Contagionism Catches On Margaret DeLacy Contagionism Catches On Medical Ideology in Britain, 1730–1800 Margaret DeLacy Portland, Oregon, USA ISBN 978-3-319-50958-7 ISBN 978-3-319-50959-4 (eBook) DOI 10.1007/978-3-319-50959-4 Library of Congress Control Number: 2017940808 © The Editor(s) (if applicable) and The Author(s) 2017 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. 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Cover illustration © Heritage Image Partnership Ltd / Alamy Stock Photo Printed on acid-free paper This Palgrave Macmillan imprint is published by Springer Nature The registered company is Springer International Publishing AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland ACKNOWLEDGMENTS This book draws on a reference base of thousands of books and articles. Many of them were borrowed for me by the interlibrary loan department of the Multnomah County Public Library in Portland, Oregon. I thank the library itself and the dozens of libraries that generously made these works available to me through interlibrary loan, in most cases free of charge. This book would have been impossible to write without their help. Many libraries also made materials available online or allowed walk-in access to their holdings. They include the British Library, the Library of the Royal College of Physicians, the University College Library and the Wellcome Library for the History of Medicine in London; the Bodleian Library in Oxford; the Huntington Library in San Marino, California; the Hunt Institute for Botanical Research in Pittsburgh, Pennsylvania; the John Rylands Library in Manchester; Dickinson College in Carlisle, Pennsylvania, the Lancaster City Library in Lancaster; the Lancashire Record Office in Preston; the Liverpool Record Office in Liverpool; the Manchester City Library in Manchester; the National Library of Medicine in Bethesda, Maryland, which also provided and created many microfilms; the Newcastle City Library; the Yale University Library; and, in Portland: the Family History Center of the Church of the Latter Day Saints, the Oregon Health Sciences University, Portland State University Library and Reed College Library. Those libraries and librarians who assisted with specific problems are named in the notes, but I should also like to thank Richard Behles, Geoffrey Davenport of the Royal College of Physicians Library, Gina Douglas of the Linnean Society, Stephen Greenburg of the National Library of Medicine, Christopher Hamlin, David Harley, Jeff and Liz McBride, v vi ACKNOWLEDGMENTS Richard Wall and David Zuck, and to acknowledge debts to the late Arthur J. Cain, James Cassedy and Worth Estes. The Humanities, Science and Technology program (part of the National Endowment for the Humanities) provided a three-year grant for 1989–1992 that initiated this project. An earlier fellowship from the American Council for Learned Societies first enabled me to study the history of medicine. My colleagues in the National Coalition of Independent Scholars and the Northwest Independent Scholars Association offered support and encouragement. Family members, including my mother, Elizabeth Eisenstein, and my brother, Edward Eisenstein, read and commented on early drafts; I wish my mother had lived to read the final version. My husband, John DeLacy, not only put up with this seemingly endless project but provided an outstanding in-house information technology service. CONTENTS 1 Introduction 1 2 Fever Theory and British Contagionism in the Mid- Eighteenth Century 19 3 Contagionism after 1750: John Pringle and James Lind 55 4 Animate Disease after 1750: Exanthemata Viva 89 5 Counting and Classifying Diseases: Contagion, Enumeration and Cullen’s Nosology 125 6 John Haygarth and the Campaign for Contagion 165 7 Contagionism, Politics and the Public in Manchester, 1780–1795 207 8 Institutionalizing Contagionism: The Manchester House of Recovery 243 Conclusion: A New Medicine 283 vii viii CONTENTS Appendix: Four Different Approaches to Organizing Illness Excerpted from Boerhaave, Huxham, Fothergill and Cullen. 285 Bibliography 295 Index 327 ABBREVIATIONS AND SHORT TITLES BM see MB DM see MD ECCO Eighteenth-Century Collections Online, parts 1 and 2, created by Gale Digital Collections from digitally scanned microfilms of books published in Britain during the eighteenth century FRCP Fellow of the (Royal) College of Physicians of London FRS Fellow of the Royal Society Google Book database at https://books.google.com/ HathiTrust The HathiTrust Digital Library, www.hathitrust.org JHMAS Journal of the History of Medicine and Applied Sciences JP justice of the peace MB Bachelor of Medicine (including Oxford BM) MD Doctor of Medicine (including Oxford DM) MP member of Parliament Munk’s Roll William Munk, The Roll of the Royal College of Physicians of London Phil. Trans. Philosophical Transactions of the Royal Society of London, online at rstl.royalsocietypublishing.org N&R Notes and Records of the Royal Society of London ODNB Oxford Dictionary of National Biography (2004–), www. oxforddnb.com ix CHAPTER 1 Introduction Contagionism is the idea that a material substance transmits disease from patient to patient. This book will trace the development of British con- tagionism during the eighteenth century, the interlinked evolution of increasingly definite and detailed ideas about the nature and behavior of contagious diseases during this period, and the effect this had on the transformation of the medical profession, and medical institutions during the early industrial period. Within an apparently ossified and actually chaotic profession, the mainstream conceptualization of many acute illnesses gradually shifted from a “physiological” theory that attributed illness to changes in a patient’s internal equilibrium to an “ontological” theory that blamed diseases on different entities that invaded the body from outside. This shift enabled physicians in different places to cooperate in new ways. Contagionism benefited from broader social developments such as the improvement of transportation, foreign wars, and the growth of provincial towns, but it especially flourished within a community of doctors trained outside England that had emerged from three coincidental transformations within British medicine: in medical ideas, in the nature and content of medical education, and in the sort of men who became physicians. Contagionism has always been contentious and its history has been fragmented, evolving from being uncritically celebratory in the late nineteenth century to predominately negative by the late twentieth century. Historians of the idea have concentrated on particular © The Author(s) 2017 1 M. DeLacy, Contagionism Catches On, DOI 10.1007/978-3-319-50959-4_1 2 1 INTRODUCTION time periods and places—especially on the formative period for European medical ideas from the mid-sixteenth century to the mid-seventeenth century, and on the nineteenth and twentieth centuries. They have also focused only on certain facets of contagionism. In the late nineteenth and twentieth centuries, historians of medicine traced the development of theories of contagium vivum (living or animate contagion) in the sixteenth and seventeenth centuries, often terminating their accounts in the early 1720s, with the “last” contagionist publications by Richard Mead and Benjamin Marten among other authors.1 The historians saw these authors’ works as “precursors” to Pasteur’s more developed germ theory, which would attribute many communicable diseases to infections by living microorganisms. However, because they were interested in contagium vivum, not contagionism itself, they encoun- tered a puzzling gap in the eighteenth and early nineteenth centuries instead of the smooth trajectory of medical progress they expected.2 As a result, they often skipped from the medical revolution of the seventeenth century to that of the mid-nineteenth century without spending much effort on the rest of the eighteenth century, when nothing of importance seemed to have happened.3 A seminal article by historian Erwin Ackerknecht lent strength to this overall picture of eighteenth-century medicine as backward, complacent and ineffective by referring to the “paradox” that opposition to contagion- ism was strongest in the period immediately before Pasteur’s break- through.4 Ackerknecht’s claims: that liberal reformers at the turn of the nineteenth century