Treating Measles in late Seventeenth-Century London and Dublin by Elizabethanne Boran

This month, Elizabethanne Boran, librarian at the Edward Worth Library, Dublin, writes on treating measles in late seventeenth-century London and Dublin, with particular focus on the works of John Pechey (1654-1718), many of which were collected by the Irish physician Edward Worth (1678-1733). 

A keen collector of medical works

Title page of  John Pechey's Collections of Acute Diseases (1691)

‘These Measles began very early, as they use to do, to wit, at the beginning of January, 1670/1 and increasing daily, came to their height at the Vernal Æquinox, i.e. the Tenth of March: afterwards they gradually decreas’d. and were totally extinguish’d the following July’. Thus begins John Pechey’s account of an outbreak of measles in his Collection of Acute Diseases (London, 1691), a book collected by the early eighteenth-century Dublin physician, Edward Worth (1676-1733). Worth was a keen collector of all kinds of medical and scientific works and was particularly interested in infectious diseases. As the Worth Library’s online exhibition on infectious diseases demonstrates, his main areas of concern were plague, smallpox, syphilis, and tuberculosis, not to mention all kinds of fevers, but he was also avidly interested in books on other infectious (and non-infectious) diseases.

John Pechey

Perhaps it was for this reason that Worth was drawn to the works of John Pechey (1654-1718), for he collected no less than seven books by this popular author: Pechey’s Collection of Acute Diseases (London, 1691) had quickly been followed by his Collections of Chronical Diseases (London, 1692). Three years later Pechey’s Storehouse of physical practice was on the market and in the next two years he produced a book a year: Treatise of Women’s Diseases (London, 1696) and Treatise of Children’s Diseases (London, 1697). All of these books were collected by Edward Worth who joined to them a 1700 edition of Pechey’s Promptuarium praxeos medicae (which had been a Latin translation of the Storehouse), and, finally, in 1707, Pechey’s Compleat Herbal of Physical Plants. Though these books didn’t not represent the entire output of Pechey (which includes a host of pamphlets on the virtues of his famous medical concoctions), it is clear that Worth was drawn to Pechey’s understanding of disease, which was, in turn, heavily dependent on the works of the great English physician, Thomas Sydenham (1624-1689), whose works were translated and published by Pechey.

Portrait of Thomas Sydenham

A fractious relationsip with medical authorities

Pechey was the son of William Pechey, a Sussex ‘Practitioner in Physick and Surgery’, whose influence his son publicly acknowledged in the fifth part of his Collection of Acute Diseases. Judging by this dedication, Pechey had a fractious relationship with medical authorities. Initially his education had been unremarkable: he had taken a BA and MA from the University of Oxford in 1675 and 1678 respectively and in late 1684 he had successfully taken the Royal College of Physicians licentiate examination. Three years later he, and a number of other licentiates, set up practice at the Golden Angel and Crown in King’s Street, London and it was there his trouble started. His and his colleagues’ decision to advertise their medical services with the admirable promise that ‘the sick may have advice for nothing’ was met with less than enthusiasm by the medical authorities, who were appalled at Pechey’s approach. Legal battles ensued and it was in this context that Pechey issued the first edition of his Collections of Acute Diseases, which was published in London in 1686. In effect, Pechey had simply translated Thomas Sydenham’s works on smallpox and measles into English, no doubt in an effort to demonstrate how mainstream his medical teaching was. This was by no means plariarism: Pechey undoubtedly had the support of Sydenham in translating his work and he was himself keen to give credit where credit was due. Indeed he informs the reader that he had ‘chiefly collected from Dr Sydenham, because I have found by Experience, that his Methods in Acute Diseases have been most successful in practice. The Chapter of a Peripneumony was taken from Willis. The Chapter of Women’s Diseases, from Riverius and from Mauriceau, The Chapter of an Apoplexy, Lethardy, Coma and Carus; likewise from Riverius.’ It is revealing that works by all these authors were likewise collected by Worth.

The 'English Hippocrates'

The choice of Sydenham was a shrewd one – as the numerous editions of Pechey’s English translation of Sydenham’s complete works testify. But if Pechey hoped to win approval by translating Sydenham’s works his hopes were dashed for Sydenham’s own relationship with the Royal College of Physicians was problematic. It is at first sight surprising that so eminent a physician, one who was regarded as the ‘English Hippocrates’ due to his emphasis on clinical experience, was never made a Fellow of the College. However, it was precisely Sydenham’s advocacy of experience over theoretical medicine that threatened the status of the members of the College. Sydenham might have avoided publishing his most radical attacks on the medical establishment but there was sufficient criticism of them in his famous Methodus to ensure that they were less than attracted to the likely social implications of his health regime.

Bleeding a patient

'These Men blame me for Englishing their Mysteries'

 So Pechey’s advocacy of Sydenham, though it fitted in perfectly with his own medical philosophy, was unlikely to endear him to the Royal College of Physicians who were already incensed by Pechey’s propensity for advertising his medical wares. Not only this, but, as Pechey explains to the reader in Worth’s 1691 edition of the Collection of Acute Diseases, the very method of his popularizing of Sydenham was criticised: ‘These Men blame me for Englishing their Mysteries, though they know that Hippocrates and Galen and Celsus, and many others wrote in their Mother-Tongue.’ That didn’t stop him for, as his preface to his father makes clear, his publications represented not only an opportunity for financial gain but more importantly were part of a crusade to defend the importance of practice and experience over theory, and, at the same time, to democratize medical knowledge by making the works of eminent doctors available in English to non medical readers. In this Pechey seems to have been following his medical hero, Sydenham, for the latter never joined the ranks of fashionable doctors and was more than happy to treat poor patients.

Bleeding

Therefore, much of Pechey’s description and suggestions for treating measles comes directly from Thomas Sydenham. Certainly both men would have concurred that ‘the Patient be kept in his bed onely two or three days after the eruption, that the bloud may gently breath out, according to its own genius, through the pores of the skin, the inflam’d Particles that are easily separable which offend her; and that he have no more cloaths nor fire, than he is wont to have when he is well’. Though Sydenham in general opposed the treatment of bleeding in cases of fever and smallpox, he admitted that in some cases of measles the standard practice of bleeding should be implemented. Edward Worth’s collection of medical books demonstrate that this early eighteenth-century Dublin physician was a keen follower of the Pechey-Sydenham approach to infectious disease.

Elizabethanne Boran is librarian at the Edward Worth Library, Dublin. She may be contacted at elizabethanne "dot" boran "at" hse "dot" ie.

Charles Lucas (1713-1771) by Harriet Wheelock

This week marks the 300^th anniversary of the birth of Charles Lucas, a politician, physician and writer.

Charles Lucas was born on 16^th September 1713. Left penniless on the death of his father, Lucas was apprenticed to a Dublin apothecary. Apothecaries, at that time, were the least respectable branch of the rapidly expanding medical profession, but the only one a man in Lucas’ position could hope to access. The apothecaries’ trade was notorious at the time for fraud, malpractice, adulteration of medicines and the use of poison. Lucas actively campaigned for legislation to control the profession, and was partly responsible for the 1735 act which gave this College the power to regulate the Apothecaries trade.

Rising in his profession, in 1741 Lucas was chosen by the barber-surgeons’ guild to represent them on Dublin Corporation. Lucas campaigned against the usurpation of the rights of the common citizens by the Lord Mayor and Alderman, and was instrumental in getting the matter examined by committee. However, his outspoken views created enemies and in 1744 he lost his seat on the Corporation.

Lucas’ appetite for politics had been whetted and in 1749 he decided to contest the vacant parliamentary seat for Dublin. He expanded the arguments he had used on the Corporation, to argue against the deliberate erosion of the citizens’ rights of the entire population of Ireland. His denial of the right of the English parliament to make laws for Ireland raised some eyebrows, but he really overstepped the mark when he stated that there was ‘no general rebellion in Ireland since the first British invasion, that was not raised or fomented by the oppression, instigation, evil influence or connivance of the English’.  Parliament condemned Lucas’ ‘rebellious doctrines’ and ordered his arrest, forcing Lucas to flee to the Isle of Man.

Lucas used his 11 years of exile to great advantage; he studied medicine in Paris and Lieden, before establishing a practice in London and publishing many political and medical works. In 1760, after the accession of George III, Lucas was pardoned and allowed to return to Ireland. On his return he immediately and successfully contested the Dublin parliamentary seat, and was active in pressing for parliamentary and medical reform. For the medical profession his most lasting legacy was Lucas’ Act, passed in 1761. This greatly extended the powers of the College of Physicians, re-establishing their right of inspection over Apothecaries, and giving them the right to compile a Pharmacopoeia, cataloguing and detailing the mixture of all drugs which could be prescribed. Lucas died on 4^th November 1771, at the age of 58.

To mark the tercentenary of Lucas’ birth, the Royal Academy of Medicine in Ireland will be holding an evening symposium of Lucas on 23^rd September in Dublin City Hall, starting at 5pm. The programme is as follows:

Professor James Kelly, St Patrick’s College/DCU; The Life and Significance of Charles Lucas: An Overview

Professor Jacqueline Hill, NUI Maynooth; Dublin and Irish Politics in the Age of Charles Lucas

Dr Eoin Magennis, President of the Eighteenth Century Ireland Society; Charles Lucas and Patriot Politics in mid-18th Century Ireland

Professor Marian Lyons, NUI Maynooth; The Professionalisation of Medical Practice in Dublin during the Early-17th Century: the Case of Thomas Arthur, M.D.

Dr Susan Mullaney, RAMI/UCC; Charles Lucas and Medical Regulation in 18th Century Ireland

Sean J. Murphy, M.A., Genealogy Teacher, UCD Adult Education; The ‘Essay on Waters’ and other Medical Writings of Charles Lucas