BerksFHS Logo  

Berkshire Family Historian
September 2001

upBerks FHS indexContents

Berkshire Family Historian
Main Page, September 2001 Contents

Rural Robustness - health and medicine in the nineteenth-century countryside

Lori Williamson

The countryside has long been perceived as a healthier place in which to live and work than the city. Edwin Chadwick, sanitarian and public health campaigner, noted in his 1842 Report on the Sanitary Condition of the Labouring Population of Great Britain that agricultural labourers were much healthier and could enjoy greater longevity than their urban counterparts. In London, which by mid-century had eclipsed Manchester as the classic industrial 'shock' city, full of destitution, disease and despair, the average life-expectancy for an industrial worker was a meagre 35 years (by the end of the century this had increased to 50 years). Historians of rural England have constantly remarked, using data available to them, such as Reports of the Registrar General for Births, Deaths and Marriages, on the favourable effects on longevity of

country life and living. Some, however, such as G.E. Mingay, have emphasised that quantity of rural years did not necessarily equate with or result from a high quality of life. Variations existed in the standard of living of country dwellers, yet one must not be misled into believing that all of rural England resembled an idealised Constable painting. The country was not necessarily a land of plenty; very often, especially during times of agricultural crisis, it was a land of want. Rural areas, like urban areas, suffered from poor sanitation, pollution, destitution and disease, albeit on a somewhat reduced, although to Victorian social observers no less shocking, level.

Many country men, women and children were adversely affected by poor nutrition and cramped, damp, poorly ventilated cottages, which had neither drains nor privies but which were often in close proximity to open cesspits and filthy ditches which overflowed with sewage and refuse. Even in areas which boasted privies, often no more than earth closets, there was still the problem of cleaning them out. In her semi-autobiographical 'Lark Rise to Candleford', Flora Thompson recollects the overwhelming stench that would envelop the Oxfordshire hamlet in which she lived during the twice-yearly emptying of the deep pits that served as privies. Victorians, in both country and city, could not just 'flush' waste away. Piles of human and animal excrement were breeding grounds for disease-carrying flies and water-borne germs, while the over-crowded conditions of many country cottages contributed to air-borne illnesses.

A poor diet, which one initially would not equate with country life, weakened resistance to illness. Many country dwellers were self-sufficient and prepared nutritionally adequate meals from the produce of their garden or allotment. A pig, as Flora Thompson emphasises, was vital to sustenance; its slaughter was a ritualised public spectacle and nothing was wasted. Mingay has discovered, however, that not all country wives were resourceful when it came to feeding their families; nutrition was little understood, and country women in general found themselves criticised by their contemporaries for their inability to produce nourishing soups.1 Florence Nightingale censured these same women for refusing to believe in sanitation and for helping to spread disease by their lack of domestic skills and ignorance about hygiene.2 Bread, lard and tea, sometimes mixed with dust by unscrupulous village shop-owners to make it go further, formed the basis of the rural diet for women and children; as the principle wage-earners it was the men in a family who received what meat was available.

The low wages given to agricultural labourers, which ranged regionally from 6s. - 15s. a week3, obviously played a part in poor diets, as did inferior quality of food available, inadequate cooking facilities or fuel shortages. Food purchased in village shops was often adulterated (the same held true for urban areas), which adversely affected the health of those consuming it; alum, a combination of aluminium and potassium, for example, was added to flour to whiten bread. And contrary to what one might think, there was a shortage of fresh milk. Many country children, therefore, drank inferior tinned milk, which lacked vitamins and minerals necessary for proper development. 'Atrophy', or malnutrition, killed many an infant and young child, as did 'overlaying', convulsions and stomach disorders caused by poor hygiene and cramped living conditions. It was possible also for children to be over-dosed with the opiate Godfrey's Cordial, used to quell fractious infants. Country children, like those in cities, succumbed to cholera, smallpox, typhoid, diphtheria, whooping cough, scarlet fever and measles, with the under-fives being the most vulnerable. In Oxfordshire, for example, deaths of children under five years of age made up 28 per cent of the total 2,937 deaths reported for 1897.4 The logbooks kept by rural schoolmistresses chart epidemics amongst school children, and as Pamela Horn has noted, crowded classrooms filled with malnourished pupils helped disease to spread.5 One in every ten country children would not survive to adulthood, vet infant mortality rates were considerably lower in the country than the city where the national average stood consistently at 151 per 1,000 throughout the nineteenth century.

Both adults and children were susceptible to tuberculosis, although country consumptives were more likely than their urban counterparts to survive. Rheumatism plagued the aged, who relieved their aches and pains with opium (aspirin was not available until 1899). In general, self-help and self-sufficiency formed the basis of rural medical care. Neighbours would rely upon each other for assistance, and doctors would be called only once all home remedies had failed or when the patient was close to death. For a modest fee of a couple of shillings, the village midwife, who possessed neither anaesthetics nor obstetrical instruments and who received her training on the job rather than in a classroom (midwives were not regulated until 1902), would assist a woman in labour; a doctor would attend a birth only if there were severe complications. The ever-present danger was that the labouring woman would contract puerperal fever, a uterine infection that was fatal in an age without antibiotics. Charity also played its part in post-natal care. The new village mother would receive from the clergyman's daughter' the box', which contained baby clothes on loan and gifts of tea, sugar and groats for gruel. 'The box' would be returned to the rectory after one month, with the contents cleaned and ready for the next new arrival.

As well as cultivating a vegetable garden, most country women grew herbs for both culinary and medicinal use: thyme, parsley, sage, peppermint, lavender, pennyroyal, horehound, camomile and rue. Camomile tea was imbibed as a nerve-soother and tonic while horehound was mixed with honey into a cold remedy. Shallots not only flavoured cooking, but also were heated and inserted aurally as a cure for earache. One of the more off-putting home remedies for whooping cough, which was popular in East Anglia well into the twentieth century, was the consumption of a fried mouse; in Oxfordshire it was thought that whooping would cease after the patient was driven 'round the sheep-folds before breakfast.6 Similarly nauseating to modern sensibility is the teething ring that a Herefordshire woman made for her children; a bag of wood lice, which she tied around her children's necks and on which they cut their teeth 'beautiful'. 7

Superstition and folk-lore figured in rural medicine. Charms were used for animals and people, with professional charmers claiming to cure everything from toothache to ague and burns. An early nineteenth-century Weobley charmer offered the following for mad dog bites:

'Fuary, gary, nary,
Gary, nary, fuary,
Nary, fuary, gary.

Write this on a piece of cheese, and give it to the Dog.8

In Herefordshire it was believed that chilblains could be prevented in adulthood by taking a baby outdoors during its first winter and rubbing its feet in the first snow. A sheep's lung was applied to the soles of the feet of a patient suffering from pneumonia in order to draw out the disease from the human's lungs. Styes in eyes could be cured by touching them with wedding rings or crossing them with the tip of a cat's tail nine times. The application of a dead man's hand to a wen on the neck was believed to effect a cure. In Weobley a mole would be used in such cases in one of either two ways. First, its nose would be made to bleed and the blood crossed over the wen nine times. The mole would be released and it would take the wen with it. In the second approach the mole was cut in half and applied to the wen overnight. The following day the two halves of the mole would be removed and buried, and as the mole's body decayed it was thought that so too would the wen.9

If self-help, charity and folk-lore failed then professional medical help would be resorted to. Few could afford to pay a country doctor's fees, although many physicians treated their patients free of charge. Near the end of the century some country doctors set up subscription schemes for patients, which would cover basic medical treatment and drugs. District nurses were introduced into many rural areas in the closing decades of the century, with funding for their services coming from charitable donation and the cottagers themselves. Benevolent individuals who financially supported rural hospitals recommended needy cases, but we must question the effectiveness of hospital care in an age of limited medical knowledge. In his diary for 1870, the Reverend Francis Kilvert, curate of Clyro in Radnorshire, remarked upon the condition of young Meredith, 'who has had his jaw locked for six months, a legacy of mumps. He has been to Hereford Infirmary where they kept him two months, gave him chloroform and wrenched his jaws open gradually by a screw lever. But they could not do him any good... '10

Cottage hospitals, charitable initiatives located in converted cottages, began to appear in rural areas in the 1860s. They were modest in scope and endeavour: treatment was offered by a nurse and visiting doctor to a handful of patients who were expected to contribute towards their care in a modest financial way. What these hospitals offered rural inhabitants was rest and good nutrition rather than medical treatment. They also offered a welcome alternative to rural workhouse infirmaries, which were degrading, degraded places, staffed by pauper nurses and blighted by the pauper taint, shunned by all but the very sick and destitute. Flora Thompson sadly recollects the tale of one aged man in her Oxfordshire hamlet who had the misfortune of falling ill and of having no one to look after him. The doctor called in the relieving officer, and both prepared the old man for the journey to the workhouse infirmary.

'Laura saw the carrier touch up his horse with the whip and the cart turn, and she always wished afterwards she had not, for, as soon as he realized where he was being taken, the old soldier, the independent old bachelor, the kind family friend, collapsed and cried like a child. He was beaten. But not for long. Before six weeks were over he was back in the parish and all his troubles were over, for he came in his coffin.'11

The nineteenth century witnessed many epidemics in country and city; malnutrition and sub-standard housing were common; mortality rates for adults and children were high; life expectancy, when compared to today, was relatively low. A child born in i8oo had a better chance of survival in the country than the city, but this did not mean that it would survive into adulthood. In the very large families of Victorian England, parents were well prepared for the deaths of some of their children. Medical knowledge was limited as too was the treatment offered by practitioners, both lay and professional. What is striking about rural health care in the nineteenth century is its diversity: folklore and age-old herbal remedies co-existed with district nurses and cottage hospitals and the gradual infiltration throughout the medical community of more sophisticated medical knowledge which led to many life-saving discoveries. Some of the more superstitious remedies offered to nineteenth-century patients might seem ludicrous today, but what we must remember is that people had faith in them, and faith plays an important part in the healing process.


1 G.E. Mingay, Land and Society in England, 1750-1980, London: Longman, 1994, p.99.

2 See, for example, Letters from Miss Florence Nightingale on Health Visiting in Rural Districts. Reproduction of a Printed Report originally submitted to the Bucks County Council n the year 1892. London: P.S. King & Son, 1911. Reprinted in Lori Williamson, ed., Florence Nightingale and the Birth of Professional Nursing, Bristol: Thoemmes Press, 1999.

3 See Pamela Horn, Labouring Life in the Victorian Countryside, Stroud: Allan Sutton Publishing Limited, 1995, PP. 118-19. It must be noted that money was often supplemented by wages in kind.

4 See Pamela Horn, The Victorian Country Child, Strand: Allan Sutton Publishing Limited, 1990, p.215.

5 See ibid., pp.202-203.

6 Quoted in ibid., p.200.

7 Ella Man, Leather, The Folk-Lore of Herefordshire, Hereford: Jakeman & Carver; London: Sidgwick & Jackson, 1912, p.70.

8 Ibid., p.74.

9 For medical superstition in Herefordshire see ibid., pp.77-85.

l0 Quoted in A.L. Le Quesne, After. Kilvert, Oxford: Oxford University Press, 1978, p.204.

11 Flora Thoinpson, Lark Rise to Candleford, London: Penguin, 1988, p.90.

Statistical material is taken from B. R. Mitchell, British Historical Statistics, Cambridge University Press, 1988.

Lori Williamson, Ph. D., has published books and articles on modern British social history and the history of medicine. Her latest book, Power and Protest. Frances Power Cobbe and Victorian Society, will be published this year by Rivers Oram Press. In the autumn she will be teaching 'Patients and Practitioners. An Illustrated History of Medicine, 1750-present'on Thursday afternoons from 2:30-4:30 for Oxford University Department for Continuing Education.

Web-page produced by DandyLion Services
Please contact the webmaster with any queries
Berkshire Family History Society 2001

updated 26th November 2001