by Lucy Inglis
The late seventeenth century was a time of change in the apothecary business. People had more money to spend on what they may previously have regarded as luxury items, and increasingly, self-medication was becoming part of the daily regimen of many. Drugs, then as now, required a trusted retailer and good apothecaries were valued members of the community, a far cry from the itinerant quacks of the quarterly fair. Their business, in many ways, was more reliable and safer than that of physicians, whose results were often decided more by luck than by their own skill. As Francis Bacon observed, the patient may be doomed from the outset and ‘therefore many times the imposter is prized and the man of virtue taxed’.20 The apothecary, however, had a much steadier business, often more concerned with the long-term management of chronic conditions, yet competition between the two factions, the doctors and the apothecaries, was fierce, as evidenced in a speech by Dr Samuel Garth at the Royal College of Physicians in 1696:
Medicine itself is sick. This Art, of all others the most useful, knows not how to help itself; while rather from mock Physicians, than diseases, this country suffers . . . Here an operator, mounted on his pyed horse, draws teeth in the streets; another is so obliging, as to be at home at certain hours to receive fools; another pores in urinals, and if he finds no disease there, he makes it . . . Yet not with weapons do these swarms of mountebanks inflict wounds, but with some nostrum more dangerous than any weapon.21
The nostrums he sneers at were a reference to the medicines available from the druggists and apothecaries that lined certain London streets, and dispensed medicines across the counter. The speech was a call for the Royal College of Physicians to bring the making and dispensing of medicines into the realm of the doctor, and remove it from the hands of the apothecaries. The suggestion was to sell medicine to the poor at cost price, but what seems like an early, positive attempt at regulation of medication in favour of the patient, was also a turf war. The London Dispensary opened in 1698 at the College near St Paul’s Cathedral, ‘where all sorts of Medicines both Chymical and Galenical are prepared of the best drugs, and with all the exactness imaginable’ in an ‘Elboratory’ with two consulting rooms and an attendant apothecary at all times. The Company of Apothecaries, who had already sworn to ‘suitably comply with our just and real intention and désigné of serving the public in affording medicines prescribed by us to such poor at rates answerable to the lowness of their condition’, had no intention of giving ground.22 Bitter battles ensued, erupting into violence on one occasion when a velvet-coated physician and his friends entered the dispensary and attacked the two apothecaries’ apprentices in their blue aprons.
The founding of the London Dispensary sets out the separation between the doctor and the maker of medicines, and is a perfect example of the struggle between the medical profession and drug manufacturers. It’s also the moment that the quality of medication was brought into the public realm, rather than remaining solely a matter of commerce.
Apothecaries’ shops first became sophisticated retail outlets in Italy, France and Holland, with display and attractive packaging part of the shopping experience. Of the different kinds of retailers operating in London in the late 1600s, apothecaries tied up nearly 40 per cent of their capital in their shop fixtures and fittings. Although there would have been significant investment in manufacturing equipment such as stills, it indicates that a large amount of money was spent on display. The shop of John Arnold, London apothecary, had an inventory of 117 glasses, 295 gallipots and jars, which we associate with old apothecaries’ shops today, as well as 183 boxes and barrels.23 The interior was a carefully balanced blend of form and function, usually spread over two rooms, so that more expensive or dangerous items could be stored at the back, and also allowing for privacy should the need arise. Apothecary shops became synonymous with exoticism, some showing stuffed alligators or snakes, or strange creatures in jars. In April and June of 1633, London apothecary Thomas Johnson displayed in his window the first bananas known to have reached England. These shops were designed to entice the customer and all of this was a stage set that physicians such as Sydenham and Dover were familiar with. Dover abhorred corrupt apothecaries, particularly those who operated freely without obtaining prescriptions from a doctor. The relationship between the two professions was a finely balanced one. Clearly, Sydenham and Malthus worked closely together, but it was Malthus who would have physically made laudanum in the Pestle & Mortar on Pall Mall. Yet, physicians felt on the whole that they were more qualified than apothecaries, and that no apothecary should dispense without prescription. It was an ongoing and often fraught debate.
Meanwhile, Dover had made enough money to take a trip to the West Indies in 1702. In 1708, he decided to invest significantly in a pair of ships, the Duke and Duchess out of Bristol, to sail around the world, and set off late the following year. It was a remarkable journey. On 1 February 1710, they were off the coast of Chile near the supposedly uninhabited Juan Fernández Islands, when a light was sighted on one of them, Más a Tierra (Closer to Land). Dover led a landing party to investigate, and there found Alexander Selkirk, Scottish privateer, who had been cast away on the island some four years before with only a musket, hatchet, knife, cooking pot, a Bible and his clothes. Selkirk was later one of the inspirations for Daniel Defoe’s Robinson Crusoe. Selkirk accompanied the ships back to England.
Later, off the coast of Ecuador, the expedition picked up plague after a battle with the locals, and this was a decisive moment for Dover. As head of the medical services on board, he treated 180 sailors with methods he had learned from Sydenham, and lost no more than thirteen. The surgeons on board ‘made heavy complaint’ to Dover about the lack of medicine for such an amount of sick men, although Dover had been sure that the ships were well provisioned when they set out.24 Returning to England in 1711, Dover had doubled his original investment, and had enough money to finally live a more leisured life.
Sydenham’s laudanum recipe had been disseminated across Europe and America, and new versions of it were already being invented. A Leiden-based chemist, Jakob Le Mort, produced his own version of laudanum. It was significantly less powerful, and contained honey, liquorice, aniseed, camphor, salt of tartar and flowers of Benjamin, as well as opium. It appeared in London in 1721 listings as an Elixir asthmaticum, although it was commonly known as paregoric. It rapidly became one of the staples of the household medicine cabinet, used to treat coughs and asthma – as the official title would suggest – to ease diarrhoea, and to quiet restive or teething children.
In 1729, Dover published his best-known work, The Ancient Physician’s Legacy to his Country, to great success. Both a robust home medical manual and an outlandish advertisement for his own services, Dover’s book is full of wild inaccuracies in its descriptions of both diseases and cures, but it is a marvellous read and ran to eight editions. Although it has many weaknesses, the Ancient Physician is excellent on pharmacology, and dispels some of the myths surrounding drugs of the time, particularly that of ‘signatures’. This tradition essentially paired ailments with drugs that either resembled them somehow, or had the same name: liverwort for liver problems, for instance. Dover dismissed these cures as nonsenses, including the ancient alchemical talisman of a bezoar stone, long carried to ward off gall and kidney stones among richer classes, which he refers to as ‘that petrified Matter of Disease, cut out of the Paunches, Galls and Bladders of some of the nastiest creatures in being’.25 He had no time for theriac or mithridate, or any sort of ‘such good-for-nothing Compositions’. He did, however, advocate the ingestion of large amounts of mercury for everything from asthma to worms, which brought outrage from the medical community and earned him the name ‘Dr Quicksilver’. But most importantly, the Ancient Physician introduces the recipe for what would become, along with laudanum and paregoric, one of the most popular medicines of the next two centuries:
Take Opium one Ounce, Salt-Petre and Tartar vitriolated, each four Ounces, Ipocacuana one Ounce, Liquorish one O
unce. Put the Salt-Petre and Tartar into a red-hot Mortar, stirring them with a Spoon till they have done flaming. Then powder them very fine; after that slice in your Opium; grind these to a Powder, and then mix the other Powders with these. Dose from forty to sixty or seventy Grains in a Glass of White-Wine Posset, going to Bed.—Covering up warm, and drinking a Quart or three pints of the Posset-Drink while sweating. In two or three Hours, at farthest, the Patient will be perfectly free of Pain.26
Like Sydenham, Dover himself gave away the recipe, but the medicine took his name immediately and Dover’s Powder was used as a general panacea until after the Second World War. It was often found in bulk in the medical panniers of captured Italian troops, and wasn’t banned in India until 1994. The success of the book, and his piratical adventures at sea, had made Thomas Dover a comfortable man, and he retired to live with his friend Robert Tracy, to whom the Ancient Physician was dedicated, before dying in 1742.
The New Culture of Intoxication
‘Life is a pill which none of us can bear to swallow without gilding; yet for the poor we delight in stripping it still barer.’27
James Boswell
Thomas Dover expired just as Britain was at the height of the Gin Craze. Introduced from Holland after the Restoration of 1660, gin exposed London’s drinkers to strong liquor for the first time. Traditionally a nation of beer drinkers, they aspired to drink Continental spirits such as brandy, but that had been banned by King William III in 1689, and an Act of Parliament passed to ‘encourage the distilling of brandy and spirits from corn’ was passed in 1690.28 Raw gin could be anything up to 140 per cent proof, and tales of strokes and blindness were not uncommon. And as acceptable gin can be made with bad grain, whereas decent bread cannot, farmers loved the industry and the British government wholeheartedly promoted home-grown distilling, but soon it had a terrible crisis on its hands. London’s working population were mostly self-employed casual labourers, including the semi-skilled such as seamstresses and tailors; their careers were feast or famine. Gin became so cheap, and was so intoxicating, that people who had been paid and subsequently indulged were then reduced to a state where they were unable to seek labour in the coming days. A labour force previously reliant on nourishing beer and ale was ruining itself on spirits, as a treatise comparing the two describes, noting the full effects of a gin hangover:
His eyeballs, see, in hollow sockets sink,
Bereft of health and sleep by burning drink . . .
His liver even vitrifies his blood,
His guts from Nature’s druggery are freed,
And in his bowels salamanders breed29
Added to the sheer availability of gin was the fact that gin shops did not need a licence, so gin could be sold in private establishments, and men and women could drink together, with the consequent loss of inhibitions. In one case, William Bird’s maid, Jane Andrews, was left in charge of his Kensington house, but instead went out to a gin shop, got drunk, and invited three of her fellow patrons back to her employer’s house, where she ‘proposed to the company that they, and she, should go to bed together’, which they did.30 This sort of behaviour threatened the ruling class with a lack of order they could not tolerate, particularly in their own homes, and measures were put in place to curb gin drinking, namely a series of five largely ineffectual Acts of Parliament, passed between 1729 and 1751, as the craze reached its peak.
The Gin Craze is linked to the trend for consumption of opium and all other intoxicants by a number of important factors. Gin itself was not necessarily addictive, and was often actively unpleasant to drink, but it fulfilled a need in the working-class population that had been suppressed by the move from the land to towns and cities, primarily London: namely, the need to celebrate the brief interlude of not being at work. The sheer strength of gin meant that it rendered most drinkers drunk very quickly, and publicly. The public and profligate nature of this binge drinking was what was most troubling to the governing classes of the time. The aristocrats and politicians also drank, but their intake was deemed a private matter. They were torn: were the labouring poor being paid too much, so could therefore afford such drunken abandon, or did the economy benefit through their profligacy?
Contemporary writers discussed and usually lamented the rise of luxury constantly. The goods flooding into Britain from all over the New World, Europe and Asia were no longer the exclusive preserve of the royal court. The new middle classes now enjoyed tea, coffee, silk and ivories, as well as opium, ambergris and other expensive products. Many in the old guard were reminiscent of Pliny the Elder in his diatribes against silk, although there were conflicting voices. Daniel Defoe argued in favour of the national distilling trade, with the notion that domestic consumption was a positive thing. Bernard Mandeville’s poem ‘The Grumbling Hive: Or, Knaves turn’d Honest’, published in 1705 just as gin started to become popular in London, imagined that private vices and the need to consume were what kept society cohesive, despite the complainers. When, inside the hive, ‘Honesty fills all their Hearts’, many die and the bees become dull and less productive. Mandeville concluded with ‘Bare Virtue can’t make Nations live, In Splendor’.31 Many writers realized that the state increasingly depended upon an urban population who could be taxed on their consumption, no matter how poor. The Gin Craze was the perfect example of this debate, and one of the best-documented early social crises that revolved around working-class intoxication.
The middle-class hand-wringing in the endless tracts on luxury was, of course, as meaningless to the men and women inhabiting the gin shops of Covent Garden as the habits of Jahangir and the alcoholics of the Mughal court. Gin was a way to escape the daily miseries and drudgery of their lives, and soon the collective pursuit of oblivion on London’s streets was out of control. The ‘meaner, though useful Part of the Nation, as Day-Laborers, Men and Women Servants and Common Soldiers, nay even Children are enticed and seduced to taste, like and approve’ railed the pamphlets, as London’s working classes were ‘frequently seen in our Streets in such a Condition abhorrent to reasonable creatures’.32
Charles Davenant, the politician and writer, who had initially argued in favour of the gin industry, realized that gin was, ‘a growing fad among the common people and may in time prevail as much as opium with the Turks, to which many people attribute the scarcity of people in the east’.33 Politicians and economists alike were forever afraid of a fall in population, reducing the workforce and available military manpower, as well as decreasing tax revenues, but the fear of gin taking over and decimating the labouring population was real. Bearing in mind that gin was primarily consumed and produced in London, then the figures are alarming. In England and Wales in 1700, total consumption was around 1.23 million gallons. By 1714, that figure was up to almost 2 million gallons per year; by 1745, 6.4 million and, by 1751, 7.05 million. So by the end of that period, it amounted to a gallon per head of the whole population, per year.34
The Irish faction of St-Giles-in-the-Field succumbed rapidly and with shocking consequences such as desertion, child malnutrition and prostitution. There was a corresponding rise in crime, and much of it involved drunken violence and theft. The reality of social unrest and women left destitute and inebriated on the streets mobilized London’s new middling classes, as well as the government, to work towards social change. New organizations, such as the Society for the Promotion of Christian Knowledge (SPCK) founded in 1689, the year before the Distilling Act, had risen up to try and take positive action by distributing pamphlets and engaging with the unfortunates. Others, such as the Society for the Reformation of Manners, were less positive, seeking to catch miscreants behaving lewdly in order to have them prosecuted.
By the 1730s, things were in a desperate state in London. One particular case shocked the city and the nation, and galvanized the reformers and the government. Judith Defour worked as a throwster, twisting silk fibres into thread. She had a weakness for gin, and often turned up to work a little worse for wear, but otherw
ise seemed a normal employee. She had a daughter, Mary, aged a little over two years old, but was no longer in touch with the father and money was scarce. For this reason, and perhaps the drunkenness, Mary had been staying in the parish workhouse. One Sunday, Judith collected her for a visit, already the worse for wear. Whether she knew Mary had been outfitted with a new set of clothes that week or not, was never established. After keeping her daughter out for longer than she should, Judith carried her into the fields behind Brick Lane in the eastern part of London and choked Mary with a piece of linen. She insisted she was aided by a woman named ‘Sukey’. Stripping the body, they left it in a ditch and took the clothing to a dealer where they ‘sold the Coat and Stay for a Shilling, and the Petticoat and Stockings for a Groat. We parted the Money, and join’d for a Quartern of Gin’.35 Defour insisted, even in the face of a guilty verdict and a sentence of death, that it was Sukey who had made her kill her daughter. Defour’s own mother said in court that ‘She never was in her right Mind, but was always roving.’36 The author Henry Fielding, the Covent Garden magistrate in charge of overseeing so many cases in which intoxication played a part, was convinced that ‘the gin’ alone was to blame for many crimes, ‘for the intoxicating draught . . . removes all sense of fear and shame, and emboldens them to commit every wicked and desperate enterprise’.37 Fielding, it may be noted, ridden with gout and dropsy, died of alcoholism in Lisbon in 1754.
The Defour case became notorious, bringing together as it did the societal fears of the age: a woman of loose morals, drunkenness, and a vulnerable and ultimately murdered child. For men to carouse drunkenly in the streets was one thing, and to be expected, but for women to lose themselves to drink was quite another. Infanticide was a constant preoccupation of reformers during the craze, as were the ‘diminutive, pygmy . . . withered and old’ children of gin-drinking women.38 A man deeply affected by seeing these children in the street, ‘exposed, sometimes alive, sometimes dead, and sometimes dying’, was Thomas Coram, an abandoned child himself who had led a hard life at sea.39 Coram spent the 1720s and 30s campaigning for enough money to begin London’s Foundling Hospital, hoping to house some of these infants, and was in the end successful, mainly thanks to well-known campaigners such as the Duchess of Somerset and William Hogarth. On the first day of admissions on 25 March 1741, far more women applied than there were places for children, and ‘a more moving scene can’t well be imagined’.40