How One Book Revolutionized Family Medicine
Colonial era medicine relied on a combination of local herbal remedies and European textbook cures, until William Buchan published a practical medical book for home use.
Colonial era medicine depended upon a combination of herbal remedies borrowed from folklore or medical procedures recommended in textbooks. Although medical books were available to the public, most were too complicated (or inaccurate) to be used by ordinary people. It was not until Dr. William Buchan (1729–1805) published Domestic Medicine; or, the Family Physician in 1769 that a practical medical book for home use was popularized.
From Theology to Medicine
Buchan was born in southeastern Scotland in 1729. Although his parents were strict Presbyterians, they still encouraged their son to study medicine and the natural sciences. According to Dunn (2000), before Buchan attended university he knew enough medicine to act as an amateur physician for his village.
In 1749, Buchan went to Edinburgh University to study theology. Over the next few years, however, he devoted more time to studying medicine than Divinity. Buchan switched his course of study and qualified as a physician in 1758. He was appointed surgeon at the Foundling Hospital in 1759, where he gained experience in treating children’s diseases as well as learning how to care for infants.
When funding for the Foundling Hospital ended, Buchan began a private practice in Sheffield. Over time, he witnessed poverty as well as the ignorance of his patients in matters such as personal hygiene.
Helping the Public Become Private Practitioners
Buchan was concerned about the welfare of the general public. Doctors did not always practice in remote areas, and he thought that many illnesses and accidents could be prevented if a patient knew what to do beforehand.
Buchan (1785) acknowledged that “medical authors have generally written in a foreign language . . . in terms and characters unintelligible to the rest of mankind.” Thus, in his spare time, Buchan set about writing a book of sensible advice that the average person could understand. If he succeeded, he knew he would remove “the veil of mystery” from medicine, which tended to make it “a suspicious art.”
While Buchan knew that “the cure of diseases is doubtless a matter of great importance,” he also recognized that to “live medically, is to live miserably.” Thus, his main goal was to make the public into private practitioners, with enough medical knowledge to teach them the causes of disease so that “the preservation of health” was attained through proper preventive measures.
Domestic Medicine; or, the Family Physician
In 1769, Buchan published Domestic Medicine; or, the Family Physician. The book was divided into several parts. Part I focused on the known causes of disease, including diseases of the mind (e.g., melancholy) as well as of the body. Part II discussed symptoms and treatments for common diseases such as fevers, measles, colds, and stomach upsets. The Appendix recommended common medicinal preparations (or “simples”) that every family should have on hand, followed by detailed instructions on how to combine those ingredients into various medicines. Buchan also included a Glossary in order to explain some of the technical terms that he could not otherwise “banish . . . when writing on medicine.”
The success of Domestic Medicine was immediate. The book was republished in London, and soon spread overseas to the Colonies, where an edition appeared in Philadelphia in 1774. Other editions followed in New Hampshire, Massachusetts, Connecticut, New York, and South Carolina. At one time, his book was so popular that it was found in cities, farms, frontier settlements, as well as on sailing ships. By the time Buchan died in 1805, 19 editions had been published and more than 80,000 copies had been sold.
Was Buchan’s Medical Advice Sound?
Buchan advised physicians to rely less on scientific principles than on “experience and observation,” and he used the same approach in writing for the general public. For the most part, common sense is evident. To avoid infection, children were advised to keep away from those who were ill. To maintain good health, Buchan stressed the importance of exercise, fresh air, proper sleep, clean clothing, and washing hands.
Buchan’s book also advocated radical public health measures such as inoculation against smallpox — either forcibly by the power of the State, or more simply through bribery. Before artificial respiration was invented as a term, Buchan described a procedure very similar to that known today to treat drowning cases. Even Buchan’s home remedy for severe nosebleeds (placing the genitals in cold water) has a sound medical basis, as cold water lowers the temperature of the nasal mucous membranes and induces blood vessel constriction, which stops bleeding.
Of course, the book was not without questionable treatments and errors. His suggestion to use “fresh cow-dung” to treat bruises was probably no more successful in his day than today. Chambers (1869) also recounts how one edition recommended a prescription containing “one hundred ounces of laudanum,” instead of only 100 drops!
The Influence of Domestic Medicine
For its time, Domestic Medicine was remarkable in revolutionizing family medicine. Buchan gave the public good advice on how to treat common ailments, advocated exercise and cleanliness as preventive measures in place of drugs, and made medicine more accessible to those without access to physicians. Although the usefulness of Domestic Medicine has been surpassed by advances in medical knowledge, its importance cannot be discounted.