, George Washington was losing more men to smallpox than he was to the source of the British, and I have to say this under "Hushed Toans" living in Hartfordshire, the UK. You know, I'm surrounded by

British people around here, but he wrote to the Continental Congress saying, "Would you please remove your stupid rule that says I can't unoculate the troops?" Because Congress had said, "You are not allowed to unoculate people because people can die from being unoculated." Well, then you don't want to be fair, you don't want if you give everyone an inoculation at the same time, you don't want everyone knocked out by the side effects or the dangers of that immediately.

Of course not, but when you look at it, you get, if you get a smallpox the normal way, you have a 30% chance of death. I mean, when you pair that against COVID-19, where we had things pretty badly, I mean, it's like nothing in comparison. Smallpox was so bad, but if you got an inoculated, your chance of dying was 2%. And then you were immune for life. So George Washington argued with Congress and said, "Look, you've got to let me inoculate people." And when they

kept saying, "No," he'd eventually disobeyed orders and inoculated his troops anyway.

And I mean, it really turned at the tide of battle. I mean, it is incredible because that

chapter of American history is so often forgotten, but it was really inoculation against small pox that led the Americans to ultimately defeat the British and take their own country. I mean, that just goes to show. And George Washington was able to sort of change course by what had been the the previously held idea of how to what to do with your army. And in 1777 was able to enoculate his entire army to turn the tide of war. There's really nothing more American than that.

Yeah, I know. I know, and also he was such a, it took such character and courage to stand up to the continental congress and say, "You know what? You're wrong." I mean, that's that. I mean, it was a new country. I mean, it wasn't even a country yet. It was a new rebel state that was trying to do the right thing. And it's to be able to stand up to all these people who put their faith in him and say, "Nope, then we're going to enoculate anyway." And he was right to do it.

I mean, they, they, they were losing so many soldiers to the disease. I mean, and it was really

to take back Boston after the British took it, but he couldn't because there was horrendous

“smallpox outbreak in the city. So, and he knew that his rebel fighters could not enter without”

catching the disease and dying and droves. So how knowing this intentionally infected American citizens and then sent them out of the city to go and have a chat with George Washington and his soldiers in the home that they would trigger a spread of the disease. I mean, literally, germ warfare and

Washington figured this out. And that was a big part of him ultimately saying, "Ungan have to

just obey Congress and do the right thing here." And, you know, and inoculation was absolutely the way to go. Well, Matt, thank you so much for talking about this topic, for writing this book, which, if you're a fan, a no-listener of the show,

“it is just chock full of fascinating historical stories. I loved it. The book is,”

"I told you so scientists who were ridiculed, exiled and imprisoned for being right

out February 24th." Matt, where can the good people find you if they want to follow you,

follow your writing, and is there anything else we can plug? You guys did totally find me on the McMillan page at St. Martin's Press. You can also find me, you know, I mean, I'm all over the place, but I do hope they have a good read. Absolutely. Thank you so much for taking the time to to speak with us today. Absolutely, my pleasure, Dana. Noble blood is a production of "I Heart Radio" and "Grimmond Mild" from Aaron Manky. Noble blood

is hosted by me, Dana Schwartz, with additional writing and research by Hannah Johnston, Hannah's Wick, Courtney Sender, Amy Height, and Julia Milani. The show is edited and produced by Jesse Funk, with supervising producer Rima Il Kayali, and executive producers Aaron Manky, Trevor Young, and Matt Frederick. For more podcasts from "I Heart Radio," visit the "I Heart Radio" app, Apple podcasts, or wherever you listen to your favorite shows.

[Music] Hey, this is Wells Adams, with "By Order of the Faithful's podcast alongside my fellow Faithful's and co-hosts," Tamara Judge, and Dolores Katania. The three of us have been watching this season of "The Traders," and we've been inside that castle, so we have insight unlike many others. This season of "The Traders" may be the best we've ever seen. Listen to "By Order of the Faithfuls

on America's Number One podcast network, "I Heart" followed by "Or to the Faithfuls," and start listening on the free "I Heart Radio" app today. When segregation was a law, one mysterious black club owner, Charlie Fitzgerald, had his own rules. "Segregation in the day, integration at night."

“It was like, "Separine in another world." Was he a businessman, a criminal, a hero?”

Charlie wasn't an example, a pal, they had a crush in. Charlie's place, from Atlas, Obstura, and Visit, Mirdle Beach. Listen to Charlie's place on the "I Heart Radio" app. Apple podcasts, or wherever you get your podcasts. Almost 30 years together, four kids, and some of reality TV's most unforgettable moments, we're taking you behind the scenes in our podcast between us, with me, Heather DeBrow. "And me, Terry DeBrow." The unfiltered, behind closed doors

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But what's the latest rumor I'm gay, right? First of all, if I were gay, I would be...

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