Disease, medicine and the urban poor in Newcastle-upon-Tyne, c. 1750-1850

Abstract

This thesis is the first full-length quantitative and qualitative analysis of the institutional and medical responses to sickness and disease in Newcastle-upon-Tyne, between 1750 and 1850 – the period conventionally ascribed to England’s first ‘industrial revolution’. Using a wide range of largely unexplored archival material it assesses the healthcare options available to the poor population of Newcastle. It proceeds to uncover the poor’s individual experiences, how sickness and disease impacted on their lives and the ways in which healthcare options and strategies developed across the century between 1750 and 1850. The thesis begins with a comprehensive examination of Newcastle’s demographic history. This involves an evaluation of the city’s published Bills of Mortality. Using this largely neglected demographic source, chapter one reveals new and crucial information about the changing size of the population in all of the city’s parishes and describes how the city grew between 1736 and 1850. Newcastle did not share in the rapid population expansion experienced by the country as a whole in the second half of the eighteenth-century. After reconstructing Newcastle’s demographic record, a second chapter analyses the living conditions in the city in order to contextualise its population history. This chapter provides evidence to show that Newcastle had many of the epidemiological characteristics of the pre-industrial city which enabled it to act as a reservoir of diseases and infections. The second section of the thesis examines the institutional responses to sickness and disease in the city. This section of the thesis is divided into two chapters: the first looks at the role of the Newcastle Infirmary founded in 1751 for the poor of Newcastle, Durham and Northumberland and the second analyses the Newcastle Dispensary founded in 1778. Both of these institutions played important but different roles in the city’s medical landscape – collectively admitting over half a million patients during the century under study. An examination of the characteristics of these individuals reveals that both institutions provided healthcare to different elements of the population. The analysis also provides key information on the types of diseases and ailments which were commonly experienced by the working poor in the city. Both studies reveal an intertwining relationship between the role of the Infirmary and the Dispensary. While both provided care to the ‘deserving’ poor, the former ii treated mainly accidents and surgical cases and the latter catered specifically for chronic, infectious and sometimes lethal maladies. After having analysed those who turned to the city’s voluntary hospitals, the last section examines the experience of the pauper population, focusing on the healthcare delivered to the sick poor under the Old Poor Law. Attention here is paid to both outdoor medical relief and also to that provided in parish workhouses. This chapter shows that medical services were an important part of the ‘relief culture’ in the city and that the workhouse system in Newcastle played an integral part in what has been described as the pauper ‘economy of makeshift and mend’. High levels of sickness and disease amongst the city’s inhabitants meant that overseers of the poor were constantly dealing with relief applications which were sickness related. The chapter provides abundant evidence that even with the growth of alternative healthcare institutions in the city, Poor Law medical services developed rather than declined in the period. It is concluded that Poor Law medicine played a very significant part in the lives of Newcastle’s poor.