Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 7-Day Trial for You or Your Team.

Learn More →

In sickness and in health: the British experience, 1650–1850

In sickness and in health: the British experience, 1650–1850 Essay Review ROY PORTER and DOROTHY PORTER, In sickness and in health: the British experience, 1650-1850, London, Fourth Estate, 1988, 8vo, pp. 324, £25.00. Until recently, as the authors point out, the history of medicine had doctors as its heroes. Today, when the concern of most researchers is with the social, professional, and institutional aspects of the history of medicine and more with broadly health and healers of all descriptions, modem scholarship has become "increasingly critical of, or even hostile towards, the profession". No one denies the gain from the new scholarship, or from developments such as the increasing collaboration between social historians, demographers, geographers, and epidemiologists, which has resulted in yesterday's speculation being replaced by today's rigorous analysis. Yet the greatest changes have been in method and approach rather than historical material. The main sources for the history of medicine are still in large part the records of healers (in the broadest sense) and institutions, the of the registers parishes and offices of civil registration, and literary, political, and religious sources of relevance to historians of medicine. Neither the old nor the new-style medical history in the words of the has, authors, "set much store on personal experience". Most historians are concerned with diseases and concepts of disease, practitioners (orthodox and and unorthodox), the health of populations rather than individuals. Roy and Dorothy Porter claim a quite different approach. They are concerned with people, not patients, with the experience of sickness, not diseases, with medicine as seen by the sufferer than rather the healer, and most of all with lay perceptions of health, birth, childhood, old age, and death. They deal, they say, in attitudes rather than actions. the They emphasize personal rather than the collective. Defying the pejorative connotations of the word, they are to happy claim that their work is "necessarily impressionistic". Many, ofcourse, have made use ofdiaries and documents to illustrate a thesis. personal But as far as I know no one has previously collected such a vast selection of together personal experiences and attitudes with the express of them and them alone to purpose using explore health, sickness, and medicine from the patient's of view. With of point purity purpose, the authors rejected all institutional sources such as and law hospital poor records, believing that experiences of sickness that are filtered through the minds of doctors or other law officers poor will inevitably be distorted. Instead, they have confined their research to first-hand documents, letters, diaries and the "table-talk of sufferers and comments of those them". It is as surrounding if they had taken a tape recorder back to what term the they long eighteenth century (1650-1860) and carried out the of a Paul or equivalent Thompson, Tony Parker, Studs Terkel interview with met. The trouble is that the as were everyone they only authors, they readily concede, confined to "interviewing" one section of the literate. population-the if it is the book is a Thus, nothing else, magnificent anthology of the middle and upper class and attitudes to sickness and and death between 1650 and experience health, illness, 1850, and a tribute to the authors' and The of such an industry scholarship. problem putting anthology into has been dealt with the book into three sections: shape by dividing Health, Sickness, and and Self. are titles such as 'Embodiment Suffering Chapters given impressive and self', of and and 'Conceptualisations illness', 'Creating identity', 'Coping resignation' and each chapter is illustrated a rich selection from their vast store of sources. by The final chapter, 'Conclusion' is both a disclaimer to disarm the critic and an affirmation of their achievement. There is an an index. impressive bibliography and excellent There is no common theme the one that there used to be except unsurprising a lot of pain and a lot of diseases and died of them. sudded deaths said Oliver many people "Many dyed lately" Heywood in the seventeenth and is ill" said Keats in the century, "everybody nineteenth, that "Life's fine thread was ever The book is written with the showing precarious". verve, vigour, to we are accustomed from and raciness which these authors. "Our are brisk and readings 213 Essay Reviews assertive" they say, and they certainly are. "We believe a bold survey is called for" and they express the hope, "we have shown just how rich and vital was the culture of sickness amongst the vocal laity". The pace is exhilarating. As evidence is piled on evidence to support a generalization, there is scarcely time to draw breath to say "Hang on a second-are you really sure that was generally true? Was the evidence so clear-cut?" Preferring the bold assertion, they have little time for the on-the-one-hand-on-the-other kind of proviso. At the risk of sounding churlish, however, it seemed to me there were occasions when some of the generalizations seemed a shade too sweeping; when punchiness rather than precision determined the construction of a sentence. Mostly these were the occasions when a quantitative assertion was implicit, when they implied there was more of this or less of that, as they were bound to do with almost every general observation. Take one small seemingly innocent example: the statement, "Today's minor nuisance, like 'flu, was yesterday's killer". A model of brevity. Who could quarrel with that? Well, there might be an alternative version. For example: "Diseases such as influenza were more commonly fatal in the long eighteenth century than they are in the twentieth. Yet the worst epidemic of influenza on record occurred in 1918 and people still die of the disease in the second half of this century, especially the elderly and the infirm. Moreover, some of the epidemics of influenza in the past resembled today's in being mild and rarely fatal. The perceived mildness of influenza today is due in large part to the frequent habit of dignifying the common cold with the title of 'flu." That, if more precise, is admittedly dull. Although this is an example of little importance, it illustrates the short, bold, sentences that are used to link a series of quotations and demonstrate a series of shared perceptions and common attitudes. It is a persuasive technique. There is for example, the statement that "even a natural event such as childbirth, which, as the epitome of Creation itself, should have been a cause ofjoy, terrorized a mother's heart". This is one of those occasions when one suspects the authors were carried away by the purple passage, the impressionistic approach, and the deliberate rejection of anything smelling faintly of statistics. They also say that "birth was itself extremely dangerous for both mother and child" (my italics) and refer to the risks of birth". And when "appalling giving they go so far as to state that "innumerable mothers in died childbed", followed by the curious remark that "all had better things to do than document their demise", one is entitled to ask what is meant by "appalling", "innumerable", and "extremely which dangerous"? They are terms suggest a huge mortality, but how huge? One death in every five deliveries? one in ten? one in twenty? No wonder they added the comment: "What is is the noteworthy hardihood with which so many women habitually faced the perils of childbearing. Were they fatalistic?" In fact the risk of dying in childbirth in the mid-eighteenth century was of the order 1.0 to 1.6 per cent. By 1900 it was about 0.5 per cent over the whole country but still as as 1 cent in high per some areas. That sort of risk persisted until 1934. You can translate this into actual experience by calculating the number of maternal deaths per decade in a small town or village of, say, 2,000 people. Assuming a constant birth rate, 1734 and 1934 were not so very different. Women in the eighteenth and nineteenth centuries had only slightly more reason to fear childbirth than our mothers and grandmothers did in the 'twenties and 'thirties of this century. I suspect that people have always tended to adapt to constant and familiar causes of death, even to the much greater toll of deaths amongst infants. As as the recently 1950s, elderly working-class women giving their family histories would say in a matter-of-fact or even manner, with pride: "Had seven and brought up five", "Had eight and lost three". Most no mothers, doubt, had were that there was after wept at the loss of their infants, some relieved not, all, another mouth to feed, and usually, it the loss of a few infants in a seems, they accepted large family because it was happening all about them. In their to five out of seven or view, bring up with a eight in the early 1900s was no mean achievement. Even we tolerate today scarcely murmur a the roads which not continual weekly rate of death on (mostly young people) only exceeds in a football but also the toll of all the deaths in the recent tragedy stadium, weekly maternal deaths in England and Wales at time in the last 300 for the 1870 any years except period to 1910. 214 Essay Reviews These are minor criticisms of a book which you can open anywhere and become enthralled. It is a marvellous compilation of the vivid and the unexpected. For instance, an Archbishop of Canterbury offered £1,000 to anyone who can "help him to the gout" to drive the distemper from his head. This gives us a sudden glimpse of a perception of diseases which behave like competing of driving the others hyenas, some preferring one part of the body to another and each capable of a in without away. As for the vivid, Fanny Burney's unforgettable account mastectomy 1810 benefit of anaethesia is almost unbearable to read. the home the The chapter on "reconciliation with death" (one of most successful) brings importance of religious belief in the absence of today's high expectation of cure. Now, perhaps, we are less easily reconciled, less concerned with dying a good death, let alone a pious one, less confident about putting our house in order because we do not expect to die until death comes harmlessly in advanced old age. There are many interesting and sometimes provocative speculations in the book about changing attitudes and perceptions. But in the end, the book is at its best when "the sick and vocal laity" are left to speak for themselves. Irvine Loudon, Wellcome Unit, Oxford http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Medical History Pubmed Central

In sickness and in health: the British experience, 1650–1850

Loudon, Irvine
Medical History , Volume 34 (2) – Apr 1, 1990
Download PDF
3 pages

Loading next page...
 
/lp/pubmed-central/in-sickness-and-in-health-the-british-experience-1650-1850-l5QMIxt642

References

References for this paper are not available at this time. We will be adding them shortly, thank you for your patience.

ISSN
0025-7273
Publisher site
See Article on Publisher Site

Abstract

Essay Review ROY PORTER and DOROTHY PORTER, In sickness and in health: the British experience, 1650-1850, London, Fourth Estate, 1988, 8vo, pp. 324, £25.00. Until recently, as the authors point out, the history of medicine had doctors as its heroes. Today, when the concern of most researchers is with the social, professional, and institutional aspects of the history of medicine and more with broadly health and healers of all descriptions, modem scholarship has become "increasingly critical of, or even hostile towards, the profession". No one denies the gain from the new scholarship, or from developments such as the increasing collaboration between social historians, demographers, geographers, and epidemiologists, which has resulted in yesterday's speculation being replaced by today's rigorous analysis. Yet the greatest changes have been in method and approach rather than historical material. The main sources for the history of medicine are still in large part the records of healers (in the broadest sense) and institutions, the of the registers parishes and offices of civil registration, and literary, political, and religious sources of relevance to historians of medicine. Neither the old nor the new-style medical history in the words of the has, authors, "set much store on personal experience". Most historians are concerned with diseases and concepts of disease, practitioners (orthodox and and unorthodox), the health of populations rather than individuals. Roy and Dorothy Porter claim a quite different approach. They are concerned with people, not patients, with the experience of sickness, not diseases, with medicine as seen by the sufferer than rather the healer, and most of all with lay perceptions of health, birth, childhood, old age, and death. They deal, they say, in attitudes rather than actions. the They emphasize personal rather than the collective. Defying the pejorative connotations of the word, they are to happy claim that their work is "necessarily impressionistic". Many, ofcourse, have made use ofdiaries and documents to illustrate a thesis. personal But as far as I know no one has previously collected such a vast selection of together personal experiences and attitudes with the express of them and them alone to purpose using explore health, sickness, and medicine from the patient's of view. With of point purity purpose, the authors rejected all institutional sources such as and law hospital poor records, believing that experiences of sickness that are filtered through the minds of doctors or other law officers poor will inevitably be distorted. Instead, they have confined their research to first-hand documents, letters, diaries and the "table-talk of sufferers and comments of those them". It is as surrounding if they had taken a tape recorder back to what term the they long eighteenth century (1650-1860) and carried out the of a Paul or equivalent Thompson, Tony Parker, Studs Terkel interview with met. The trouble is that the as were everyone they only authors, they readily concede, confined to "interviewing" one section of the literate. population-the if it is the book is a Thus, nothing else, magnificent anthology of the middle and upper class and attitudes to sickness and and death between 1650 and experience health, illness, 1850, and a tribute to the authors' and The of such an industry scholarship. problem putting anthology into has been dealt with the book into three sections: shape by dividing Health, Sickness, and and Self. are titles such as 'Embodiment Suffering Chapters given impressive and self', of and and 'Conceptualisations illness', 'Creating identity', 'Coping resignation' and each chapter is illustrated a rich selection from their vast store of sources. by The final chapter, 'Conclusion' is both a disclaimer to disarm the critic and an affirmation of their achievement. There is an an index. impressive bibliography and excellent There is no common theme the one that there used to be except unsurprising a lot of pain and a lot of diseases and died of them. sudded deaths said Oliver many people "Many dyed lately" Heywood in the seventeenth and is ill" said Keats in the century, "everybody nineteenth, that "Life's fine thread was ever The book is written with the showing precarious". verve, vigour, to we are accustomed from and raciness which these authors. "Our are brisk and readings 213 Essay Reviews assertive" they say, and they certainly are. "We believe a bold survey is called for" and they express the hope, "we have shown just how rich and vital was the culture of sickness amongst the vocal laity". The pace is exhilarating. As evidence is piled on evidence to support a generalization, there is scarcely time to draw breath to say "Hang on a second-are you really sure that was generally true? Was the evidence so clear-cut?" Preferring the bold assertion, they have little time for the on-the-one-hand-on-the-other kind of proviso. At the risk of sounding churlish, however, it seemed to me there were occasions when some of the generalizations seemed a shade too sweeping; when punchiness rather than precision determined the construction of a sentence. Mostly these were the occasions when a quantitative assertion was implicit, when they implied there was more of this or less of that, as they were bound to do with almost every general observation. Take one small seemingly innocent example: the statement, "Today's minor nuisance, like 'flu, was yesterday's killer". A model of brevity. Who could quarrel with that? Well, there might be an alternative version. For example: "Diseases such as influenza were more commonly fatal in the long eighteenth century than they are in the twentieth. Yet the worst epidemic of influenza on record occurred in 1918 and people still die of the disease in the second half of this century, especially the elderly and the infirm. Moreover, some of the epidemics of influenza in the past resembled today's in being mild and rarely fatal. The perceived mildness of influenza today is due in large part to the frequent habit of dignifying the common cold with the title of 'flu." That, if more precise, is admittedly dull. Although this is an example of little importance, it illustrates the short, bold, sentences that are used to link a series of quotations and demonstrate a series of shared perceptions and common attitudes. It is a persuasive technique. There is for example, the statement that "even a natural event such as childbirth, which, as the epitome of Creation itself, should have been a cause ofjoy, terrorized a mother's heart". This is one of those occasions when one suspects the authors were carried away by the purple passage, the impressionistic approach, and the deliberate rejection of anything smelling faintly of statistics. They also say that "birth was itself extremely dangerous for both mother and child" (my italics) and refer to the risks of birth". And when "appalling giving they go so far as to state that "innumerable mothers in died childbed", followed by the curious remark that "all had better things to do than document their demise", one is entitled to ask what is meant by "appalling", "innumerable", and "extremely which dangerous"? They are terms suggest a huge mortality, but how huge? One death in every five deliveries? one in ten? one in twenty? No wonder they added the comment: "What is is the noteworthy hardihood with which so many women habitually faced the perils of childbearing. Were they fatalistic?" In fact the risk of dying in childbirth in the mid-eighteenth century was of the order 1.0 to 1.6 per cent. By 1900 it was about 0.5 per cent over the whole country but still as as 1 cent in high per some areas. That sort of risk persisted until 1934. You can translate this into actual experience by calculating the number of maternal deaths per decade in a small town or village of, say, 2,000 people. Assuming a constant birth rate, 1734 and 1934 were not so very different. Women in the eighteenth and nineteenth centuries had only slightly more reason to fear childbirth than our mothers and grandmothers did in the 'twenties and 'thirties of this century. I suspect that people have always tended to adapt to constant and familiar causes of death, even to the much greater toll of deaths amongst infants. As as the recently 1950s, elderly working-class women giving their family histories would say in a matter-of-fact or even manner, with pride: "Had seven and brought up five", "Had eight and lost three". Most no mothers, doubt, had were that there was after wept at the loss of their infants, some relieved not, all, another mouth to feed, and usually, it the loss of a few infants in a seems, they accepted large family because it was happening all about them. In their to five out of seven or view, bring up with a eight in the early 1900s was no mean achievement. Even we tolerate today scarcely murmur a the roads which not continual weekly rate of death on (mostly young people) only exceeds in a football but also the toll of all the deaths in the recent tragedy stadium, weekly maternal deaths in England and Wales at time in the last 300 for the 1870 any years except period to 1910. 214 Essay Reviews These are minor criticisms of a book which you can open anywhere and become enthralled. It is a marvellous compilation of the vivid and the unexpected. For instance, an Archbishop of Canterbury offered £1,000 to anyone who can "help him to the gout" to drive the distemper from his head. This gives us a sudden glimpse of a perception of diseases which behave like competing of driving the others hyenas, some preferring one part of the body to another and each capable of a in without away. As for the vivid, Fanny Burney's unforgettable account mastectomy 1810 benefit of anaethesia is almost unbearable to read. the home the The chapter on "reconciliation with death" (one of most successful) brings importance of religious belief in the absence of today's high expectation of cure. Now, perhaps, we are less easily reconciled, less concerned with dying a good death, let alone a pious one, less confident about putting our house in order because we do not expect to die until death comes harmlessly in advanced old age. There are many interesting and sometimes provocative speculations in the book about changing attitudes and perceptions. But in the end, the book is at its best when "the sick and vocal laity" are left to speak for themselves. Irvine Loudon, Wellcome Unit, Oxford

Journal

Medical History – Pubmed Central

Published: Apr 1, 1990

There are no references for this article.