A RETROSPECT ON MEDICAL PRACTICE
279
III
A PICTURE OF SEMI-RURAL PRACTICE A HUNDRED
YEARS AGO
In February, March and April, 1851, there appeared in three
instalments in the Ladies Companion a short novel from the pen
which later in the same year was to commence that delightful and
ever-fresh story of Cranford. Mr Harrison's Confession, like its
greater successor, is essentially a novel of situations in which the
hero gets himself into all kinds of amusing impasses in his efforts
to establish himself as a general practitioner in the town of Duncombe. As the predecessor to Cranford, the story will always be
of interest to students of literature; as a living document of social
history it is of absorbing interest to students of medical history.
Mrs Gaskell was a niece of Peter Holland, surgeon, of Knutsford
(1766-1855) and was brought up until she was fifteen by an aunt.
It is said that she used as a child to accompany her uncle on his
rounds. Peter Holland's son, Sir Henry Holland, Bart., M.D.,
F.R.S. (1788-1873) was physician to the Prince Regent. There is no
doubt that Mrs Gaskell moved in a circle which had medical
contacts and thus became acquainted with the ways of the profession. The skill with which she made use of her observations are
reflected in that delightful character Mr Hoggin in Cranford and
to an even greater extent in Mr Harrison and his cousin, Mr
Morgan.
The story is told by the doctor himself to his brother who,
having recently returned from Ceylon, is visiting him for the first
time since he began practice. It is the familiar tale of the young
doctor trying to establish himself. " I had," says Harrison, "just
finished walking the hospitals . . . and I wanted to go abroad like
you, and I thought of offering myself as a Ship's Surgeon; but I
found I should rather lose face in my profession so I hesitated."
Whilst he was hesitating he received a letter from his father's
cousin, Mr Morgan, offering him a share in his practice. He was
to have a third of the profits for five years and after that a half
share with ultimate succession-an arrangement not uncommon
today. Mr Morgan, a dapper little man of middle age, " keeps his
chin close shaven, wearing a black dress coat and dark grey
pantaloons; and on his morning round to his town patients, he
invariably wears the brightest and blackest of hessian boots, with
dangling silk tassels on each side. When he goes home, about ten
o'clock, to prepare for his ride to see his country patients, he puts
on the most dandy top boots ... which he gets from some wonder-
280
R. M. S. MCCONAGHEY
ful bootmaker a hundred miles off." Mr Morgan had strong views
on the manners to be adopted by the young practitioner. After
quoting a dictum of Sir Everard Home to the effect that " a general
practitioner should either have a very good manner or a very bad
one," he casts his vote in favour of the former. " I therefore have
students to acquire an attentive anxious politeness, which combines
ease and grace with a tender regard and interest ". . . . " Identify
yourself with your patients, my dear sir," is his advice, " really
feel pain while listening to their account of their sufferings, for it
soothes them to see the expression of their feeling in your manner."
This is indeed the cult of the bedside manner par excellence.
In amongst the comedy of the story is the sad death of little
Walter, the rector's youngest child. It was a case of croup and was
treated in a warm bath without avail. Then leeches were fetched
and applied to the throat. " He resisted at first!" but was lulled
to sleep, " with the black leeches yet hanging to his fair white
throat." And there is the case of John Bronncher, the jobbing
gardener, who fell and injured his wrist so severely that an amputation was feared to be necessary; to leave it to heal was courting
death from lockjaw. Every country practitioner will enjoy the
account of the situation which arises out of this case. All the
inhabitants take sides in the discussion on the merits of up-to-date
treatment versus traditional management.
In the course of the story we learn that the stethoscope-the
old wooden type it would be-was not at that period carried as a
routine (the top-hat had not yet come in as a convenient receptacle
for that ungainly weapon) for when Miss Carry wished to get poor
Harrison into a compromising attitude she bade him bring his
stethoscope on his next visit, for" she thought she had a weakness
about the heart."
The main plot of the tale hangs round the matrimonial misadventures of the young bachelor doctor and ends, as all such tales
should, on a happy note, the hero getting married on an income
of three hundred pounds a year.
R. M. S. MCCONAGHEY.
REFERENCES
Gaskell, Elizabeth C. Cousin Phillis and other tales, etc. World's Classics,
Oxford, 1911.
Payne, George A. Mrs Gaskell and Knutsford. 2nd Edition. Manchester,
1905.