Jaundice is a yellowing of the skin and eyes. It is caused by a build up of a compound called bilirubin. It has a variety of possible causes. The liver normally breaks down bilirubin, so often jaundice is a sign of liver problems. Causes can include liver damage from alcohol abuse or viral hepatitis.
In the 19th century, doctors didn’t known the causes of jaundice. There was an epidemic of jaundice—probably hepatitis E—in Martinique in 1858. On St. Martin, people probably developed jaundice for a variety of reasons. Our 19th century notebook contains a treatment for it:
Rhubarb 2 drams
Castile soap 1 dram
Oil of annis 12 drops rubbed together & made into 18 pills two taken night & morning & a warm bath every other night going to bed, it is necessary to take exercise.
Rhubarb, castile soap and anise seed oil are all common in prescriptions from European doctors at the time. Unlike some treatments, none of the ingredients are actual poisons. But the rest of the treatment is more interesting than the medicine.
Bathing became more common over the course of the 19th century, but for most people it was still rare. The resources required to take a warm bath would have been exceptional at the time on St. Martin. One would need a cistern with plenty of water, a tub, and people to draw and heat the water.
This is one of the clearest signs of status and wealth recorded in the notebook. The person receiving this treatment would have to be a wealthy planter, or family member. Depending on the time this was written, they were either a slaveholder or controlled a workforce of formerly enslaved people. They were part of a tiny group of people living in some comfort. The vast majority of the people on the island worked to provide that luxury, but lived in poverty.
No one cutting cane or picking salt would have needed a reminder that it is “necessary to take exercise.” Even less-wealthy white St. Martiners were doing plenty of hard physical labor at the time.
The very next treatment is for pills “to act on the Liver.” Perhaps they were for the same condition that caused the jaundice. The recipe for these pills also includes rhubarb and anise oil. But these pills also include mercury, which is highly toxic.
In 19th century St. Martin, wealth could buy many things. It could buy a warm bath every other night. It could buy a life free from manual labor. It could buy the advice of fellow plantation owner Dr. Allaway. But it couldn’t buy health.