Suzie Grogan - Death, Disease & Dissection

Death, Disease & Dissection

The Life of a Surgeon-Apothecary, 17501850

Suzie Grogan

First published in Great Britain in 2017 by

Pen & Sword History

an imprint of

Pen & Sword Books Ltd

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Barnsley

South Yorkshire

S70 2AS

Copyright Suzie Grogan, 2017

ISBN 978 1 47382 353 2

eISBN 978 1 47388 641 4

Mobi ISBN 978 1 47388 640 7

The right of Suzie Grogan to be identified as Author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988.

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For Peter, always.

M any people have offered support in the writing of this book but I would particularly like to thank the staff at the Wellcome Library and The London Library for their expertise, and the libraries themselves for offering a wonderful space in which to work on my research trips to London.

A special thank you to John Ford MD FRCP who contacted me on behalf of the Society of Apothecaries and pointed me to some little-known but important biographies of interesting men of the period, and to Mike Rendell, not only a Georgian Gent, but a gentleman in the true sense of the word who offered his terrific knowledge of the period and lent me some very precious, original documents to photograph for this book.

Once again, I have been away on a number of occasions to concentrate on writing this book, and would like to send my love and thanks to my great friend Cornelia Marock and her family, who invited me to stay with them in Liechtenstein for a week of writing, when it looked as if I would never finish the manuscript. My daughter, Evie, also put me up, or put up with me, on research trips to London, which I know rather cramped her style. Thank you darling.

Thank you to my friends Sarah Whittingham, Angela Buckley and Gill Hoffs who have, at various times (and probably without knowing it) inspired me to keep writing and supported me when the task felt overwhelming. I wish them all very good luck with their own books, to be published in the coming months.

Sincere thanks to all at Pen and Sword for their hard work in bringing this book to publication, and a special mention for my husband Peter, for his endless patience, proofreading skills and constant supply of strong coffee.

I n the twenty-first century, we talk about going to see our GP as a first point of contact when we have a health worry. How many of us stop to consider, however, that the men and women, we make an appointment to see, are members of a long line of hard-working doctors who have been treating our minor health concerns and signposting us to other services for the more serious conditions, for more than 200 years? That their forbears were eighteenth and nineteenth century surgeon-apothecaries and a mixed band of practitioners, from the powerful physician and surgeon to the horse doctor and local nurse, working with what few tools they had to make us well?

The doctors of the late eighteenth and early nineteenth century were regularly lampooned in cartoons of the period as men willing to feed the worst fears of their patients and take their wealthy and worried-well patients for every penny they could squeeze out of them. The patients, too, were often seen as hypochondriacs with more money than sense, willing to try any weird and wonderful, but probably useless, preparation to cure themselves of an imagined ill, or the results of their overindulgence and dissipation.

In this book, I wanted to move away from that frequently bewigged stereotype and highlight some of the hard-working and idealistic men who, often by luck, have had their story noted down somewhere, and their diaries and ledgers uncovered for the wonderful social history they contain. At the same time, I wanted to address the context, the medical world within which they worked and the difficulties they faced. There were many practical obstacles, from affording apprenticeships and further training, to the social prejudice many of them faced throughout their working lives. From the late eighteenth-century Poor Law regulations, which allowed some of them to build up a practice that paid, to the post-1834 new Poor Law changes, which took away much-needed income and made it harder for the dedicated doctor to treat the poorest in his parish? What competition did they face? What conditions could they treat, and with what? What changes did they see in that period of great industrial upheaval and enlightenment thinking?

.) The social niceties of medicine are fascinating and the arguments between, and within, the different colleges could go to extremes.

At what point did the surgeon-apothecary appear, and when had he fully metamorphosed into the general practitioner? Irvine Louden in Medical Care and the General Practitioner offers an academic perspective on the period, with a vast array of statistics and detailed examination of the medical changes, and has found the first reference to general practitioner in a letter by one H written in 1809. He feels it isnt important to be specific about the dates but that, in this more general history, the change was almost complete by the end of the period and seems to be a label that changed as society changed; from the remnants of the mystical medicine of rural lives long past, to the mechanised, practical society of the industrial revolution and the reign of Queen Victoria. Medicine progressed in giant leaps as anaesthesia was identified, as the true causes of epidemics and the transmission of infection were recognised, and as doctors discovered there were ways that medicine, as well as surgery, could cure rather than just control. The label described the man, and eventually, it would describe the woman too.

Medical treatment and cure, rather than palliative medicines, were in their earliest stages of development in this period. There were no antibiotics of course, and no anaesthesia until towards the middle of the nineteenth century. The surgeon-apothecary would have been faced with many patients suffering a fever without any hope of identifying the cause so, despite the doctors best efforts, his treatment was often ineffective. He was there to offer comfort and reassurance, to give confidence to the patient and family, in the hope that it may aid recovery.

Conditions behind a general sickness were mainly unidentified diabetes, for example, was not identified until 1889, and it can cause a variety of symptoms that are easy to treat today but would have mystified many 200 years ago. Heart conditions could be treated by digitalis, the use of which was identified by William Withering in 1785, but in the early nineteenth century, its use was largely confined to treating oedema (swelling as water collects in the tissues). A lack of Vitamin C had been discovered as the cause of scurvy, and malaria responded to cinchona bark, a source of quinine. Pain could be eased with laudanum (a tincture of opium in alcohol, and highly addictive), and there were various cures for venereal disease. looks more closely at the practical and medical help a medical man could give, and the remedies at his disposal.