Jab well done: Quaker medics’ enduring healthcare legacy

THE role played by Quakers in Bristol’s industry and commerce during the 18th century is well documented. Less so is their major influence on the health professions and whole social fabric of the city.

Often the same Quaker dynasties who made a fortune from their business investments – the Harfords, Goldneys, Champions and Frys, to name but a few – then used some of that wealth to fund improvements in local healthcare.

Meanwhile, other Society of Friends members became some of the city’s most prominently successful doctors and surgeons. They achieved it despite Quakers forming only a tiny minority of the population. The total number of Friends in Bristol in the early 1700s has been put at well under a thousand.

In a population of about 20,000 at the time, that’s less than five per cent, albeit a higher proportion than in any other English city.

By now the persecution suffered by Quakers, since their breakaway from the established Church of England in the mid 17th century, had largely stopped. However, they still faced prejudice in the jobs market and were barred from all local government, political or military roles.

However, many of these religious dissenters thrived on a career in medicine, which suited their shared ethos of helping people most in need. It could be as a practitioner healing the sick, or as a benefactor funding and organising the charities which ran Bristol’s first hospitals and “dispensaries” (early health clinics).

The well-heeled Quaker medics and healthcare philanthropists all knew each other and worshipped together at the Quakers Friars Meeting House, along with their patients. Many of them lived in the same enclave of Bristol (the St Pauls area), or in the medieval “old city”.

From the mid-1700s they formed a tight-knit distinctive community, united by a bond of religion in adversity and strong moral values. Families also shared a lively social life in houses within easy walking distance. Their dinner parties and casual visits for tea also became a forum for discussing the latest ideas on medicine and science.

At the heart of this influential Quaker network was the diarist Sarah Champion Fox (1742-1811). For half a century she kept a daily record of life, illness and death, social interaction and deep personal friendships. Her inner circle included some of the city’s most ground-breaking and high-profile doctors. One was Dr Abraham Ludlow junior (1737-1807), favourite house physician for the Quaker community and a pioneer in smallpox jabs, who then helped to introduce Edward Jenner’s vaccine in Bristol. Abraham had family and professional links with Jenner (1749-1823), a country doctor in the quiet Gloucestershire town of Berkeley, about 20 miles north. The Bristol Quaker was a cousin of Daniel Ludlow (born in 1720), a surgeon in nearby Chipping Sodbury. Here, at Daniel’s practice, Jenner served a seven-year apprenticeship from the age of 14.

Dr Abraham Ludlow was that rarity among Quakers – a flamboyant and arrogant-looking self-publicist. A colleague at the Bristol Infirmary, where he was appointed as a surgeon in 1767, wrote this memorable description of him on his ward rounds: “He had cultivated a stately and pompous walk, with a stiff, standoff manner, and his enormous wig … was in itself most imposing …

“He was distinguished from the common mass by an imposing exterior.

“He moved with a measured step and affected a meditative countenance, with a pomposity of diction and manners which could not but keep the vulgar at a respectable distance.”

However, a very different impression of Dr Ludlow is given by Sarah Champion Fox in her diary. She knew him not only as her family doctor but also as a personal friend, and portrays him in a much more favourable light, stressing his hard work and dedication to all patients.

Ludlow’s expertise in the battle to curb smallpox is revealed in a diary entry for March 20, 1768: “Went with my niece and nephew ... to the inoculating house at Barton Hill, opened by one of Sutton’s partners, Abraham Ludlow & John Ford.”

This was 30 years before Jenner’s first use of cowpox pocks to immunise people against the deadly form of the disease. Until then eighteenth century doctors relied on inoculation, otherwise known as “variolation”. It meant deliberately infecting someone with matter from smallpox pustules. It was rubbed into an incision in their arm, with the aim of inducing a mild illness in the short term and protection in future.

The Sutton referred to in Sarah’s diary was Robert Sutton, a country practitioner in Suffolk, or his son Daniel. They made inoculations far

Dr Abraham Ludlow: “a flamboyant and arrogant-looking self-publicist.” safer, quicker and less painful, by using a cleaner and sharper lancet to make a smaller incision.

A surgeon from Ipswich, John Rodbard, teamed up with two surgeons from the Bristol Infirmary, Abraham Ludlow and John Ford, to open their “inoculating house” at Barton Hill, then a rural retreat on the edge of the city. Sarah’s diary goes on to describe it as: “A very commodious house fitted for the reception of any patients, & under good regulations. After the operation we brought them home till they sickened, and then sent them back with a servant who was to be subject to the rules of the house.”

Two weeks later Sarah added a rather complacent note about the outcome: “April 4th. The children being pretty well, whom we had seen most afternoons at the inoculating house, I went to Stoke [Bishop] for the summer.”

Presumably, the children were Sarah’s niece and nephew, whom she’d taken for this new jab under the care of her trusted family doctor.

The Sutton method still failed to immunise children against smallpox, but mitigated its effects and reduced the numbers dying from it. It was a major step forward, but soon largely forgotten – because along came Jenner with his light bulb moment that changed everything.

Meanwhile, Dr Ludlow’s private practice, which he ran from home at 12 Cumberland Street, St Pauls, and from premises in neighbouring Brunswick Square, was earning him £2,500 a year (about £400,000 in today’s money).

The medical practice was so lucrative that in 1774 Ludlow gave up his post at the Infirmary. He then helped set up a new community health centre for the poor, offering them free treatment. The Bristol Dispensary on Stokes Croft, funded by charity, was the first in a gradual roll-out of dispensaries across the city. Dr Ludlow was appointed as lead physician, with a team that included at least five other Quakers among the medics and management committee.

A key development at the Bristol Dispensary was its early introduction of the cowpox vaccine against smallpox. By 1801, just three years after Jenner published his paper on vaccination in the face of a hostile medical establishment, the Dispensary began offering it free to children from poor families.

In the Dispensary’s early years, until 1786, Dr Ludlow had a close friend working there with him. His younger fellow Quaker Dr John Till Adams (1748-1786) was another class act on the Bristol medical stage.

Till Adams, son of a local shoemaker, became fully qualified as a druggist, apothecary (part GP and part chemist), surgeon and, eventually, physician (senior doctor with a university medical degree). Till Adams also stood out among physicians in that his fee varied according to what the patient could afford, even reducing to zero for the poorest.

In the Dispensary he took on the role of man-midwife, helping Dr Ludlow to make assisted childbirth safer and more widely available. His remarkable versatility was

Left, “Dispensing of medical electricity (electrotherapy). Oil painting by Edmund Bristow, 1824. (Wellcome Images) Peter Cullimore’s book also looks at the way in which many Bristol practitioners tried to use electricity as a medical treatment in the 1700s

Right, Brislington House in the 1830s. Pioneered the

humane treatment of mental illness, but with strict social class

boundaries even though he lived only a street away in central Bristol. Of course, this Fry’s assortment all knew each other well.

Like the Till Adams duo, Joseph started out as an apothecary and druggist. He was apprenticed to a highly regarded Quaker practitioner in Basingstoke, Dr Henry Portsmouth, and received extensive training in the medical properties of plants and herbs and the compounding of drugs.

His apprenticeship convinced Joseph that chocolate and cocoa were nutritious and beneficial to your health. It also introduced him to Dr Portsmouth’s eldest daughter Anna. They fell in love and married in 1755. He ran a thriving apothecary shop and practice in Small Street, before switching to chocolate production, by 1761, in larger premises at 8 Narrow Wine Street. When the business expanded later into factory mass manufacturing, J.S. Fry and Sons continued to advertise their chocolate as a product to improve your health.

Joseph Fry and other wealthy Quaker entrepreneurs in Bristol also made their presence felt behind the scenes. They took control of the charities on which healthcare for the poor – in other words, most people – depended.

For example, after the new Infirmary was founded in 1736, eight consecutive treasurers were Quakers and mostly from the same influential family, the Champions. Two more rich benefactors from the Society of Friends, Joseph Harford and Edward Ash, followed them in that crucial policy and fund-raising role, until 1808.

One uniquely intriguing Quaker called Shurmer Bath (1738-1800) had the distinction of being both a philanthropist and an amateur doctor. He was a maltster by trade, living at 93 Stokes Croft, who enriched himself by twice marrying into a Quaker family of former slave owners. The Durys had sold their sugar plantations in Barbados in 1762 and resettled in Bristol.

Shurmer’s most lasting achievement was to set up the Bristol School (or “Asylum”) for the Blind, which trained visually impaired young people in craft skills for future employment.

He was best known in his lifetime as “Dr Bath”, an unqualified medical practitioner with good intentions but no training. He saw patients in Bristol, and even had a surgery in Bath, while dispensing large quantities of medicine to the poor free of charge.

This included his ‘Shurmer Bath’s Restorative or Strengthening Pills.’ Soon after his death in 1800, though, his family began selling them as a commercial product.

Shurmer must have been turning in his grave at the Quaker burial ground in Redcliff, after his pills were advertised in the London papers as a tonic for girls and young women: “They are particularly useful in all complaints to which Females are subject, and are peculiarly adapted to the constitutions of Girls of about twelve or thirteen years of age; and for those young women who have pallid complexions, are afflicted with shortness of breath, and great reluctance to exercise.”

In late middle age Sarah Champion married a Plymouth banker, Charles Fox. His relative Edward Long Fox, son of a Quaker doctor in Falmouth, moved to Bristol and became a leading specialist in mental health.

Edward Long Fox (1761-1835) had qualified as a physician by studying medicine at Edinburgh University, before gaining a post at the Bristol Infirmary in 1786.

Dr Fox was a bold medical entrepreneur with a real flair for business and built a hugely profitable private practice. This, with canny investments in regional infrastructure projects, including canals and public utilities, left him seriously rich.

Dr Fox also ran a successful “lunatic asylum” at Cleve Hill in Downend, Bristol, for seven years. This was preparation for the main venture of his career, which made him a great reformer in treating mental illness.

In the ‘Age of Enlightenment,’ socalled “lunatics” were still often cruelly locked up, and even chained, like savage animals. Dr Fox led a new generation of reformers who favoured a kinder and more humane regime, based on his Quaker moral values and the premise that madness was curable.

He paid £4,000 for 300 acres of common land at

Brislington, a village on the road to Bath and designed every last detail of Brislington House to turn these principles into reality. When it finally opened in 1806, the cost of building and equipping it totalled an enormous £35,000. That would be over three million today.

The patients were divided into three social classes, reflecting each level of Georgian society. Men were also separated from women and patients with the worst symptoms kept apart from the milder cases.

The asylum comprised a row of seven detached houses, spaced out evenly in a symmetrical pattern. The central house was the largest and most expensive, for the upper crust only. It was divided into two sections, one for gentlemen and the other for ladies. Each had its own staircase and communal sitting room and everyone was given an individual bedroom.

Three more single-sex houses were built on each side of the central building, again separated into accommodation for patients deemed second class and, furthest along, third class. Each building also had separate courtyards, for exercise and fresh air, with an elevated grassy mound in the middle where patients could view the surrounding countryside.

The yards also incorporated 12-feet-high walls to prevent escape.

A parliamentary report in 1815 ranked Brislington House at number one in a list of private “madhouses” to emulate. Designs for the first county asylums, then subsequent ones, were modelled on Dr Fox’s establishment. Public opinion, which had once looked on madness as a spectator sport, swung decisively behind regulation and reform.

The Quakers had a lasting impact on healthcare in England’s second city, with their progressive approach to medicine and devotion to helping people access it. » Pills, Shocks & Jabs: The remarkable Dissenting Doctors of Georgian Bristol by Peter Cullimore is published by Bristol Books and is available from independent bookshops locally, or from www.bristolbooks.org

LONDON bookseller and publisher Nathaniel Butter, “dwelling at the Pide Bull neere Saint Austins Gate” is not a well-known figure, but he has some claim to being the first newspaper editor in England.

In the early 1600s he seems to have had a prosperous business. He published the first print edition of Shakespeare’s King Lear in 1608 as well as plays by other writers.

But publishing in an age when monarchs had a lot more power, and who often acted on their own whims, or those of influential courtiers, was a risky business. In 1622, Nathaniel Butter was in prison, writing letters pleading to be released because he had a wife, three children and a fourth on the way.

His crime? He published a pamphlet criticising the accession of the new Holy Roman Emperor, Ferdinand II. The offence is all in its title: A Plain Demonstration of the Unlawful Succession of Ferdinand II Because of the Incestuous Marriage of His Parents.

Butter was a Puritan, bound to be hostile to the Catholic rulers of central Europe, while King James I’s regime was hostile to Puritans.

Happily, Butter was released and resumed his career, which increasingly consisted of publishing news, often in very sensational form, from around Europe. Then as now, many looked down their noses at this kind of thing. Butter was satirised in a play by Ben Johnson, while another critic called him “Batter” because he (figuratively) vandalised church doors.

In the 1620s and 30s he made much of his living by publishing short pamphlets relating individual items of news, and in 1622, not long after being released from prison (or maybe even while he was still in there), he published a very sensational story indeed about the courage of four young men from Bristol.

In the 1600s, the north coast of Africa was a hotbed of piracy. Working from various ports and minor states which were nominally part of the Turkish Ottoman empire, pirates preyed on Christian shipping in the Mediterranean.

While they were interested in loot, their primary goal was to take captives who could then be sold into slavery.

Their activities were not confined to the Mediterranean. The Barbary pirates, also known as Corsairs, raided as far afield as Ireland, the South West coast of England and even Iceland in their pursuit of human contraband.

Between 1609 and 1616, according to one figure, England also lost 466 merchant ships to the pirates, and in some years the St James Fair had to be cancelled because of pirates in the Bristol Channel.

The exact number of Europeans enslaved by Muslim pirates based in North Africa from the Middle Ages to the early 19th century is unknown, but it may have been over a million in total.

While Europeans enslaved Africans for forced labour, the main business of the Barbary pirates was ransom. It was industrial-scale kidnapping.

Wealthy families paid up, while various Christian organisations raised money to pay for the freedom of poorer people. Others ended their days in working in places like Tripoli, Algiers, Tunis or Salé. Younger women were forced to become concubines, while many men were assigned to be galleyslaves, chained to the oars of the pirates’ ships.

Some could win their freedom by converting to Islam, but this meant they could probably never return home.

The depredations of the pirates is one of the less-remembered causes of the English Civil War. The corrupt and incompetent government of Charles I raised taxes – “ship money” – to pay for naval vessels, but the King’s navy was incapable of protecting the Bristol Channel from pirates, let alone English ships in the Mediterranean.

The problem lasted long after the war, though. So, for instance, we know of one Bristolian, Henry Knight, whose brother appealed for £130 for his ransom in the 1670s. Appeals by the church for ransom money for individuals or groups of Bristol sailors were common.

Some Bristol sailors, however, managed to escape this awful fate.

Nathaniel Butter’s 1622 pamphlet tells us that four young men of Bristol managed to get the best of 13 pirates, and took the ship to Spain where the tables were well and truly turned with the nine surviving marauders being themselves sold into slavery.

If this account is to be believed, and as far as we know there are no other records of this episode, the Bristol lads achieved this remarkable feat exactly 400 years ago – in October of 1621.

The tract relates that they were crewmen of the Jacob, a 120-ton merchantman out of Bristol, which was attacked near the Straits of Gibraltar by “Turkes or Pirats of Argier” (Algiers), where after “a long and sharpe fight … the English ship being opprest with the multitude of their enemies, was taken.”

All of the ship’s crew were taken into slavery, though four young men, John Cooke, William Ling, David Jones and Robert Tuckey were kept to help sail the Jacob into Algiers, along with 13 pirates, who were more accustomed to galleys and probably didn’t have a clue how to work a sailing ship.

Mr Butter tells us that the four youngsters pondered their awful fate, “to be chained, beaten, made slaves, and to eat the bread of affliction in the Galleys all the remainder of their unfortunate lives, to have their heads shaven, to feed on coarse diet, to have hard boards for beds, and which was worst of all, never to be partakers of the heavenly word and Sacraments.”

(We’ve changed the 17th-century spellings!)

Conferring together, Butter relates, the four resolved that rather than “suffer a slavish life” they would “try the hazard of a memorable death”.

Their chance came when a storm rose. The “Turks” relied on the Bristol boys to help them sail the ship, and so they called the pirate captain to help them take down the mainsail. As he was helping with this, they threw him overboard.

But he was a big man and clung

on to the side of the ship and was about to clamber back on board when John Cooke took the wooden pump handle and tossed it to William Ling who “gave him such a pelt on the head as made his brains forsake the possession of his head, with which his body tell into the sea.”

The 120-ton ship was not big (think of it as perhaps twice the size of the Matthew so surely the other Corsairs would have seen what had happened to their leader, or heard his cries?

Apparently not. The noise of the storm had drowned out his shouts to his comrades, and were busy elsewhere on the ship. John Cooke now ran to the Master’s cabin and grabbed a pair of cutlasses and passed one to William Ling, saying:

“Courage, my fellows and countrymen! God strengthen and assist us!”

(Or so Butter tells us. One suspects he’s using a bit of poetic licence, and that in reality the language of the men was rather more matter-of-fact and/or coarse.)

In the ensuing fight, two pirates were killed, another seriously wounded, and another jumped overboard to “go seek his captain”. The others, some of them wounded, ran below decks where the Bristol boys closed the hatches on them. An attempt by the pirates to sabotage the Jacob’s steering gear was soon stopped.

The storm had abated by the morning, and the Englishmen had now armed themselves with muskets as well. They called up two or three pirates at a time to help them sail the ship until they reached the port of “Saint Lucas” (presumably Sanlúcar de Barrameda, near Cadiz) in Spain “where they sold the nine Turks for galley-slaves, for a good sum of money, and as I think a great deal more than they are worth.”

“These brave sparks and spirits, the darlings of valour, to their long-lasting fame and their country’s never-dying honour, makes Bristol famous, Britain glorious, their reputations precious and the Turks contemptuous.”

Nathaniel Butter goes on to point out that had the four Bristol boys been gentlemen or military or naval officers, or rich young bucks with “more money than wit” their exploits would have been heralded and praised far and wide.

As it was, they were just poor sailor boys from Bristol, good Christians who were modest about their achievement and didn’t want any publicity:

“These worthy Mariners that have been so delivered do, and ever did, attribute all the means of their deliverance to the mighty hand of God, and that they are so far from taking any of these things to their own praise or glory that some have … done their best to suppress them from being printed.”

You can read the whole story (it’s not that long) at https://tinyurl.com/47ty2mm2 if you can deal with the 17th century spellings.

If you do, you can easily see a straight line from the crowd-pleasing account of Mr Butter, the noisy patriotism, the implied contempt for the idle rich, and the overstatement you’ll find in many modern tabloid newspapers and websites.

He may or may not be England’s first newspaper publisher, but he could well be the first Red-Top sub-editor.

“All these things are true upon mine own knowledge,” he says of the remarkable story of the Jacob, and we must assume that in its essentials it’s accurate.

Whether or not any of their family and friends back home called them, as Butter did, “four rich caskets of home spun valour and courage”, we don’t know.

You have to imagine that if they returned with the proceeds of the sale of some Barbary pirates into slavery, it would have been them paying for the beers, not their mates.

Nathaniel Butter at the sign of the Pied Bull near St Augustine’s Gate evidently did not prosper in the long run, though we don’t know why. A brief obituary in 1664 tells us he “died very poore”.

Protestors applaud a tanker driver at Avonmouth, September 2000. Fuel depots were picketed by protestors, many of them working in road haulage, angry at rising petrol and diesel prices

WELL, my friends, once again we have a fuel crisis – and that takes me right back to 2000!

I had been a widow then for eight years and, having decided to give up my car when my first husband died and I moved to Stockwood, from then on it was either Shank’s Pony or the bus.

When I took my grandsons out or away, they were more excited to go by coach or train than by car, so it worked well, although in hindsight it probably wasn’t one of my better ideas to take out all four together.

Then in 2000 I met my second husband Derek, although of course when I met him, I had no idea he would become my second husband!

When he asked me out, just after I met him, I was somewhat reluctant but eventually agreed and arranged to meet him by the bus stop in Stockwood Road. Well, much to my surprise, he arrived in a rather splendid black Toyota Corolla – not that I knew what it was but it was certainly rather magnificent.

Now, I would not like my readers to judge me as being rather superficial, but it was a nice change to be chauffeured about instead of catching buses everywhere, although my bus card meant travel was free.

After a month or two of going out with Derek, I introduced him to my family and that went down quite well. Then came September and the shortage of petrol.

Derek was coming to dinner and phoned to say he didn’t have much petrol.

I said “better postpone, then” but he said he was sure he could buy fuel in Stockwood. Famous last words – or was he being a mite crafty?

When he failed, he suggested he would have to stay the night! Adding, when he saw my expression, “in the spare room obviously!”

However, I simply said he could catch a bus home and get his car