View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by University of Hertfordshire Research Archive The Rise and Fall of the Apothecaries’ Assistants 1815-1923. Derek Westwood Adams Submitted in partial fulfilment of the requirements of the University of Hertfordshire for the degree of Doctor of Philosophy May 2010 Dedication This is for my father and mother Ernest Wilfred and Hilda Adams, and my maternal grandmother Alice Wightman, all of whom, in common with the families discussed in this thesis, understood the importance of education as a means to a successful and fulfiling life. But it was particularly my father that I had in mind while engaged in this work. He was extremely proud when I passed the 11+ examination and obtained a place at Grammar School; sadly he died shortly afterwards and so was unable to enjoy my subsequent academic successes. He would have been equally proud of this achievement; sorry it took so long Dad. 1 Acknowledgements I am grateful to the Master and Wardens of the Worshipful Society of Apothecaries of London, who by allowing me access to the archives of the Society, made the research phase of this work possible. Dee Cook, the Society‘s Archivist deserves my special thanks. It was during a conversation with her that the subject of the apothecaries‘ assistants arose as a possible topic and once I had decided on it, she enthusiastically helped me to find my way about the archive and offered many helpful suggestions. Similarly the library staff at the Pharmaceutical Society have been equally helpful. I would like to acknowledge the assistance given by Professors Owen Davies and Jonathan Morris, my supervisors at the University of Hertfordshire. I am particularly indebted to my primary supervisor, Owen Davies, for his encouragement, academic guidance and moral support. Finally, I would like to express my thanks to my wife Kay who, perhaps with some misgivings, generously agreed to my pursuit of this degree even though it meant that I was not available for long periods when my presence would have been helpful. As always she was supportive throughout. 2 Abstract. The central theme of this work is the elucidation of the circumstances that led to the decline of the apothecaries‘ assistants. The Apothecaries Act (1815) formerly recognised them as dispensers of medicine and provided an appropriate examination and qualification. Initially, starting in 1850, men were the only candidates for the examination and it was not until 1887 that the first woman qualified. From that time the occupation became increasingly popular among young women, as it provided them with respectable employment dispensing medicines in institutions and doctors‘ surgeries. This situation prevailed until The National Insurance Act (1911) transferred almost all the dispensing to the chemists and druggists. This dissertation examines the aspirations of the Pharmaceutical Society, the Society of Apothecaries, the government and the assistants themselves, all of whom were intimately involved in the changes brought about by the Act. While much has been written about medical history in the nineteenth century, little interest has been shown in the apothecaries‘ assistants who were the main dispensers of medicines for a period of about 70 years. This thesis advances our understanding on this subject. Additionally, as most of the assistants were women from middle class families, it opens a window on the social and cultural changes that these young women and their families were experiencing in the second half of the nineteenth century. 3 List of Contents Page Abstract 3 Chapter 1 Introduction 6 Chapter 2 The Formalisation of the Role of the Apothecaries‘ 85 Assistant Chapter 3 The Rise of the Female Apothecaries‘ Assistants 152 Chapter 4 The Introduction and Amendment of Related 212 Legislation Chapter 5 The Decline of the Apothecaries‘ Assistants 286 Chapter 6 Conclusions 358 Appendices 370 Bibliography 392 4 Graph, Tables and Appendices Graph Graph comparing numbers of male and female 108 assistants qualifying by time. Appendix Schedules of Subjects of the Minor Examination to come into 370 1 force after July 1891. Appendix Regulations Relating to the Assistant‟s Examination. 379 2 Appendix Table 1: Maximum number of servants recorded in the 382 3 censuses between 1871 and 1901 per family of those passing the Apothecaries‘ Assistant‘s Examination. Appendix Table 2:Apothecaries‘ Assistants – Father‘s and 383 4 Brothers‘ Occupations. Appendix Table 3: Father‘s and Brothers‘ Occupations for those 388 5 women who gained entry onto the Pharmaceutical Society‘s register. Appendix Substances included in the Schedule of Poisons 390 6 (Schedule A) in the Pharmacy Bill, 1867 Appendix Table 4: Examination fees income from the Assistants 391 7 compared with that from the Apothecaries. 5 Chapter 1 Introduction This thesis examines the history of the apothecaries' assistants in the nineteenth and early twentieth centuries, and proposes that their demise between 1903 and 1923 was brought about by three sets of circumstances related to the National Insurance Act (1911). First, the Pharmaceutical Society had, almost from its inception, wished to annex the dispensing of medicines as part of the profession‘s province.1 Fortunately for them Lloyd George when formulating his National Insurance Act in 1911 separated prescribing and dispensing.2 The Pharmaceutical Society, seeing an opportunity, resolutely lobbied parliament during the formulation and introduction of the Act, to transfer dispensing from the doctors‘ surgeries, where it was performed by apothecaries‘ assistants, into their own hands. Secondly, Lloyd George was not prepared to allow the livelihood of the apothecaries‘ assistants to stand in the way of this transfer and obstruct the passage of his Bill. The assistants, who numbered only about 4000, presented an unsubstantial obstacle. They operated under the patronage of the Society of Apothecaries and consequently believed that the Society would protect them. Because of this and because they worked as individuals in doctors‘ surgeries or in hospital dispensaries, they had no other organisation to protect their interests. Thirdly, the Society of Apothecaries failed to provide any effective support for their assistants when the 1 J. Anderson Stewart, „Jubilee of the National Insurance Act‟, Pharmaceutical Journal, 189, 5150, (1962) 35. 2 Hansard’s Parliamentary Debates, fifth series, vol. XXV, 1 May-19 May 1911, cols. 610-677. 6 pharmacists mounted a challenge to the assistants‘ chosen career. The abandonment of the assistants by the Society after 1911 was unexpected and reduced their status significantly. The published work on medical history is extensive. Much has been written about the origins and development of the physicians, apothecaries, surgeons, pharmacists, nurses and midwives.3 Additionally, fringe practitioners such as herbalists, quacks, hydropathists and hobbyist clergymen have all featured in the literature.4 In contrast the development and subsequent decline of the apothecaries‘ assistants has received no significant mention. Yet for a period of about 75 years this group of practitioners provided an important and effective service as dispensers of medicines in this country. Apparently, they have been overlooked or considered unimportant by the broader study of the history of medicine in the second half of the nineteenth century. Yet their history gives us valuable insights, not only into the professionalisation of medicine and dispensing, but also into the wider social change occurring at the time. 3 M. Pelling, Common Lot: sickness, medical occupations and the urban poor in early modern England (London and New York, 1998) 4 See I. Loudon, „The Nature of Provincial Medical Practice in Eighteenth Century England‟, Medical History, 29, (1985) 4; A. Digby, Making a Medical Living: doctors and patients in the English market for medicines, 1720-1911 (Cambridge, 1994), p. 20; R. Sturgess, „Quackery: a barely believable history‟, Pharmaceutical Journal, 275, 7381, (2005) 795; K. Watson, Poisoned Lives: English poisoners and their victims (London and New York, 2004), p. 41; H. Marland, Medicine and Society in Wakefield and Huddersfield 1780-1870 (Cambridge, 1987), p. 240; S.C. Lawrence, Charitable Knowledge: hospital pupils and practitioners in eighteenth century London (Cambridge, 1996), pp. 74-75; V. Berridge, „Health and Medicine‟ in F.M.L. Thompson, (ed.) The Cambridge Social History of Britain 1750-1950, vol. 3, Social Agencies and Institutions (Cambridge, 1990), pp. 188-189; J. Bradley and M. Dupree, „Opportunity on the Edge of Orthodoxy: medically qualified hydropathists in the era of reform, 1840-60‟, Social History of Medicine, 14, 3, (2001) 417-419; J. Burnby, A Study of the English Apothecary from 1660-1760 (London, 1983), p. 83; A. Robb-Smith, „Medical Education at Oxford and Cambridge Prior to 1850‟ in F. Poynter, (ed.) The Evolution of Medical Education in Britain (London, 1966), p. 37; M.E. Fissell, Patients, Power and the Poor in Eighteenth Bristol (Cambridge, 1991), p. 16. 7 They were not a highly educated group by comparison with the physicians, and as individuals did not achieve wide spread recognition for their work in the field of medicine. Unlike many apothecaries and physicians, they did not gain recognition through their involvement in civic activities and as dispensing has traditionally been performed out of the public‘s sight, they had no direct contact with the public. They worked