[WED]Dr. Westover's Diary

[Nancy Baer]

Mary,

Thank you for putting this article out there for all of us.  Is The
Practitioner a magazine?  Wonder if I could still find a copy of it at one
of the larger libraries around.......probably on microfiche by now.  Any
suggestions?

Nancy
Southern MD
----- Original Message -----
From: "Mary Jackes" <mjackes@telusplanet.net>
To: <wedmore@lists.tutton.org>
Sent: Wednesday, May 01, 2002 12:49 AM
Subject: Re: [WED]Dr. Westover's Diary


> 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
> 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.
>
> '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'
> 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 £12. 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, £20. 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
> 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.
>
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