Tfe `Hungry Torties: -First - Epsom College Archive Website

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-First
Tfe 'Hungry Torties:
1.1 Tfe Condition of the Toor
INSftSlT;
In the 1840s doctors
were in the front line
of change.The
population of the
United Kingdom had
almost doubled
between 1801 and
1841, but towns had
grown so fast that they
had begun to eat their
own populations.
Not on/y is there not a
breath of sweet air in
these truly infernal scenes;
but, for a large pan of the ;
time, there is the
abominable and
pernicious stink of GAS to
assist in the murderous
effects of the heat In
addition to the heat and
the gas mixed with steam,
there are the dust, and
what is called the cotton
flyings or fuz, which the
unfortunate creatures
have to inhale; and the
fact is, the notorious fact
is, that welkronstitutioned
men are rendered old and
past labour at forty years
of age, and that children
\ rendered decrepit and
deformed, and thousands
•: upon thousands of them
are slaughtered by
consumption before they
arrive at the age of 1 6,
And are these
establishments to boast
of?
(William Cobbett, Political
Register, 1824)
Average ages at Death,
1843
England and Wales 40.2
years: Manchester 24.2
Birmingham
Bradford
_Bristol_
7I£QQ_
|
13,000
61,000
102,000
26,000
85,000
202,000
67,000__
J24,000_
^Iardiff_
10,000
Glasgow
287,000
Liverpool
299,000
~L
_|_;1 , 1 17,000
252,000
2,239,000
(Mitchell and Deone, 1962, pp 19, 24-27)
Edwin Chadwick, in his'Report on the Sanitary Condition of the
Labouring Population', 1842, had convincingly proved that:'Disease
is always found in connection with damp and filth, and close and
overcrowded dwellings'
pagel
1.1 Tfe Condition oft fie Toor
In his daily round a doctor was exposed to the
worst of the conditions. The reports of Medical
Officers of the Poor Law Unions give ample
evidence of the conditions they witnessed.
From the few observations
: animal and vegetable
which 1 have been enabled
matters, which then
to make respecting the
undergo decay and emit
causes of fever during the
: the most poisonous
two months which / have
held the situation of house
i exhalations. These matters
are often allowed to
surgeon at the Dispensary,
accumulate to an
/ am inclined to consider
:
the filthy condition of the
town as being the most
prominent source. Many of
immense extent, and thus
become prolific sources of
malaria, rendering the
>
the streets are unpaved
atmosphere an active
poison. . . it may also be
and almost covered with
stagnant water, which
mentioned that in many of
'• these streets there are no
lodges in numerous large
holes which exist upon
i privies. . .
their surface, and into
which the inhabitants
throw all kinds of rejected
(Mr. Pearson, Medical
Officer of the Wigan
Union, 1842)
And in the 1830s to add to industrial grime and
deprivation had come the dreaded Cholera,
which, with no cure in sight, bore down heavily
on everyone who visited the poor as well as on
the poor themselves.
In the 1840s the Poor
Low Amendment Act of
1839 was forcing the
poor into the Poor House
The streets most densely
populated by the humbler
classes are a mass of filth
where the direct rays of
the sun never reach. In
some of the courts 1 have
noticed heaps of filth,
amounting to 20 or SO
tons, which, when it rains
penetrate into some of
the cellar dwellings. A few
public necessaries have
been built, but too few to
serve the population. To
take a single example of
one of the more extreme
cases shown to me when
visiting them during the
day, a room was noticed
with scarcely any furniture
and in which there were
two children of two and
three years of age
absolutely naked, except
for a little straw to protect
them from the cold, and
in which they could not
have been discovered in
the darkness if they had
not been heard to cry, . .
In numerous dwellings a
whole family shares one
room. But no
circumstance has
contributed more to
the injury of the
inhabitants than the tax
upon windows...
The most intolerable
nuisance is certainly one
resulting from a
slaughterhouse situated in
the very centre just off
the most fashionable part
of the town. It is just off
Grey Street the nuisance
consists in the presence of
great quantities of animal
matter. . .
Dense black clouds of
smoke from
manufacturing prevail to
a great extent in
Newcastle and
Gateshead. In the lower
parts of the town the
amount of black smoke is
extremely great and their
position renders it prone
to retain it and other
offensive smells. As much
as 20 to 50 tons of acid
are discharged into the
atmosphere.
(Dr. D.B. Reid: Report on
the Sanitary Conditions of
Newcastle, Gateshead,
North Shields, Sunderland,
Durham and Carlisle,
1845)
FIRST THOUGHTS
The worst excesses of
the Industrial Revolution
William Sproat, aged sixty
were just beginning to be
tackled in the 1840s
next case. On 2 7th
week or ten days affected
Mr. Kell, I visited, by
request, William Sproat,
with diarrhoea; but he was
"Well, society may be in
other's habits, thoughts,
its infancy," said Egremont
and feelings, as if they
slightly smiling; "but, say
what you (ike, our Queen
zones, or inhabitants of
reigns over the greatest
different planets; who are
nation that ever existed."
"Which nation?" asked
formed by a different
breeding, are fed by
were dwellers in different
the younger stranger, "for
different food, are ordered
she reigns over two."
The stranger paused;
by different manners, and
Egremont was silent, but
same laws."
October, accompanied by
not so ill as to be obliged
to relinquish his
son of William Sproat
employment... On
in a low damp cellar,
Wednesday morning,
October / 9th, he became
The mid- 840s were marked by the worst
famine in Britain's history - the Irish Potato
Famine - which killed millions and caused huge
emigration to England and Scotland. Britain was
clearly in trouble, as was the rest of Europe,
where revolution smouldered. In 1848 was
published in England Karl Marx and Frederick
Engels'The Communist Manifesto'.The condition
of England was giving cause for concern.
now proceed to the
years, a keelman, employed
at the pier, had been for a
senior... We found him
near the Fish Quay, close
worse, and was unable to
to the river, and also to
his late father's
continue his work. On
Thursday evening, October
residence...
The attack commenced
20th, at 6 o'clock I was
with copious fluid,
colled to him, and found
him vomiting and purging,
tainted with blood. He
had been severely
but with no symptom of
purged... The surface of
collapse.
On Wednesday morning,
the body was cold.
October 26th, he was
(Dr. R. Qanny.A
much weaker; the pulse
Description of the Recent
scarcely beating under the
fingers, countenance quite
Sunder/and, Gateshead and
shrunk, eyes sunk, lips dark
Newcastle, 1832)
Visitation of Cholera to
blue... at twelve o'clock at
noon
noo
he died...
Letter to his wife by Charfes Kingsley, (1819-75)
London, Oct. 24 (849
eray niti w
are not governed by the
looked inquiringly.
"You speak of—" said
"Yes," resumed the
younger stranger after a
Egremont, hesitatingly.
"THE RICH AND THE
moment's interval. "Two
nations; between whom
POOR."
there is no intercourse
(Benjamin Disraeli, Sybil,
and no sympathy; who are
as ignorant of each
1842)
T
page 3
E HISTORY OF THE
ROYAL MEDICAL
TOUNDATI
1.2 ife 'Medicat Profession an
Doctors in the 1840s were not trained
as we expect today. Physicians qualified
by apprenticeship to other doctors,
being examined by the Society of
Apothecaries. As Licentiates of the
Society of Apothecaries (ISA) they were
entitled to practise, but only those with
academic scientific training became
Doctors of Medicine (MD). After
qualification they would continue to
study for their Membership of the Royal
College of Physicians, if they wished.
Surgeons had less training, learning mostly by
experience, often on naval ships. They would
probably qualify by becoming Members of the
Royal College of Surgeons, but need not do so.
The law did not restrict the practice of Surgery
and did not enforce a scientific education.The
challenges of increasing population and disease
lack of scientific training was added their
dependence on fees, unless charities or local
Poor Law Boards employed them. Payment v
often difficult to enforce for obvious reasons.
Perhaps the worst part of a doctor's
medicament was his exposure to disease,
regularly attended patients who he could r
; and often fell victim to his own i
Mr. John Propert:
an example of a successful surgeon
John Propert was born at Blaenpistyll, near
Cardigan on July 19th 1793. He was educated
at Cardigan Grammar School under
Reverend Thomas Morgan, but left at the age
of 15 to become an ensign in a militia
regiment (the Napoleonic Wars were then at
their height). With slender means and no
prospects of promotion he left the service
and articled himself to a respectable medical
practitioner, Mr. Noot, of Cardigan. A relative
advanced the money for Propert to study in
London, where he arrived in 1811, to become
the student of the celebrated Abernethy. Six
months later (aged only 18) he qualified as a
surgeon. Three years of additional study
gained him his diploma as Member of the
Royal College of Surgeons. Although almost
penniless, he set up practice in Portland
Place, London and was soon very successful.
Attempts to improve the position of medicine
as a profession fell foul of the fact that, in the
early nineteenth century, many practising
doctors had qualified before the enforcement
of any examination system at all. It was not unti
1815, that the Licentiate of the Society of
Apothecaries was instituted as a minimum
qualification for physicians. Even then, without
government action there could be no general
enforcement of standards while so many
remained unqualified. Only private efforts
would work in these circumstances, and these
seem to have been concentrated in two main
directions - towards insuring practitioners
against bad debts and negligence suits and
The failure of the
scheme may have
been partly for the
reasons that Mr Martin
gave, but it was also
because the scheme
they proposed was so
comprehensive that
the whole profession
would have needed to
unite in its support,
which it did not.The
Prospectus speaks of a
school, or schools, but
the Minutes clearly
show that a number of
separate schools were
envisaged. Real
leadership would be
necessary to drive
such a scheme
through, such as that
supplied by Mr John
Propert a few years
later Mr Martin wrote
in 1858:" I believe that
Mr Propert was the
only man to realise his
scheme and carry it to
full success."
towards taking care of the widows and orphans
left by doctors who died before they could
make themselves financially independent.
In a Minute Book lately discovered in the
archives of the Royal Medical Foundation, there
is evidence of an early attempt to provide
support for doctors' widows and orphans. Mr
Thomas Martin of Reigate began discussions in
I 844, which were chaired by Sir John Forbes, of
Old Burlington Street, London, (Physician to
Prince Albert and the Royal Household) in
order to provide a number of'Schools for the
Sons of Medical Men'
Tram a fetter fay "Mr. Tnomas 'Martin
to 'Mr. "Wiftiam <Af(ison,nth November 1858
^ ~" , ~JJ~""r
^^, <,M,y. JL was agreed that those (Members oj the Committee
wh,
resided in or near London shouttform a seCect committee to meet,
defifaerate, and to correspond \\>itn the-provincial'Members. (By favour of
The failed
Sir John Torfaes the select Committee assembCedat his house.
Sir John Tories
protection scheme
T^he (ate <Dr. rfarawick
'Mr. Wallace ofCarshafaon
'And myseff as Secretary.
J
'After much defa&eration and correspondence a plan or prospectus was
agreed to Reprinted and circulated...
'At the meeting at Shejjie(d3ist July 1845 the general Committee
assembled, "Mr 1-Codgscm in the chair. Tnen this Committee reported to the
meeting of the 'Association that the general'opinion of the profession
•wherever expressed was in favour oj the plan and that contributions
shoufdhe invited to carry it out.
Contributions were invited and eleven or twelve hundred pounds promised
or paid inpart but thepCan did not meet with the support anticipated
and it gradually ceased to interest the Profession. 1 was then too much
engaged in medicafpractice and was not a man of sufficient importance to
advocate the plan, it has therefore been forgotten excepting by yourself, Sir,
andafe\v other friends...
pageS
.2 Tfe Wedicat Profession and'Reform
S C II O O L S
M KN-
S O N S 0 V M K D 1 (' \-
i-,..'i.a v
:mr.n:il inn-rim! .»f lh. I
A*KK-i*ti*n. held ,«t V.uli jYipton,
" i» vuu»idrrthc
=
but, a committee wuappomiru.
_
mcni »ml nrjnni/Mion of 8e&oeS« fbr An adn tifen oftta
Sons of Mom\wi> t.f tht- -Mcair.il I'mtV^ioit. ou --i<-h low
A'L t
HTIII- ot'cxpenv a* iniitht IK- (nnM«icnt w-ith.t ( ".ur-vi-.f
• ( i i ; < , L ' L . H ,.[' :. hiv.>,!i c s i , r.u :t-:
A i ' ! . . > i i L i l ' =1 w.i ' i n u ' r
•tixtd thai the- mattor to b«^ taken into consideration hail
reference to the profrwion at larttr.it w.i- tttfOOttoi
that thr rommine*1, after having digested a plan of pn>! > i-.till.'. -lU'!!lli r: \> III tl. tlll'Coilll' 11 "tYiii- \
!', I,--':•'<,:.
VI' 10 t i l l ' UVX! ^l-liri'il . n - ' i - t i l l ' ^ ui'lll.' H!''!niHT-.
S C H O O L S
OK.
Pu.
FOR
S O N S
l IT i i --
' . . i i i .; i Kplanarion o
nn-
i,-y
I'm
O F
THE
M E D I C A L
M E N
<c
'
-'hoot, or -. ii.-=: .,
The Prospectus of / 844
.. .everyone is well aware both of the necessity of an improved
preliminary education for youth destined for the medical or other
professions, and of the impossibility of obtaining this at ordinary
schools, without incurring an amount of expense beyond the
means of many parents. It is also generally known that schools on
a plan similar to that now recommended, have been established
by members of other professions, for instance the Clergy, and the
Officers of the Royal Navy, which have been most successful in
realising the hopes with which they were founded...
They propose, therefore, in the first instance, to raise the sum of
TEN THOUSAND POUNDS, at the least, as the basis on which
all their future proceedings must rest...
The committee consider it advisable at present to prepare for the
establishment of one school only, consisting of not less than two
hundred, nor more than three hundred boys. The committee,
however, hope that this school may ultimately be made to
comprehend five hundred...
Tenth. The government of the Institution to reside in a Council,
twenty-four in number, being all members of the
medical profession...
John Forbes, Chairman
Thomas Martin, Secretary
London, 26 Dec. 1844
page 6
T H E H U N G R Y F O R T I E S : T H E 1: I R S T T H O U G H T S
Could the veil be
The medical profession also attempted to
protect its members through insurance. A
newspaper report found in the first Scrapbook,
saved by Mrs Gordon Watson daughter of John
Propert, records the failure of a scheme,
started with the best of intentions. The "Medical
Protection Office" had foundered partly
through mismanagement and partly because of
the huge liabilities borne by the profession:
"The office books showed the enormous
amount of £300,000 of unpaid debts due to
the members of that society alone."
uplifted from the
household sanctuary of
many
*" j of
"• the now
humble homes of those
who were the wives
and children, though
now widowed and
orphaned, of once
prosperous medical
men, the scenes
presented would quail
even the stoutest hearts.
Sad as was the history
of a country surgeon,
lately portrayed with so
much eloquence in the
Times, in connexion
with the iniquitous
income-tax, that
picture, far from being
overcharged, might
have been painted in
still darker colours. The
after-history of such a
family, particularly
where there are six or
seven, instead of two
children, would be too
painful to dwell upon.
Honour, then, to those
who would avert such
This report of I 85 I also records the generosity
of Mr Propert: "The liabilities of the conductors
of the society were great, and Mr Propert
stepped in, and with great generosity paid from
his own pocket all the debts of under £ 10 due
to members.This proceeding needs no
comment."
The Medical College scheme of the 1850s
would learn from both these attempts.The
liabilities of the donors would be more
restricted and the scheme would be more
limited than the original educational proposals,
while insurance would be limited to benefits for
widows and orphans, and would not include
responsibility for debts.
The history of the
movement to establish a
'College for the
Education of Sons and
Orphans of Medical
, Men, and also for the
Reception of Distressed
Members of the Medical
Profession, or their
Widows,' is not without
its interest. Three or four
years back, Mr. Propert,
with the single view of
benefiting a large class
of Ms medical brethren,
consented to be the
patron of what was to be
called a 'Medical
Protection Office.'
Having full confidence
in the integrity of the
immediate movers in
the scheme, Mr. Propert
comment. But in the
investigation of the
accounts of the defunct
Society, it soon became
evident that one of the
chief causes of the
impoverished state of
many of our brethren
resulted from the
injustice which they
received at the hands of
those whom they had
been the means of
restoring to health. The
office books showed the
enormous amount of
£300,000 of unpaid
debts due to the
members of that Society
alone!...
Impressed with the
conviction that, if
properly managed, and
lent the influence of his
name, in every
legitimate manner, to
forward the interests of
the society, and as he
believed, of the great
body of its members. It
is scarcely necessary to
go through the details of
the career of that
Society, its fearful
mismanagement, and its
utter and irretrievable
ruin. The liabilities of
the conductors of the
Society were great, and
Mr. Propert stepped in,
and with great
generosity paid from his
own pocket all the debts
under £10 due to
members. This
proceeding needs no
calamities! And
especially at this time
would we do honour to
the efforts that are
being made by that
most respectable
member of our
profession, Mr. Propert,
to establish an
institution to remedy
the evils of which we
have spoken.
The Lancet, April 5th,
1851
placed under the control
of a responsible body,
who would have no
pecuniary interest in it, a
Protection Society
might be of great
service to the
profession, Mr. Propert,
on reconstructing a new
one, determined not to
make the office a mere
debt-collecting office,
but to combine with it a
far nobler and higher
object - an object in
which every friend in
the profession must feel
an interest. Hence the
origin of the proposed
Medical College...
British Medical Journal,
1851
page?