Kill or Cure
Medicine, Midwives and Mercury: 350 Years of Medicine in North Craven
Vinegar and Brown Paper
Vinegar and brown paper? Yes: to treat cuts, swellings and bruises, and headaches. Housewives concocted and stored home remedies, mostly using plants and herbs but sometimes snails, woodlice, worms and similar as well. Powdered earthworms were recommended for warts and corns, and to loosen a tooth before extraction. Other treatments once inflicted included:
For sprains, strains, lame back and rheumatism
Good sized live toads, four in number: put into boiling water and cook very soft; then take them out and boil the water down to 1/2 pint, and add fresh churned, unsalted butter 1 lb and simmer together; at the last add tincture of arnica 2 oz.
A mouse rotted and given to children to eat.
17th Century Medicine
In the 17th century, science slowly began to supplant superstition as well as medical diagnoses based on the four humours: blood, phlegm, black and yellow bile. Isaac Newton, Christopher Wren and Samuel Pepys all served as president of the new Royal Society.
It was thought that fevers and raised blood pressure were caused by too much blood. Doctors deliberately cut veins to release this ‘bad’ blood. Leeches were used, too. When placed on the skin, they consume four times their own weight in blood.
“Nurse” were originally meant “wet-nurse”. By the 1660s, their role had developed; they were caring for the sick. They could earn 8/- a week to nurse plague and smallpox patients.
Dead body parts were thought to prevent infection. Powdered mummies from Egypt were rubbed on the skin to improve tone, or mixed with alcohol and drunk to cure internal bleeding.
18th Century Enlightenment
By the 18th century, there were three tiers of medics: The College of Physicians (founded 1518) of Oxford and Cambridge Anglicans. Then came surgeons; below them, apothecaries, as yet unregulated.
The latter diagnosed and treated the poor who could not afford physicians. But who was genuine and who a quack? Surgeon-apothecaries became common: there were several in Settle in the 1700s.
Abraham Sutcliff (1721-98), born in York and apprenticed to a surgeon in Kendal, taught himself Latin and walked to Edinburgh in winter to attend classes. A Quaker, he could not be awarded a degree, so when he came to Settle to practise around 1740, he was called an ‘apothecary’.
In 1761, John Coakley Lettsom (1744-1815), joined Sutcliff as his apprentice. After five years he attended university, became a doctor and founded the Medical Society of London. He is said to have bought his old mentor a degree from Aberdeen University, in gratitude.
By the end of the century, Lettsom was urging people to trust Edward Jenner’s cowpox vaccinations as inoculation against smallpox.
The 19th, 20th and 21st Centuries
In the early 20th century Bentham and Settle had several independent medical practices, and some villages also retained their own doctors. The first woman doctor Elizabeth Dowell, arrived in Bentham with her GP husband Leslie in 1930. The O’Connors, another married partnership, took over one of the Settle practices. They were succeeded in 1959 by Dr Pamela Hogg (later Douglas).
GPs possessed medical and surgical skills. They were dedicated and committed to their patients, always on call, journeying through snow and ice to deliver babies and treat patients on isolated farms. They often made up their own medicines for common ailments, aware that many patients could not afford to pay for their care. Dr Clegg in Long Preston was known for his ‘black cough bottles’ and ‘white stomach bottles’, 1/- each.
In the 1970s, group practices were developed to centralise resources. In Settle, after renting space in the – un-soundproofed – Folly, Dr Barry Brewster and partners designed and built Townhead Surgery. Opened in 1976, it won an award for the best functional surgery in the UK. In 1991, Dr Brewster and his team featured in ‘The Doctor’ on TV which followed a year in the life of a rural GP.
The Yorkshire (road) Ambulance Service, formed on 1 July 2006, covers 6,000 square miles in Yorkshire, from isolated moors, dales and coastline, to inner cities, and serves over five million people. It employs 5,700 staff who, with over 1,150 volunteers, deal with an average of over 2,500 emergency and routine calls a day.
A Kindly But Nervous Man
Hypochondriacs are abnormally anxious about their health, monitoring every cough and ache. In the past they were prey to quacks and unscrupulous doctors.
One hypochondriac was William Lodge Paley, schoolmaster at Giggleswick National School, 1812-39. His perpetual headache he described as ‘an irritable feeling in my pericranium which the severe exercise of patience [with the pupils] makes worse.’ Dr Harrison sensibly advised him to wash his head with vinegar and water. He was afraid of catching a head cold if he left off his wig, and he constantly complained of pain.
He condemned drunkenness and was scared of death, and yet he lodged in the Black Horse pub overlooking Giggleswick churchyard. In his diary he notes local epidemics and fatal illnesses: typhus, smallpox, and also suicide due to hardship, shame and ‘lunacy’. He spared no detail in recording amputations and tooth extractions. Describing a woman’s funeral in August 1824, he wrote: ‘as they kept her too long and she had died of dropsy, water came through her coffin.’
Paley reveals the clashes between old and new in medicine. He writes of smallpox vaccination and of a local man and son journeying to the Eye Infirmary in London ‘to get the child’s eyes cut in hopes to get it sight.’ In contrast, two local medics ordered ‘strong liquors’ to keep alive a patient with ‘putrid fever’ (typhus); the patient did not survive.
In 1840, about one child in six died before the age of one, and one third before five, mainly from such infectious diseases as typhoid fever, typhus, tuberculosis, diphtheria, cholera and scarlet fever. Housing conditions for the working class were poor: few had water closets, and drains ran open in the street.
Edwin Chadwick’s campaigning for better working conditions and improved public sanitation, clean drinking water and a medical officer in each town bore influence locally, too. During the cholera outbreak in the country in August 1854, a Settle Chronicle editorial expressed concern that although Settle was ‘well supplied’ with sewers, many households were not connected to the main drain, and open channels remained in the street. Nor were there traps on the grates, so smells were obnoxious, especially along the High Street between the Talbot and what is now Fox’s Kitchens.
The 1875 Public Health Act enshrined Chadwick’s recommendations in law, and working conditions were improved by the 1874 and 1878 Factory Acts.
Settle Rural Sanitation Authority ensured that sanitation and water by-laws were honoured, and contagious disease controlled, for which they set up the isolation hospital at Giggleswick.
Many drastic procedures used in the past to treat mental illness often made sufferers mere ghosts of themselves. With changes in social attitudes, sufferers speaking out and advances in psychiatric care, mental health issues are now treated differently
Trephination (trepanning), dates back 7,000-odd years. It involved removing a small part of the skull with an auger, bore or saw. It was done to relieve headaches, mental illness or even demonic possession by releasing evil spirits.
Bloodletting and purging were, originally an ancient Greek treatment. They gained prominence in the west from the 1600s to treat diseases. Bleeding – by ‘cutting’ or by leeches – purging and vomiting supposedly also corrected an imbalance believed to underlie mental illness.
Lobotomy won the Nobel Prize in Physiology and Medicine in 1949. A sharp instrument was inserted into the brain above the eye socket, surgically cutting or removing the connection between the prefrontal cortex and frontal lobes, thereby disrupting the brain’s circuits. Seriously risky, it now obsolete.
Mental institutions were commonly held to be brutal, where patients were treated like animals. Later treatment there became more enlightened, and from the 1970s, contained a strong ethos of community and care.
Today, mental health is more prominent than ever. One in four of us will experience mental health issues; Every Mind Matters campaigns to empower people to take control of their mental health.
‘Quack’ is derived from the Dutch kwaksalver, a hawker of salves. Quacks moved from town to town, providing questionable diagnoses and selling questionable home-made cure-alls.
Unproven, ineffective, sometimes dangerous treatments and medicines have been peddled to the gullible throughout history, often combined with showmanship. Grandiose claims were made for simple stuffs: in the mid-19th century, revalenta Arabica, advertised as a restorative and ‘empirical diet for invalids’, came with glowing testimonials. It was only lentil flour, sold at an inflated price. Some quack remedies contained alcohol, opium and honey which gave some relief, but no cure. The opiates in others would have been addictive, to the benefit of the quack’s purse. Some remedies were effective: mercury, silver and arsenic compounds will have helped; willow bark, containing salicylic acid, is the precursor of aspirin. Quinine in Jesuit’s bark effectively treated malaria and other fevers.
However, knowledge of appropriate uses and doses was limited and quacks soon became seen as charlatans, frauds and imposters.
The National Health Service
In 1948, on the introduction of the NHS, the first universal care system in the world, a leaflet was sent to all households: ‘It will provide you with all medical, dental and nursing care. Everyone – rich or poor, man, woman or child – can use it or any part of it. There are no charges, except for a few special items. There are no insurance qualifications. But it is not a “charity”. You are all paying for it, mainly as taxpayers, and it will relieve your money worries in time of illness.’
It is worth reflecting on the success of the NHS in our Craven area since then. While it has enabled far more people to access ever more sophisticated treatment, have we lost something? By the 1990s, it had become centralised with distant managers, and with GPs no longer allowed to carry out minor interventions and forced to refer patients to specialists. Specialist centres often involve travelling greater distances, away from local support networks.
Even so, Castlebergh Hospital in Giggleswick was reprieved from closure by a campaign headed by local doctors with massive public support. A centre for community care, it continues to provide beds for local patients. Defibrillators placed in rural areas has increased survival rates from cardiac arrests and the Yorkshire Air Ambulance Service provides fast access to emergency care, rather more swiftly than the early bicycle ambulances.
Looking back on the story of medicine in our area, the greatest success is achieved through a combination of professional and voluntary support.