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
success
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.

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…”

Dr.
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