Life in Scotland in the 18th century was filled with dangers not least from physicians’ treatments of sick patients. Some ‘cures’ might provide clues to the prevalence of early deaths.
A single example will illustrate what I mean.
Severe constipation might be tackled by immersing the patient’s lower extremities in cold water, or making them walk along a wet pavement (flagstones/setts) and dashing the legs and thighs with cold water. If this didn’t result in producing a stool, and I’d be surprised if it did, then a quantity of quicksilver (mercury) was called for, as much as one pound, to be swallowed by the unfortunate sufferer. If the quicksilver proved too much for the patient he or she was suspended by the heels to encourage the quicksilver back out through the mouth.
Healing was often the result of long-term observation by physicians and trial and error attempts to deal with illnesses which might prove successful or might not. When the Scottish physician William Buchan decided to put his observations and recommendations into print so others might benefit from his knowledge he made himself unpopular with colleagues who wanted to preserve an aura of mystery around the art of medicine.
The first edition of Buchan’s book appeared in Edinburgh in 1769 and proved a great success from the start. His Domestic Medicine or A Treatise on the Prevention and Cure of Diseases by Regimen and Simple Medicines was to become a standard work not only in this country but across the world. It was reprinted in over 140 English language editions selling some 80 000 copies and it was translated into several languages. Domestic Medicine proved particularly popular in America with several cities reprinting their own editions so it would be found in homesteads and plantations and carried on journeys west by pioneers – a medical bible that advised on just about any physical or mental danger that might afflict a person. Catherine the Great of Russia showed her appreciation of the great man by awarding Buchan a gold medal for his comprehensive guide to medicine.
Ships captains, responsible for the health of their sailors away from home for months at a time, would carry Buchan’s Domestic Medicine with them on voyages. When mutiny broke out on HMS Bounty Captain Bligh’s copy was one of the pieces of property purloined by the mutineers, led by Fletcher Christian, when they abandoned ship and went into hiding on Pitcairn Island.
Today Buchan’s work is a curiosity, a glimpse into a world very different from ours, where death was never far away from a stricken patient. But not all treatments sound outrageous for the good doctor’s keen observational skills can strike a chord with us on several ailments, such as gastric difficulties, when he warns of over-indulgence in fatty and rich foods.
Buchan was an enthusiast for exercise and fresh air which he recognised was essential to generally good health. He was also a keen advocate of the Scottish diet – simple and nutritious and gentle on the stomach and gut.
At a time when personal hygiene was not easy to achieve because of poor supplies of clean water he, nevertheless, advocated frequent washing. It is easy to see how such sensible advice would in time provide the groundwork for recongising that adequate and clean water supplies in our expanding and overcrowded towns and cities were essential to improving human health during the 19th and 20th centuries.
In his section on diet, Buchan examines the differences between the average Scottish and English habits of eating during the eighteenth century. He despairs at the quantity of animal meat consumed in England (when it could be afforded) because he warned too much animal meat led to circulatory and gastric problems, to nausea and excessive thirst (leading to the over-consumption of beer which he regarded as expensive and wasteful of money that might otherwise have been spent on nutritious food).
The more sedentary the occupation the less animal meat that should be eaten he cautioned. What meat was consumed should be mixed with vegetables was his advice. He came across too many people in England, where he also practised medicine, who ate too few vegetables with the result scurvy was extremely common in England. He also blamed an excess of meat for blunting the imagination and inducing ferociousness in individuals. His conclusion was too much meat made people angry, produced lethargy and rotten teeth through scurvy while at the same time was an expensive way to eat. Mixing meat and vegetables in soups or stews, he reasoned, would feed more people for the same cost as one person’s serving of meat but in England when meat was boiled it would be taken out of the water and the stock was thrown away, so discarding the nutritious juice that could have provided a tasty soup.
Cooking meat, he observed, was largely limited to the most expensive methods of roasting and broiling so that little money remained for clothes so the common people he came across in England appeared scruffy and poorly dressed.
He wrote that the English diet was the most restricted in all of Europe consisting of little more than meat, bread, butter, cheese, ale and porter. Even children in England were encouraged to drink alcohol from an early age
Buchan noted that the consumption of bread was as great in France as it was in England but the French made ‘copious use of soups and fruits’ whereas the English largely confined themselves to bread (and meat when affordable) eaten mainly with butter – which he condemned as excessively oily and detrimental impact on the stomach. Despite this children of the poorest of the population in England virtually lived on bread and butter.
Bread, he argued, was a wasteful way of utilising grain – better to eat the grain directly – and bread and flour were open to all manner of adulteration such as chalk, alum and lime. He recommended eating a variety of breads made from different types of flour – rye, potato, rice, oat, maize, buckwheat, Indian corn and barley rather than be confined to costly wheat.
Oat bread, he points out, was universally eaten in Scotland. Bread then referred to any solid made out of flour such as bannocks and oatcakes not just loaf. Buchan held up the Scottish mixed diet as preferable to the English while admitting it tended to be quite restricted and unvaried, certainly among the poorest people, it was nevertheless wholesome and affordable.
Oatmeal, milk, broth, vegetables, occasional meat formed the bulk of the Scottish diet. Instead of the large quantities of beer drunk in England, Scots tended to drink more water. (Of course there was whisky but I haven’t come across references to that.) The result, according to the doctor, was a population that was cheerful, active, healthy and strong. In an aside aimed at Samuel Johnson who derided the Scots habit of eating oats which he regarded only fit for horses, Buchan suggests if English horses ate less of it and English men more- it would be to their advantage and, ‘lessen the expense of living.’
If you remember Buchan thought grain best eaten directly. He advocates hasty pudding as an ideal means of serving them. Hasty Pudding could be made from any grain boiled up with water or milk and a little butter or molasses- such as porridge, rice, Indian corn or wheat puddings that might be varied with the addition of spices such as cinnamon or ginger.
He regrets the very few types of grains cultivated in Britain and dependence on foreign imports and he deplored the number of horses that ate large quantities of what grain was grown. Buchan estimated some 2 million horses were kept in Britain which required the equivalent of 3 acres of grain each, totalling some 6 billion acres of grain consumed by horses, enough grain he wrote to feed half the population of Britain. Many of those horses were used to draw carriages ferrying men and women around who he concluded would be far healthier if they got out and walked instead.
The growing popularity of the herb tea also came to his attention which he criticised for its lack of nourishment and how it was drunk with milk and sugar which he noted could be better utilised in the preparation of a nutritious meal.
He accused women taking tea of being too partial to eating too many muffins, crumpets and other spongy bread soaked in liquid butter and consuming fatty pastries who would then complain to doctors about indigestion. Despite his side-swipes at ignorance and over-indulgence Buchan was not against perfectly good food such as butter, only its excessive use on bread and buns foods of low nutritional value. He did recommend those undertaking hard physical labour should add butter to vegetables and non-oily fish but not people who sat around all day or people in sedentary occupations because too much butter would make them sluggish and the addition of cheese could produce ‘fires in the blood’ and constipation as well as drink cravings, presumably due to its salt content. Instead he urged greater consumption of roots and fruits.
Potatoes he regretted were too little eaten except in Scotland and Ireland despite being easily grown and he recommends them boiled or roasted or as a meal served with milk, butter or gravy. Where potatoes were to be stewed or made into broth he recommends boiling them first to get rid of poisons – because the tattie, as he points out, is related to nightshade.
A variety of vegetables in the diet such as Jerusalem artichokes, parsnips, carrots, salsify, beets, cabbage, kale, cauliflower, onions, leeks and broccoli perhaps made into cheap and nourishing stews and soups were recommended by Buchan to easily improve health in individuals but cautioned against too many at one time for fear of wind and flatulence. However, he concluded this was not as serious as consuming too much meat for animal food led to the accumulation of bile and subsequent inflammation affecting parts of the body which is more or less where we began.
William Buchan died in 1805 and is buried in Westminster Abbey in London.