Mrs Stephens' Cure for the Stone

21 Dec 2010

An essential and ongoing function of our research is to try to assess the character of the Board of Longitude, and to put it in context. One important question is how usual was it in Georgian Britain to have a government body both funding scientific research and making rewards for technological innovations?

The Board of Longitude "disposed" of exactly £157,169 during its 114 years of existence.[1] Approximately a third was spent on publications, principally the Nautical Almanac, published annually by the Board from 1767. Another third of the Board's expenditure went on expeditions, experiments, instruments and overheads, the latter consisting mostly of payments to the Board's Commissioners for attending meetings. The final third was spent on rewards to individuals for their development of techniques and scientific instruments. Although established in 1714, the Board did not, as far as we know, formally meet until 1737. From that date the Board made regular payments, in effect research grants, to the clockmaker John Harrison, typically of the order of £500 every three or four years.

This funding enabled Harrison to develop a series of marine timekeepers over a period of thirty years, or to "bring his machine to perfection", as the Board characteristically instructed him to do in June 1746.[2] This was by and large the only expenditure by the Board until 1765, when it made two notably large payments, namely another £7,500 to Harrison upon his successful explanation of the principles of his most recent timekeeper, the large watch now known as "H4", and £3,000 to the widow of the Göttingen mathematician Tobias Mayer, for his lunar and solar tables to be used in conjunction with an instrument such as an octant to determine the longitude at sea using the lunar distance method.

Hence by the mid-1760s, the Board had given staggered payments to John Harrison amounting in total to £13,500 as encouragement for further research, and as a reward for past endeavour. What other examples of government payments to scientific individuals or institutions were there in the fifty or so years after the establishment of the Board, and what sort of amounts of money were involved? So far in our research it seems there were very few, but we're still looking! One rare and fascinating example of a large sum being offered by the government as a reward for a medical advance is the case of Joanna Stephens, awarded £5,000 by the government in 1740 for her cure for bladder stones. The sums involved, and the manner in which a proposed technique that was of clear benefit to the nation was investigated through trials and testimonials, all have rather nice similarities to the contemporaneous Harrison case.

Bladder stones or merely "stones" or "the stone" were an extremely common and very painful condition in the 18th century. Various kinds of mineral deposits accreted in the bladder and the general urinary system, possibly exacerbated by diet, and almost certainly made substantially worse by the chronic dehydration that was the norm in this period due to the absence of safe drinking water. Stones and the related "gravel" were sometime passed, with great pain, and often caused blockages, leading to an inability to urinate, secondary infections, and death. Lithotomy, "cutting for the stone", was one of the very few regularly performed early-modern invasive surgical procedures that wasn't amputation, but was extremely risky.[3] Lithotrity or lithotripsy, the breaking up of the stones within the bladder, using a catheter-like steel instrument, was only developed later, in the first few decades of the 19^th century.[4] An effective lithontriptic, a remedy taken orally to ease the pain and perhaps dissolve the stones, was thus much desired mid-century. In 1738 Joanna Stephens announced a cure, and demanded £5,000 for disclosing it.[5] A private subscription was set up, raising £1,356 by December 1738. Stephens petitioned Parliament, which in April 1739 agreed to pay £5,000 if she revealed her cure in full, and if what amounted to a clinical trial was successful. Stephens agreed to these terms and presented her recipe to the Trustees appointed by Parliament and the editors of the London Gazette, where it was published. Stephens' medicine consisted of a powder, decoction and pills, containing respectively calcined shells and snails, herbs boiled with soap, and calcined snails, burnt vegetables, honey and more soap.

The Trustees oversaw a series of year-long trials on four men suffering from stones. Detailed examinations were undertaken by both surgeons and physicians, several of whom were Trustees, and all of whom were eminent. The Trustees, amongst them the Archbishop of Canterbury, the Speaker of the House of Commons, and Robert Walpole, Chancellor of the Exchequer and in effect first Prime Minister of Britain, were satisfied that Stephens had both "made a discovery" of the contents of her medicines and the manner in which they should be prepared and administered, and they were convinced of the "utility" and "efficacy" of the cure. The only dissent came from two (out of 28), including, significantly, Thomas Pellet, President of the Royal College of Physicians, who refused to endorse a statement made by the other trustees that the medicine had "dissolving power".  Nevertheless, Stephens received £5,000 from the Exchequer in March 1740, and promptly disappeared from history.

Needless to say this wasn't the end of the affair. Stephens had as many detractors as supporters, resulting in numerous pamphlets. Dr Stephen Hales, FRS, coincidently (or perhaps not) winner of the Society's 1739 Copley Medal for his investigation of the stone, and one of the appointed Trustees, undertook lengthy chemical investigations of both stones and Stephens' medicine, as did S.F. Morand and C.J. Geoffroy of the Académie Royale des Sciences in Paris. Geoffroy analysed the medicine and concluded that the large quantity of soap contained lime, which would dissolve the stones, and oil, which would relax the urinary tract. Morand and Hales both subjected stones to detailed tests in a variety of in vitro conditions, in warmed urine, in varying amounts of Stephens' medicine, and so on, making precise measurements of the weight of stones before and after these tests. The question of whether a parallel can be drawn between stones and medicine in a glass or earthen vessel, and stones and medicine in the bladder, was of course far from agreed upon.

The case of Joanna Stephens was full of disagreement: some thought her medicine was not novel at all, and hence unworthy of the substantial payment, others thought her medicine was potentially useful but still thought that nothing had been proven or discovered, and others viewed her a charlatan. The comparisons to the assessment by the Commissioners of the Board of Longitude of Harrison's H4, twenty years later, are interesting. As described above, Harrison was awarded £7,500 in 1765 for his achievements, including an "experimental exhibition" of how the timekeeper worked. None of the Longitude commissioners in 1765 doubted that Harrison's fine-tuned timekeeper had itself determined longitude at sea to the required accuracy, but ambiguity remained as to what had been discovered, whether a practicable solution had been found, and whether it was possible for any other timekeepers to be constructed that would be able to determine longitude at sea. Even after lengthy trials at sea and inspections in London, the central question of what constituted a discovery remained.[6]

The Board of Longitude became, amongst other things, an arbitrator of discoveries and inventions. It was a jury that assessed instruments and techniques and put them under trial. An obvious comparison is to the burgeoning patent system, and this requires investigation. The comparison to Joanna Stephens, however, shows how in our future work we should think of medicine, and the case-history tradition, as another rich source of comparison as we investigate science and innovation in the Georgian world.

For a facsimilie of Joanna Stephens' "full discovery" in the London Gazette for June 16th 1739, see these two images:

http://www.london-gazette.co.uk/issues/7815/pages/2