I’ve recently become rather obsessed with the medical app ‘figure 1‘ which provides a fascinating glimpse into medical cases around the world. It’s not for the faint of heart. Nor is this post.
While searching for evidence of midwives in the parish records held by the Flintshire Records Office I came across a graphic, detailed and tragic account which serves as an excellent example of the treatment of the sick and dying in eighteenth-century Britain.
In 1749 a gravely ill man was found lying in the road in the parish of Hawarden, Flintshire. His condition was described by parish officials as ‘helpless and starving’, and he had clearly been in this state for some time as his limbs were ‘mortified’. A retrospective diagnosis based on this small but striking detail is impossible, but he was likely suffering from gangrene caused by an illness such as peripheral artery disease or an infection which had turned septic. This excruciating condition would have completely incapacitated him, and rendered him unconscious if not feverishly delirious. On top of this, he was also penniless. It would have been clear that he was not long for this world.
In eighteenth-century Britain the responsibility of care for the poor fell on parishes. Individuals were only eligible for support from the parish in which they were born, or in which they had been granted legal settlement through marriage or long-term residence and employment. Parish officials collected poor rates from better off residents, and distributed support to the deserving poor either in the form of cash, tangible goods such as clothing, shoes or basic food stuffs, or by paying other parishioners to house and nurse the sick and poor during their time of need.
So what happened if a person fell ill somewhere other than their parish of legal settlement? They would either be ‘removed’ to their home parish, or they were cared then and there, and their parish of legal settlement would be sent a bill. In this case, however, officials we not able to identify this ‘poor traveller’, where he came from, or where he was going. So what happened to him?
Parishes not only had a legal duty to care for the sick and poor, they also had a moral one. Church authorities would have been familiar with moralising biblical stories such as the parable of the rich man and Lazarus found in the Gospel of Luke. In the story a rich man refuses to give scraps from his table to the poor, sick Lazarus who lay at his gate. When both men eventually die Lazarus goes to heaven, but for his greed the rich man is damned. It’s not difficult to see the parallels between the poor, starving, gravely ill man found on the highroad in Hawarden and poor Lazarus.
We’ll never know if such stories played on the minds of parish officials in Hawarden, but we do know this poor, sick, unnamed traveller was provided for at the parish’s expense. A widow named Martha Lewis was paid 11 shillings to take, ‘him in that wretched and deplorable condition’ and care for him until ‘the time of his death‘, however long that was. 11 shillings was more than double the average payment made to Mrs Margaret Johnson, the local midwife when she delivered the babies of paupers and tended to mothers as they recovered.
The poor man seems to have died a horrible, festering death as the next rather detailed entry of expenditure was for the removal of his corpse, ‘which was become very loathsome and nauseous.’ One can only imagine the putrid smell, which if his limbs were gangrenous would have been lingering around him from the moment he was discovered on the road. Martha Lewis must have had an iron constitution! So bad was his state that his coffin had to be carried away to the churchyard on a hired cart because the neighbours refused to carry him on a bier, or stand.
And that was then end of the story for this poor, desperately unwell, unknown man. Infections, wounds and the visible signs of disease were not rare in the eighteenth century, but the amount of vivid detail the official who recorded these entries went into suggests this incident was particularly graphic, even by the standards of the day.