Blog Re-launch tour: Just Don't Get Sick by Joana Starnes

Hello, 

So today, I am welcoming my lovely friend, and wonderful author, Joana Starnes, with her post about illness in the Regency era.

I have known Joana since 2014, when we realised through Facebook that we lived in the same town.  We met for a coffee and the rest is history! We have shared many, many adventures since then, attending the festivals together, going to lectures and talks, visiting National Trust properties, and as many other activities as we could possibly manage - sometimes with the most tenuous Austen connection - but any excuse for sharing a day out together! I am so glad to call Joana a friend, and it is all thanks to our mutual love of Jane Austen. 

So now, it's over to her. Thank you for this excellent and interesting post, Joana! 

JUST DON’T GET SICK!

When Jane was ill at Netherfield in Lost in Austen do you remember Mr Bingley insisting ‘No-no-no,  Miss Price must stay here, she is the best possible nurse. She has Paracetamols’? And well he might rely on Amanda’s paracetamols, because there was precious little he or anyone else could offer as a substitute.

If you ever lay hands on a time machine and set it to the early 1800s be sure to have a healthy supply of painkillers and antibiotics with you, and if you’re not past childbearing age think again before you get the engine running! Mrs Bennet blithely tells her husband that ‘people don’t die of little trifling colds’, and if that held true it was largely thanks to human resilience and not to Georgian medicine.

The best medical attention that Mr Darcy’s ten thousand a year could buy would have been from a Fellow of the Royal College of Physicians. The charter granted by Henry VIII gave the Fellows and their licentiates the exclusive right to practise in London and for 7 miles around. The College also granted an ‘extra licence’ that permitted the holder to practise as physician outside the 7 mile limit, but the restrictions were difficult to police. As for the degree itself, it was acquired by studying the writings of Hippocrates (400s BC) and Galen (129-216 AD) and it was acceptable to have someone sitting the final examination for you.

Outside of London and the major cities the most common medical practitioner was the apothecary, such as Mr Jones, summoned to Netherfield to attend Jane and prepare draughts, in the absence of paracetamols. In theory, the apothecaries were the equivalent of a modern day pharmacists.

(The Apothecary and his Trade, John White, Bath 2015)

They were supposed to supply medicines rather than prescribe them, but especially in rural areas they might have been the only source of medical attention and acted more or less as general practitioners.

(Visiting the Apothecary, Bath 2015)

Some, the surgeon-apothecaries, would have been apprenticed in performing minor operations such as lancing boils, setting bones, bloodletting and sometimes even amputations.

The training varied widely. At the beginning of the century the successful completion of an apprenticeship was enough for setting up practice and earning a living from dispensing drugs and performing minor surgery. Apothecaries greatly outnumbered doctors, even in major cities. In 1775 Bristol, for example, there were 8 physicians to 56 surgeon-apothecaries.

And their services did not come cheap. Household bills from Dunham Massey, a large estate near Manchester now in the care of the National Trust, show that in 1822 two apothecaries were paid £55 pounds over a 3-month period, at a time when the house steward, the highest-ranking male servant, earned £90 a year and the third housemaid £10 a year.

All well and good. If you’re taken ill in Regency England let’s say you’re lucky enough to afford the best treatment money can buy. Let’s say you can even afford the services of the disciples of one of the most reputable physicians of his day, William Buchan, MD (1729 – 1805), Fellow of the Royal College of Physicians, Edinburgh and author of the Treatise on the Prevention and Cure of Diseases that went through 19 editions, sold 80 000 copies in his lifetime, was translated into the main European languages and among other things earned him a letter of commendation and a gold medal from the Empress of Russia.

                                                                               William Buchan, MD

If Georgian medicine is your thing and you’ve skimmed through the Treatise for fun, you will have discovered that some of Dr Buchan’s principles were surprisingly in tune with modern concepts. He believed that cleanliness, exercise and a sensible diet keep people healthy; that fresh air is beneficial in the sickroom; that feverish patients shouldn’t be covered with too many blankets, and that the number of visitors to the sickbed should be kept to a minimum in order to limit the risk of infection. Also, he maintained that mothers should nurse their babies if at all possible, and if a nurse is hired the mother should keep a close eye on her offspring’s welfare rather than abandoning her newborn child ‘to the sole care of a hireling.’ He argued that babies should not be swaddled and that suitable clothes allowing free movement should be used both for children and adults. Also, that young ladies warmed by exercise after a long night of dancing should not then gad about outdoors in their thin muslins without suitable wraps if they cared for their health. There are whole chapters dedicated to cleanliness, intemperance, the risks posed by wet clothes and wet feet, as well as the problems caused by succumbing to strong emotions like anger, fear, grief and love. If you have a really quiet afternoon, look up Dr Buchan’s Treatise on the Internet and glance over the introductory chapters. Poor Mr Darcy, he had no idea, had he, of the medical dangers he exposed himself to when he allowed himself to be ruled by passion!

Sadly, most of the treatment sections of the Treatise make grim reading. The germ theory of disease would not emerge for another five decades or so after Dr Buchan’s death. The all-prevailing belief in Georgian times was that disease was caused by an imbalance in the Hippocratic four humours: blood, black bile, yellow bile and phlegm, and treatment should be aimed at restoring that balance. How? Why, by relying on time-honoured methods, of course: bleeding, vomiting, purgation, applying irritants on the skin to cause blisters and thus extract the poisons from the body and other similar measures that leave the modern reader in wonder that patients survived the cure, as well as the condition. Calomel (mercurous chloride) was liberally prescribed as a purgative. Everyone swore by Laudanum (tincture of opium, approximately 10% opium equivalent to 1% morphine) and it was considered highly beneficial in treating most things, from palsy to nervous dispositions, all the way to calming down babies and children who grizzled too much.

What about Miss Bennet’s fever? If the heat of the body is very high, 40-50 drops of sweet spirit of nitre should be made into a draught, with an ounce of rosewater, two ounces of common water, and half an ounce of syrup. And prompt bleeding is of the greatest importance in cases such as these!

But you may be reassured to hear she must also drink plenty of diluting liquors such as water-gruel, or oatmeal-tea, clear whey, barley-water, apple-tea or orange-whey, deemed an excellent cooling drink.

Heaven forefend that the condition should worsen and affect the lungs! In that case a man would benefit from losing 12-14 ounces of blood (but less if the patient is a female of a delicate constitution). And if there is violent pain to the chest it should be alleviated with a fomentation made by ‘boiling a handful of the flowers of the elder, camomile and common mallows or any other soft vegetables, in a proper quantity of water’. Leaves of various plants such as cabbage might also be applied warm to the patient’s side ‘with advantage.’

Mustard whey is beneficial in nervous fevers (Mrs Bennet must have required a steady supply) but Dr Buchan also argues that in nervous disorders exercise is superior to all medicines. Anything goes: riding on horseback is considered the best, but walking or riding in a carriage might work as well, as would a trip to the sea or even a sea voyage. Maybe Mrs Bennet knew what she was talking about when she thought that a little sea-bathing would set her up for good.

Dr Buchan has a lot more to say about all manner of conditions, but I’d much rather not put you off your dinner. Have a look through his Treatise if you’re of a strong constitution and if you’re lucky enough to go time-travelling to Regency England just don’t get sick!

* * * * * *

J J Rivlin ‘Getting a Medical Qualification in England in the Nineteenth Century’

P Hunting ‘History of the Society of Apothecaries’

Pamela Sambrook ‘A Country House at Work’, 2003

Wm Buchan ‘Treatise on the Prevention and Cure of Diseases’, 1785

Images from ‘So You Think You’re Sick’ – a talk and demonstration by John White at the Jane Austen Bath Festival 2015 (photos J Starnes).

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Good luck! And a massive thank you to my dear friend Joana for that informative post - personally, I suspect I never would have survived in the Regency era! 

Other posts from my re-launch tour - comment on each one for more entries to the giveaway!

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