Those of you who have read any of my Georgian murder-mystery books featuring Dr Adam Bascom will know that one of the important series characters is Peter Lassimer, an apothecary. I was therefore fascinated to find an article in a publication from the University of Melbourne, Australia, describing an 18th-century manuscript in their library [See reference at end of post].
The contents were written on the backs of many of the plates of an atlas of anatomy, and lie somewhere between a list of medicines and a set of recipes for prescriptions. While the name of the author is not known, the text was written sometime between about 1727 and 1740 by an apothecary in Hampshire, in the south of England, serving towns such as Portsmouth and Havant.
Apothecaries of the time delivered most of what we would now term primary health care. Physicians were too expensive for all but the wealthy and surgeons specialised in amputations and bone-setting, as well as often being barbers as well. Apothecaries were not allowed to charge a consultation fee, but made all their income from the sale of remedies — some they made up themselves and others they bought in ready made. They also dressed wounds, prescribed remedies and made up prescriptions for physicians and others. Many sold herbs and ‘exotic’ groceries, such as tea.
There were many pharmacopoeias (lists of medical drugs) available at the time, but not all linked those drugs to specific medical conditions, or showed how to combine them into remedies. As an aid to future prescribing, and keep track of results, some apothecaries kept a prescription book . This might include a record of the medicines supplied to specific patients, the name of any physician involved, the costs, the dosage and the prescription itself.
This particular manuscript combines elements of a pharmacopoeia and a prescription book by listing actual medical conditions with their associated remedies. Thirty-four specific diseases or groups of diseases are covered, often on the back of the plate from the original anatomical atlas linked to them. The information supplied also includes general comments about the drugs used, plus a list of detailed remedies, a few of which are linked to a named patient and contain the level of detail normally included in a prescription book.
Information such as this offers a fascinating list of remedies available at the time with evidence of their use, which had been found beneficial, and indications of extra information collected by the apothecary himself. Since other medical men are mentioned in conjunction with the prescriptions the apothecary made up for them, we can calculate that around two-thirds of the cases were the apothecary’s own patients and a third patients of various local physicians, surgeons and other apothecaries. There also seems to be a single prescription made up for a herbalist.
Most of the identifiable patients were adults who suffered from the typical ailments of both that time and this. There were women with gynaecological problems, elderly folk beset with respiratory and digestive problems, strokes, heart disease and ‘languor’ (depression). There were also periodic outbreaks of infections and fevers, especially in the winter. As might be expected, patients came primarily from amongst the ‘middling sort’, with a few gentry. Artisans and the poor were unlikely to be able to afford the cost of anything but home remedies or occasional visits to a Cunning Man or Woman.
Overall, the book contains around 1,000 ‘recipes’. Even so, it may be that the manuscript was never fully completed. For example, space was left for text never added and the content as it stands has no remedies for cuts and abrasions, associated infections, sprains, and several more serious injuries.
How typical was all this of actual medical practice of the time? That’s hard to say, given that so few similar items have survived. What is clear is that whoever compiled the book was devoted to his craft and assiduous in keeping and consulting his records. The ailments he was faced with were certainly common everywhere at the time. So were the bulk of the remedies, drugs and herbs he used. But if his practice was, as I suspect, typical of many at the time, his method of record-keeping might well have been almost entirely original.
[Reference] Dorothea Rowse , “The Hampshire apothecary’s book: An 18th century medical manuscript in the Baillieu Library”, University of Melbourne Collections , Issue 3, December 2008.