Domestic Medicine: A comparison between historical and contemporary health advice for the public

1. Christopher Horne. 91018391. MA 2011/12 Domestic Medicine:A comparison between historical and contemporary health advice for the public Click the mouse to navigate through the resource…

2. Can you think why a physician (doctor) of the past may have wanted to give health advice to the public? “All these remedies can be purchased at my store!” “Did physicians write their prescriptions in the common language of the country, and explain their intentions to the patient…it would inspire him with absolute confidence in the physician, and would make him dread every man who pretended to cram secret medicine down his throat”. William Buchan, Domestic Medicine (1807)1 Interpretation: Dr Walwyn had another motive for giving public health advice here: as an advertisement for the remedies in his store! Interpretation: William Buchan thought it was important for physicians like himself to give understandable advice to the public. He hoped that this would set their advice apart from the many other ‘less reliable’ sources of medical information at the time, for example quacks, apothecaries or ‘wise women’. This is William Walwyn, a physician and the author of ‘Physick for families’ (1681), a book for households, listing remedies for common illnesses.2

3. Cleanliness: contemporary advice Cleanliness: historical advice “Diseases of the skin may indeed be caught by infection, or brought about by poor living, or unwholesome food, but they will seldom continue long when cleanliness prevails.” William Buchan. Domestic Medicine 20th (p.95).1 Comparison: Skin infections such as acne (spots) can result from poor skin hygiene, but can also be affected by hormone levels and general health. This product works ‘by fighting the bacteria that causes spots, removing dirt and oil from the skin surface and helping to unblock pores’, according to the manufacturer.3 Can you think of a current day example of similar advice being given? Image B Interpretation: William Buchan is saying that in crowded places like hospitals and jails, keeping things clean is very important. As a current day example, look at the rate of deaths from the hospital infection Clostridium Difficileafter a programme of deep cleaning and hand washing was introduced in NHS hospitals in 2007.4 “In places where great numbers of sick people are collected together, as gaols, hospitals etc. cleanliness ought to be most religiously observed.” William Buchan, Domestic Medicine 20th (p.100).1 Image C Image A

4. Mental Health “The hypochondria affection, melancholy, is a sort of delirium without fever. The absurdity of the patients behaviour, inactivity, dislike to motion, loathing of food, rumbling of the bowels, anxiety of the precordia, palpitation of the heart. Cure: Exercise must be taken, generous wines may be drank freely”. “We tend to view the mind as a disembodied entity, but it is becoming increasingly clear that the whole body is involved in the thinking process. Without it, your body would be unable to generate a sense of self, or process emotions properly”. Click the mouse to see some different pieces of information on mental health. Can you think which ones are historical advice, and which ones are contemporary? This is a drawing of a dissected brain, by Samuel Solley (1847)5 The New Scientist article: ‘Your Clever Body’, 2012.6 Thomas Marryat, Therapeutics (1818).8 “Some people still think that depression is trivial and not a genuine health condition. They're wrong. Depression is a real illness with real symptoms, and it's not a sign of weakness or something you can 'snap out of' by 'pulling yourself together. Treatment for depression usually involves a combination of medicines, talking therapies and self help.” Interpretation: Thomas Marryat is describing a group of symptoms associated with depression - lethargy, anorexia, palpitations. Exercise is now recognised as an important treatment of depression (although the same cannot be said of wine!). “It is sufficient for us to know, that there is established a reciprocal influence between the mental and corporeal parts: and that whatever injures one, disorders the other”. NHS Choices depression advice, 2010.7 William Buchan, Domestic Medicine (20th).1

5. I hope you have enjoyed navigating through this resource. Take a moment to consider what lessons you may have taken away…….. Then click to reveal my key learning points from the project. And finally………. Rabies: historical advice Rabies: contemporary advice Lesson 1: - Whenever, you are being given advice, consider the motive for that advice. - As a doctor giving advice, it is important to be honest and explain things clearly. Lesson 2: - Careful observation was enough for many doctors of the past to make some good assertions, like the link between cleanliness and disease. Lesson 3: - However, we should not underestimate the benefits of scientific progress, and try to base all health advice on evidence. “For the bite of a mad dog – 1 spoonful of the juice of Rilworth Plant every morning, or as much as the stomach takes till apprehensions have ceased” William Buchanon, Domestic Medicine 1792.9 Interpretation: What William Buchanon describes as a ‘mad dog’ is likely to a dog infected by the virus ‘Rabies’, which can be passed on to humans through a bite. It is unlikely that the juice of Rilworth Plant would have been able to help cure the disease. To the right is a drawing of the peppermint plant, another commonly used plant based treatment of the day. (William Woodville ,1793)10 Comparison: Official treatment recommendations now have to be based on evidence of effectiveness. The World Health Organisation advises cleaning the wound quickly after a bit from a mad dog, quickly followed by a vaccine against the rabies virus which also contains a substance designed to inactivate the infection. On the right is a very highly magnified image of the rabies virus.11 Image D

6. References: Domestic Medicine. William Buchan, 20th edition 1807. (PHC085) Physic for families. William Walwyn 1681 (PHC004) ‘Clearasil’ website: http://www.clearasil.co.uk/skin-talk.php Office of national statistics – C Diff death rates 2006 - 2010 http://www.ons.gov.uk/ons/rel/subnational-health2/deaths-involving-clostridium-difficile/2006-to-2010/index.html The Human Brain: it’s structure, physiology and diseases. Samuel Solly 1847 (PHC269) ‘Your Clever Body’. The New Scientist magazine, 15/03/2011, page 35. NHS choices website http://www.nhs.uk/Conditions/Depression/Pages/Treatment.aspx Therapeutics: or, the art of healing, Thomas Marryat 1818 (PHC212) Domestic Medicine , William Buchan 1792(13th edition) (PHC010) Medical Botany, William Woodville, 1793 (PHC033) World Health Organisation, Rabies post exposure prophylaxis guidelines - http://www.who.int/rabies/human/postexp/en/ Images: unless otherwise specified have been sourced from the Plymouth Medical Societie’s historical collection website: Image A: Sourced from Wikipedia (creative commons license) http://theloveforhistory.com/wp-content/uploads/2011/06/plague_380x529_712060a.jpg Image B: My own picture Image C: Image from reference (4)# Image D: Sourced from Wikipedia (creative commons license): http://en.wikipedia.org/wiki/File:Rabies_Virus_EM_PHIL_1876.JPG