Eighteenth-Century fashionable diseases, and the dangers of crowded rooms.

“Fashion, like its companion luxury, may be considered as one of those excrescences which are attached to national improvement; Whilst one part of a polished nation is assiduously engaged in cultivating the arts and sciences, another part is not less busily employed in the invention and regulation of its fashions”.

So wrote James McKittrick Adair in 1790 at the beginning of his Essays on Fashionable Diseases. Adair was a medical luminary. According to the blurb at the start of his book he was variously a member of the Royal Medical Society, a Fellow of the Royal College of Physicians of Edinburgh, Physician to the Commander in Chief of the Leeward Islands and colonial troops, a judge on the Court of King’s Bench…the list went on.

As a physician to the wealthy Adair was in prime position to observe the types of conditions that afflicted his clients, but also the types of conditions that were becoming fashionable. The eighteenth century was perhaps the golden age of the ‘trendy’ disease. Where once sickness had been something feared and malign, some conditions were now becoming if not desirable then not unwelcome either. This was the age of the ‘heroic sufferer’; letters became filled with narratives of illness, commonly with the writer fashioning themselves into the role of embattled victim, wrestling with almost overwhelming symptoms and constantly surprised that they even had strength to hold a pen. These were the types of people who seemingly darkened the door of McKittrick Adair’s consulting rooms.

Of the evil influence of ‘fashion’, Adair was in no doubt. No longer was it just contained to dress, but influenced manners, politics, morals, religion and, worst of all in his view, even medicine was becoming enthralled to the “empire of fashion”. Whereas fashion had long influenced people in their choice of doctors, it was now influencing their choice of diseases too. This is how Adair explained the rise of fashionable diseases.

When doctor and patient were both persons of fashion, the patient would enquire of the doctor what condition their symptoms displayed. The doctor, not wishing to offend the polite patient’s ear with a lengthy medical discourse (or perhaps even not knowing!) gives the symptoms a general name – e.g. nervousness. As sickness and symptoms are a popular topic for discussion, the patient speaks to others and ascribes similarities where, Adair argued, none exist, but soon the condition becomes widespread…and fashionable!

In the early part of the eighteenth century “spleen, vapours or hyp was the fashionable disease”. Thirty years previously, a treatise on nervous diseases had been published by a professor of physic at Edinburgh. “Before this”, Adair argued, “people of fashion had not the least idea they had nerves”. At some stage an exasperated apothecary of his acquaintance, bowed under the weight of symptoms from a wealthy patron exclaimed “Madam, you are nervous!”. As Adair put it “the solution was quite satisfactory, the term became fashionable and spleen, vapours and hyp were forgotten”.  But the process didn’t end there…

The 'faces' of nervousness and biliousness.
The ‘faces’ of nervousness and biliousness. (Courtesy of Wellcome Images

“Some years after this, Dr Coe wrote a treatise on biliary concretions, which turned the tide of fashion: nerves and nervous diseases were kicked out of doors, and bilious became the fashionable term. How long it will stand its ground cannot be determined”.

In many ways Adair was forward looking, and questioned the role of his fellow practitioners and their ministrations. He was particularly frustrated by the old Galenic practices of bleeding and purging, which still clung on in the late eighteenth century. “The idea of bleeding and purging each spring and fall, to prevent fevers and other diseases, was formerly very general in this country”. This was due to the “ignorance and knavery” of rural medicators who, he argued, feathered their nests by “disciplining whole parishes” in this way.

Worse still, many patients who only suffered slight complaints were now given to violently purging themselves using an array of potent substances from magnesia, salts and rhubarb to James’s purging pills, which destroyed the very health that they were trying to preserve! Adair’s point was that people were simply overdoing it with medicines. Instead of the odd purge, potion or pill, people were taking them every day, ill or not, to the extent almost that the cure became the kill!

Adair had other words of warning for the fashionable, in terms of their continued attendance at packed society balls. In places like Bath, where Adair had his practice, fashionable functions were everywhere and life for the well-heeled was a constant round of parties, balls and visits. Danger, however, lurked in this lifestyle.

Just as blacksmiths, bakers and glassmakers were weakened by the excessive heat of their trades, he argued, so the cramped, airless fug of the ballroom was deeply injurious to the human body. Heat and fire could only hurt the delicate constitution so, once again, in their quest to be fashionable, the dandies and fops of Bath society were putting their health in danger.

Part of the problem was the noxious air that became trapped in crowded rooms. The smell of sweaty, unwashed bodies mixed with stale perfume, alcohol and coal smoke to produce a toxic miasma that threatened to overwhelm those delicate constitutions. The very atmosphere of Bath made the whole situation worse, surrounded by hills and therefore trapping the residual warmth and creating a cauldron-like atmosphere. The steam from the hot baths added to this, as did the fires caused by so many visitors in their lodging houses. Bath was the modern Babylon as far as McKittrick Adair was concerned.

His book is interesting as it sits right on the cusp of change. He was ‘modern’ enough to see the changes in medicine and disease, but still essentially rooted in ideas of the past, e.g. the concept of bad airs and heat. He wrote as a professional who criticised other professionals but still took the same position as did elite physicians of the 16th and 17th centuries, who complained constantly about quacks and empiricks.  Most of all Adair’s book fizzes with Enlightenment style and language, but also seems oddly familiar in tone. Even at 200 years distance, it feels like we could hold an interesting conversation with this man.  What stories would he be able to tell us about his clients?!

The English Priest’s Powder: A 17th-century quack doctor’s advertisement

The marketing strategies of 17th and 18th-century quack doctors are now familiar territory. As Roy Porter’s outstanding book Quacks did so well to bring alive, early modern Britain was a vibrant medical market, a panoply of colourful characters and dubious remedies. They were, to use Porter’s phrase, “a ragtag and bobtail army of quacks”.

Taking advantage of the newly-available cheap print, quack doctors produced reams of advertisements to peddle their wares. Ranging from brief, straight to the point details to more sophisticated means of selling, quack doctors were often skilled wordsmiths; in many ways they needed to do something to stand out from the crowd. With so many different medicines and vendors jockeying for position, they needed to be innovative. This might include elaborate descriptions of the virtues of their medicine. They often included testimonials from those who, they claimed, recovered through the use of their pill or potion. They might use imagery to embellish their advertisements. Occasionally, though, some particularly innovative strategies can be found. One of my favourite is the clever tool of selling without appearing to sell. One of the ways this was done was by disguising the advertisement in the form of a book. A case in point is the engagingly titled Riddles mervels and rarities: or, A new way of health, from an old man’s experience, published in 1698 by Thomas Mace.

Title page from 'Riddles and Mervels' - availble on EEBO (copyright)
Title page from ‘Riddles and Mervels’ – availble on EEBO (copyright)

At first glance this appears to be a typical ‘self-help’ book, a genre popular in the period. In his opening preamble, Mace sets out his philosophy that age and experience are better than any university-trained, licensed physician. Anticipating howls of derision from the faculty, Mace acknowledged that “I am no physician either by education, graduation, licence or practice’. And yet, he argued, a man like himself of 80 years knew his own body better than any young man of 20 or 30 who had merely spent 5 years reading books in a university. Compelling stuff!

The first hint that all might not be as it first seems occurs early on with the inclusion of the following:

“TO Prevent all Frauds, know, That This Rare Power, known by the Name of the English PRIEST’S-POWDER, is to be had No where but at These few Places Following, viz. By the Author (Tho|mas Mace) at his House in St. Peter’s Parish in Cam|bridge, near the Castle; And at Mr. Daniel Peachcy’s in St. Buttolphs Parish there: And in London, by Mr. Adam Mason at his House in Old Bedlam near Bishops|gate; And by Mr. William Pearson, Printer, at the third Door in Hare Court in Aldersgate-street near the Meet|ing House; And by Mr. John Vaughan, Milliner, at his House in Grivil-street near Hatton Garden; and by Mr. Will. Benson in the Old Baily”

Indeed, advertisements in ‘proper’ books were not unusual, but the alert reader will no doubt note the name of the creator and seller of the powder…one Thomas Mace – the man who claims to be no physician. Disguised within an ‘explication of the title page’, the sell goes on…

Universall-Physical-Me|dicine, for all sorts of Constitutions, and all sorts of Maladies, Sicknesses, and Diseases, is a Chymical Prepar’d Powder which for some late years past I have Publish’d in the Name of the English PRIE                         T’S POWDER, and which it self is never to be Taken, either Inwardly (as Physick) nor Ap|plyed Outwardly to any Wound, Sore Scab, Bruise, Swelling, Pains, Aches, Head-Ach Rheumetick-Sore-Eyes, &c. All which, and many more, tis most Ad|mirably good for.) I say, it is never (it self) to be us’d or Apply’d (as Me|dicine) But (only) a lycture, which It sends forth, into some Certain Li|quors; into which it is to be Infus’d, for some certain Hours: And Those Li|quors, (Retaining its Virtue) are only to be us’d; And (as Physick) are to be taken, into the Body, in the way of Potion; […]ther for Vomit, Purge, Glister, or Sweat; But in the way of Chirurgery, are only Outwardly Applyed, by Washings or Bathings &c.

As the book progresses, it seems to revert to the ‘every man his own physician’ style. Mace assured the reader that his intentions were honourable and that he only wished to “Accommodate the Meaner sort of Men; but more especially the Poorest of all, who stand most in Need of Help and Comfort in their Sicknesses, seeing no Great and Skillfull-Physicians, will so much as look after Them, or scarce think of their Miseries; so that many Thousands live in Misery; Languish and Dye, for want of That which every ordinary House keeper might Easily Purchase, and not only have the Benefit of it for himself and his whole Family, during his Life, in all common Sicknesses, and Disea|ses, but might also be assisting to all his Poor Sick Neighbours round Him”

There follows a discourse on the Philosopher’s stone, including several pages of what can only be described as vernacular poetry. A short stanza should suffice:

MUch Talk has been of The Philosophers-Stone,
From Ages past; That by its livge alone,
‘Twould turn Inferiour Metals into Gold.
A Glorious Worder sure, if True; but Hold!
Where is’t? Who has’t? we no such Thing can see;
‘Tis surely Folded up in Mystery

There is even a page of music to allow the reader to literally sing the praises of the remedy!

EEBO (Copyright)
EEBO (Copyright)

But the next sections of the book, although clothed in a discussion of the miraculous effects of the philosopher’s stone, are in fact a shining example of pure quack rhetoric. On first glance it seems that Mace is merely reporting the effects of the ‘philosopher’s stone’ on a range of conditions. But, looking more closely, his ‘priest’s powder’ has been cunningly woven into the narrative. A clue comes in the title to his first section – “The admired use of this powder (or stone)”…which one is more prominent?!

The real clincher comes in the “Eight eminent stories” of the power of the “powder (and stone)”.  Ranging from the dying man who could not sit upright but recovered almost as soon as he had taken the powder, to the cured leper, to the woman suffering from yellow jaundice, whose “foul, corrupt stomach” was poisoning her food, all were miraculously brought to recovery not only by the mysterious priest’s powder but by the personal intervention of the ubiquitous Thomas Mace…who, as he was no physician but knew his own body, clearly just happened to be passing!

This was selling by not selling. The reader, perhaps expecting a list of cures and remedies for all ailments, and lulled by the promise of being able to cure themselves of all maladies without the need for physicians, surgeons or apothecaries, was instead subject to stealth marketing. Mace provided everything about his powder, including where to buy it and how to use it, but disguised it in a discussion of the ‘Philosopher’s stone’ to try and locate his ‘Riddles and Mervels’ as a scientific discourse. Clearly this was an advertisement, but it shows the innovation of medical retailers, and the lengths to which they went to sell their goods. Little is known about Mace. By his own admission he was an old man, but was he someone with a genuine concern for his fellow man, or just another medical entrepreneur, out to make a fast buck. You decide.

Beards, razors, and the history of shaving – BBC Radio interview from 2011

Over the past year, I’ve noticed that many of the hits on my site have been related to my work on razors and shaving. Accordingly, I thought it might be fun to upload a radio interview I did from a couple of years back, talking to the legendary Roy Noble about my work.

Admittedly I’m no Melvyn Bragg when it comes to interviews…but I did my best and it was fun! Let me know what you think.


p.s. not sure about the copyright issues here…I’m sure the BBC will be good enough to let me know if they’re not happy!