[Research by Lisa Ellis, who portrays Miss Bates]
Medical care in early 19th century England followed strict distinctions of class that mirrored society in general. The practice of medicine was still hit and miss, with too many people dying from the treatment by doctors and apothecaries that was designed to save them. Bleeding through the use of leeches and cutting veins was a common treatment. Healers did not bother to practice hygiene. They seldom washed their hands and rarely ordered bandages to be changed.
Regency doctors and physicians were positioned on the highest rungs of the medical social ladder. These men, often the second or third sons of gentlemen, made their living in one of the few professions that a man of their social standing were allowed to pursue. They attended prestigious schools like Oxford or Cambridge and studied Greek or Latin. Their training, which did not include an apprenticeship or practice with actual patients, consisted of observing medical procedures in a lecture hall. As gentlemen, they would not soil their hands with manual labor, like dissect a corpse for instruction. Doctors would dine with the family, but they would not directly accept a fee for their services (in other words, they didn’t present their patient with a bill). They preferred to be paid in a more discreet manner.
Midwives in the Regency Era
Female midwives enjoyed a secure position before the 18th century, obtaining licenses from the bishop and making a respectable living. By the end of the 18th century, men had infiltrated the profession. Male midwives tended to use instruments during birth; female midwives did not. If they delivered a healthy baby, they would receive additional fee from the godparents. Although male midwives were associated with scientific progress, cases of child bed fever rose with the increased use of forceps during delivery. By the early nineteenth century,midwives were relegated to assisting only the births of lower class women, and their social rank had fallen to reflect their customers’.
The woman of the house was in charge of taking care of common complaints, such as a cold, headache, stomach ache, or rash. They handed down recipes for herbal remedies and folk medicine to their daughters, whose education included knowing which herbs and plants to grow in the kitchen garden or collect from nature. Eighteenth and nineteenth century cookbooks offered recipes for lozenges, tinctures, and poultices. Cures included hot wines, syrups, soups, and herbal tea infusions.
Given the prevalence of illnesses of all kinds, the predominant concern was to avoid being ill in the first place. In medical historian Roy Porter’s apt phrase, ‘People took care before they took physic.’ The proverb ‘Prevention is better than cure’ dates back at least to the seventeenth century and there was a growing tradition of preventive medicine to avoid what might be called dis-ease, including attention to diet, exercise and a healthy environment.