the medical activities of mid-nineteenth ?· forthe nature ofthe fringe, see w.f. bynumand...

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  • Medical History, 1987, 31: 415-439.





    During the eighteenth and nineteenth centuries, many facilities were created with theexpress aim ofproviding medical care and treatment. The foundation oflarge numbersofdispensaries and infirmaries, the establishment ofa formal channel ofmedical reliefthrough the agency of the New Poor Law, and the setting up of a network of friendlysocieties, with facilities for the pecuniary and medical relief of their sick members, gavethe poor and labouring classes of this period more access to medical treatment thanthey had ever had before. Meanwhile, those wealthy enough to pay for private medicalcare could utilize the services of a growing number of qualified medical practitioners.Yet rich and poor alike continued to resort to a variety of"unqualified" or "fringe"sources of medical aid. For some, such forms of medical treatment supplementedtreatment by a "regular" practitioner; for others, with limited access or money, or witha preference for fringe methods, these were the sole means of medical relief.A wide variety of labels has been thrown up to describe the unqualified, influenced

    by a practical need to distinguish this group from the protessionals and by sociologicalterminology, the fringe, periphery, alternative or unorthodox practitioners, para-medics, quacks, and so on. The labels refer to a heterogeneous collection ofindividualsand groups, using varying methods of diagnosis and treatment, drawing on folktraditions, ancient remedies or the "new sciences" of, for instance, hydropathy,homeopathy, mesmerism or medical botany, or, in some cases, on showmanship,trickery or commercial enterprise. Until at least the mid-nineteenth century, we are notreally in position to distinguish between professional practitioners and the fringe interms of the quality of treatment given, its scientific standing or success rate. In suchcircumstances, it is perhaps most useful to distinguish between fringe and orthodoxmedicine on the grounds of legal and professional inclusion and exclusion.1 Thenineteenth century saw not only the survival of traditional fringe practitioners-folk

    *Hilary Marland, PhD, Medisch Encyclopedisch Instituut, Vrije Universiteit, van der Boechorststraat 7,1081 BT Amsterdam, The Netherlands.The author gratefully acknowledges the assistance ofher former colleagues at the Wellcome Unit, Oxford,

    where she was a Research Fellow when this paper was written; also the support of the ESRC, who funded theFellowship (ref. A23320031): and John Pickstone for his valuable comments.

    I Roy Porter, 'Quacks: an unconscionable time dying' unpublished paper, Wellcome Institute for theHistory of Medicine, London, 1983, p. 1. For the nature of the fringe, see W. F. Bynum and Roy Porter(editors), Medicalfringe andmedical orthodoxy, 1750-1850, London, Croom Helm, 1986; and Roger Cooter,'Interpreting the Fringe', Bull. Soc. soc. Hist. Med., 1981, 29: 33-36.


  • Hilary Marland

    healers, wise-women, midwives, bone-setters, and itinerant quacks-but also theflourishing of new unorthodox and para-medical groups, including homeopathists,hydropathic practitioners, medical botanists, and chemists and druggists. Ifwe wish totake into account all individuals and facilities involved in the dispensing of medicalcare, and to build up a picture of the total amount and nature of medical treatmentavailable, then we cannot leave the unqualified or fringe practitioner out of ouranalysis. This paper will examine the activities, most specifically the medical activities,ofone ofthe new groups ofmedical personnel to emerge during the nineteenth century,the chemists and druggists, and attempt to assess their role in the provision of medicaladvice and treatment.By the mid-nineteenth century, chemists and druggists made up the most numerous

    group ofpara-medical personnel. For this reason alone, a study of this group and theirfunctions would seem to be useful in making any assessment of the range and form ofmedical assistance available during the nineteenth century. In addition to beingnumerous, however, chemists and druggists were also versatile, offering a very widerange of medical services. While the most clearly-defined function of the nineteenth-century chemist and druggist was to make up the prescriptions of qualified medicalmen, this was not normally their most important function, and they also engagedthemselves in a number of what can be described as medical or even fringe activities.These activities, which included "over-the-counter-prescribing", the making up offamily recipes, and the sale ofa wide range ofdrugs and patent remedies, accounted forthe largest proportion of the chemist and druggist's trade.

    Moreover, in professional and social terms, chemists and druggists constituted anambiguous group. While involved in activities which aligned them with the rest of the"ringe, the middle-class status of many chemists and druggists, their growingprofessionalism, frequent expertise, close working relationship with the medicalprofession, and, in many cases, wealth and high social standing in the communities inwhich they worked, made them distinct from other fringe groups. The chemists anddruggist were one ofthe few fringe or para-medical groups to emerge during this periodwho could lay claim to some form of professional standing. By the mid-nineteenthcentury, they were slowly organizing and taking on some features of a professionalgroup. The formation of the Pharmaceutical Society in 1841, the establishment of thePharmaceutical Journal, the setting up of schools and courses specializing in theeducation of pharmacists, and the development of uniform standards of training andexamination, which became compulsory under the 1868 Pharmacy Act, wereimportant aspects of this process. Already, by 1842, the Pharmaceutical Society had2,000 members.2 Yet these developments did not lead to a narrowing down of thefunctions of the chemists and druggists to the compounding and dispensing ofprescriptions; nor did they inhibit their fringe activities.

    This paper will be limited in both geographical scope and time. Many of the datahave been taken from a survey of the West Riding, with special reference to Wakefieldand Huddersfield, although an effort has been made to place developments in these

    2 For more on these developments, see G. E. Trease, Pharmacy in history, London, Bailliere, Tindall &Cox, 1964; F. N. L. Poynter (editor), The evolution of pharmacy in Britain, London, Pitman MedicalPublishing, 1975.


  • The medical activities of mid-nineteenth-century chemists and druggists

    two communities into a national perspective.3 Wakefield, primarily a market andservice centre, experienced only a steady rate of industrial growth during thenineteenth century. Huddersfield was, on the other hand, a rapidly expanding textilecommunity, an exemplary nineteenth-century industrial town. However, bothexperienced urban development and population growth during the early andmid-nineteenth century-Wakefield in a rather less dramatic form-and the rise in thenumber ofchemists and druggists appears to have been closely tied to this urbanizationprocess. In addition, the paper will cover only the middle decades of the nineteenthcentury, using the Apothecaries' Act of 1815 and the 1868 Pharmacy Act as roughboundaries. During the early- and mid-nineteenth century, there was a remarkableincrease in the numbers involved in pharmacy. This was an era of special significancefor the chemists and druggists, not only because of their remarkable growth innumbers, but also because it saw their independence of the apothecaries, the clause tccontrol chemists and druggists being dropped from the Apothecaries' Act, and, at theend of this era, the campaign for, and the passing of, the Pharmacy Act had importantimplications for the professionalization and self-identity of the chemist.

    Overall, chemists and druggists have received scant attention by medical historians.Those studies that have been undertaken have tended to concentrate on the growingprofessionalism of this group during the nineteenth century,4 and on the competitionbetween chemists and druggists and general practitioners for dispensing work.However, it is not issues relating to the professionalization of this group that willconcern us here. Nor will this paper give much coverage to the training ofchemists anddruggists during the nineteenth century, or to their economic status and standing in thelocal community. While it is generally accepted that chemists and druggists involvedthemselves in less orthodox activities, and that over-the-counter-prescribing and thesale of drugs directly to the public were vital components of their businesses, thesefunctions have not been fully described and analysed. This paper will look in somedetail at the medical activities of the chemist and druggist, most specifically at thosewhich took him beyond his role as a medicine supplier, and which could be seen asplacing him in the context of medical practice.

    Data on chemists and druggists, as compared with information on other sections ofthe medical fringe during the nineteenth century, are widely available. In contrast withother fringe elements, chemists and druggists were easily identifiable, in most caseshaving a fixed location, their shops. For the Wakefield and Huddersfield survey, thestarting-points for a collection of numerical data were the census returns and tradedirectories. While figures taken from these sources tend on the whole to understate thesize of the medical fringe, the data on chemists and druggists appear to be morecomplete and reliable (especially ifthe two sources ofdata are used in conjunction with

    3 This pap