The old poor law and medicine

Abstract

SUMMARYTHIS ARTICLE is a survey of the treatment of the sick poor in the counties of Berkshire, Essex, and Oxfordshire from c. 1720 to 1834 based on parish records. Its general argument is that the sick poor received sympathetic and humane consideration bearing in mind contemporary medical knowledge and the limited facilities available.General medical aid is first considered -broken limbs, midwifery, eye complaints, etc. This is followed by a section on the use of provincial hospitals and those in London. Parishes readily availed themselves of these institutions and it is suggested that they were not as great a menace as has been often maintained. The role of the dispensaries is also considered. A short section follows on the treatment ofthe mentally deranged pauper and the use of private asylums. A brief comment is made on the medical contract system. The problem of smallpox in the parishes is examined. It is argued that the effects of the disease were so serious and the use of inoculation so widespread, particularly in the rural areas -that this treatment might well have had some effect on mortality trends in the second half of the eighteenth century. Vaccination also became very popular in the parishes after the first decade of the nineteenth century. This, it is also maintained, made an important contribution to mortality trends -particularly when local authorities were able to treat the whole of the poor.The action against typhus and cholera is then considered. Examples are cited of progressive authorities who made strenuous attempts to secure a healthier environment and which might, in a small way, have made a contribution towards improving the health of the local communities.A concluding section attempts to compare the achievements in these three counties with findings in other areas and makes some tentative conclusions. Much more work of this nature clearly needs to be carried out at local level before an overall and definitive picture emerges.

Depth and diversity in parochial healthcare: Northamptonshire 1750–1830

“…The activities and finances of the poor law doctor have been explored by historians such as Joan Lane (Lane 1981: 10-14) a"d E. G. Thomas (Thomas 1980), but little attention has been given to the medical culture at the fringes of formal medicine, yet funded (and therefore endorsed) by the parish authority. By broadening our concept of what constitutes 'medical relief, a more complete picture can begin to be constructed of the experience of the sick poor, the various formal and informal (yet parochially funded) sources of health care which they could expect to receive at different stages of the life cycle, and how this medical culture operated within the structure of parochial relief.…”

“…Yet Marland's 1987 study of healthcare for the poor in communities in West Yorkshire stands out as the most suhstantial, systematic and suhtle analysis of this matter (Marland 1987). Like Lane (Lane 1981, concentrating on data from Warwickshire), Fissell (Fissell 1991, concentrating on Bristol), Thomas (Thomas 1980, concentrating on Berkshire), and Williams (Williams 1999, concentrating on Bedfordshire), Marland sees considerahle scope for local variation in practice and experience. Thus, while all contrihutors to the secondary literature acknowledge the centrality of sickness to many individual claims for poor relief, there is only limited primary evidence of important issues such as: the way in which the claims of the sick poor were treated, the nature of their treatment, the sentiments of the sick poor themselves and the relationship between parochial healthcare and the wider medical marketplace.…”

A ‘Scottish Poor Law of Lunacy’? Poor Law, Lunacy Law and Scotland’s parochial asylums

“…Scholars have explored lunacy history through the Poor Law (see Andrews, 1996; Fessler, 1956; Pelling, 1985; Rushton, 1988; Suzuki, 1991, 1992; Thomas, 1980), but Bartlett’s (1999) more concerted shift of approach to care for the insane – beyond psychiatric specialists and institutions towards the history of poverty relief – provide the chief historiographical foundation for the present paper. Bartlett argues that, properly to comprehend lunacy after 1834 in England, one must examine what he terms the ‘Poor Law of Lunacy’.…”