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		<title>Institutional Medicine and State Intervention in Eighteenth-Century Ireland part 1</title>
		<link>http://www.g-thang.net/?p=14</link>
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		<pubDate>Wed, 02 Mar 2011 18:46:57 +0000</pubDate>
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				<category><![CDATA[medicine]]></category>

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		<description><![CDATA[Introduction &#160; In recent years the history of medicine in the early modern period in Ireland has begun to move beyond the ‘official’ institutional histories that dominated the medical historical landscape during the nineteenth and twentieth centuries.1 nevertheless, much work still remains to be done on medical institutions and on the constituent elements of the [...]]]></description>
			<content:encoded><![CDATA[<p><strong><img class="alignleft size-full wp-image-35" title="l_c417d6c3" src="http://www.g-thang.net/wp-content/uploads/2011/10/l_c417d6c34aed7c813ceabae5d55fe883.png" alt="" width="600" height="729" /><span style="color: #000000;">Introduction</span></strong></p>
<p>&nbsp;</p>
<p><span style="color: #000000;">In recent years the history of medicine in the early modern period in Ireland has begun to move beyond the ‘official’ institutional histories that dominated the medical historical landscape during the nineteenth and twentieth centuries.1 nevertheless, much work still remains to be done on medical institutions and on the constituent elements of the Irish medical profession2 if we are to <a href="http://www.africanmangolabs.co.uk/"><span style="color: #000000;">African Mango</span></a> maintain with confidence that the eighteenth century saw medicine become institutionally based and increasingly state funded, and that this provided the foundations upon <a href="http://www.desireedress.com/servlet/the-Wedding-Dress-cln-Plus-Size-Wedding-Dress/Categories" target="_blank"><span style="color: #000000;">plus size wedding dresses</span></a> which modern medical structures were built.3   little dresses research, for example, has <a href="http://www.midlandtradeshowdisplays.com" target="_blank"><span style="color: #000000;">trade show booth</span></a> been undertaken into the nature and timing of the funding of Irish medical institutions by the state in the form of parliamentary grants and appropriations. Furthermore, no systematic analysis has been <a href="http://www.realpennystocks.com" target="_blank"><span style="color: #000000;">penny stocks to watch</span></a> dedicated to examining how often, in what ways, and with what degree of success the Irish parliament attempted to regulate, reform and develop these institutions. this omission is  <a href="http://www.newecigs.net" target="_blank"><span style="color: #000000;">electric cigarettes</span></a> all the more striking as this was a period when the Irish parliament grew in both influence and importance, and was increasingly disposed to stimulate economic regeneration and development through the use of legislation and the allocation of public monies.4</span></p>
<p><span style="color: #000000;">this  study seeks to redress this gap in the historiography by </span><a href="http://internetmarketing1.us">SEO Service </a><span style="color: #000000;">examining institutional medical legislation.5 a total of 65 measures of this description (see appendix) were initiated by the Irish parliament in the eighteenth century. they can be disaggregated into five main categories, pertaining to voluntary hospitals, county infirmaries and  <a>leather furniture</a> houses  of  industry;  medical  education;  the  formation of the royal  college  of Surgeons (rcSI);  the sale and production of drugs and medicines; and the regulation of the ‘practice of physic’ by preventing the unlicensed (druggists, apothecaries and surgeons, among others) from prescribing to patients or administering internal medicines.6 this article focuses on the latter two</span></p>
<p>snoring chin strap categories,7  in order to establish the extent to which the Irish parliament concerned itself with the regulation of both practitioners and the provision of drugs. In the process, it will provide new perspectives on the preoccupations, aims and legislative objectives of the main baby shower cakeseighteenth-century medical institutions and practitioners, and extend our understanding of the process whereby interest groups</p>
<p><span style="color: #000000;">lobbied Ireland’s executive and legislature, a subject still to be explored in detail by political historians, especially for the early to mid-eighteenth century</span></p>
<div>
<p><span style="color: #000000;">consistent with the pattern established during the reign of elizabeth I, the regulation of Irish medicine at the end of the seventeenth century was firmly vested in the hands of the main bodies of practitioners. thus, the guild of Barber-Surgeons</span></p>
<p>, now governed by a charter issued in 1687 by James II, oversaw the interests and concerns of surgeons, though their unhappiness that they were bound in an institutional  connection with the less skilledcraft of barbering ensured that it was far from being an efficient or respected body. It was not ineffective at representing and protecting the interest of surgeons against encroachment, but it made little attempt either to police those who practiced or to uphold high standards of care, and seems to have devoted its energies primarily to non-medical issues.9</p>
<p><span style="color: #000000;">By comparison, thecollegeofPhysicians, which received its charter in 1666, was both more vigorous and possessed of fuller power to regulate the medical marketplace. It was granted a new charter in 1692 during the reign of William III and his wife Mary. as provided for by this document, the newly constituted college comprised a president and 14 fellows, <a href="http://www.furnitureoutletworld.com/Leather_Furniture.html">leather furniture</a> from among whom four censors were chosen. Fellows held office for life unless removed for misconduct, and replacements were chosen by election. all  fellows were Protestant, and were expected to be well-disposed to the monarch. Significantly, the College’s charter stated that only physicians licensed by it were allowed to practise indublinor within a seven-mile radius. pokies The unlicensed could be fined £10 for every month they practised, whereas graduates in physic from the universities ofcambridge,Oxford,</p>
<p><a href="http://www.pokie.com">pokies</a> orDublinwould be licensed, upon paying a fixed fee, by the College without further examination. as this indicates pokies, thecollegeofPhysicianspossessed extensive powers to examine and licence those who sought to practice physic, but it was more than just a licensing body for physicians. Its powers extended over <a href="http://www.businessemaildirectory.co.uk/email-list-i-269.html">email lists</a> the other branches of medicine, surgery excepted. thus, physicians working outside of the capital (unless graduates from the above <a href="http://itsabouttreadmills.com/product/sole-f63-treadmill/">sole f63</a> universities) were to be examined by the president and censors and provided with a written testimonial, which allowed them license to practice if found suitably qualified. Midwives likewise were required to be examined and licensed, and those who failed</p>
<p><a href="http://itsabouttreadmills.com/product/sole-f80-treadmill/">sole f80</a> to do so could be penalised for plying their trade without authorisation, while druggists,apothecaries and pharmacists operating in the capital were liable to be examined on their expertise and professionalism. Indeed, thecollege ofPhysicianswas empowered to search apothecaries’ shops and houses, and authorised to destroy all medicines and drugs deemed unsound or unsafe. In addition,dublin’s apothecaries were precluded, subject to a penalty of £20, from employing an apprentice who had not been examined by the college for his expertise in latin: a clause included to ensure apprentices could read the prescriptions given to them by physicians.10<a href="http://www.g-thang.net/wp-content/uploads/2011/10/sickbed.gif"><span style="color: #000000;"><img class="alignleft size-full wp-image-37" title="sickbed" src="http://www.g-thang.net/wp-content/uploads/2011/10/sickbed.gif" alt="" width="334" height="237" /></span></a></span></p>
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		<title>Accessing medical advice</title>
		<link>http://www.g-thang.net/?p=11</link>
		<comments>http://www.g-thang.net/?p=11#comments</comments>
		<pubDate>Sun, 30 Oct 2011 18:39:15 +0000</pubDate>
		<dc:creator>admin</dc:creator>
				<category><![CDATA[medicine]]></category>

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		<description><![CDATA[Although  the late early modern public had good reason to regard the medical profession sceptically, the recognition that they total gym xls possessed useful information served to ensure that the public did not hesitate to appeal for professional medical assistance when this was available. however, pokies they were equally disposed (when they could afford it) [...]]]></description>
			<content:encoded><![CDATA[<p><a href="http://www.g-thang.net/wp-content/uploads/2011/10/C0031502-18th_Century_Anatomical_Engraving-SPL.jpg"><img class="alignright size-full wp-image-27" title="C0031502-18th_Century_Anatomical_Engraving-SPL" src="http://www.g-thang.net/wp-content/uploads/2011/10/C0031502-18th_Century_Anatomical_Engraving-SPL.jpg" alt="" width="384" height="530" /></a>Although  the late early modern public had good reason to regard the medical profession sceptically, the recognition that they<br />
<a href="http://itsabouthomegyms.com/product/total-gym-xls/">total gym xls</a><br />
possessed useful information served to ensure that the public did not hesitate to appeal for professional medical assistance when this was available. however, <a href="http://webpokies.com/">pokies</a> they were equally disposed (when they could afford it) to seek a second, or a third or fourth medical opinion. this was not always possible, of course, even for those with deep pockets, with the result that the health conscious were obliged to have resort to a variety of different strategies to compensate. One response, <a href="http://bootswithcharacter.com/">uggs</a> identified by Lord Molesworth in 1724 and put into practice by Bishop Synge of elphin in the 1740s, was to limit one’s movements to those parts of the country where good quick payday loans medical assistance was available. this  was not a practicable solution of course, and because the slow percolation of apothecaries, surgeons and physicians during the eighteenth century did not facilitate all who sought access to appropriate medical assistance, people were obliged to develop other strategies to assist with the diagnosing of illness and the prescription of drugs. One tactic that was widely employed to overcome the implications of the shortage of medical expertise was the epistolary consultation. It is not possible to estimate how commonplace this was, but  evidence for the practice inenglandand continentaleuropeand from family papers of Irish origin indicates that both the ill and their carers had little hesitation in appealing by letter to knowledgeable</p>
<p>physicians for information and direction.108 annehamiltonof tullymore, county down is one such example. She knew hans Sloane, who was born at Killyleagh in the same <a href="http://1200caloriediabeticdiet.net/">diabetic diet</a> county in 1660. Between 1708 and 1721 she openly sought his ‘directions in what you think may be proper’ when her own health or that of members of her family members was poor, or when she was simply<br />
dissatisfied with the advice of her regular doctor. She was not, as this suggests, a passive receptor of information; she had her own ideas on what was appropriate, as evidenced by the fact that she informed Sloane on  one occasion that she was resolved ‘to blister this night’ to ease a ‘disorder in my head’ Though Sloane’s replies to Mrs Hamilton are not available, there is sufficient evidence to suggest that many medical practitioners were willing to provide detailed instructions on paper. the dublin physician, thomas Kingsbury, advised Francis Price, in response to a query in 1736 as to how he should deal with the fact that he was ‘spitting blood’, to ‘draw a<br />
<a href="http://5poundsin2weeks.com/">weight loss pills</a> little blood’ and to ‘take supping meats of a tenacious kind’. a year later when Price’s son was ill, Kingsbury conveyed ‘a list of purgatives’ to induce vomiting as well as his usual directions as to diet, and he offered comparable advice some months later in respect of a similar ailment, when he instructed Price <a href="http://surearticles.com">work from home</a> how to administer ‘a vomit of twelve grains of ipecacuanha powdered’ to a child still at nurse. these  were comparatively straightforward problems. the treatment of a ‘falling of the womb’ was more complex, but this did not discourage Kingsbury, who conveyed a complex medication to Francis Price to make up with advice on how it should be administered.110</p>
<p>By no means all queries were answered with the clarity displayed by thomas Kingsbury, but it is clear that both patients and their relatives expected an informed and reasoned response when they consulted a physician. Bishop Synge made this explicit when he observed of his daughter’s physician in 1752 that he ‘told me facts without giving any opinion either of the nature or causes of your complaints’.111 It is apparent also that among the social elite at least the power in the doctor–patient relationship lay squarely with the latter. this  may be attributable ultimately to their relative social stations and economic power, but it was a manifestation also of the fact that members of the elite were  more than ordinarily informed medically, and not at all disinclined to display or to use that knowledge.</p>
<p>It was desirable, of course, in a <a href="“http://www.slavic-inzenjering.net/bose-companion-3-series-ii-review/”">Bose Companion 3</a> world where so much medication was auto- administered, where the ill were attended to domestically, and where skilled medical operatives <a href="http://www.slavic-inzenjering.net/logitech-x-540-5-1-surround-sound-speaker-system/">logitech x-540</a> were not always available, that someone within the family unit was medically aware. the problem, as Bishop Synge conceded when he admitted his incapacity to offer ‘proper answers to … very proper questions’, was that most family experts were possessed of quite limited knowledge. this  did not deter Synge who was disposed to recommend ‘purges’ and other decoctions for <a href="http://www.seocompany.biz">seo firms</a> those within his circle that experienced stomach or abdominal ailments, and (still more worryingly) horse ointment for piles. however, Synge was at least conscious of his limitations. thus, when his efforts to assist a young boy at elphin, by administering ‘spirit of opodeldock’ for a serious ‘pain in the thigh’, proved unsuccessful, he did not hesitate to admit that the ‘disorder is beyond us’, or delay in seeking a place for this patient, and others with equally resistant conditions, in adublinhospital. advice, to be sure, was available in abundance. <a href="http://www.facialhairremovalforwomeninfo.com/">hair removal for women</a> Indeed, it was the norm when news of illness spread for friends and family to stand forward with medical counsel as well as morale support.113  the experience of hercules langford rowley who expressed his thanks in august 1759 to lord Fitzwilliam ‘for the trouble and pains you have taken to procure the medicine for my son from lord Montague, to whom I think myself highly indebted for so great an obligation’, is not untypical.114 Others offered advice that would have satisfied even a doctor, as Sir Richard Musgrave demonstrated when he informed Bishop thomas Percy in 1799 on how to deal with a persistent cough: I would recommend to you to bathe your feet at least three times a week in hot water going to bed, and if you don’t wear flannel next to your skin apply some to your breast and shoulders. Should your cough continue to <a href="http://www.starshandbags.com">replica bags</a> keep you awake at night take 15 or 20 drops of laudanum going to bed in whey.115</p>
<p>&nbsp;</p>
<p>there was an inherent danger that advice from well-intentioned but misguided friends might serve to exacerbate rather than to ease a troubling condition, but there was little alternative when, as archbishop cleaver of Ferns observed despairingly of the experience of his daughter in 1798, ‘various prescriptions’ issued by medical professionals failed to work.116 a minor ailment could be complicated by a culture of domestic medication that permitted patients, and their families, a major say in how illness was treated. this was more likely when a family member or close companion was seriously ill, as evidenced by the reaction of lady louisa conolly to the ‘dreadful’ experience of the death in acute pain of her sister, cecelia. It was, lady louisa observed, a  most ‘distressing scene’ because of the powerlessness of those in attendance to ease her sister’s suffering: ‘we could not sometimes hit  pon any position of her  poor emaciated frame, or the pillows to give her an easy posture, and her poor countenance looked so distressed that it went to one’s heart’.117  experiences such as this were intensified by the avowal by candid members of the medical professions that there were many conditions ‘it was not in the power of medicine to remove’.118  as a result, by the beginning of the nineteenth century, there was a striking increase in belief in the curative efficacy of nature. This took its most tangible form in the increased enthusiasm for sea-bathing, but it also sustained a strong belief in the therapeutic value of residing in a ‘drier and warmer’ climate.119</p>
<p><img class="alignleft size-full wp-image-26" title="article-1130463-033751A1000005DC-640_468x286" src="http://www.g-thang.net/wp-content/uploads/2011/10/article-1130463-033751A1000005DC-640_468x286.jpg" alt="" width="468" height="286" />Since neither of these options was available to more than a minority, and both were of little value in dealing with serious illness, there was no reduction in resort to proprietary or other medicines. Moreover, the strength of the tradition of domestic medicine ensured not only that people were as willing as ever to try the newest remedy, but also that they took more than was appropriate in a desperate, and sometimes counterproductive, attempt to secure relief.120  It is hardly surprising therefore that louisa conolly was prompted to observe ‘how delightful the next world will be, free of all these vexations … and all sorrow and sickness is at an end’.121</p>
<p><strong>Conclusion</strong></p>
<p>Though the experiences of pain and distress chronicled by lady louisa conolly bear ample witness to the limitations of medical care at the beginning of the nineteenth century, conditions had improved over the previous 150 years. In this, as in so much else in medical history,Irelandresemblesengland, of which it has been said that by the early nineteenth century ‘a broad, better education public had emerged, far more familiar with medical book-knowledge than had been</p>
<p>the case a century earlier’.122  It is true that the improvement in personal health was more modest, but the anglophone population of the early nineteenth century was certainly more aware of the possibilities of diagnostic medicine and of the nature of disease. yet, it was knowledge hard learned as the system of diagnostic medicine inaugurated in the seventeenth century was so rude and underdeveloped that the population was long obliged to look for medical assistance wherever it  could be procured. One of the most important consequences of this was the development of an elaborate tradition of domestic and self-medication. this was premised on the realisation that it was incumbent on each household, and on its adult members in particular, to assume direct responsibility for the well-being of all its members both while in a state of health as well as when ill. In order to assist with this, households needed information, and they sought to collect and preserve this in receipt books that were passed, like family heirlooms, across generations. the information they contained was of doubtful value in many instances, but the changing content of these books over time bears witness to the displacement of the once dominant magico-medical cures by more ostensibly practical medications, which was in keeping with the greater amount of medical information that was made available. Much of this information, like the proprietary medicines that were consumed, may have originated with <a href="http://www.emanio.com/data-mining/DataMiningSoftware.html">Data Mining Software</a> unorthodox and irregular medical practitioners (quacks). nonetheless, it played its role in convincing a population that <a href="http://winonlinerewards.com/win-free-iphone-4">win free iphone 4s</a> had to come to terms with the reality of illness and disease that for all their ubiquity these were not conditions that had simply to be endured. there was, to be sure, much endurance required in the face of illness in late early modernIreland, but it could have been still worse. the recognition that intervention could make a difference served to equip people with an enhanced understanding of the body. It also prepared them to accept professional medication, <a href="http://www.fourwindsinteractive.com/">digital signage</a> when the reliance on the home and on the tradition of domestic medication that was such a crucial aspect of the medical culture of the early modern era, gave way in the nineteenth <a href="http://www.ergohumanstore.com/">ergohuman</a> century to the hospital, the dispensary and the doctor’s surgery as the primary sources of dependable medical care.</p>
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		<title>The practice of self-medication</title>
		<link>http://www.g-thang.net/?p=9</link>
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		<pubDate>Sun, 30 Oct 2011 18:35:21 +0000</pubDate>
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				<category><![CDATA[medicine]]></category>

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		<description><![CDATA[In keeping with his membership of the royal college of Physicians at edinburgh, William Buchan anticipated that Domestic Medicine would assist ‘to destroy quackery’.90  this assumed that the medicine-consuming public was at one with him in perceiving a clear distinction between orthodox and unorthodox medicine, which was not the case. What is certain is that, [...]]]></description>
			<content:encoded><![CDATA[<p><img class="alignleft size-medium wp-image-30" title="article-1130463-033751A1000005DC-640_468x286" src="http://www.g-thang.net/wp-content/uploads/2011/10/article-1130463-033751A1000005DC-640_468x2861-300x183.jpg" alt="" width="300" height="183" />In keeping with his membership of the royal college of Physicians at edinburgh, William Buchan anticipated that Domestic Medicine would assist ‘to destroy quackery’.90  this assumed that the medicine-consuming public was at one with him in perceiving a clear distinction between orthodox and unorthodox medicine, which was not the case. What is certain is that, given the increased availability of  <a href="http://www.theessay.co.uk/">Essay writing service</a> medicines of all kinds, guides such as Buchan’s Domestic Medicine were invaluable in assisting those who engaged actively in self-medication. the extent to which this happened is difficult to assess, but references in correspondence to the effectiveness of ‘balsam of capivi’ and ‘oyl of turpentine’ in  easing the passage of a kidney stone, to the frequency with which individuals ‘took physsick’, and the readiness with which opium was consumed indicates that there was a considerable amount of casual self medication.91  this  may well have been more prevalent among those for whom the expense of a professional consultation was not a minor consideration. nicholas Peacock, the county limerick agent farmer, is a case in point. Peacock routinely ‘took physick’ to ward off the threat of a <a href="http://www.pmcorporatelaw.com/register-cyprus-company-company-formation-in-cyprus">register cyprus company</a> cold or to relieve the feeling of ‘being unwell’.92  Mary lucas  of drumcavan,  countyclare,  who took a vomit in May 1741 to combat the impact of illness is another such example. Richard Griffith, who led a precarious lifestyle as a landowner and retainer, may fit the same bill, though he was one of many who were drawn by the temptations of opium, the dangers of which had become a subject of comment by the 1780s.93</p>
<p>Because of their awareness of the hazards, medical <a href="http://stationarybikestands.net/">bike stand</a> practitioners cautioned repeatedly of the dangers of self-medication. however, patients were wilful, and unwilling always to be guided by medical advice, which was unnervingly fallible in any case. Moreover, as medical retailers developed their sales networks to the extent that it was possible to have select proprietary medicines ‘sent, sealed up, to any part of Ireland … with full and plain directions’, and as the belief in the possibility of medicinal cure intensified, the willingness of the public to treat itself seems to have grown proportionately.94 Others <a href="http://www.clipsleypetshop.co.uk/bird-supplies/parrot-supplies/parrot-cages">parrot cages</a> used private networks to the same end. edmund Spencer of renny requested Francis Price in Wales in 1747 to send him ‘a little of the Jesuits’ drops’ in anticipation that he would be enabled to repeat the ‘great cures’ he had previously achieved with this product. the countess of Kildare was so convinced of the merits of Ward’s<br />
<a href="http://free-xbox.net/">Free Xbox 360</a> drops, which were widely taken  for stomach complaints, that she reminded her husband in 1759 to get her a bottle inLondon. Bishop Edward Synge placed an equal confidence in Jesuits’ Bark, but all took second place in the market place to James’s Powder.95 James’s Fever Powder was probably the most popular proprietary medicine of the eighteenth century. Nobody <a href="http://www.wordans.com/funny+tshirts">funny t shirt</a> inIrelandseems to have held it in quite the high esteem that caused George Washington famously to describe it as ‘one of the most excellent medicines in the world’. Yet it was still enormously popular, and following its introduction in the 1740s, sales appreciated rapidly, and it was readily available in all the major medical retail outlets and in most (if not all) <a href="http://www.watchesbyjames.com/rolex/">Rolex replica watches</a> of the main urban centres in the kingdom by the 1790s.96 Its<br />
<a href="www.mghomebuilders.com">edmonton show homesloveseats</a> sustained such impressions; his recovery in 1763 from ‘spotted fever’ with the assistance of James’s Powder was deemed all the more remarkable because his physicians had given up hope.98 The impact of these and similar anecdotes were reinforced by aggressive advertising, which ensured that James’s Powder was already firmly established as the most popular fever medicine and general pick-me-up by the early 1770s, when it was a familiar presence in private medical chests. Elizabeth Upton of county Down is a case in point; her accounts indicate that she purchased a dozen packets of James’s Powder, and four boxes of James’s pills for her personal use in 1772–3.99 Others were more cautious, and with good reason. <a href="http://pizza-expressvouchers.co.uk/">Pizza Express vouchers</a> James’s Powder was not an innocent placebo; it was an ‘antimonial powder’, comprised of one part oxide of antimony and two parts phosphate of calcium. It was a diaphoretic, which meant that it induced perspiration,</p>
<p>and while this could have a positive effect if one was feverish, it could also prove<img class="alignright size-full wp-image-32" title="folly3-thumb" src="http://www.g-thang.net/wp-content/uploads/2011/10/folly3-thumb.jpg" alt="" width="420" height="336" /></p>
<p>deleterious. cases such as that of dorothea Stackpoole of edenvale, <a href="http://www.atkinsdietfoodlist.org/atkins-diet-phase-1">Atkins Diet Phase 1</a> county clare, who died of fever though she took eight James’s Powders, and that of the army officer, Thomas Ash Lee, who ‘lost his life by it’ encouraged caution.100  Indeed, Bishop Synge responded to news of the death of Major lee by counselling against its use.101 however, such concerns proved short-lived, as the imperatives of illness encouraged men and women to spend freely on the purchase of drugs and other medical paraphernalia. It was, for example, possible in dublin in the 1770s to buy a stocked medical chest ‘of the utmost utility to families’ complete with a copy of <em>The Family Physician </em>to suit one budget.102  Such facilities were beyond the resources of most, but the preparedness of lady louisa conolly to spend £42 on health-related items ensured not only that the medical market remained vibrant, but also that James’s Powder and other heavily advertised nostrums continued to  sell well.103  Indeed, even trained physicians integrated their usage into their proscribing practices. William drennan, who practiced medicine at newry during the 1780s, certainly did so. he favoured tartar emetic in instances of fever for the simple reason that it could be ‘more safely applied’, but recognising that other, more experienced, doctors did not share his reservations (‘they [James’s Powder] are ordered in the slightest feverish cases, and even to children’), he came to adopt a more relaxed attitude.104 he remained convinced that it did not possess the ‘quieting’ properties that many ill persons required, but his willingness to prescribe the Powder in small quantities in combination with opium, hemlock and camphor to assist his sister overcome a debilitating fever was indicative.105 Because of the risks attached to the consumption of medication, many opted to drink mineral water in the belief that this was a safer way to health. the preferred option was to visit a spa, and depending on its perceived therapeutic worth either to drink or bath in the water. Because the most highly esteemed mineral waters were abroad, members of the Irish elite who could afford it, featured prominently among the visitors toBathandBristolhotwells  inengland,  and Spa in the austriannetherlandsin the eighteenth century. however,Irelanddeveloped its own spa network and, beginning in the late seventeenth century, locations such as chapelizod, templeogue and lucan incountydublin, Ballyspellan in county Kilkenny, Mallow in county cork and Swanlinbar in county cavan, along with many other less firmly established destinations, played host to a steady flow of visitors who came to drink the waters for therapeutic reasons.106  For those who could not visit a spa, for reasons of convenience or cost, drinking bottled mineral water was an option, and it was possible to purchase bottles of an expanding variety of spa waters in dublin from the 1740s. It is a measure, indeed, of belief in the merits of water drinking that the craze for tar water promoted by Bishop george Berkeleyproved remarkably resilient. everyone was not equally convinced of its virtues. William Buchan observed tartly of tar water that it ‘falls greatly short of the character which has been given of it’, but he accepted that it possessed ‘some medicinal virtues’. his decision to include it in the extensive list of medicines he appended to the text of <em>Domestic medicine </em>was consistent with the commitment Berkeley and he shared to self-medication.<img class="size-full wp-image-33 aligncenter" title="index_history-of-medicine-study-guide-1_0_210621265" src="http://www.g-thang.net/wp-content/uploads/2011/10/index_history-of-medicine-study-guide-1_0_210621265.jpg" alt="" width="175" height="175" /></p>
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		<title>Institutional Medicine and State Intervention in Eighteenth-Century Ireland part2</title>
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		<description><![CDATA[CONTINUED FROM PART ONE Though the physicians believed these regulations justified, they were also acutely conscious that they were not easily enforced, and eager to affirm their medical ascendancy and the authority of their charter, they sought repeatedly during the 1690s and early decades of the eighteenth century to secure legislation giving it statutory force, [...]]]></description>
			<content:encoded><![CDATA[<p>CONTINUED FROM PART ONE</p>
<p><img class="alignleft size-full wp-image-20" title="18_77p1" src="http://www.g-thang.net/wp-content/uploads/2011/01/18_77p1.jpg" alt="" width="396" height="298" />Though the physicians believed these regulations justified, they were also acutely conscious that they were not easily enforced, and eager to affirm their medical ascendancy and the authority of their charter, they sought repeatedly during the 1690s and early decades of the eighteenth century to secure legislation giving it statutory force, in order to ensure that those without the appropriate university qualifications and/or licenses did not encroach on the prestigious, often very profitable, professional territory of the physician. Such legislation would have served also to give them greater influence over the trade in drugs. however, one should not conceive of their campaign as simply self-motivated. altruistic, philanthropic and charitable instincts, combined with the enlightened, fashionable desire to ‘improve’Irelandand the Irish, also informed their actions. It was these ideals after all that motivated activists involved with the voluntary hospital movement of the eighteenth century. Furthermore, as well as thecollegeof  Physicians,dublin’s  well-to-do physicians were prominent in  thedublinPhilosophical Society, the [royal]dublinSociety, and other improving societies of the day.11</p>
<p>&nbsp;</p>
<p>at  their second ever meeting, on 20 January 1693, the college  of Physicians resolved that every fellow was to ‘concurr proportionally to carry on the passing of our patent [charter] into ane act of Parl[iamen]t and be att charges accordingly’.12 a week later the college selected two of their number, the President, Patrick dun, and the censor John Madden, to ask the solicitor general, Sir richard levinge, and one of the judges of the court of common Pleas, richard cox, to draft a bill that would give their charter statutory authority.13 after perusing the draft bill</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p>and accompanying petition (which were conveyed via the lord lieutenant, henry Sydney, 1st earl romney), the Irish Privy council, which included levinge and cox  among its members, unsurprisingly gave it their assent.14   however,  since the 1692 parliament did not resume following its controversial prorogation in december, when the lord lieutenant refused to accede to MPs assertion that they possessed the ‘sole right’ to initiate financial legislation, the bill stood no chance of reaching the statute book at this time, and the Irish Privy council effectively killed it by not forwarding it for consideration at the english council Board.</p>
<p>Though the failure of this first attempt to secure legislative confirmation of their chartered rights was a setback, the members of thecollegeofPhysicianswere determined to reanimate the matter at the earliest opportunity. In May</p>
<p>1695, nearly three months before the Irish parliament reconvened, the college established a ‘committee to consider and order the affairs relating to the bill for confirming our charter by act of parlament [sic]’.15   It evidently concluded that there was no likelihood of their 1693 bill ever emerging out of the Irish Privy council.  Perceiving that they were more likely to obtain the legislation they desired by appealing to parliament, the Physicians’ bill committee resolved in September 1695 to petition parliament to initiate an appropriate measure. It was further decided that richard cox should be employed to draft a petition embracing their request for presentation to the house of commons.16  In deciding to proceed in this manner the physicians rested their hopes on a sympathetic parliament, and since, as James Kelly has pointed out, ‘the 1695 session established that the Irish parliament would be afforded an active role in the making of law for the Kingdom of Ireland by acknowledging its entitlement to initiate legislation in the form of heads of bills’, this was a logical way to proceed.17 unfortunately, for the college of Physicians, it too encountered an insuperable obstacle.</p>
<p>On completion, cox’s  petition was ‘fairly transcribed’ and revised by the original bills committee. It was then delivered to the tory MP for carlingford, Sir John hanmer, to present to the house of commons.18  Meanwhile, thecollegeofPhysiciansbade its fellows to canvass as many MPs as possible to ensure that the commons  both acceded to the demands of the petition and supported</p>
<p>&nbsp;</p>
<p>the consequent heads of a bill.19  In addition, to discourage petitions being lodged against their passage through parliament, a circular letter was ‘sent to the chief surgeons and apothecaries to be by them subscribed, allowing of the usefulness of our charter to the publique’.20</p>
<p>the college of Physicians’ petition was brought before the house of commons on 20 november  1695, and the house  immediately gave William Ponsonby, MP for county Kilkenny, leave to bring in the heads of a bill entitled, ‘For the confirmation of the charter granted to the College of Physicians’.21  this petition, and the legislation that arose from it, made explicit its intentions to regulate the apothecaries’ trade, as well as to suppress the unregistered from practising as physicians.22 however, despite the college’s efforts, the surgeons and apothecaries of  the  Barber-Surgeons’ guild  determined to  oppose  the  measure, and  they presented a petition seeking permission to present their concerns on 23 november</p>
<p>1695.23 the guild’s petition persuaded the commons’ select committee, to whom the heads of a bill to confirm the College of Physicians charter had been referred, to allow a delegation from the guild to appear before them to present their case. This was sufficient to convince MPs not to proceed with the measure and it was dropped soon afterwards by the house.24</p>
<p>the  petition of the Barber-Surgeons’ guild  shows clearly that it was the</p>
<p>‘practising physic’ clauses of the proposed legislation, and their effective banning of anyone but trained physicians from prescribing to patients and administering internal medicines, that most concerned surgeons. the  petitioners argued that the legal enforcement of a prohibition on apothecaries and surgeons ‘practicing physic’ would affect the health, and thus the performance, of his majesty’s navy and army, as most ships did not possess both a surgeon and a physician. the barber- surgeons had decided shrewdly when they chose to oppose the measure on these</p>
<p>&nbsp;</p>
<p>During the first half of the eighteenth century surgeons became increasingly disillusioned with their association with barber- surgeons, and after the 1750s few joined the Barber-Surgeons’ guild. this  dissociation was largely the result of the rising status of many surgeons, a consequence of their association with the burgeoning voluntary hospital and county infirmary systems. After three unsuccessful attempts during the mid-1770s to secure legislation to set up their own representative body, Irish surgeons received a royal charter to form thecollegeofSurgeonsin 1784. they were now able to regulate their own membership and develop a system of surgical education: schools of anatomy and surgery were founded, a licensing system put in place, professors appointed, and students enrolled.grounds, given the geo-political reality of the near total war then raging between the three kingdoms ofIreland,Scotlandandengland,  and catholic  France. In addition, the petition suggested that an act giving the physicians’ charter the force of law would affect the health of the poorest in society as it would oblige those who were ill to seek the services of all three branches of the medical profession (which they could not afford to do), rather than just the all-encompassing aid of a surgeon or apothecary. Finally, it was contended that because the act prevented unlicensed non-physicians from preparing or administering medical compositions, the ability of surgeons to perform their trade must be severely affected, as nearly every ailment required both internal and external medicines, many of which they alone had the skill to prepare.25</p>
<p>despite this further discouraging setback, thecollegeofPhysicianstried on three further occasions during the next eight years to have their charter given the force of law, only to witness each initiative fail in its early stages. In July 1697, the College paid Counsellor William Usher five guineas to study ‘all such acts as are relateing to the practise of physique in england’,26   as well as the charter of the college of Physicians of Ireland, ‘and thence to draw [up] a short publique bill as he shall think fitt’.27  this  done, the Solicitor general,  richard  levinge, was invited on 9 September 1697 to peruse the draft heads and to present it to the house of commons at the earliest opportunity, in return for which he was given a gold watch. Payment of this type may have been felt by the college of Physicians to be a more discreet way of rewarding the services of a privy councillor and law officer than a monetary fee.28  In any event, it secured levinge’s goodwill, and a fortnight later, on 24 September, he was given leave by MPs to bring in the heads of a bill ‘to regulate the practice of physic’.29 these heads were referred to a select committee, which promptly rejected them for reasons unknown. It is probable that their actions were prompted by pressure, or anticipated pressure, from the Barber- Surgeons’ guild.30</p>
<p>A year later, on 27 October 1698, Sir John Meade, lawyer, legal official and MP for county tipperary, was given leave by the house of commons to bring in a heads of a bill entitled, ‘to regulate the practice of physic in this kingdom’; while five years later, on 29 September 1703, Benjamin Burton, a committed social and economic improver and MP for dublin city, brought in heads entitled, ‘For regulating the practice of physic and chirurgery, and of apothecaries, in the city of dublin’. Both heads were given leave, presented and referred to a select committee for consideration, but once again they proceeded no further. It is probable that they too were rejected by the house in anticipation of the type of opposition that had defeated the proposition in 1695.31</p>
<p>&nbsp;</p>
<p><strong>The 1725 heads of a bill to confirm the charter of the College of Physicians</strong></p>
<p>&nbsp;</p>
<p>Following the rejection of the 1703 measure, thecollegeofPhysicianswent silent on the subject of giving its charter the authority of law for almost fourteen years. the fact that successive presidents and fellows devoted much of their energies to medical education may partly explain this hiatus: in 1715 it established the first King’s professorship in medicine, a post funded by the will of Sir Patrick dun. Furthermore, it could not have escaped the attention of the IrishcollegeofPhysiciansthat the campaign pursued over two centuries by thelondoncollegeofPhysiciansto extend and revive its legal right to prevent those who were unlicensed from practising physic had recently come to an abrupt halt.</p>
<p>In 1704, the house of lords in Westminster ruled, in their judgement on the infamous ‘William rose case’, that apothecaries might prescribe to patients in the same way as physicians as long as they did not charge for their advice but only the drugs they supplied.32  alarmed  by this, and determined to protect the privileged position of physicians, the college of Physicians of london pursued a similarly protracted, if marginally more successful, parliamentary battle for the legal right to regulate the production and sale of drugs and medicines than its Irish equivalent. In 1723, an act was passed, in the face of opposition from the company of apothecaries  of london,  which gave the london  college  of Physicians the power to examine the premises of apothecaries, ‘druggists’ and ‘chymists’ and destroy anything deemed unsound or unsafe.33 although this act was temporary, valid initially for a period of four years, it was renewed for a further three years in 1727, once more in the teeth of opposition, on the same grounds, from the company of apothecaries. however, when it expired in 1730 it was not renewed because of the continuing vehement opposition of the apothecaries.34</p>
<p>Meanwhile, having concluded, based on their own experiences and what they gleaned of events inengland, that there was no prospect of their securing legislative recognition of their intrinsically monopolistic claims, thecollegeofPhysicianssought in 1716 to combat abuses and to protect their own privileged position by using the powers provided them by their charter. they were particularly anxious to prevent ‘apothecaries from practicing physic’,35  on the grounds that if this problem continued to be ignored dublin’s physicians would greatly ‘suffer in their business’.36 to this end, it was decided that a circular letter should be sent to dublin’s apothecaries37  threatening to remove the lucrative custom of the city’s leading physicians from those who continued to ‘practise physick’:<img class="alignright size-full wp-image-21" title="175px-Jonathan" src="http://www.g-thang.net/wp-content/uploads/2011/01/175px-Jonathan_Swift_by_Charles_Jervas_detail.jpg" alt="" width="175" height="197" /></p>
<p>&nbsp;</p>
<p>Whereas several apothecarys of this city have presumed to practice physick, and that in many cases to the great detriment of the sick, and to the apparent neglect of their own proper business, which is to prepare, keep and dispense good and wholesome medicines, and not to prescribe physick to patients, we, the president and censors of the College of Physicians do, by order of the said College signifie to you that the members thereof, whether fellows, candidates or licentiates will not for the future direct any note or prescription to the shop of any apothecary, who shall be convict before them of practicing physick without the advice, consent or direction of some physician approved by the college.38</p>
<p>&nbsp;</p>
<p>this  admonition failed to achieve the hoped for result, and in June 1725 the college  of Physicians, possibly buoyed by the success of the london  college of Physicians in securing a drugs act at Westminster in 1723, decided to attempt once again to secure a charter act.39 On 1 november 1725, the college paid henry Singleton, MP for drogheda, £6 sterling to draw up a draft heads for an act to confirm their charter.40 a fortnight later the college ordered that the ‘treasurer do give the president, Richard Helsham, ten moiders for the feeing of five lawyers in order to have their opinion on our bill’.41 a special committee was also appointed to liaise with leading dublin surgeons and apothecaries to dissuade them from petitioning against the charter heads of a bill once it appeared in parliament.42 college of Physicians’ petition requesting parliament to give their charter legal recognition was heard in the house of commons on 1 december 1725, and immediately Singleton was given leave to bring in a heads of bill ‘for preventing the abuses in the practice of physic, and for searching and examining all drugs, medicines, waters, oils, and compositions used or to be used for medicines … exposed to sale or kept for that purpose within the city of dublin.’43  these heads resembled previous initiatives in all but title, and the reaction was comparable. Once more thecollegeofPhysicians’ canvassing proved futile, as the heads came under sustained challenge from the representatives ofdublin’s surgeons, druggists and apothecaries, who presented three petitions against the measure. resorting to what was now established opposition rhetoric, they complained that if the proposed heads were passed they would detrimentally affect the profitability of their business and their ability to treat the sick. This was sufficient reason for MPs to hesitate, and the measure was rejected after a division of the house.44 the campaign had cost the fellows of the college of Physicians a total of ‘thirty pounds eleven shillings and two pence’ in fees.45</p>
<p>Between 1692 and 1725, thecollegeofPhysicianspursued a time-consuming and expensive, two-pronged, legislative campaign to regulate the production and sale of drugs and medicine and the ‘practice of physic’. their object was to secure legislation that would both cement their privileged position at the top of the Irish medical profession as well as improve public health. during this campaign, thecollegeofPhysiciansproved skilled at lobbying, gathering political intelligence, producing meticulously drafted heads of bills, and indentifying and canvassing sources of opposition to them. this was in keeping with the fact that its fellows were often wealthy and possessed of a wide array of political and social contacts in the upper reaches of Protestant society.</p>
<p>unfortunately for thecollegeofPhysicians, the surgeons, apothecaries and druggists they were eager to regulate were still more adept at raising opposition to their initiatives. these interests argued that, if made law, the provisions provided for in the 1692 charter would prevent them from prescribing and producing compounds, drugs or medicines as they saw fit, and that this would not only rob them of a large part of their livelihood but also diminish their ability to attend to those who could not afford the services of a physician. It was this influential argument, first and foremost, that doomed every legislative venture launched by thecollegeofPhysiciansbetween 1695 and 1725. In pre-1782 parliaments, petitioning was an extremely effective form of lobbying (and one that was used frequently, especially before 1732). Both Irish MPs and peers, as well as British and Irish privy councillors, regularly rejected or respited legislation that parties, representing a variety of religious, corporate or individual interests, asserted either disadvantaged them or society at large.46</p>
<p>The financial cost and loss of face that resulted from the failure of successive legislative campaigns, along  with  the  fact  they  were  becoming increasingly involved in matters of medical education,47 convinced thecollegeofPhysiciansat some point in the mid-1720s to cease their efforts to have their charter confirmed in law. they were probably encouraged to do so by the fact that their counterpart inlondonalso abandoned its attempt to secure a ‘practice of physic’ act. It was thus ironic that when the College of Physicians finally obtained the legal right to regulate the way medicines were made and sold in Ireland but they did so as a</p>
<p>result of the efforts of a fully apprenticed apothecary, charles lucas.</p>
<p>&nbsp;</p>
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