The Rise of the Medical Profession

By Judith Leask

The medical profession – that is, the role of physician – was one of the few ‘gentlemanly’ professions of the 18th-19th centuries[1]. Was it the prospect of attaining this status in society that attracted so many young men into the profession during this era? Was there an enthusiasm to practise the emerging powers to heal the sick that drew them in, or was it a desire for a place of public prominence at a charitable hospital? For some it may have been a philanthropic ambition to address the shameful living conditions of the poor, in both urban and rural locations; for others, no doubt, it was a hankering to gain access to the drawing-rooms of the wealthy and titled.

Dr Lydgate, the beautifully crafted character in George Eliot’s Middlemarch, was motivated by the need to view himself as a success, and to leave a legacy – to leave his name to some key piece of advancement in medical science; Dr Harrison in Elizabeth Gaskell’s The Cranford Chronicles wished to spread modern medical principles to the sleepy country town.

Whatever their varying motivations, young men were increasingly drawn to the study of this field – prominent centres of learning were London hospitals[2], as well as Edinburgh[3] and Glasgow[4]. In the later part of the 19th century, it was not only the young men who aspired to this profession – women began to question why they should be shut out, and began to break down the door (more on this later).

Anatomy

An improved knowledge in this area was essential for advancing medical science, and a continuous supply of cadavers was required to educate students of medicine, but the public were naturally averse. From the times of Henry VIII, dissection had been associated with the executed corpses of convicted felons or murderers, which were not permitted to be buried, and therefore did not receive the proper religious rites[5]. To have one’s body dissected was therefore an added punishment, and was a mark of an utter lack of respect, even ignominy. It’s easy to imagine, therefore, that doctors who pursued this form of study were held in suspicion – why would any person of respectability wish to do such a thing? Who could tell what such a doctor, so lacking in a sense of moral rectitude, may do to gain a further supply of cadavers to study?

The increasing demand for cadavers that outstripped the supply of executed bodies had somewhat ghoulish, if perhaps predictable, results – the practice of grave-robbing began to flourish. The trade of the Resurrectionists paid quite well: a gang of 15 grave robbers operated in the vicinity of Lambeth, using 30 burial grounds, until they were rounded up in 1795[6]. Families who were wealthy enough would have their deceased relative entombed in a metal coffin or had a mortsafe of iron bars placed around the grave.

Illustration of resurrectionists at work - Credit

While disturbing a grave was a criminal offence, the taking of the corpse was not – a corpse was not considered property, therefore could not be stolen[7]. However, engaging in this act was very ill-advised, given the strength of public feeling against dissection, and many medical students were lucky to escape with their lives from the angry crowds when suspected of being involved.

Others found a more direct source of cadavers to sell – famously Burke and Hare killed 15 of the lodgers who stayed at Hare’s Edinburgh lodging house over the course of about a year, until they were discovered in 1828. Before embarking on this killing spree they had taken the body of a man who had died of natural causes to the university and sold it for £7 10s; it seemed they could not resist engaging in a further trade[8].

This grisly trade resulted in the Anatomy Act of 1832, which gave physicians, surgeons and medical students the legal right to corpses that were unclaimed after death, in particular those who had died in a hospital, prison or workhouse [9].

Burke and Hare circa 1850 - Credit

Hospitals

The setting up of charitable hospitals also flourished through this period.

To take London as an example, in the early 18th Century St Thomas’s and St Bartholemew’s hospitals were the only two hospitals, endowed by Henry VIII and Edward VI respectively, and were supported by estates confiscated from the church at the time of the reformation. Then came Guy’s Hospital, founded in 1721 and supported by the large estate of Thomas Guy – these three ‘endowed’ hospitals could survive independently without the need for public donations[10] .

Further hospitals were set up in the 18th century via charitable associations. Coinciding with advancements in medical knowledge, hospitals became places where one might seek a cure, rather than simply receiving refuge and comfort. Many were also institutions for medical training, with some being set up specifically to serve close-by medical colleges.

This sounds as though people who could not afford to pay for their chosen doctor to treat them at home were well catered for – that multiple hospitals that served the growing urban population would provide for their needs. The reality was unfortunately quite different; in most cases it took some time and effort to gain admission – and often time was not on the patient’s side. To receive charitable treatment a patient would have to seek a letter of recommendation from a governor, who would be limited to the number they could recommend, and could pick and choose who they agreed to support.

Admissions were also only possible on one or two days a week[11].  Imagine falling ill with a dangerous fever on a Tuesday, if admissions at your local hospital occurred on Mondays only. Fortunately from the 1820s, institutions began to appear that did not require such a recommendation, or any payment – they would treat in case of need. Prince Albert was the supporter of one such hospital.

In addition to general hospitals, a number of lying-in (or maternity) hospitals were established.

Initially these were for married women only; perhaps the controversy that arose from these hospitals related to taking this activity into a more public sphere rather than existing only in the domestic – certainly the attendants were women only at first. One can only imagine what was said by genteel folk of the General Lying-In Hospital’s policy of admitting single as well as married women, when it was established in London 1767[12] .

Women in Medicine

In the 18th and early part of the 19th century, women’s role in the medical world extended to midwifery only, an occupation for a skilled low-born female.

As far as education was concerned, schools that admitted girls equipped them to be considered ‘accomplished’ and to at least know a little history, and so on; after all, what genteel man would want a wife who could not hold a reasonably intelligent conversation with their dinner guests, or play the pianoforte in the drawing-room? The story of women educationalists is a fascinating one – of women who defied convention to set up schools that taught a full curriculum, such as the Cheltenham Ladies’ College, founded in 1858[13] .

No university in this country awarded degrees to women until the University of London in 1878[14]  – and the London School of Medicine for Women, established in 1874, formed an association with this university in the late 1800s[15]  to enable women to train as doctors. To put this into context – Oxford did not award degrees to women until 1920[16], and Cambridge in 1921 began to acknowledge the studies of women but only with a ‘diploma’[17] . The first woman doctor in this country (registered in 1859) did not gain her degree here – Elizabeth Blackwell studied in Geneva, New York, gaining her medical degree in 1849, the first woman in America to do so[18].

Elizabeth Blackwell Postage Stamp - Credit

Can you imagine what it must have been like, as a young woman with aspirations, to attempt to break through the beliefs so firmly rooted throughout society at the time? To persuade the world to break with the centuries-old convention that prohibited their having an education and a professional role?

Nursing

While this post is about medicine, I couldn’t possibly neglect to mention Florence Nightingale in a discussion on healthcare and women’s roles in the 19th Century. She is described as the founder of modern nursing, and after her famous role as ‘the lady with the lamp’ in the Crimean War, she set up the nursing school at St Thomas’s hospital in 1860[19]. At a time before germ theory was accepted as the cause of disease, Florence instilled more sanitary conditions in hospitals and transformed nursing care.

Florence Nightingale - Illustrated London News, 1855 - Credit

But it is her determination to pursue her passion despite her family’s opposition that fascinates me – her refusal to have her life shaped by the conventional roles dictated by society. It was my admiration for her approach that led me to preface my book with this quote:

‘The world is put back by the death of every one who has to sacrifice the development of his or her peculiar gifts to conventionality.’ – Florence Nightingale.

Notes

 [1] http://englishhistoryauthors.blogspot.co.uk/2015/09/gentlemanly-professions.html
 [2] https://www.medsci.ox.ac.uk/about/history/oxford-medical-sciences-through-the-centuries/1800s
 [3] http://www.electricscotland.com/history/medical/medicine8.pdf
 [4] https://en.wikipedia.org/wiki/List_of_historical_medical_schools_in_the_United_Kingdom
 [5] http://www.leeds.ac.uk/chb/lectures/anatomy1.html
 [6] http://onlinelibrary.wiley.com/doi/10.1046/j.1440-1622.2001.02127.x/pdf
 [7] https://en.wikipedia.org/wiki/Burial_Act_1857
 [8] https://en.wikipedia.org/wiki/Burke_and_Hare_murders
 [9] https://en.wikipedia.org/wiki/Anatomy_Act_1832
 [10] http://www.nhshistory.net/voluntary_hospitals.htm
 [11] ibid
 [12] https://en.wikipedia.org/wiki/General_Lying-In_Hospital
 [13] https://www.cheltladiescollege.org/about-clc/history-of-college/
 [14] https://en.wikipedia.org/wiki/Timeline_of_women%27s_education
 [15] https://en.wikipedia.org/wiki/London_School_of_Medicine_for_Women
 [16] http://www.telegraph.co.uk/only-in-britain/oxford-university-allows-women-to-graduate/
 [17] https://en.wikipedia.org/wiki/University_of_Cambridge#Women.27s_education
 [18] https://en.wikipedia.org/wiki/Elizabeth_Blackwell

 [19] https://en.wikipedia.org/wiki/Florence_Nightingale

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Judith Leask is a long-term reader of historical and classical novels, and began writing fiction when dared to do so by a fellow wordsmith in her project management office. Six years, many writing group sessions and several re-writes later, her first novel Her Peculiar Gifts has now been released – a contemplative tale of James, a shy doctor, and his daughter Laura, who possesses unused talents. A further historical novel, set in Jamaica, is underway, and for her dragon-loving children she wrote The Silver Shell, to be released soon. Her story about the ghost of Charles Dickens can be found in the anthology Haunted. She has discovered a passion and a talent for developmental editing, and is now a freelance book editor with Just Right Editing. This gives her the chance to read and help to refine all manner of books – which is heaven for a bookworm.

https://judithleask.wordpress.com/
https://judithleask.wordpress.com/just-right-editing/

Alfred and Octavius, the Lost Princes

By Catherine Curzon

George III by Ramsay

There is much to be said for a loving home and a warm hearth, and George III was fond of both. Whatever challenges he faced in Parliament and no matter how much the government niggled and needled, George could always take comfort in his domestic life. As war raged, he took refuge in the gentle comfort of his devoted consort, Queen Charlotte, and their growing brood of children, using Richmond Lodge as a family home and commissioning a sweeping programme of renovation and repair at Windsor Castle. 

George was devoted to his children who were expected to study hard and behave in a manner befitting the offspring of the very pious king. Even so, he loved to spend time in the company of his children, playing with them and sharing with them his own favourite pastimes. They were permitted to attend the theatre and other entertainments and, behind the scenes, all seemed happy.

It would not last.

Real life was set to force its way into his family idyll in the most upsetting way and the household would never quite recover. So far, George and Charlotte had welcomed fourteen children (the last would be born in 1783) and remarkably for an eighteenth century couple, all of the children survived infancy. Tragically, that was about to change and in the space of less than twelve short months, those loving parents would lose not only one child, but two.

In the Georgian era, smallpox was a very real and present threat to the lives of everyone, whether king or pauper. The disease claimed hundreds of thousands and survivors rarely escaped devastating side effects that ranged from scars to blindness. For any parent, the news that their child had been infected would be terrifying and for the royal couple, things were no different.

Queen Charlotte by Ramsay

In 1782, George and Charlotte took the decision to have their youngest children inoculated against smallpox and by June, they no doubt rued that day. Little Alfred, the couple’s youngest son who was a full eighteen years younger than his oldest brother, fell ill not long after receiving the treatment. In order to speed his recovery he was taken to enjoy the sea air at Deal in the care of Lady Charlotte Finch, his devoted nurse.

A cheery little boy with a bright disposition, Alfred was nevertheless laid terribly low by his inoculation and began to experience smallpox-like blemishes on his face, whilst his breathing grew ever more laboured. Only when it appeared that the seaside was not working its magic was he returned to Windsor. Here he was attended by court physicians and their conclusion, when it came, was devastating.

Little Alfred would be dead within weeks.

“Yesterday morning died at the Royal Palace, Windsor, his Royal Highness Prince Alfred, their Majesties youngest son. The Queen is much affected at this domestic calamity, probably more so on account of its being the only one she has experienced after a marriage of 20 years and having been the mother of fourteen children.”1

Alfred by Gainsborough

Prince Alfred of Great Britain passed away on 20 August 1782, just a month shy of his second birthday, and the royal family were rocked by his unexpected death. Protocol did not demand official mourning for one so young but, officially or not, his parents and siblings wept for the cheerful child. He was buried at Westminster Abbey with full honours and though George and Charlotte mourned his loss, they could at least take comfort in their surviving children. The king, in particular, doted on the boy who was now his youngest son, three year old Octavius. In his darkest moments he admitted that, should Octavius have died, then he would wish himself dead too.

These were to be fateful words.

Despite Alfred’s death, it was still reckoned that inoculating the children against smallpox posed less of a risk than leaving them open to the infection so little Octavius and his best friend, five year old Princess Sophia, were given the treatment. Whilst Sophia suffered no ill effects and would live to a ripe old age, things did not go so 

Octavius by Gainsborough

The queen was pregnant with her final child when, just days after receiving the smallpox inoculation, Octavius grew terribly ill. Unlike Alfred, whose sickness progressed over time, Octavius declined with alarming speed and died on 3 May 1783. The king was beyond devastated, tormented to distraction by grief and as the situation in America neared its endgame, George was perhaps lower than he had ever been.

“On Saturday, on the Majesties arriving at Kew, in their way to Windsor, and finding Prince Octavius in a dangerous Way, they determined to stay there all Night and sent an Express to Windsor to acquaint the Attendants of the Reason of their continuing there.

The same Night died at Kew, his Royal Highness Prince Octavius, his Majesty’s youngest Son, in the fifth Year of his Age.”2

The king brooded on the loss of his children, wondering whether their inoculation against smallpox had contributed to their early deaths. Where once there had been the laughter of infants, the gentle distraction offered when Charlotte and George played adoringly with the youngsters, now there was only silence and grief, the royal household plunged into sadness. A little respite came with the birth of Princess Amelia in August of that same year and George showered her with love, filling the void where his sons had been with the cheer of this new daughter. Little Amelia, or Emily, as she was known, lived through childhood but years later it would be her death that was to have a catastrophic effect on the father who adored her.

Sources

1. London Chronicle (London, England), August 20, 1782 - August 22, 1782; issue 4014, p.1.

2. Daily Advertiser (London, England), Monday, May 5, 1783; issue 17249, p.1.

Bibliography

Anonymous. George III: His Court and Family, Vol I. London: Henry Colburn and Co, 1821.

Black, Jeremy. George III: America’s Last King. New Haven: Yale University Press, 2008.

Craig, William Marshall. Memoir of Her Majesty Sophia Charlotte of Mecklenburg Strelitz, Queen of Great Britain. Liverpool: Henry Fisher, 1818.

David, Saul. Prince of Pleasure. New York: Grove Press, 2000.

Hadlow, Janice. The Strangest Family: The Private Lives of George III, Queen Charlotte and the Hanoverians. London: William Collins, 2014.

Hibbert, Christopher. George III: A Personal History. London: Viking, 1998.

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Glorious Georgian ginbag, gossip and gadabout Catherine Curzon, aka Madame Gilflurt, is the author of A Covent Garden Gilflurt’s Guide to Life. When not setting quill to paper, she can usually be found gadding about the tea shops and gaming rooms of the capital or hosting intimate gatherings at her tottering abode. In addition to her blog and Facebook, Madame G is also quite the charmer on Twitter. Her first book, Life in the Georgian Court, is available now, and she can be seen performing in An Evening with Jane Austen, starring Adrian Lukis and Caroline Langrishe, at Gloucester Cathedral on 22nd October.

Dr. Richard Russell and Brighton

by Lauren Gilbert

Dr. Richard Russell by Benjamin Wilson c 1755

A blue plaque honouring Dr. Richard Russell on the Royal Albion Hotel in Brighton says, “If you seek his monument look around.” Who was Dr. Russell and how did he come to be honoured with the same words applied to Sir Christopher Wren in St. Paul’s?

Richard Russell was born in Lewes in November 26, 1687, the son of Nathaniel and Mary Russell, and the oldest of seven children. He was baptized in the parish of St. Michael on November 27, 1687. Nathaniel Russell was a surgeon and apothecary. Richard was educated at a grammar school in Lewes. Destined to follow in his father’s footsteps, he studied and worked with his father. The elder Dr. Russell’s patients included William Kempe, Esq. of South Maling Deanery, near Lewes, and his family. Young Richard became acquainted with Mr. Kempe’s only daughter, and their mutual affection combined with their disparate social standings resulted in an elopement. Although Mr. Kempe was not happy, he ultimately came around.

Richard went to the University of Leyden in Holland to study medicine and qualified with a dissertation in 1724.  Upon his return to England, he was at some point elected a Fellow of the Royal Society. He returned to practice in Lewes. Ultimately, he and his wife moved into his father-in-law’s house in South Maling Deanery after Mr. Kempe passed away. He continued his medical studies, becoming very interested in glandular conditions, and wrote several works on the subject including  “Glandular Diseases, or a Dissertation on the Use of Sea-Water in the Affections of the Gland” in Latin, published in 1750 (it went through 6 printings), where he discussed both bathing in and drinking seawater as treatment for these problems. He was far from the first to espouse the sea as a cure, but was extremely successful with it. Brighthelmstone was a fishing village near Lewes at the time, and was considered one of the most accessible places to take the seawater cure. (Sources indicate that the village was not a poor one, as sometimes noted.)

As Dr. Russell’s fame and standing grew, more and more of his patients went for treatments.  Lodging houses and other amenities sprang up, and the town became known as Brighton.  (Ultimately, it overtook Lewes as a town of note, Lewes becoming known as “Lewes, near Brighton.”)  Dr. Russell built a house in Brighton (subsequently the site of the Royal  Albion Hotel), Russell Street was named for him, and his portrait was hung in the Old Ship. His house was large and had easy access to the sea, which was convenient for him and for his visiting patients. He moved there permanently in 1754. His treatments were apparently considered very successful.

Dr. Russell was a noted physician, known for his skill, until his death in December 1759. He was buried in the family vault at South Maling Church. After his death, his house was rented to seasonal visitors, including the Duke of Cumberland (brother of George III). The Duke's nephew, the Prince of Wales, visited the Duke there, which was the beginning of the prince’s love affair with Brighton and completed the transformation of the fishing village to modern seaside town. The house was demolished in 1823, and the Royal Albion Hotel was built on its site. The hotel opened in 1826.

Dr. Russell’s oldest son William inherited his estate but chose to practice law and finally changed his name to his mother’s maiden name of Kempe.

Sources include:

The Argus on line. “Old Man of the Sea”  by Adam Trimmingham, posted January 2, 2010, here
Brighton and Hove on line.
“Russell Dr. Richard, Proponent of Brighton’s Seawater Cure, c 1750s.” Reproduced with permission from the Encyclopedia of Brighton by Tim Carder, 1990. [Extract] here
Brighton Works on line.  “Brighton Bathing.” here
France Thalasso.  “Doctor Richard Russell.”  here
GoogleBooks. Lower, Mark Anthony.  The Worthies of Sussex: Biographical Sketches of the Most Eminent Natives or Inhabitents of the County from the Earliest Period to the Present Time.  Printed for subscribers only by George P. Bacon, Lewes, 1865. PP. 59-61. here
Jane Austen's Regency World.  “Every possibility of earthly happiness” by Chris Cole.  Issue 16, July 2005.  PP. 7-10.

Image from Wikimedia Commons: Dr. Richard Russell by Benjamin Wilson c. 1755 here

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Lauren Gilbert is a member of the Jane Austen Society of North America and the author of Heyerwood: A Novel.  Her second novel, A Rational Attachment is in process.  She lives in Florida with her husband.  For more information, visit her website here.

Superstitions and Bodily Health

by Diane Scott Lewis

Before modern medicine lay people and some physicians held the belief that transferring the ailment to another object could cure you of disease. Since antiquity, and well into the eighteenth century, people believed that men reflected aspects of the natural world. It was a dominant strategy that explained the mysteries beyond the ken of the science of the day.

A man in late seventeenth century Somerset claimed that his brother was cured of a rupture by being passed through a slit cut in a young ash tree, three times on three Monday mornings before dawn. When the tree was later cut down, his brother grew ill again.

To cure jaundice, you took the patient’s urine, mix it with ashes and make three equal balls. Put these before a fire, and when they dried out, the disease leaves and he’s cured. In Devon, to cure the quartan ague, you baked the patient’s urine into a cake, then fed the cake to a dog, who would take on the disease.

Even Richard Wiseman—a Barber Surgeon—who wrote Chirurgicall Treatises during the time of Charles II, believed to remove warts you rub them with a slice of beef, then bury the beef.

Color as well played a part in how health was viewed. “Yellow” remedies were used to cure jaundice: saffron, celandine with yellow flowers, turmeric, and lemon rind. John Wesley, who wrote Primitive Physick, in the mid-eighteenth century, suggested that sufferers of this illness wear celandine leaves under their feet.

Health was also governed by astrological explanations. Manuals intended for physicians and apothecaries included this “otherwordly” advice. Nicholas Culpeper detailed which herbs were presided over by which planets in his famous health text, Culpeper’s Complete Herbal. For example, if a headache was caused by the actions of Venus, then fleabane (an herb of Mars) would cure the malady.

However, the Vox Stellarum, the most popular almanac in the eighteenth century, took a more moderate view: “Men may be inclin’d but not compell’d to do good or evil by the influence of the stars.” Yet this same almanac, in 1740, listed which diseases were prevalent in certain months—a vestigial form of astrological medicine.

 

Thank goodness more enlightened physicians, such as brothers William (a leading anatomist and renown obstetrician) and John Hunter (one of the most distinguished scientists and surgeons of his day) in the eighteenth century, came along to bring medical thinking into the modern world. Though superstition among the lay people remained.

I delved into this research for a character, a young physician, in my still unpublished novel, Ring of Stone. Information taken from, Patients, Power, and the Poor in Eighteenth Century Bristol, by Mary E. Fissell, 1991.

To learn more about my novels: http://www.dianescottlewis.org