A glimpse at medical practices in the 19th century

The following is a re-print of a past column by former Advertiser columnist Stephen Thorning, who passed away on Feb. 23, 2015.

Some text has been updated to reflect changes since the original publication and any images used may not be the same as those that accompanied the original publication.

 

From time to time, I find myself in discussions about whether the 19th century was superior to the 20th.

The argument most frequently voiced in support of the latter is that medicine and medical practice have advanced dramatically over the past 100 years. For those of us who have survived major illness, this argument is a powerful one.

During the mid-19th century, the medical profession could offer little that was of real benefit for most illnesses. Physiology was still a developing science, surgery was at best clumsy, there were no hospitals in the modern sense, and medicines often did more harm than good.

Nevertheless, doctors were numerous. Some commentators claimed that Canada had far too many professional men, particularly doctors and lawyers, and that the real need of the country was for skilled tradesmen.

Elora’s first doctor arrived in October, 1847. He was John Finlayson, a 35-year-old Scotsman. At the time, Elora had a population of perhaps 300, but the doctor also served people in the adjoining townships. In 1848, Finlayson was appointed coroner for the Wellington district.

Finlayson called himself a physician. At the time there existed a hierarchy in the medical profession. Physicians were at the top; their duties consisted of diagnosis, advice and the prescription of drugs. Beneath them were surgeons, who worked with their hands, and a rank lower were the apothecaries who dispensed drugs but could also prescribe them. This was the old British guild system, and it had to contend with ideas imported from the United States. By the 1860s, the distinctions between physicians and surgeons had largely blurred in Canada.

American ideas of democracy extended to medicine. Many Americans found the secrecy and closed nature of the medical profession offensive. Two popular books, both with the title Domestic Medicine, became very influential, affecting popular opinion up to the 1870s. These books promoted a distrust of professional medicine, and they argued that fresh air and cleanliness could do more for a patient than any doctor.

Eighteen months after Finlayson started to build his Elora practice, another doctor opened an Elora office. This was William Middleton, son of James Middleton, one of the Bon Accord pioneers. Middleton had apprenticed with Dr. William Clarke of Guelph and he listed himself as a surgeon. He had married Henrietta Allan, daughter of Elora’s leading citizen, Charles Allan.

Soon there was more competition, when Joseph Small opened a medical practice in Elora. Of the three doctors, Middleton seems to have done the lion’s share of business. His local connections helped a great deal. As well, most Elora residents resented Finlayson’s overbearing manner and snobbishness.

During the early 1860s, Middleton operated from a second-floor office on Mill Street, and lived with his mother-in-law, Grace Allan, in the Allan house on Church Street. (95 Church St., on the southwest corner of Church and North Queen). He afterward built a fine brick house on McNab Street (42 McNab).

Dr. Small did not remain long in Elora. In 1859, his place was taken by Arthur Paget, a 26-year-old Welshman. Dr. Paget resided in several houses over the years. In the 1860s, he lived in the house built by James Geddes (22 Metcalfe St., directly across from the LCBO), and set up his office and surgery in the basement. In 1875, he moved to the house at the corner of David and Smith Streets (220 Smith St.).

Dr. Finlayson continued his practice into the 1870s, but he found it necessary to supplement his income. Political connections enabled him to be appointed postmaster of Elora in 1859. During the 1860s, he sorted mail and operated a bookstore with his son-in-law, W.H.L. LaPenotiere.

More doctors came to Elora in the late 1860s: William Savage in 1867 and W.R. Pentland in 1869. Dr. Savage seems to have been the first university-trained doctor in the village. He had practiced in Winterbourne for a year before coming to Elora at the age of 21. Although young, Dr. Savage slowly built a reputation as a skilled medical practitioner. By the mid 1870s, he had displaced the other doctors in the village to become the busiest physician in Elora.

Dr. W.R. Pentland operated a drug store while attempting to build a medical practice on the side. As the new man in town, he had a tough time of it: there were five doctors in Elora in 1870, with the population around 1,600. Pentland had problems with his own health. Running the drug store took most of his time, but he did have the advantage in being able to offer an over-the-counter diagnosis and then sell the medication for it.

For a period of almost six years there were five doctors in Elora: Finlayson, Middleton, Paget, Savage and Pentland. None of them was able to earn a decent living. Much of their work consisted of setting broken bones, or dealing with the complications of accidents. The older ones, with rudimentary training at best, relied heavily on the old standby treatments of their profession: letting blood, purging and blistering.

Not surprisingly, the university-trained doctors who kept pace with new developments eventually gained public confidence.

As well as competition among themselves, Elora’s doctors also had to contend with practitioners on the fringe of the profession, with people who treated themselves with popular medical books and folk medicine, and with mail order medicine.

As often as not, childbirths were supervised by midwives. Their presence is noted in newspaper accounts of difficult births, when doctors were summoned, and they occasionally advertised in newspapers, but we know little of their activities. For example, were they part-time professionals, or merely friends and relatives who assisted when called upon?

In the mid-19th century there were also travelling doctors of various types. Some were specialists in fields such as optometry; others offered various cures for cancers and other puzzling ailments. These practitioners usually set up shop in a hotel room for a few days or a week.

Herbalists and homoeopathists offered alternative treatments. These seem to have been fairly common. Their methods and practices covered a broad range, from folk traditions to science-based theory. Some of these specialists were also qualified doctors.

The often-hostile division between herbal healers and mainstream medicine had not yet developed.

*This column was originally published in the Elora Sentinel on May 17, 1994.

 

Stephen Thorning - 1949-2015

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