The physic of charity: Health and welfare in the West Country, 1690-1834

Mary Elizabeth Fissell, University of Pennsylvania


This thesis examines health care for the poor in eighteenth-century England in a local study of Bristol and the South West. During the eighteenth century, two institutional initiatives altered traditional patterns of health care provision. First, the poor law, England's local welfare system, began to hire surgeons on contract and to pay for domiciliary care. In Bristol such care was centralized in the city workhouse, while in the rural parishes it remained more closely linked with other poor relief. Second, voluntary infirmaries were founded in many provincial cities, including Bristol. Such institutions, however, were shaped by local political and sectarian struggles to control charity as much as they were by medical agendas. It was only as the infirmary began to offer instruction in surgery that its character as a medical workplace became pronounced. The advent of such institutional options for health care influenced both the medical professions and popular health. As the hospital became central to medical education, traditional apprenticeship training waned and fewer and fewer barber-surgeons practiced in the city. At the same time, hospital medicine increasingly denied the validity of popular knowledge about the body, emphasizing localistic approaches to disease rather than sympathetic and humoralistic ones characteristic of lay practices.

Subject Area

Science history|European history

Recommended Citation

Fissell, Mary Elizabeth, "The physic of charity: Health and welfare in the West Country, 1690-1834" (1988). Dissertations available from ProQuest. AAI8816168.