[WED]Dr. Westover's Diary

[Mary Jackes]

This seemed interesting enough to reproduce in full.  Hope I got rid of all
the scanning errors - it did not scan well.

A 17TH CENTURY COUNTRY DOCTOR
JOHN WESTOVER OF WEDMORE

BY FRANCES NEALE

The Practitioner vol 203 November 1969 pages 699-704

THE Isle of Wedmore (fig. 1) is a distinctive hump of land rising out of
the low-lying and -- until 19th century drainage-- waterlogged levels of
central Somerset, flanked by the rivers Axe and Brue. Throughout its long
history it has pursued a remote and somewhat isolated existence: a valuable
area of workable land, much sought after among the flooded moors,
surrounding the self-sufficient little village community of Wedmore itself

	YEOMANRY OF WEDMORE
When, in the course of the 16th century 'troubles' of Reformation and
Dissolution, the great ecclesiastical landlords who had dominated and
squabbled over this precious area of dry farmland during the middle ages
disappeared, their lands were promptly bought up by their former tenants,
the small yeomanry of Wedmore. One such family was that of the Westovers,
known to have been already living in Wedmore in 1509, and by the 1540's
firmly established as local gentlemen-farmers, small-scale landowners,
sometimes following another trade and farming 'on the side', always pillars
of the village and the church.
  Between the 16th and the 18th century a succession of seven John
Westovers--fathers, sons and nephews--succeeded each other in Wedmore. A
John Westover acquired his local estates from lands sold up by the Dean of
Wells and the dissolved Glastonbury Abbey. Another John Westover makes a
brief appearance as one of the 'muster of shott' (i.e. a gunner--then
something of a novelty) who joined the county militia in 1586: the
Elizabethan equivalent of the Territorial Army.

	ACROSTIC EPITAPH
In the 17th century, this hitherto solid but undistinguished village family
produced in succession two doctors: John Westover father and son. Very
little is known of John Westover senior, 'chyrurgeon', and nothing of the
circumstances in which he became a doctor and presumably influenced his
more distinguished son to follow the same career. He was born in 1616; and
it was probably he who rebuilt the Westover home and farm, replacing an
older house with the present mid-17th century Porch House. Except for this
distinguishing feature from which it takes its name, however, the rest of
the house has been extensively altered in the 18th and 19th centuries.
  John Westover senior died in 1678, and is buried in the perish church of
St. Mary, Wedmore, with his wife Joan who died in 1692. Their gravestone
carries a delightful acrostic epitaph, unhappily obscured by the font
subsequently placed partly over it; but including a deflationary warning to
'Repent, for doctors dye'.

	REMARKABLE ACCOUNT BOOK
His son, John Westover junior, was born in 1643. He lived at Porch House,
ran the Westover farm and estate--and also built up a flourishing practice
and widespread reputation as a doctor who dealt not only with the usual run
of village accidents and ailments, but who pioneered the treatment of the
mentally sick in a way that seems much in advance of his time. This 17fh
century doctor, in an obscure corner of Somerset, has survived because his
'Journal' has survived: a remarkable account book kept from 1685 to 1700,
which ever since has been in the possession of the local family who later
acquired the Westover estate.
  Dr. John Westover's 'Journal' illustrates the great value of accounts to
the historian. In his anxiety to account for every penny, he records
detailed explanations of his income and expenditure which amount in places
almost to case-histories of his patients, and a diary of his days.
Intermixed with his medical accounts are pages devoted to the management of
his farm and estate, providing sidelights on crops and livestock, wages and
prices. The 'Journal' is in fact a paper ledger-book. The doctor's writing,
while still remarkably clear, degenerates especially towards the end of the
book into a scrawl suggesting the haste of many latter-day doctors. His
spelling is decidedly his own, occasionally achieving a degree of broad
'Zummerzet' remarkable even for the phonetically minded 17th century.

	FEATHER MATTRESS FEE=20
His journal records in 17th century terms many of the ills with which a
general practitioner would deal today: agues, distempers, farm accidents,
'distractions', fractures, toothache, fever, itches (for which a 'girdell',
presumably some form of medicated plaster or bandage, was almost always
prescribed) and pains. His remedies included cordials, juleps, bleedings,
plasters and pills.
 =20
'January 14th, 1687: Marey Counsell of Blackford had a potons for her
dystemper & A bottell to be taken 3 spoonfulls every evening & cost 4s.=
 6d.'.

  Some of his treatments seem orthodox enough; others less acceptable now
than they doubtless were then. But his concern for his patients is
particularly noticeable: his visiting round was frequent and far-reaching.
He visited a local villager six times in approximately ten days (daily at
first) to dress a scalded foot; total cost, 10s. Other, more expensive,
visits were made -- presumably on horseback -- to patients in Axbridge and
Langford (about four and ten miles away, respectively) and even to Bristol,
over twenty miles off. One such, Mrs. Kelson, moved away from Wedmore
(where there is still a Kelson's Farm) to Bristol in 1688, but Dr. Westover
continued to treat her 'for Melancholy'.
  Dr. Westover's fees seem to have varied according to the means of the
patient, and some of his wealthier patients would seem to have faced fairly
heavy bills. Recent actuarial researches have suggested that in 1685-1700,
1s. had a purchasing power equivalent to approximately 10s. in 1968 (note
added by Mary - I remember that 10s. was worth US$1.20 in 1967). An average
cost for a medicine, such as 'a julep for a surfit' (indigestion mixture)
was about 1s. 6d. William Counsell paid 5s. in 1697 for 'a licker to drive
out ye small pox'; and 'Blooding Captain Boulting' also cost 5s. He charged
5s. again when he 'redused a dislocation of the Shoulder of the Widow Simes
of Wedmore', although someone else -- her employer, or the cause of her
accident? -- promised to pay. In 1690 it cost 'Cosen Barrow'  2s. 6d. 'for
the cure of his sune being bitt with a mad dog'. He allowed some patients
to pay by instalments, and, very occasionally, a debt is noted as being
'abated' altogether. On other occasions Dr. Westover received payment in
kind: in grain, meat, and once, as a return for attending to a double
fracture of a 'foot joint', a 50-pound feather mattress.

	'THE MAD HOUSE'=20
The accounts relating to his case of the mentally sick are mingled with
these day-to-dayrecords of his village practice and farming activities.
This aspect of his work has left, however, a more permanent memorial in
Wedmore: the beautifully proportioned 1th century stone building in the
grounds of porch House, which is known as Westover's Barn, and which after
many years as an increasingly dilapidated farm-building has recently been
most symapathetically converted into a private house (fig. 2). This 'Barn'
was built in 1680, shortly before his Journal opens, as the annexe in which
John Westover housed his mental patients. Originally it had three doors,
and an external staircase; and long after the Westovers had disappeared
from Wedmore, it was known locally as 'The Mad House'.
  Here his mentally sick 'inpatients' lived, together with the occasional
serious injury or patient for tooth extraction, close by his own home.
There is very little information about any treatment he attempted but it is
possible to distinguish in the accounts, between the incurables, who were
usually charged only for 'table' (i.e. board and lodging) and those whose
bills were for 'cure and table'; certainly many seem to have left the Barn
as cured.
  The accounts (fig. 3) indicate his humane treatment of these patients,
curable and incurable alike. The charge for a year's board was usually
about =A312. Shirts, caps and shoes are purchased from time to time.'Extras'
were often obtained for some patients: playing cards, hairpowder and
tobacco feature among their bills. One lady ran up an account that
included, besides her hoard for a year, 3/4 pound of tobacco, 4 quarts of
brandy, and 14 bottles of claret: total, =A320. From these entries, this
Wedmore hospital seems a far remove from  Hogarth's horrific Bedlam
engravings. Small wonder that Dr. Westover's patients are recorded in his
account book as coming from places as far apart as Bristol and Tiverton,
Gloucester and Exeter.

	A LONE PIONEER?
John Westover had filled his account book by 1700/1701; and its
predecessors or successors, if any, have not survived. Dr. Westover himself
died on February 11, 1706, and was buried with his parents in the parish
church. Thereafter the family seem to have become solely farmers, and the
last John Westover died in 1766.
  The sudden appearance of this 17th century doctor in a remote Somerset
village poses many questions. Was he unusual?  Or is it merely the chance
survival of his 'Journal' that makes him appear so?  Had he contemporary
country doctors of whom we know nothing?  Bristol, the nearest major city,
had a strong tradition of 'hospitals' extending back to the monastic
establisbments of the middle ages; care of the sick was specifically
included in the functions and facilities of the coordinated 'Incorporation
of the Poor' set up by the City in 1696 -- in John Westover's time. T'he
opening of the Bristol Infirmary, after long preliminaries, followed in
1737. How far afield did Bristol thinking spread?
  Yet even so, nothing similar to Westover's enlightened treatment of the
mentally sick is recorded in or around Bristol at such an early date. In
the absence of surviving records, we do not at the moment know whether he
was a lone pioneer with ideas on the treatment of mental illness; or one
reflection of a more widespread interest in the subject among local medical
men; or simply a physician with a stronger social conscience than many of
his contemporaries about the subhuman conditions in which the insane were
normally kept.

	EARLY CONCERN WITH COMMUNITY HEALTH=20
It might, however, be worth noting that, as a village, Wedmore seems to
have had an early and well-developed concern for the health of the
community. Among the parish records of the 18th century there is copious
evidence that the parish regularly employed a 'parish doctor' to attend to
the poor and needy sick of the village free of charge, his bills being met
out of the poor rates. During the later 18th century the parish doctor sent
in his hills to the Overseer of the Poor with a regularity which makes them
a mine of contemporary medical information very similar to the 'Journal' of
a hundred years earlier.
  Similar medical bills are to be found in many parish records, although
not usually as early in date as those of Wedmore. It might be tempting to
wonder whether this was a result of the influence and activities of the two
Westovers? The Wedmore parish accounts have been the subject of a
non-medical study which will, it is hoped, be published by the Extra-Mural
Department of the University of Bristol in the not too distant future. Dr.
John Westover's 'Journal' was described by Dr. N. G. Horner in a brief
article in the 'Proceedings of the third International Congress of the
History of Medicine' (1922).
  It would seem that there might be worth-while opportunities for a wider
investigation by a qualified person into this subject of early rural
medical practice, among the private and parish records of villages far
beyond this one rather isolated mid-Somerset community.
  The kind permission of Mr. J. C. Hawkins, of Wedmore, to study the
'Journal' is gratefully acknowledged.

------------------------

The following figures are not very clearly reproduced on my xerox copy of
the article:-
Fig. 1. Map of North Somerset, showing the Isle of Wedmore.
Fig. 2. Porch House and Westover's Barn, Wedmore
Fig. 3. Page 67 and the facing page of the 'Journal'. The chief interest of
this is the lefthand page, which contains a series of accounts paid in
instalments by Nathaniel Jeanes for the 'Tabling', i.e. boarding in the
Barn, of his sister Elizabeth Jeanes: one of Westover's mental patients.
Besides her board, purchases made for her include 3s. 6d. for shoes and
stockings, 3s. 6d, for 'a payer of Bodises' (corsets), and 'a lace for her
Bodises, 1/2d.', and 'Item for A Apron, 1s. 3d.', amongst others.

Mary Jackes
Edmonton, Alberta, T6G 0N8, Canada.