An Intelligent Woman’s Observation and Experience of 18th Century Medicine
As was normal in the 18th century, Mary Wollstonecraft (1759-97) lived with a semi-permanent awareness of the possibility of ill-health, more or less serious, and a certain amount of knowledge as to what might be done about it, if and when it befell. Her letters, novels and polemical writings (1) without being more obsessively morbid or hypochondriacal, contain numerous reference to states of health, medicine both preventive and curative, and doctors. Inevitably her own life, and that of people close to her, involved encounters with all of these, in her case culminating in her death from post-partum complications (the baby was the future Mary Shelley), at age 38. In medical as in other contexts, she did not believe in passively putting up with whatever was happening around or being done to her. She held strong views and made them known.
The start she got in life could have been worse. She was born into a middle-class household, grand-daughter of a fairly prosperous weaver and daughter of a fairly unsuccessful ‘gentleman farmer’. (2) Her earliest years were spent in London, then the family moved several times, first to Epping then to Beverley in Yorkshire. Few details of her childhood are on record, but she seems at least to have been reasonably healthy, and her siblings likewise survived and flourished. Her first biographer, William Godwin (3), noted that, whatever Mary’s mother’s limitations, she had a good record in this respect, contributing to her daughter’s ‘remarkably robust’ constitution. One brother, Henry Woodstock Wollstonecraft, for a time unknown to biographers then supposed to have died as a neonate, was apparently apprenticed to an apothecary in Beverley in 1775. (4) The general silence about him has been taken to indicate that he was something of a ‘back sheep’; on the other hand, he may have been content to shake off his often erratic family. This tenuous connection with the practice of medicine was in any case a lot less significant for Mary than the contacts she formed through affinity and shared ideas. It may, however, ‘place’ her socially on a level comparable with a section of its professionals.
|Section of family tree|
That robust constitution was usually ‘supported by both will-power and common sense’, but not always. In spite of her professed contempt for ‘nervous complaints, and all the vapourish train of idleness’ (5), her letters often seem to harp on a succession of ill-defined malaises and souffrances. Perhaps these complaints served as a safety-valve, enabling her to give vent to her more negative feelings even as she devoted her considerable energies to a range of projects and activities that would be daunting to most people. (6) The occasions when a physician was actually consulted on her behalf seem to be rare; when necessary, she evidently acquiesced or accepted their ministrations with stoicism. Following a recommended treatment, she gave credit where it was due: in October 1779 ‘I was advised by one of the faculty [a doctor] to bathe in the sea, and it has been of signal service to me.’ That was at Southampton, after she had left home to be employed as companion to a notoriously ‘difficult’ elderly lady in Bath. (7)
Some months later she wrote to her girlhood friend Jane Arden about a pleasant encounter during a journey from Windsor to London: “The post Coach is very convenient, and the passengers happened to be agreeable. – They consisted of a Physician and his Son, whose character I was acquainted with, and whose conversation was very rational and entertaining: – he has published several things that have been much approved of, and he has travelled thro’ the old and new continent. – “
Not free of bodily ills, she confided to George Blood, brother of her friend Fanny, in a letter of 3rd July 1785, “I have been very ill, and gone through the usual physical operations, have been bled and blistered – yet still I am not well.-“ In February 1787, by which time she was governess to an aristocratic family in Ireland, she wrote to her sister Everina: “My little pupil is still delicate, tomorrow the physician is to pay us a visit Lady K[ingsborough] intends consulting him about me, though I have requested her not, as I am sure it would answer no good end.” The following month: “l am not well, the Physician who attends this family thinks I have a constant nervous fever on me – and I am sure he is right.” The spring didn’t help much. In May: “I am still unwell, and begin to believe that I ought never to expect to enjoy health. My mind preys on my body – and, when I endeavour to be useful, I grow too interested [emotionally involved] for my own peace.”
Much of this may have been psychosomatic in origin, due to her depressed state of mind, compounded by discontents and difficulties in the Kingsborough household; anyway, the impression of non-stop introspective moping is belied by indications that she was not only managing to lead quite an active social life, but had made a start with her writing career. She had already written and had published her Thoughts on the Education of Daughters, 1786. Among its innovative ideas, she particularly recommended ‘elementary’ medicine as a suitable subject of study for women, an idea to which she returned later on. For most women, a more likely prospect was to be conscripted as unpaid and often unthanked nurses when relatives or close friends – or sometimes mere acquaintances – fell ill or met with accidents.
“When pain and anguish wring the brow...”
Mary performed her share of such ‘duties’ and was to be on occasion, in her turn, at the receiving end of friendly care. In 1782, although their relationship had not been particularly happy, she attended her mother during her last illness until she herself became ill from the stress of constant demands and lack of sleep. A couple of years later she was called in to look after her sister Eliza who appears to have been suffering from post-natal depression. Mary took the situation so seriously that she decided Eliza had to be rescued from her husband, braving the scandal this would cause. It was not entirely a successful intervention; Eliza survived to make some kind of life for herself, part of it with her sister Everina, but the baby and the marriage did not. Mary was of course blamed at the time, and some of her biographers have been almost equally judgmental, but no-one can know whether leaving her sister to her matrimonial fate would have had a better outcome. They had seen something of domestic violence in their own family; Mary told Godwin that she had sometimes tried to protect her mother from her father by sleeping outside of her room.
Not long after this episode, in late 1785, Mary travelled to Portugal to be with her friend and former colleague in running a school, Fanny Blood, now Fanny Skeys, who had recently married and was pregnant. She was also in an advanced stage of pulmonary tuberculosis. On the voyage out Mary got an idea of what this might involve, when she helped a fellow-traveller, also a TB sufferer, through bouts of coughing and seasickness. She had done some reading in medical books and realised there could not be much hope for Fanny, who died along with her infant shortly after the birth. Mary had no complaints about the medical care provided, as she wrote to George Blood, commending “Dr. Jeffray who accompanied her to Lisbon” as “such a man as my fancy has painted and my heart longed to meet with – his humane and tender treatment of Fanny made me warm to him.” She added, “I am still trying to get him a place but my hopes are very faint”, suggesting that she was already a person of some influence with useful contacts. Fanny her self had fostered the friendship, having mentioned when writing to Mary’s sisters (also involved in the school) “a young and romantic but ugly” physician who was there in Portugal, having described him to Mary too: “and she is, I hope, prepared to love him.”
Writing as Therapy
“Her anxiety led her to study physic [medicine], and for some time she only read books of that cast; and this knowledge, literally speaking, ended in vanity [emptiness] and vexation of spirit, as it enabled her to see what she could not prevent [...]” “The physician, who was in the house, was sent for, and when he left the patient, Mary, with an authoritative voice, insisted on knowing his real opinion. Reluctantly he gave it, that her friend was in a critical state; and if she passed the approaching winter in England, he imagined she would die in the spring; a season fatal to consumptive disorders.”
As well as nursing friends, the title character is ready to undertake the care of strangers in distress. At one point, finding a “poor woman… dying of a putrid fever, the consequence of dirt and want...” she takes direct action to help her. “Mary sent the husband for a poor woman, whom she hired to nurse the woman, and take care of the children... Her knowledge of physic had enabled her to prescribe for the woman... Cleanliness and wholesome food had a wonderful effect.” This is not without risk to herself: “Not aware of the danger she ran into, she did not think of it until she perceived she had caught the fever. It made such alarming progress, that she was prevailed on to send for a physician; but the disorder was so violent, that for some days it baffled his skill... She slowly recovered.”
Another case evinces a more melancholy-romantic view of bodily ills. At first “Henry’s illness was not alarming, it was rather pleasing...” but before long, succumbing to “the close air of the metropolis” and the progress of the disease, his condition deteriorates and he too dies. “Mary” devotes herself to good works, amid strong hints that she is not long for this world. Although she later expressed doubts about the book’s literary value, it seems to have fulfilled a psychotherapeutic function for its author, together with her resolve henceforth to be ‘useful’ in the world and to try the experiment of earning her living as a writer: “Nothing calms the mind like a fixed purpose”.
Her time in Ireland, in the worst phase of her depression prior to writing the book, had brought further occasions to take on a caring role, with a happier outcome. She nursed her “little pupil”, Margaret King, through more than one episode of sickness, including a “very violent fever” which led to her life being “despaired of”. Meanwhile Mary herself continued “unwell” as reiterated in her letters, with such symptoms as “spasms and disordered nerves”, “violent pains in the side”, difficulty in breathing etc. In the summer of 1787 her employers took her with them to Bristol Hot Wells, which failed to lift her spirits much. Her novel alludes to the depressing effect of so many sick people congregated there.
Writing as Profession
It was on her return to London after deciding to give up the occupation of governess that Mary became a full-time writer. As such she participated in the literary and political circle centred on her friend and publisher, Joseph Johnson – a set she referred to as ’a sort of menagerie of live authors.” When she had lived in London before, she had come into contact with some well-known dissenters around Newington Green where she, her sisters and Fanny Blood had tried to run their school – one was Dr Richard Price – and she had met the famous Dr Samuel Johnson, neither of those being medical doctors. Among the names she was able to drop in her letters, however, was that of “Dr. Lettsome”, in the context of a picture being produced for him by the artist Sowerby, who was then introduced by the doctor to several others who had their pictures drawn. John Coakley Lettsom had written on ‘gaol fever’ and was called in to advise on its prevention in Newgate; a committed philanthropist, he also worked among the London poor. (9)
Now the scene was changing, awareness was spreading about the French Revolution’s outbreak and what it might mean, and Mary was about to gain recognition as a personage in her own right (or indeed her won right). That she succeeded in doing so was due in no small measure to Joseph Johnson. He had begun by selling medical books in his first shop, in Fish Street, near Guy’s and St. Thomas’s hospitals, and continued his interest in the subject when he went in for publishing – texts on it were prominent on his lists – and began the Analytical Review, in 1788. His partner in the latter venture, Thomas Christie, had studied medicine in Edinburgh and London, and planned to specialise in obstetrics before turning to journalism. (10) Christie’s Letters on the Revolution in France and the new Constitution established by the French Assembly were published by Johnson in 1791. He and his wife featured in Mary’s life as valued friends who gave her vital support in more than one crisis.
Mary was a contributor to the Review and attempted, among many literary tasks, an abridgement of Lavater’s Essays on Physiognomy which had been translated by Thomas Holcroft in 1789. (Holcroft was a friend of William Godwin, and was interested in, among other things, the possibility of overcoming disease by will-power.) Later she wrote about Lavater, met when he visited London in 1792, with some scepticism: he would no doubt discern qualities of a statesman in the face of a certain individual, she thought “... because he has a knack of seeing a great character in the countenances of men in exalted stations, who have noticed him, or his work”. Incidentally, ‘physiognomical’ analysis of Mary’s and Godwin’s daughter as a baby found signs of “memory, intelligence, quick sensibility and a certain lack of patience” – perhaps the analyst had known her mother.
In the inter-acting in-crowd of 1790s radical London there were naturally several medics to be found, some of whom would be inclined to try to integrate their views on medicine into a more general, political world-view. One or two may even be seen as engaging in a consciously enlightened effort to share their specialised knowledge with like-minded members of society at large, in a free and equal exchange of ideas. Such a project would be distinct both from an expert-provider/ passive-consumer model of health provision, and from that of an affluent and well-connected ‘customer’ ordering up the services required.
One doctor whose name comes up in this sort of context is Thomas Beddoes, although he was at this time based in Oxford rather than London. (11) Described as “fiercely radical and feminist” he had ideas in common with Mary, including a strong interest in education. At the time of her Vindication of the Rights of Woman, in early 1792, he had printed, although not published in full, A Letter to a Lady on the Subject of early Instruction, Particularly that of the Poor. He is said to have concluded, upon consideration or advice, that it was too subversive to be distributed. He was in favour of opening up medical education for women, in part at least, in the form of “a more select course, adapted for a female audience” because “No objection on the ground of indelicacy or disgust, can be brought against some anatomical subjects”. Later, in Bristol, he continued his efforts to this end; in 1797 Joseph Johnson published his introductory lecture to an anatomy course. He was also a friend of Godwin. Both, as philosophers who would help to establish the ideal national curriculum, were included in Josiah Wedgwood’s plan for educating an elite of moral improvers. (12)
Some of her best friends...
Two of the doctors from the radical scene who were to be in attendance, as friends as well as physicians, during Mary’s last days, were Anthony Carlisle and George Fordyce. The home life of the latter – not to be confused with the Rev. Fordyce whose restrictive and repressive views on women she denounced – was the subject of a favourable reference in a letter from Mary to her sister Everina in December 1792: “You remember Dr. Fordyce, I lately dined at his house, and I have seldom been in company with more intelligent pleasing women than his two daughters.” Considered by some as eccentric, he was charged in sundry anecdotes with drunkenness and uncouth behaviour (hardly character traits that would be expected to appeal to the somewhat fastidious Mary), not to mention with being persistently Scottish. She would be expected, though, not to have much of a problem with his reputed disregard of fashion and ornament, and general no-nonsense attitude. (13)
Anthony Carlisle, younger by about thirty years, had attended Fordyce’s lectures, and had studied under the famous surgeon John Hunter at the Windmill Street School; he had already achieved some success, becoming a Fellow of the Royal Society at 32. He was appointed surgeon to the Westminster Hospital in 1792, and was to rise to a certain eminence in his profession, seemingly fairly distant from radical currents. Traces of continuing influence from the spirit of the 1790s may be traceable in his reputed forthright style, unorthodox ideas, and “unaffected and invariable humanity to the suffering poor.” (14) He was said to have originated the practice of open consultation on ‘the propriety of operating in cases admitting the slightest doubt’; he advocated common sense, and down-to-earth skills deployed with neatness and precision. Perhaps Mary’s own influence impinged on his thinking, which seems to echo hers at a few points. He was firmly opposed ‘man-midwives’, and wrote to Robert Peel in support of women practitioners of midwifery. His style of pithy realism can evoke Mary too: “In your idea of the powers of remedies do not be too sanguine, for you are liable to disappointment”. He went further than she had done in criticising orthodox medicine when he defined it as an art “founded in conjecture and improved by murder.”
Godwin reports that in the early 1790s, Mary “took a young girl of about seven years of age under her protection, the niece of Mrs. John Hunter and of the present Mrs. Skeys [Fanny Blood’s widower had remarried], for whose mother, then lately dead, she had entertained a sincere friendship.” The implication that John Hunter’s name would be familiar to readers suggests that one of the girl’s aunts was Anne Hunter, wife of the celebrated surgeon, whose own household was incurring heavy expenses at the time. (15) The fostering by Mary did not last very long; the girl was sent to Everina, by then in Ireland, in 1792 when Mary was preparing to go to France, and subsequently to Ruth Barlow, another of the radical set. This sort of passing round of children was not particularly unusual nor perceived as necessarily damaging, as evidenced in novels as well as biographies of the time.
Mary’s acquaintance in the medical profession, then, was not comprised of merely marginal figures. Idiosyncratic and unconventional they may have been, but most (Beddoes being an exception, and her connection with him is uncertain) made their way to and remained in the mainstream.
E. A. Willis
Published online only (so far).
Next, Part 2: Magnum Opus, travels to France and Scandinavia, and more.
1. A Vindication of the Rights of Woman [VRW] and several other books by Mary Wollstonecraft can be found in various editions in libraries and/or currently in print. A multi-volume edition of MW’s collected works, edited by Marilyn Butler and Janet Todd, was published in 1989.
2. Claire Tomalin, The Life and Death of Mary Wollstonecraft. Weidenfeld & Nicolson, 1976.
3. William Godwin, Memoirs of the Author of A Vindication of the Rights of Woman . Facsimile edition, bound with VRW. Gregg International Publishers, 1970.
4. Ralph, ed. and Preface, Collected Letters of Mary Wollstonecraft. Ithaca/London, Cornell U P, 1978. Superseded by Janet Todd, ed. (Allen Lane 2003).
5. VRW, Facsimile edition as at note 3 above; p.272, note.
6. Quotations from MW’s letters are as in the Wardle edition, note 4 above.
7. Sources for biographical incidents: Notes 2, 3, 4 as above; and Kenneth N Cameron, ed., Shelley and his Circle, vol. 1. Oxford U P / Harvard U P, 1961.
8. Mary Wollstonecraft, Mary, and The Wrongs of Woman, ed. and intro. G. Kelly, OUP, 1961.
9. John Coakley Lettsom, Medical Memoirs of the General Dispensary in London, for part of the years 1773 and 1774. London, Edward and Charles Dilly, 1774. MW’s Letters to George Blood, July and August 1785. On gaol fever and Newgate, see previous post.
10. Tomalin, p.78.
11. Sources for Beddoes’ biography: J E Stock, Memoirs of the Life of Thomas Beddoes with an Analytical Account of his Writings, London, John Murray, 1811; Roy Porter, Doctor of Society: Thomas Beddoes and the Sick Trade in Late Enlightenment England, Routledge, 1991.
12. William St. Clair, The Godwins and the Shelleys. Faber & Faber, 1989, pp.99-100.
13. Sources for George Fordyce’s biography: F G Parsons, The History of St. Thomas’s Hospital, vol.2, From 1600 to 1800, Methuen 1914, pp. 225-7; Sir George Clark, A History of the Royal College of Physicians of London, vol.2, OUP, 1966; William Munk, The Roll of the Royal College of Physicians of London, vol.2, 1700 to 1800 (1978), pp. 173-6.
14. Sources for Carlisle’s biography: John Langdon-Davies, Westminster Hospital: Two Centuries of Voluntary Service, 1719-1948, John Murray, 1952; R J Cole, ‘Sir Anthony Carlisle, FRS (1768-1940)’, Annals of Science, vol.8, 1952, pp. 255-70.
15. With reference to John Hunter: Sir D’Arcy Power, British Masters of Medicine. London, Medical Press & Circular, 1936, p.47. Anne Hunter was a poet, some of whose verses were set to music by Haydn, so she may well have been around, among other literati.
Suggestions for Further Reading. Published after the above article was written (c1995):
Lyndall Gordon, Vindication: A Life of Mary Wollstonecraft. (Little, Brown 2005) Virago 2006.
Janet Todd, Mary Wollstonecraft, a Revolutionary Life. Weidenfeld & Nicolson, 2000.
Janet Todd, ed. The Collected Letters of Mary Wollstonecraft. Allen Lane 2003.
Claudia L. Johnson, ed. The Cambridge Companion to Mary Wollstonecraft. CUP 2002.
Black Flag No. 227, Summer 2008, includes writing by Emma Goldman on Mary Wollstonecraft.
See also: an assessment of MW from a left-libertarian perspective on this blog.