Dr. William Buchan M.D. 1729 - 1805
 

Eighteenth century Scotland was a difficult time for the children of all classes as medical knowledge and treatment of childhood diseases was as at best primitive. Although there had been Plague ratsuccess eradicating plague, and typhus and cholera had declined, there was still malaria until the late eighteenth century which took its toll of debilitated children. But it was smallpox which was the worst killer of small children and which had to await nationwide inoculation and vaccination to contain it.

Edinburgh and Glasgow were the centres for medical training in the whole of Britain and were held in great respect throughout the world. But the number of graduate doctors produced by the universities was woefully short of the needs of Scotland and many of the new graduates immediately went to England or abroad to practice.

Fortunately, there came on the scene some pioneers of medicine whose contributions to the health of the country is often overlooked. There was for example William Smellie of Lanark who published papers about midwifery in 1752 and 1763 and gave much needed advice about containing the dreaded puerperal fever and the need for cleanliness. But the doctor whom I believe made the greatest impact was Dr. William Buchan.

Dr William Buchan M.D.He was born in 1729 at Ancrum where the famous Covenanter  John Livingstone once was minister. It seems that his grandparents were staunch Presbyterians and may well have been in the flock of John Livingstone and they exiled themselves in Holland to escape the persecution and the Killing Time of the late 1680s. His father was a tenant of the Duke of Roxburgh and tolerated the young William`s interest in medicine but he was originally destined for the church. William Buchan studied in Edinburgh for some nine years in which he seemed to spend more time on botany and medicine rather than theology. In the end he graduated in medicine and  worked for some time in Sheffield, Yorkshire. He met and married a Miss Peters and settled in Edinburgh in 1766  where for 12 years was face to face with the poverty and the ignorance of people about such simple things as hygiene.

 In 1778, with a growing reputation and list of publications, he moved to London where he continued to produce revisions and additions to his works until his death on 25 February 1805. A grateful nation rewarded him with burial in Westminster Abbey.

Dr. Buchan's contribution was to promote simple hygiene particularly amongst the poor and provide the first "modern" advice on self-care. Hitherto medicine had been a closed art with a whiff of mystery about it, while published advice was sparse and pretty well along the lines of witchcraft. T. C. Smout, in his History of the Scottish People 1560 - 1830, quotes from "The Poor Man's Physician", by John Moncrief (1712).

"...take a little black sucking puppy choke it, open it and take out the gall .. give it all to the child ... with a little tile tree flower water..."

Nose gay maskDr. Buchan first published work was a thesis he presented in Edinburgh entitled "Infantum Vita Conservanda" in which he observed that about half the children born in Britain die before their twelfth birthday.

 In 1769, he published his "Domestic Medicine" which was to become the standard work of reference for family medicine and ran to no less than 22 editions. The full title of some of his publications illustrates the simplicity of his advice:

"Domestic Medicine: or, a treatise on the prevention and cure of diseases by regimen and simple medicines. With an Appendix, containing a dispensatory for the use of private practitioners. " (1794)

"Domestic Medicine: or , The family physician: being an attempt to render the medical art more generally useful, by showing people what is in their own power, both with respect to the prevention and cure of diseases." (1802)

"Advice to mothers on the subject of their own health; and on the means of promoting the health, strength, and beauty of their offspring." (1803)

 The National Library of Scotland records that there have been 61 publications of Dr. Buchan's works including a translation of "Domestic Medicine" into Spanish. (1818)

In the Preface to "Domestic Medicine" Dr. Buchan tells us his friends said, "...it would draw on me the resentment of the whole faculty " and that "By the more selfish and narrow minded part of the Faculty, the performance was condemned; while many ... received it in a manner which at once showed their indulgence, and the falsehood of the common opinion, that all physicians wish to conceal their art..."

Buchan's advice is to us almost rudimentary and we might find it difficult to believe that basic washing was not common - a once a year bath, if at all, while simple regimes of breathing clean air, having a nutritious diet and taking exercise were seldom understood or practised. He also was ahead of his time in advocating cleaning of the streets, widening them, and supplying clean water.

His observations about nursing and management of children came from extensive work among infants in the Foundling Hospital, Edinburgh where he had much experience of treating disease and also of trying different nursing methods and its effects. From this experience he came to the dreadful conclusion that "almost one half of the human species perish in infancy, by neglect or improper management."

Some quotations from "Domestic Medicine" best illustrates the sensible advice for cleanliness and the care and management of children:

"The want of cleanliness is a fault which admits of no excuse."

"Diseases of the skin are chiefly owing to want of cleanliness."

"Frequent washing not only removes the filth and sores which adhere to the skin, but likewise promotes the perspiration, braces the body, and enlivens the spirits."

"Nothing can be more preposterous than a mother who thinks it beneath her to take care of her own child, or is so ignorant as not to know what is proper to be done for it."

"Few things prove destructive to children than confines or un- wholesome air."

"Sufficient exercise will make up for several defects in nursing; and it is absolutely necessary to the health, growth and strength of children."

 "Children thrive best with small quantities of food frequently given. This neither over loads the stomach, nor hurts the digestion and is certainly most agreeable to nature."

"The clothing of infants is so simple a matter, that it is surprising how any person should err in it; yet many children lose their lives and others are deformed by inattention to this particular."

"A child never continues to cry long without some cause, which might always be discovered by proper attention."

"Allowing children to continue long wet is another pernicious custom of indolent nurses."

"On the proper management of children depends not only their health and usefulness in life, but likewise the safety and prosperity of the state to which they belong."

....and a warning about heritable diseases, ahead of his time:

"A person labouring under any incurable malady ought not to marry."

 "Such children as have the misfortune to be born to diseased parents will require to be nursed with greater care than others."

Professor Smout so aptly describes Dr. Buchana's work as "...a monument to common sense and good advice simply expressed".

 Clearly the sound advice was a major stepping stone towards the concept of Public Health that finally arrived in the 1840s.

I am sure we would all agree most heartily with Dr Buchans` observation that 

"No part of Medicine is of more general importance than that which relates to the nursing and management of children."

A fuller biography of the man and his habits is at www.electricscotland.com/history/significant_Scots.htm

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