"Send for the Doctor! "
Medicine in the Regency Era
In my up-coming novel, A Return to Norland, one of the main characters (no spoiler alerts here, sorry) becomes ill and medical help is sent for. In the Regency/Georgian eras, however, one did not just go to the doctor or send someone to the doctor to ask for a house call, because depending on the type of ailment, there were different people who performed different functions all under the umbrella of ‘doctoring.’
Generally, the poorer and lower middle class households first referred to textbooks such as Buchan’s Domestic medicine or the family physician (1769). Buchan wrote Domestic Medicine not as a medical text book exactly, but more like a home remedy book, which families could refer to. It described various different ailments, and their treatments, clearly enough that untrained people could diagnose and ‘cure’ (perhaps) whatever it was that ailed the family member. Jane Austen’s family supposedly had a copy.
Unfortunately, many of his remedies were not of the standard, or the wisdom, of what we know today. For instance, Buchan was a proponent of bloodletting, purging, and other treatments we know to be harmful. Not all his theories were bad, and he was a great proponent of common-sense measures such as fresh air, exercise, hygiene, cleanliness.
But what if the ailment or injury was too difficult to cure by home remedies, or that applying leeches to little Sarah for three days merely exacerbated her symptoms? What to do?
Then people had the option to summon an apothecary, a surgeon, (and many times the apothecary doubled up as a surgeon if there was no skilled surgeon in the area, as in rural locations) or if you had enough money, a physician.
Apothecaries were pretty low on the food chain, apothecaries being considered in ‘trade’. Today we would call him a pharmacist, although nowadays pharmacists are highly trained and are afforded a little more respect. But back in medicine’s relatively early days, they were the cheapest form of medical attention one could get, and usually, but not always, would come to a house if asked to call. He was addressed as Mr Whoever, or just Whoever, and would primarily mix and dispense drugs/herbs/poisons. He could prescribe and mix you a sleeping draught, or something for fever, and so on. He might also do the work of a surgeon.
The surgeon, also only addressed as Mr Whoever, or just Whoever, was trained to treat ailments from boils to headaches to broken legs. He was, however, usually trained by a doctor, and did the dirty hands-on stuff which the physician would leave to him. As a rule, he would do things such as dressing wounds, setting bones and so on. He took on the messy jobs that no self-respecting physician would touch. Blood, gore and spurious foul liquids were not unknown to him. When we look at his kit, pictured, you can get the gist of his work.
The physician was the only one of these men who was considered a gentleman. He had a university education and was referred to as Doctor Whoever. His status differs so much from that of the apothecary and the surgeon that he was respected by the families he attended, often being invited to social occasions, to dine with them, or to stay the night. Mostly the doctor’s clients would be members of the gentry and aristocracy. Reimbursement for their services had to be discreet, since a gentleman did not receive wages for labour.
On the whole, doctors were expected to avoid anything hands-on, and simply diagnosed illness or injury by asking questions and prescribed medicines which could be made up by the apothecary. England did not have medical schools, so to further his studies he would often have travelled to Scotland or even to America to study medicine in the newly set up medical schools there. A good deal of his knowledge came from on the job training, and from learning from a practising doctor.
None of this means that his medical attention was efficacious or that richer people got a better quality of expertise. In their education, never did would-be doctors practice on actual patients. All their learning was done by listening to lectures on medicine. A website called ‘Pen and Pension’ has a really interesting page on medicine in Georgian era England, and it seems that medical practice in England in the Georgian era was pretty much a free-for-all, and that there were just as many, if not more, ‘quacks’ than men with a genuine idea of how to go about things.
‘It was far from unknown for people in need to turn to the local ‘horse doctor.’ One traveller needing medical help was told …that there was no one who could do it, but a Man that lived three miles off, who was a good Physician, bled every Man, and Calf, in the neighbourhood, and was a pretty good Surgeon, for he had been originally a Sow gelder.’
Just because you could afford a physician, didn’t mean you got a treatment that worked. Nothing worked all of the time, and sometimes, less was more, as in the case of blood-letting and use of narcotics and opiates!
Overall, it might be a reasonable assumption that to call a medical person in the Georgian era would have been as much inviting death as a cure, and it is no wonder people avoided medical help until the last minute, since of course, there was no anaesthesia to help.
I will close with this interesting reference to Emperor Napoleon’s wife Josephine, who became sickly and weak while he was busy with his Egyptian campaign. Apparently, she was ordered to stayed in bed for two weeks and follow this regimen:
“Doctors drew blood from her veins and applied leeches to her wrists, prescribed medicinal drinks, ordered compresses made from boiled potatoes strapped to her limbs. Adopting a remedy centuries old, they ordered a sheep killed and wrapped Josephine in its fleecy skin.”