Public Health and Public Discourse: Contesting the London Bills of Mortality, c. 1603-1836 by Caroline Michaud Submitted in partial fulfillment of the requirements for the degree of Master of Arts at Dalhousie University Halifax, Nova Scotia August 2020 ©Copyright by Caroline Michaud, 2020 Dedication À mon père. Et toi tu es loin loin comme l’enfance Loin comme la rivière au nom de clapotis : l’Okliokma est loin de toi aujourd’hui... Yvon Michaud (1949-2006) ii TABLE OF CONTENTS List of Figures . vi Abstract . vii List of Abbreviations Used . viii Acknowledgements . ix Chapter 1: Introduction . 1 1.1: Historiographical Discussion . 7 1.1.1: John Graunt . 7 1.1.2: Early Commentary . 11 1.1.3: Historical Demography . 13 1.1.4: Early Historiography of Medicine . 15 1.1.5: Social History of Medicine . 17 1.1.6: Print Culture . 21 1.1.7: Scholarship on the Post-Plague Bills . 22 1.1.8: Public Health History . 27 1.2: Thesis Outline . 30 Chapter 2: Urban Growth and Public Health: The Bills of Mortality in the Era of Plague . 34 2.1: Plague in the London Suburbs . 37 2.2: The Plague Orders . 43 2.3: Consolidating the Bills of Mortality . 45 2.4: The City of London and the College of Physicians . 51 iii 2.5: Board of Health and Incorporation of the Suburbs . 57 2.6: The Interregnum and Medical Publishing . 64 2.7: The Restoration, Plague, and Fire . 66 2.8: John Graunt and the Birth of Political Arithmetic . 70 2.9: ‘Hidden’ Plague Deaths . 72 2.10: A Common Medical Culture . 75 2.11: Late-Seventeenth Century Demographic Changes . 79 2.12: Conclusion . 80 Chapter 3: Plague in the Public Eye: English Reactions to the Plague at Marseille, 1720-1723 . 82 3.1: The End of Plague? . 85 3.2: News of the Plague at Marseille . 90 3.3: Dr Richard Mead . 93 3.4: Maritime Quarantine . 97 3.5: The Quarantine Act of 1721 . 99 3.6: Another Board of Health . 103 3.7: Reactions to the Board of Health . 106 3.8: Resistance and Repeal of the Quarantine Act . 111 3.9: Anticontagionism . 115 3.10: Filth and Disease . 118 3.11: Suburban Graveyards . 121 3.12: Conclusion . 125 iv Chapter 4: The Bills of Mortality in the Long Eighteenth Century: the Tradition of Criticism in Context . 127 4.1: Environmental Medicine on a Local Scale . 130 4.2: Medical Institution-Building . 134 4.3: The Shift from Bedside Medicine to Hospital Medicine . 136 4.4: Anatomy and Burial Practice . 138 4.5: Under-Registration in the Bills of Mortality . 142 4.6: Attempts at Reform in the 1750s . 146 4.7: The Eighteenth-Century Searchers of the Dead . 153 4.8: Medical Professionalization and Cause of Death . 157 4.9: The French Revolution and Population Explosion . 165 4.10: Conclusion . 173 Chapter 5: Conclusion . 174 5.1: The Passing of the 1836 Vital Registration Act . 174 5.2: The Cause of Death Issue . 179 5.3: Conclusion . 181 Bibliography . 187 v List of Figures Figure 2.1: Title page to London’s Dreadful Visitation (1665) . 38 Figure 2.2: Annual Bill of Mortality for the year 1665 . 50 Figure 2.3: Geographical distribution of the plague, 1665 . 72 Figure 3.1: The port of Marseille during the plague in 1720. Coloured etching after Michel Serre . 92 Figure 4.1: The Reward of Cruelty. Etching by William Hogarth, 1751 . 139 Figure 4.2: William Hunter (1718-1783) in his museum in Windmill Street on the day of resurrection, surrounded by skeletons and bodies, some of whom are searching for their missing parts. Engraving, 1782 . 141 Figure 4.3: A crowded street in London. Coloured etching by George Cruikshank, 1812 . 168 vi Abstract The London Bills of Mortality are the longest-running continuous source regarding mortality and cause of death in any early modern city. Published weekly from 1603 until the 1830s, the Bills endured beyond their initial purpose as a plague tracking device to become the most important documents mined by English political arithmeticians and environmental physicians in the seventeenth and eighteenth centuries. These writers frequently criticized the accuracy of the data contained in the Bills, yet repeatedly failed in their attempts at reform. Using a broadly chronological approach, this thesis assesses why the Bills of Mortality endured largely unaltered for over 200 years. It argues that the success of the Bills was due to the pragmatic nature of their administration, which was based on local parish structures, while suspicion of the arbitrary powers of the state in matters of public health prevented substantial reform for the duration of the eighteenth century. vii List of Abbreviations Used GRO General Record Office JP Justice of the Peace MP Member of Parliament OBP Old Bailey Proceedings PC Privy Council SP State Papers Domestic SPCK Society for Promoting Christian Knowledge viii Acknowledgements First, I would like to thank my supervisor, Dr Krista Kesselring, for her steady guidance and support. Thank you for valuing my ideas and trusting me to tackle a big thesis. Thank you for giving me the space to come to my own conclusions, while also pushing me to make my arguments clearer, my work more focused, and my writing sharper. I will miss our chats. I would also like to thank my other committee members, Dr Justin Roberts and Dr Winston Black, for taking the time to read my work and for their insightful comments. Special thanks to Dr Colin Mitchell, Valerie Peck, and Tina Jones, who have all helped me navigate this program in ways big and small. Thank you also to the Faculty of Graduate Studies and the Social Sciences and Humanities Research Council of Canada for their generous financial support of this thesis. Thank you to the MA cohort for the camaraderie. I feel so grateful to have gotten to know each of you and to have shared this experience with you. Thank you to Sophie Blom and Sarah Toye for your friendship, it has kept me grounded. Thank you to my family—my mother Pierrette especially—for cheering me on. Thank you to my partner Ian, who’s been there through thick and thin. Thank you for bearing with me when I worked those long days, day after day, and for believing it was all worth it. Thank you for keeping me well fed and loved. Thank you also to my cat Bruce, even though he can’t read this. He deserves praise for being the best little research and writing companion I could have ever asked for. The onset of COVID-19 made many aspects of writing this thesis more challenging than they otherwise might have been, and the sheen of writing about epidemics and public health during a near complete public health-mandated societal shut down wore off quickly. Still, it pushed me to think more deeply about the extent to which public health outcomes are determined by political climate, the relationship of individual liberty to state authority, as well as how the poor or otherwise marginalised are always the most vulnerable to the ravages of epidemic disease. Death may be the great equalizer, but epidemics do not affect everyone equally. The reasons why are profoundly social. ix Chapter 1: Introduction No disease in early modern England provoked greater fear and anxiety than plague. An apothecary who lived in the London parish of St Giles in the Fields during the plague of 1665 expressed a common sentiment when he wrote that “no disease in the great army of diseases which assault our life is more dreadful and deadly than that of the pestilence.”1** In the plague pamphlet London Looke Back (1630), Thomas Dekker similarly wrote that plague “hath a pre-eminence above all others: and none being able to match it, for violence, strength, uncertainty, subtlety, catching, universality, and desolation, it is called the sickness. As if it were the only sickness, or the sickness of sicknesses, as it is indeed.”2 Numerous early modern diaries also attest the unique psychological terror of plague. Ralph Josselin, a seventeenth-century vicar of Earls Colne in Essex, recorded his and his family’s various ailments and illnesses in the diary he kept between 1616 and 1683. It is striking that Josselin did not tend to fear the diseases from which his family was most susceptible to suffer.3 After his daughter Mary died from worms, he even expressed relief that her disease had not been infectious.4 Though plague was an infrequent visitor to Earls Colne, during the London outbreak of 1665-66 Josselin 1 William Boghurst, An Account of the Great Plague of London (London: Shaw and Sons, 1894), 5. *Spelling has been modernized throughout the thesis. *All Old Style dates have been converted to New Style dates. 2 Thomas Dekker, London Looke Back (1604), in The Plague Pamphlets of Thomas Dekker, edited by F.P. Wilson (Oxford: Clarendon Press, 1925), 181. 3 Lucinda McCray Beier, “In Sickness and in Health: A Seventeenth Century Family’s Experience,” in Patients and Practitioners: Lay Perception of Medicine in Pre-Industrial Society, edited by Roy Porter (Cambridge: Cambridge University Press, 1985), 125. 4 Ralph Josselin, The Diary of Ralph Josselin 1616-1683, edited by Alan Macfarlane (London: Oxford University Press for the British Academy, 1976), 204. 1 dutifully recorded the numbers of plague dead printed weekly in the London Bills of Mortality, a common practice among diary writers in the late seventeenth century.5 Several historians have recently argued that text and print were central to the experience of plague in early modern England.6 Among the most important and influential print sources from the early modern English plague era were the London Bills of Mortality.