Disease, Medicine and the Urban Poor in Newcastle-Upon-Tyne, C

Disease, Medicine and the Urban Poor in Newcastle-upon-Tyne, c. 1750-1850 Graham A. Butler Thesis submitted in fulfilment of the requirements for the Degree of Doctor of Philosophy School of Historical Studies Newcastle University January 2012 For my parents, Leonard A. Butler & Helen M. Butler Abstract This thesis is the first full-length quantitative and qualitative analysis of the institutional and medical responses to sickness and disease in Newcastle-upon-Tyne, between 1750 and 1850 – the period conventionally ascribed to England’s first ‘industrial revolution’. Using a wide range of largely unexplored archival material it assesses the healthcare options available to the poor population of Newcastle. It proceeds to uncover the poor’s individual experiences, how sickness and disease impacted on their lives and the ways in which healthcare options and strategies developed across the century between 1750 and 1850. The thesis begins with a comprehensive examination of Newcastle’s demographic history. This involves an evaluation of the city’s published Bills of Mortality. Using this largely neglected demographic source, chapter one reveals new and crucial information about the changing size of the population in all of the city’s parishes and describes how the city grew between 1736 and 1850. Newcastle did not share in the rapid population expansion experienced by the country as a whole in the second half of the eighteenth-century. After reconstructing Newcastle’s demographic record, a second chapter analyses the living conditions in the city in order to contextualise its population history. This chapter provides evidence to show that Newcastle had many of the epidemiological characteristics of the pre- industrial city which enabled it to act as a reservoir of diseases and infections. The second section of the thesis examines the institutional responses to sickness and disease in the city. This section of the thesis is divided into two chapters: the first looks at the role of the Newcastle Infirmary founded in 1751 for the poor of Newcastle, Durham and Northumberland and the second analyses the Newcastle Dispensary founded in 1778. Both of these institutions played important but different roles in the city’s medical landscape – collectively admitting over half a million patients during the century under study. An examination of the characteristics of these individuals reveals that both institutions provided healthcare to different elements of the population. The analysis also provides key information on the types of diseases and ailments which were commonly experienced by the working poor in the city. Both studies reveal an intertwining relationship between the role of the Infirmary and the Dispensary. While both provided care to the ‘deserving’ poor, the former i treated mainly accidents and surgical cases and the latter catered specifically for chronic, infectious and sometimes lethal maladies. After having analysed those who turned to the city’s voluntary hospitals, the last section examines the experience of the pauper population, focusing on the healthcare delivered to the sick poor under the Old Poor Law. Attention here is paid to both outdoor medical relief and also to that provided in parish workhouses. This chapter shows that medical services were an important part of the ‘relief culture’ in the city and that the workhouse system in Newcastle played an integral part in what has been described as the pauper ‘economy of makeshift and mend’. High levels of sickness and disease amongst the city’s inhabitants meant that overseers of the poor were constantly dealing with relief applications which were sickness related. The chapter provides abundant evidence that even with the growth of alternative healthcare institutions in the city, Poor Law medical services developed rather than declined in the period. It is concluded that Poor Law medicine played a very significant part in the lives of Newcastle’s poor. ii Acknowledgements Since I began my historical research in 2004, I have built up numerous personal and intellectual debts. I owe a great deal to Richard Allen, whose Early Modern European history seminars and lectures which I attended during when undergraduate studies roused my interest in European social history. Upon moving to Newcastle University to continue with my studies as a postgraduate, I also benefitted massively from seminars, lectures and tutorials with Jeremy Boulton who introduced me to the world of economic and demographic history. During the course of my doctoral research I have built up numerous debts to librarians and archivists who preserve the material that this thesis is built upon, namely those people at: Tyne and Wear Archives, Northumberland Archives, Durham County Records Office, Newcastle Literary and Philosophical Society Library, Durham University Special Collections, the National Archives at Kew, the British Library, Newcastle City Library, Newcastle University Robinson Library, Cambridge University Geography Department Library and Newcastle University Special Collections. I have also benefitted from the advice and encouragement of colleagues who have been present at seminars and conferences where some of the preliminary findings of this project have been presented. Particular thanks must go to the Newcastle School of Historical Studies Postgraduate Conference (2010 and 2011) and to the delegates at Economic History Society New Researchers Conference held at Durham University in March 2010. I also owe a great deal of gratitude to Professor Sir Tony Wrigley, Dr Leigh Shaw-Taylor and Dr Peter Kitson of the Cambridge Group for the History of Population and Social Structure for generously sharing their data from the ‘Male Occupational Structure of England’. I also owe a great deal to Professor John Cannon, Dr Leonard Schwarz, Professor Keith Wrightson and the late Professor Robert Woods. My friends and colleagues at Newcastle have also been a source of friendship and advice, in particular the late Richard Potts and also Peter Wright, Michele Gamble and Ria Snowdon. This research would not have been completed in the time taken without the generous financial support I have received over the course of the past three years. I would like to acknowledge my thanks to the Newcastle University Robinson Library who granted me a generous 3-year Robinson Bequest Studentship in November 2008 and also to the School of Historical Studies, Newcastle University, for a PhD studentship which commenced September 2008. I have also received funding for research expenses and to attend iii conferences from the following bodies, all of whom I would like to thank most sincerely: Wellcome Trust Research Resources in Medical History, The Local Population Studies Roger Schofield Research Fund, The Northern Centre for the History of Medicine, and The Economic History Society. My biggest academic debt is to my PhD supervisor, mentor and friend Jeremy Boulton. Jeremy has been an exemplary supervisor and has coached me into the world of quantitative, economic and demographic history since I first came to Newcastle in 2007. My second supervisor Jonathan Andrews has also been extremely supportive and has like Jeremy provided me with much encouragement and knowledgeable advice on chapters and papers. Both Jeremy and Jonathan have been very patient while waiting for draft chapters to slowly emerge and have always provided helpful and constructive feedback. Indeed, I could not have asked for a better supervisory team. I would also like to thank my parents Helen and Len Butler, who have been extremely supportive, encouraging and loving since I began my academic studies in 2004. Over the past three years both my brother Leonard Butler and best friend John Richardson have managed to get me away from my computer screen when a pint of real ale was needed, for this I am extremely thankful. Lastly, I would like to thank my girlfriend Helen Naisbitt who has been a constant source of support, encouragement and love. G.B 20 February 2012 Newcastle-upon-Tyne iv Contents Page. Abstract i Acknowledgements iii Contents v List of Figures vii List of Tables x Abbreviations used in the text xi Introduction 1 Chapter 1: The population history of Newcastle-upon-Tyne, 1736-1850: 12 A reconstruction 1.1 Introduction 12 1.2 The growth of Britain’s metropolis of the north 14 1.3 The Newcastle Bills of Mortality 22 1.4 How accurate are the Newcastle and Gateshead Bills of Mortality? 26 1.5 Georgian Newcastle: the demographic context 30 1.6 Georgian Tyneside, size of population: some new estimates 43 1.7 Conclusion 45 Chapter 2: Determents to health, mortality and urban life in early 48 Industrialising Tyneside, 1736-1850 2.1 Introduction 48 2.2 Migrants in the city 50 2.3Georgian Newcastle, growth, housing and population density 62 2.3 Standard of living: the broad picture 79 2.4 The Structure of Newcastle’s economy and labour force: upstream from coal? 84 2.5 Poverty and the seasons 91 2.7 Water supply 100 2.8 Conclusion and summary 103 Chapter 3: ‘Rack’d and tortur’d with the most inveterate diseases and 106 painful distempers’? The sick poor and the Newcastle Infirmary, 1751-1850 3.1 Introduction 106 3.2 Sources and Methodology 108 3.3 Structure and operation 108 3.4 The Newcastle Infirmary: admission rates 112 3.5 Infirmary patient characteristics: the demographic context 116 3.6 The origin of the Infirmary patients 121 3.7 Seasonality of Admissions 124 3.8 Morbidity at the Newcastle Infirmary 133 v 3.9 Death and the Infirmary 139 3.10 Conclusion

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