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Early life, and an 1850's medical career




Wexford, Ireland
City of Wexford, on the south-east coast of Ireland, as it is today
By Ingo Mehling (Own work) [CC-BY-SA-3.0 or GFDL], via Wikimedia Commons

William Henry Hadden was born in Wexford, in south-east Ireland, in 1827.

He was the fifth son and eighth child (of eleven) born to John and Eleanor [Evans] Hadden. His father, John Hadden, born in 1778, was a Methodist minister who died from pneumonia in 1842, just before the potato famine began to decimate Ireland's population, and although County Wexford was spared from the worst depredations of the "Great Hunger", the subsequent success of his family can not have come about without substantial difficulties. Not much is known about William Henry Hadden's early upbringing, beyond what is known or can be assumed from this bald statement of his family's circumstances, and what the record says about the hardships of life, and indeed, for many the daily struggle for survival, in Ireland at that time.

Although he became more widely known in Walhalla as Doctor Henry Hadden, within his family he always was -- and still is -- referred to as William. However, it's the honorific "Doctor" that is perhaps potentially a little more problematic to a 21st century reader, because his only training appears to have been as an apothecary, which on the face of it is an archaic term for what we would recognise today as a chemist, or pharmacist, or what Americans would characterize a little more pointedly as a "druggist". But in the mid-nineteenth century, it was at the same time considerably less and yet vastly more than that.

  • Considerably less than today's chemist in the extent of their knowledge, but for all that, not markedly better or worse than the rest of the medical brotherhood of the day (yes, exclusively male then, Virginia). Even the best doctors at that time relied on knowledge that was so limited -- by modern standards -- that they would probably not be able to save you from the progress into severe deterioration of what today might be considered quite trivial and easily-remedied illnesses. Medicine was a very long way yet from the precise science that most people consider it to be today -- for example, in the absence of any greater wisdom, blood-letting was still widely practised as a primary form of "treatment" for a host of conditions whose causes were poorly or not at all understood. "Before the experiments of the mid-1860s by Pasteur and Lister, hardly anyone took germ theory seriously; even afterwards, many medical practitioners were unconvinced."01

  • Vastly more than today's chemist, because in a hierarchy of practitioners that included apothecaries, physicians and surgeons, if someone was sick enough to have exhausted all their folk-medicine nostrums and "granny" remedies without success, an apothecary would probably have been the first person of that era whose professional qualifications we (today) might acknowledge, to have been consulted, as indeed chemists still are today in some quarters.

So the apothecary, then, was rather more like the poor man's doctor. How had the humble chemist achieved this stature?

15th century French apothecary

15th century French apothecary

The answer is steeped in a respectable antiquity of its own -- in England, after all, the original "Royal" charter of the College of Physicians granted by Henry VIII in 1518 had, as a matter of course, included apothecaries as well as physicians. For as improbable as it might seem from a 21st century viewpoint, "prior to the foundation of the [Worshipful] Society [of Apothecaries of London] in 1617, London apothecaries were members of the Grocers' Company (founded 1345) and before this they were members of the Guild of Pepperers (founded before 1180). The apothecaries separated from the Grocers in 1617, when they were granted a Royal Charter by James I. During the rest of the 17th century its members ... challenged the monopoly of members of the College of Physicians to practice medicine." A 1704 ruling by the House of Lords "... effectively gave apothecaries the right to practice medicine, meaning that apothecaries may be seen as the forerunners of present-day General Practitioners"02.

In Ireland, the equivalent precursor organization had been the Guild of St. Luke, which was established by Royal Charter in 1754. "The guild was mainly under the control of the King and Queen's College of Physicians in Ireland, although they could create by-laws and exercise some control over the regulation of the profession. The Apothecaries Act of 1791 established the Apothecaries' Hall of Ireland." Under the provisions of this Act, "no apothecary could take an apprentice who had not been examined by the Hall, and apprentices were required to serve for seven years."03

Reflecting moves to regulate the medical profession that were taking place in Victoria at approximately the same time, "under the Medical Act (1858) the qualification of Licentiate of Apothecaries' Hall was included as one of the recognised qualifications needed to practice medicine in the British Isles, as well as open a Medical Hall or Apothecary Shop ... This remained the case until 1971, when the recognition was removed."04 And in its time, it was no lightweight qualification, either -- according to a letter to the British Medical Journal in 1869, examinations of the Apothecaries Hall Dublin consisted of three days of written papers at the end of the second year of professional study, and a further three days at the end of the fourth year, including individual verbal ("viva voce") examination before a panel of examiners.05

According to the Australian Medical Pioneers Index, in the early Colonial period there were some 70 LAH (Licentiate of the Apothecaries' Hall [Dublin and London]) and roughly 600 LSA (Licentiate of the Society of Apothecaries [London]) members practising in Victoria.06 Dr John O'Connell, for example, who was one of only three approved doctors who were registered to practise medicine in Walhalla in 1868, listed his only qualification as a "Lic. Apoth. Hall [Dubl] 1852".

So there was nothing at all unusual about William Henry Hadden's decision to undertake training as an apothecary. If anything, having family in the trade already would at least have made his vocational direction a little clearer for him -- his brother David at Skibbereen had previously qualified, following his own apprenticeship in turn to another brother, John, and this was the avenue that Henry Hadden sought to pursue into the profession. We know nothing about any earlier education he might have had, and it is not clear what sort of financial arrangement, if any, was concluded to address the cost of his apprenticeship.

The medical "profession", such as it was then, was in fact a disorganized jumble of people of widely varying levels of skill, even among those with legitimate qualifications. A student paper from the University of Michigan partly explains the "wild-west" nature of 19th century medical practice as follows: "Part of the problem with educating and licensing doctors was in the conflicting struggle for rights and power between licensing bodies; there were nineteen of them in the United Kingdom alone. ... While some practitioners held university degrees from the most respected medical colleges of the world, some were apprenticed to apothecaries ... Still others were quacks and drug peddlers who practiced freely with no legal sanctions against them."07

An even more fundamental distinction, however, was the one between the three major branches of medical practice -- practitioners trained in England were nominally regulated by either the Royal College of Physicians, the Royal College of Surgeons [and/]or the Society of Apothecaries, but in reality, "there was very little regulation. Early Victorian[-era] doctors often claimed that they were making great strides in clinical research and medical education, but ... there were few legal regulations over medical practice, and a wide variety of competing healers offered their services in a chaotic medical marketplace. And Victorian[-era] patients were less impressed with the progress of medicine than doctors themselves."08

  Formed with the joint objectives of ensuring professional standards, exerting a cohesive political lobby and bolstering the status of their members in the eyes of the community at large, these organizations "detailed the differing duties, legal privileges, and social ranks within the medical community:  

 
  • Physicians were university-educated and considered the most knowledgeable about medicine. They were not permitted to act as surgeons or dispense drugs as apothecaries before 1858. They were only permitted to examine patients, diagnose disease, and prescribe medications.

  • Surgeons performed operations, set broken bones, and treated accident cases and skin disorders. The nature of a surgeon's work separated him from a physician in that a surgeon had to cut, manipulate, and treat disorders on the outside of the body ... The most significant difference between surgeons and physicians was in their education. Surgeons were apprenticed just as other traditional craftsmen, while physicians were university educated. ... It was easier to become a surgeon than a physician because one only had to have enough money to be apprenticed but, in order to make a living, a surgeon often had to dispense drugs in a dual role as licensed apothecary. Unlike physicians, surgeons were permitted to be licensed as both surgeon and apothecary.

  • Apothecaries were not only druggists responsible for the sale, compounding, and supply of drugs but, thanks to the Apothecaries Act of 1815, were able to provide medical advice and prescribe medication themselves. Apothecaries, like surgeons, were apprenticed as skilled tradesman for a minimum of five years, with an age requirement of twenty-one years. The Society of Apothecaries was an important qualification to obtain so that a surgeon could also practice as an apothecary. More that 6000 apothecary licenses were issued between 1815 and 1834, half of these to surgeons.
 
  During the first fifty years of the nineteenth century apothecaries and surgeons were taking apprentices for as much as 500 guineas, and the apprentices were typically sons of other apothecaries or surgeons, clergymen, lawyers, and some schoolmasters. They were the sons of men with enough money to educate their children ... A few businessmen, tradesmen, and some farmers could manage to apprentice their sons, but they often lacked any primary education prior to their apprenticeship. More alarming was the lack of a proper education of the medical students in the universities."09  

In a paper on the introduction of surgical anaesthesia, Alison Winter wrote that "Medical students were caricatured in the press as drunken buffoons, and it was commonly said that doctors' ignorance and irresponsibility made them as likely to kill as they were to cure their patients."10 As a frame of reference among the general public, this assessment of their reputation is supported in a back-handed way by a comment that Henry Hadden was later to write to his mother regarding his fellow shipboard passengers: "There seems to be very little religion at all amongst the whole lot … for my part I never saw or heard such an immoral collection of people. Medical students are regular saints in comparison with them."11

If this was mainstream medicine, then it should cause little wonder that complaints about medical "quackery" were commonplace, but "... these complaints came from so many different sources as to suggest that the problem was ubiquitous -- there was no single type of practitioner one could seek out who was sure to be trustworthy. There were 'quacks' with formal medical training and without it, in the metropolis and in the provinces, on the faculty of the universities, and engaged in private practice. Conventional doctors were accused of quackery, as well as people we might now identify as fringe or alternative therapists, such as homeopaths, herbalists, hydrotherapists, mesmerists, and hypnotists. But calling them fringe therapists would be anachronistic, because the situation was so chaotic in early Victorian England that they were not really marginal at all -- they were just part of the fray."12

And this was equally true in gold-era Victoria, where the relatively recently-established Medical Board "had no functions other than to register the qualifications of those who presented their diplomas or certificates, and from time to time to publish a list of them in the Government Gazette. As the Act was not stringent in its provisions, a great many persons were registered whose only claim to recognition was the fact of their having practised in the Colony for a certain period. In a Gazette list, date of January 1856, there were 416 names of recognised practitioners, many of whom had furnished no evidence whatever that they had either been educated or examined, and even of those who possessed British or other European qualifications the nature of them was not specified, the only indication being the particular mention of those possessing the degree of M.D."13

 

[In point of fact, including names that were listed in the Government Gazette of January, 1856, and in supplemental lists gazetted in June and September of the same year, 447 practitioners were listed as qualifying as "Medical Witnesses at Coroners' Inquests, and Enquiries held before Justices of the Peace", but only 105 of those names included the honorific "M.D.", and a further four were "M.B." (including William McRae, President of the Medical Board)]

 

In the matter of prescribing and dispensing medication, "there was little difference between the doctor and the chemist in the treatment given or in the outcome. Both were largely ineffective in their attempts to combat the often fatal dysentery, typhoid and tuberculosis prevalent in the Colony. This was a situation that would remain until the germ-based theory of disease was understood and became the basis for treatment."14 On the goldfields, however, the trained apothecary was, if anything, an even more vital dispenser of medical care. "Linked to the doctor in a sometimes competitive relationship, he was the ‘poor man’s doctor’ who most people consulted, as his advice was free of charge ..." [His pharmaceuticals, of course, were not free.] "... The early pharmacists were generally from the lower middle class, frequently of Quaker background, and although some had special training, they were regarded more as tradespeople or shopkeepers, than as professionals. ... They were always subordinate to the medical profession, who were keen to have complete control of all prescribing and most dispensing."15

The path that any medical man took into the profession was thus one that more probably than not was dictated by simple economics: "Only those with the financial support of a wealthy family could afford the years of university study or attendance at a private anatomy school or teaching hospital that would provide an MD or admit them to the College of Physicians. For the great majority, until about 1850, apprenticeship to an apothecary or surgeon was the more usual way in which to undertake training as a doctor in Britain. The apprenticeship was arranged as a contract with a doctor willing to take on the responsibility of training a young man, who would learn by observing and assisting the doctor in his work, for a sum of between £40 to £60 paid by the apprentice’s family. The contract was a legal document that protected both parties from exploitation, and bound master and apprentice together for a set period with mutual obligations and conditions formally set down and witnessed."16

For those of more limited means, such as the Hadden family might have found themselves to be after the death of the Rev. John Hadden, "The informal route to becoming a doctor was the apprentice system. A young medical aspirant would be apprenticed to an established physician, called his preceptor. For a period of generally two to three years, the student, usually living in the doctor's home, would assist the doctor in every aspect of his practice. He would 'read medicine' with the doctor, go on all sick calls ('ride with the doctor') and perform all tasks assigned to him in connection with the case at hand. The apprentice ... was learning by observing and then, quickly, by doing. Between rounds of medical observation, ... the apprentice served as a sort of indentured servant, all for the sake of being able to emerge from his apprenticeship a full fledged physician. At the completion of his apprenticeship period, the student would be issued a certificate proclaiming him to be a physician. His career would thus be launched." This system was thought to provide advantages to both: "The student gained access to a respected and sometimes lucrative profession that carried with it social prestige. The preceptor, for his part, encouraged the apprenticeship ... the apprentice provided free labor, and served as a signal to the community that the physician was a source of knowledge and skill, capable of transmitting both to his students. Thus, the apprentice was a source of prestige to the preceptor."17

When I set out to validate Henry Hadden's precise medical credentials -- if any -- it proved too daunting a task for me, although on balance, it seems plausible that he would probably have been entitled to have called himself a "Lic. Apoth. Hall [Dubl]", as did Dr John O'Connell at Walhalla, years later. To begin with, I was oblivious to such nuances within the profession as those described above, and I had -- naively -- initially imagined that registration of all doctors has always been a concern of their professional bodies, so it was somewhat disconcerting to find that the Australian Medical Association (for example) only dates back to 1962; and its British equivalent, to 1952, and that that latter body (according to its website) “does not hold the register of doctors” in any case; and that even if it did, “membership records have not been kept”. I looked next to the Royal College of Physicians, and their website directed me to their equivalent body in Ireland, which I was somewhat surprised to learn has itself been under “Royal” charter since 1667.

A very helpful archivist there explained that “registration of medical qualifications was only introduced in the United Kingdom in 1858 with the Medical Act of that year, and earlier graduates still practising in the UK were required to register ... Before the Medical Act of 1858 there were a number of ways to gain a medical qualification, including studying at one of Dublin’s numerous medical schools, gaining a medical degree from a university or taking the licentiate examination of this College, which only a small proportion of Irish doctors took. Since many Irish doctors took their medical degrees outside of Ireland, it would be quite difficult to establish when and where he [ie, Henry Hadden] registered.”18

By a remarkably fortunate coincidence, however, when I mentioned in acknowledgement that I thought he had trained as an apothecary, she wrote back in a subsequent email that "It is interesting that you mention the possibility of Dr Hadden training as an apothecary, as I have just received the records of the Apothecaries Hall of Ireland. I have checked their registers and found a William Henry Hadden from Skibbereen, county Cork, who at the age of 15 in 1843 applied for his apprenticeship certificate from the Apothecaries Hall. He was unsuccessful and reapplied the next year, when it was granted"18 -- although to date I have not received any confirmation of his ever having been awarded a certificate for actually completing that apprenticeship.19

At that time, such an apprenticeship would certainly have been a trial by fire, however, because Skibbereen -- and most of County Cork generally -- lost approximately one third of its population in the 1840's due to the famine and resulting disease and emigration. According to the Skibbereen Heritage Centre, the famine is "now recognised as the worst humanitarian disaster of 19th century Europe", and one that was felt nowhere more acutely than it was in Skibbereen, which was one of the worst afflicted areas in the whole of Ireland -- in 1846 and 1847 (in the midst of Henry Hadden's apprenticeship years), between 8,000 and 10,000 unidentified bodies were buried at just one site, now known as the Abbeystrewry Famine Graveyard at Skibbereen. Because of a shortage of coffins, "coffins with hinged bottoms were used to carry the corpses to the graves, from which they were dropped into the earth, and the coffins were then ready to bear the next body, which could be repeated indefinitely".20 During those two horror years, more people died in Ireland than did servicemen from all British Empire countries in either of the two World Wars. Across the country, "By 1850, at least one million people had died in terrible conditions while another million emigrated as refugees. It is estimated that a further half a million births did not take place as a direct result of 'The Great Hunger'."21

The famine would surely have provided an additional stimulus for Henry Hadden to consider seeking greener pastures elsewhere. Like many of his contemporaries, he would have known that he faced a struggle to find his footing while starting out among the already-swollen ranks of his professional colleagues, many with better qualifications than his. Inevitably, he soon found himself deciding whether to stay at home and strive to establish his professional reputation, or strike out for the imagined status and prosperity that he felt would surely ensue as a relatively bigger fish in the far smaller pond of the colonies. Glowing newspaper reports and letters home from earlier migrants painting lyrical pictures of the fortunes to be won there, particularly in 1852, would have caused him, like thousands of others, to turn his eyes towards Victoria's goldfields.

Also like many, however, to some extent he saw this romantic venture as nothing more than a means to a far more pedestrian end, namely, his eventual triumphant return to his homeland. Geoffrey Serle describes a substantial tide of young professional immigrants arriving in Melbourne in the early 1850's, of whom he says that “the great majority rushed off in a spirit of high adventure to make their fortunes and return home as quickly as possible.”22 The young Henry Hadden's first and only letter home will show that this was clearly his intention, also. And confirming that this was not an isolated phenomenon, a genealogical website treating emigration from the Isle of Man, for example, suggests that mid-19th century migration to the Australian and other goldfields was in many cases a matter of men seeking a quick fortune, "with the intention of return", even if they eventually ended up in many cases "sending for their family to settle there."23 One such example was Walhalla's own early storekeeper and undertaker, William Callow, who was born on the Isle of Man in 1821.

"Initially, it was the promise of a fresh start in a new society and in a less crowded profession that most likely attracted the early emigration of doctors. However, following the discovery of gold in Victoria in 1851, the promise of ‘striking it rich’ on the goldfields became a major drawcard — as it was for thousands of others from all walks of life who came to the Colony. The experience of young Richard Tracy, MD, from Dublin was typical of those of many of the medical men drawn to the Victorian goldfields at this time. Tracy initially tried his luck on the Bendigo diggings, but finding little reward for his hard labour soon abandoned his efforts. He did, however, stay for a while to provide medical assistance for the miners from his calico tent."24 He was duly listed as a registered practitioner in the 1856 Government Gazette, but by 1868 had retreated to a practice in the new medical precinct at the already-fashionable top end of Collins Street in Melbourne.

For whatever reason people choose to emigrate, it is rarely if ever a decision that is made lightly, and one that almost always benefits the country of their destination, and this was certainly true as far as medical migrants in particular were concerned. Whether pushed or pulled, or both, and whatever it was that drove them to leave their homes and families to travel to the other side of the world, "it is evident that the early practitioners generally proved to be men of considerable energy, drive and vision." 25 Henry Hadden was clearly setting sail among a very esteemed company.

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Footnotes

01 Wikipedia entry for Florence Nightingale at http://en.wikipedia.org/wiki/Florence_Nightingale, retrieved September 11th, 2012
02 Wikipedia entry for Worshipful Society of Apothecaries, retrieved August 4th, 2012
03 from “Apothecaries' Hall of Ireland”, ACC/2011/3, p 2, at Royal College of Physicians of Ireland.
04 ibid., pp 2 & 30.
05 Letter from C H Leet, M.D., Member of the Court of Examiners, to the British Medical Journal, November 20th, 1869, pp 572-3.
06 Australian Medical Pioneers Index: “Colonial Medical Life” at http://www.medicalpioneers.com/colonial.htm, retrieved December 17th, 2011.
07 University of Michigan Student Paper on “19th Century Medicine” at http://www-personal.umd.umich.edu/~jonsmith/19cmed.html, retrieved 3rd October, 2012.
08 Alison Winter, “Mesmerism and the Introduction of Surgical Anesthesia to Victorian England” in "Engineering and Science", No. 2, 1998, p 31 at http://calteches.library.caltech.edu/671/2/Mesmerism.pdf retrieved August 26th, 2012
09 University of Michigan Student Paper, op.cit.
10 Alison Winter, op.cit.
11 Letter from William Henry Hadden to his mother, June 1st 1853 (family archive)
12 Alison Winter, op.cit., pp 31-2
13 A R McMillan, “Pennyweight Kids” (publ. Castlemaine, 1988), pp 84-5.
14 Ann Brothers, “Treating the Past: How Melbourne Medicine Came of Age”, p 11, at http://www.chs.unimelb.edu.au/__data/assets/pdf_file/0004/31288/treatingthepast.pdf, retrieved July 15th, 2012.
15 ibid., p. 9.
16 ibid., p. 4. This document includes an example of apprenticeship papers binding Thomas Stillman to his surgeon master (his father, William Stillman, Surgeon Apothecary) for a period of five years from 1841. "During this time he was not to ‘haunt taverns or playhouses, use foul language, nor absent himself from his said master’s service day or night unlawfully’. In return, his master agreed to provide food and clothing, and to ‘instruct him in the art and mystery of the profession’". The apprenticeship was clearly effective, too, because Thomas was still registered in 1868 as a qualified medical practitioner -- in Bridge Road, Richmond -- listing no other qualification than "Lic. Soc. Apoth. Lond. (1847)".
17 From “Early Nebraska Medicine”, p 12, at https://dspace.creighton.edu/xmlui/bitstream/handle/10504/30/chapter01.pdf?sequence=1, retrieved August 26th, 2012.
18 Personal emails, November 16th and 25th, 2011, initiated via inquiry to the Royal College of Physicians of Ireland.
19 Henry Hadden's great-grand-nephew, David R Hadden, wrote in an email that was received on October 15th, 2012, that "I am pretty sure that he did complete his apprenticeship as an apothecary (with Dr David Hadden in Skibbereen, his elder brother), and would have been licenced by the Apothecaries Hall in Dublin, presumably before he set off for Australia. Whether he also practiced with their elder brother John Hadden in Wexford I do not know. All three of them were Licenced as Apothecaries – only David went on and obtained the University degree of MD Glasgow in 1846 – it was not generally thought necessary until the ‘Medical Acts’ were passed some time later. Even in the past 50 years there were doctors practicing in the UK and Republic [of Ireland] with what was known as the ‘Conjoint’ diploma – MRCS, LRCP, LAH Ireland, obtained by an examination in Dublin under the Colleges of Surgeons and of Physicians, and the Apothecaries Hall. It was a general respected qualification, although not as academic as the University degree which was MB, BCh, BAO in Ireland after the ‘Medical Acts’. Rather a complicated story. Unfortunately the Apothecaries Hall in Ireland closed down as a medical licencing body about 1960 ... Their qualification would have been ‘LAHI’ – Licenciate of the Apothecary’s Hall of Ireland; there was, and still is a similar body in London which still awards diplomas in various aspects of specialist medical practice, although no longer as a licence to practice medicine as a primary qualification."
20 From “The Great Famine” at the Skibbereen Chamber of Commerce website, retrieved October 14th, 2012.
21 From the “Great Famine Commemoration Exhibition” at the Skibbereen Heritage Centre, retrieved September 14th, 2012.
22 Geoffrey Serle, “The Golden Age” (Melbourne University Press, 1977), p 47.
23 from “Manx Notebook: Emigration” at http://www.isle-of-man.com/manxnotebook/famhist/genealgy/emig.htm
24 Ann Brothers, op. cit., p 6.
25 ibid., p. 12.
 

© 2012 Bernard Bolch for the Walhalla Heritage and Development League.


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