The Medical Professions in the Georgian Era

An Apothecary’s Shop
(CC) Welcome Images

Apothecaries did not hold the same status in the Georgian era as one might think. We must recall the gentleman’s social class determined his “occupation” during the last 1700s and early 1800s.

The Victoria and Albert Museum website tells us something of the mid 1800s, and so we might guess less knowledge was available during the Regency Era. “Early Victorian ideas of human physiology involved a clear understanding of anatomy (at least among experts; but the populace often had hazy knowledge of the location and role of internal organs), allied to a concept of vital forces focused on the haematological and nervous systems that now seems closer to the ancient ‘humours’ than to present-day models. Little was known of biochemistry or endocrinology. Traditional ideas of the body, whereby women were regarded as smaller versions of men, and ‘turned outside in’ (i.e. with internal rather than external sexual organs) were gradually superseded by a binary concept of sexual determinism, in which difference governed all aspects of physiology, health and social behaviour. As the body was also defined as a closed system of energy, physical, mental and reproductive expenditure were held to be in competition. Hence the notions that male sexual ‘excess’ led to debility and female reproductive health was damaged by intellectual study. Hence, too, must have derived the Victorian prescription for many ailments: rest.”

At the top of the social class were physicians. In writing Regency era novels, these men would be referred to as “Doctor.” Most doctors during this time had apprenticed with another physician. They graduated from an acceptable university, and then did some sort of medical studies. The fact they attended a university made them “acceptable” to the upper classes, just as one who studied law or theology. We must remember during the Georgian era, England did not have medical schools, so the man would likely travel to Scotland or even to America, which had established several notable medical colleges by that time. A physician could specialize in one or two areas, but this did not mean he had been exclusively trained in that area. His was what we today call “on the job training.” He might, for example, specialize in the treatment of those placed in mental facilities or asylums, such as Bedlam. Generally, though, they treated the whole person, especially those who practiced in the rural areas. Some took appointments and limited their clientele to particular diseases.

Their clients were members of the gentry and the aristocracy. Therefore, as one might guess, they charged higher fees than did surgeons and apothecaries. Some held a practice alone. Others combined resources, but buying in to an established practice was very expensive and would be considered somewhat risky.

One thing many who write books set in the Regency era so not consider is a physician could also be a “man midwife.” The wealthy, especially, did not want the ordinary midwife, who was usually from the lower classes to deliver their children. Some even thought doing so would affect the child’s health and intelligence. So, though many midwives had more knowledge and experience in childbirth than did the university trained physician, the upper classes would choose the physician.

Surgeons (or barber-surgeons) were addressed as “Mister,” not “Doctor” Unlike a physician, most surgeons had trained as an apprentice to an experienced surgeon, rather than attending university or a “medical school.” That does not mean some did not seek out such an education, it just was not the norm. They often worked under a physician. Where a physician would prescribe a draught of some sort of concoction for the healing process, beyond performing surgery, it was the surgeon who treated wounds and broken bones. As one might imagine, surgeons would be frequently called upon, especially in the rural areas where farming was not for the feint of heart. Surgeons were NOT considered to be a gentleman, for a surgeon actually touched their patients and often encountered blood and bodily fluid as part of their practice.

Surgeons or barber-surgeons carried out operations and amputations, sometimes with a physician present for the most hazardous ones. Often they were ex-military men, for dealing with battle wounds was their province. Their training was based on a practical apprenticeship, though this was often haphazard. Because they worked with their hands, they were considered artisans.

It was 1704 before apothecaries were permitted to be thought of as part of the medical profession and legally allowed to prescribe and dispense medicines. The House of Lords granted them such status, but they were still not permitted to charge a fee for their service. Being an apothecary was considered a “trade.” Therefore, they made their money by selling medicines, medical supplies, such as bandages, and a miscellany of other items, including perfumes, spices, herbs, and even confectionery tidbits.

“THE story of the passing of the Apothecaries’ Act is an essential prelude to an assessment of the significance of that statute. The agitation for an act to regulate medical practice in the United Kingdom, and in particular to control the practice of apothecaries throughout England and Wales, began as early as 1793. From that time until 12 July 1815, when the Apothecaries’ Act received the Royal Assent, many reforms were advocated, several bills drafted, numerous petitions and counter petitions presented, and innumerable amendments introduced. At last a bill, prepared by the Society of Apothecaries, under the patronage of the College of Physicians, was submitted for consideration by the Legislature. After much revision, the bill was finally rushed through a depleted House of Commons in the closing phases of a
particularly active session. It has been, and still is, the considered opinion of many scholars that this Act marks the beginning of the process of medical reform in England. This article examines in detail both the origins and the consequences of the Apothecaries’ Act and suggests that existing interpretations need to be drastically revised.

Thomas Rowlandson’s illustration aptly entitled ‘Death and the Apothecary’ or ‘The Quack Doctor’ (note flying fish!) ~

“By the mid-eighteenth century the apothecary had assumed the functions of a general practitioner of medicine. Some apothecaries still continued to confine their activities to dispensing, while others devoted themselves to wholesale trade, or took up botany and chemistry.’ But the majority of town apothecaries and practically all those in the country attended patients of the poor and lower middle-class, prescribing and supplying medicines to them. As one pamphleteer wrote in 1773, ‘Let the case be what it may, Apothecaries have got physic principally into their own hands: this is evidently the case, especially in the country, where the Physician seldom visits any but such as are in opulent circumstances; the poor, alas, scarce ever! It is much the same in London (allowance being made for those that are in hospitals); so that Apothecaries have by far the greatest number of patients under their own care.” [The Apothecaries’ Act 1815, A Reinterpretation, by S. W. F. Holloway}

ADAM SMITH, An Inquiry into the Nature and Causes of the Wealth of Nations, Everyman Edition,
1910, Vol. i, p. 100, wrote:

Apothecaries’ profit is become a by-word … the whole drugs which the best employed apothecary in a large market town will sell in a year, may not perhaps cost him above 30 or 40 pounds. Though he should sell this therefore for a three or four hundred percent profit, this may frequently be no more than the reasonable wages of his labour, charged, in the only way in which he can charge them, upon the price of his drugs.

Pen and Pension tells us: “Dr Erasmus Darwin however, more cynically, advised a young man to remember “… at first a parcel of blue and red glasses at the windows might gain part of the retail business on market days … I remember Mr Green of Litchfield once told me his retail business, by means of his show shop, and many coloured windows, produced him £100 a year.”

“Apothecaries in London had started out as part of the Grocers’ Company. Only in 1617 was the Society of Apothecaries created by royal charter. It was slow to spread its influence outside the capital, but gradually the standards set by the Society for admission were accepted more widely. These required apothecaries to undertake a lengthy apprenticeship with a final examination, though there were still no legal rules for claiming the title of apothecary before 1815.”

Other Sources:

The Connection Between Vinegar and the Fainting Couch

Doctors in the Regency

The Invention of the Stethoscope

The Lady’s Medicine Chest

Mister, Doctor, or Hey You? Medical Personnel in Regency England

A Primer on Regency Era Doctors

Regency Era Medical Practices

About reginajeffers

Regina Jeffers is the award-winning author of Austenesque, Regency and historical romantic suspense.
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