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.
References
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.
