Georgian Era physician William Buchan wrote his groundbreaking Domestic Medicine a year before Napoleon Bonaparte was born. Buchan’s 1769 book was the first text of its kind written for the lay person rather than being a theoretical medical text written for the educated. Moreover, it addressed new health issues such as those associated with the Industrial Revolution that began in the 1760s. Domestic Medicine also was one of the first books that focused on how to prevent illness rather than cure it.
Although Buchan’s book was groundbreaking many of his theories remained grounded in the traditional medical view of humorism. Buchan was also a strong advocate for letting nature take its course and a proponent of bloodletting and purging-type cures. He believed that if the body could expel infection on its own, it would return to its natural state. He also advocated that bad air could cause illness, even death:
“People generally pay some attention what they eat or drink, but seldom regard what goes into the lungs, though the latter proves often more suddenly fatal than the former.”
He maintained that good air made for a healthy body. Although he thought bad air might cause death, he believed in most cases that unwholesome air was generally only “hurtful to mankind.” He asserted that air could become noxious and stated that varying degrees of heat, coldness, moisture, etc. could render it “unwholesome.” He also provided a list of the ways such air affected the body:
“[T]hat which is too hot dissipates the watery parts of the bloods, exalts the bile, and renders the whole humours adust and thick. Hence proceed bilious and inflammatory fevers, cholera morbus, &c. Very cold air obstructs the perspiration, constringes the solids, and condenses the fluids. It occasions rheumatisms, coughs, and catarrhs, with other disease of the throat and breast. Air that is too moist destroys the elasticity or spring of the solids, induces phlegmatic or lax constitutions, and disposes the body to intermitting fevers, dropsies, &c.
Buchan maintained that air in “great cities” could cause all sorts of health issues. He also alleged that it could be easily contaminated and fatal to its inhabitants and provided an explanation as to why cities were prone to unwholesome air:
“The air in cities is not only breathed repeatedly over, but is likewise loaded with sulphur, smoke, and other exhalations, besides the vapours continually arising from innumerable putrid substances, as dunghills, slaughter-houses, &c. All possible care should be taken to keep the street of large towns open and wide, that the air may have a free current through them. … It is very common in this country to have churchyards in the middle of populous cities. … Whatever gave rise to the custom, it is a bad one. … Certain it is that thousands of putrid carcasses, so near the surface of the earth, in a place where the air is confined, cannot fail to taint it; and that such air, when breathed into the lungs must occasion disease.”
Physician William Buchan also asserted that if air stagnated too long it caused health issues. He cited prisoners incarcerated in jails or prisons as frequently suffering from “malignant fevers,” which they then “communicated” to others. Yet, such places were not the only spots Buchan thought was prone to stagnate air. Ships were also known to be difficult to ventilate, particularly below deck and in the hold, making them susceptible to containing stagnate air.
Stagnate air could also be found in mines. Buchan noted that there two types of air there that were detrimental and destructive to miners: fire-damp and choak-damp. That was because such air was “loaded” with noxious gas that could also easily explode. There was also Buchan’s insightful mention that it was not the just the air that might harm such underground workers:
“[T]the particles of metal which adhere to their skin, clothes, &c. These are absorbed, or taken up into the body, and occasion palgies [sic], vertigoes, and other nervous affections, which often prove fatal. Lead an several other metals, are likewise very pernicious to the health”.
One story of immediate death in a mine because of noxious air happened in Dunfermline, Scotland near Blackburn in 1774. According to the Kentish Gazette:
“Three men went to their work in the morning, having good air in the mine the day before, and did not suspect anything else at that time. Two of the men, that went farthest into the mine, were seized with bad air, and immediately dropped down; the third not being so far in, turned, and come out with some difficulty. He went immediately and told John Robertson, the coal grieve, and another miner, who both ran with all speed, and got down into the mine, thinking to save the other two men; but unfortunately they went too far in; and shared the same unhappy fate with the others. They are much regretted. … We hear that their bodies have been since got out of the mine.”
Other shaft-like places were also prone to bad or stagnate air. These included wells, graves, and cellars, and, in fact, physician William Buchan said such air in these types of places could kill as quickly as lightening:
“We have daily accounts of persons who lose their lives by going down into deep wells and other places where the air stagnates: all these accidents might be prevented by only letting down a lighted candles before them, and stopping when they perceive it go out; yet this precaution, simple as it is, is seldom used.”
Buchan was right about the air as indicated by a story where two men ended up dead in one grave two men ended up dead in one grave. It involved a 53-year-old grave digger named Thomas Oakes and a 20-year-old passerby named Edward Luddett. It began after Oakes arrived at work. He opened a trap door covering a grave and descended into it. Shortly after his descent, the sexton’s daughter went to look for him and found him insensible at the bottom of the grave. She screamed and her screams drew numerous bystanders, including Luddett, who then descended into the grave and died. Ultimately, the cause of the men’s death was reported to be “suffocation, the result of foul air [caused by carbonic acid gas] emitted from the grave.”
According to Buchan, there was also the “detestable” practice of burying bodies inside churches. He noted that church air was bad for a variety of reasons and cited that “damp, musty, unwholesome” odors formed because of arched roofs and a lack of ventilation. He also reported that stagnant air was made worse by the addition of “effluvia” that commonly accompanied the dead bodies buried in churches.
Physician William Buchan also noted that unwholesome and stagnate air was also prevalent in the homes of the poor.
“These low dirty habitations are the very lurking places of bad air and contagious disease. … No house can be wholesome, unless the air has a free passage through it. For which reason, houses ought daily to be ventilated by opening opposite windows, and admitting a current of fresh air into every room. Beds, instead of being made up as soon as people rise out of them, ought to be turned down, and exposed to the fresh air from the open windows through the day. This would expel any noxious vapour, and could not fail to promote the health of the inhabitants.”
Buchan noted that rooms where fires burned caused greater dangers and were “always hurtful” to inhabitants. He also suggested that those who worked in town during the day should try to sleep in the country at night because breathing would be easier in the country’s “free air.” Moreover, he believed that sleeping in the country made up somewhat for the “want” of good air that was lacking during a person’s workday in the city.
Even though Buchan spoke about the benefits of country air, he also alleged that it could be made bad. For instance, according to Buchan, placing a house too near large lakes with stagnate water or near low marshy areas became problematic because they made the air damp and loaded it with “putrid exhalations, which produce the most dangerous and fatal disease.” Buchan also maintained that surrounding country homes with trees, plants, or high walls obstructed the free flow of air and could render such places unwholesome. He noted:
“Wood not only obstructs the free current of air, but send forth great quantities of moist exhalations, which render it constantly damp. Wood is very agreeable at a proper distance from a house, but should never be planted too near it, especially in flat country.”
Physician William Buchan also maintained that if people were crowded together (such as at a church or in some sort of assembly) air could not circulate freely and it became unwholesome. The air in such situations could also be made worse if fire or candles were burned. This bad air could then affect everyone present but in particularly he noted that it was more troublesome to those who were already sickly or in delicate health.
Physician William Buchan also believed that asthmatic and consumptive sufferers should avoid the air in “great towns.” He claimed that he had seen people afflicted with such maladies improve or even resolve their problems permanently when they visited the country. This included women suffering from hysteria and nervousness. He thus attributed such improvements to “better air” and noted that if air for the healthy was important, then good quality air was even more important for the sick:
“The notion that sick people must be kept very hot, is so common, that one can hardly enter the chamber where a patient lies, without being ready to faint, by reason of the hot suffocating smell. How this must affect the sick any one may judge. No medicine is so beneficial to the sick as fresh air. It is the most reviving of all cordials, if it be administered with prudence. We are not, however, to throw open doors and windows at random upon the sick. Fresh air is to be let into the chamber gradually, and, if possible, by opening the windows of some other apartment.
The air of a sick person’s chamber may be greatly freshened and the patient much revived, by sprinkling the floor, bed, &c frequently with vinegar, juice of lemon, or any other strong vegetable acid.
In places where numbers of sick are crowded into the same house, or, which is often the case, into the same apartment, the frequent admission of fresh air becomes absolutely necessary, Infamies, hospitals, &c are often rendered so noxious, for want of proper ventilation, that the sick run more hazard from them than from the disease. This is particularly the case when fevers, dysenteries, and other infectious disease prevail.”
Buchan believed that it was not the just sick or weak who could be affected by bad air. Unwholesome air could also affect infants and children and Buchan thought there was nothing as “destructive” to them as when they were confined in places where bad air existed. He cited hospitals and parish-workhouses as two places crowded with the old, the sick, and the infirmed, which, according to him meant, “the air is rendered so extremely pernicious, that it become a poison to infants.”
For infants and children, physician William Buchan noted that bad air was easily found in “great towns” particularly where poor inhabitants lived. He maintained that such air was detrimental, even fatal, to infants and children who had not yet reached maturity.
“As such people are not in a condition to carry their children abroad into the open air, we must lay our account with losing the greater part of them. But the rich have not this excuse. It is their business to see that their children by daily carried abroad, and that they be kept in the open air for a sufficient time. This will always succeed better if the mother goes along with them. Servants are often negligent in these matters, and allow a child to sit or lie on the damp ground, instead of leading or carrying it about. The mother surely needs air as well as her children; and how can she be better employed than in attending them?”
Demonstrative of the effects of bad air was a French study conducted in the early 1800s that seemed to support Buchan’s ideas of air quality. It focused on the mortality of infants:
“Dr. Villerne had already made some curious researches on this subject, in which he compared the mortality of children in the upper classes with that in the lower. The present memoir is formed on a similar plan. There are born at Paris about 22,000 annually; of these about two-thirds are sent out to nurse in the country; of these two-thirds, the mortality during the first year, is three out of five, while of the 7000 to 8000 nursed in Paris, more than 4000 died with the year. In the very popular quarters of Paris, where the streets are narrow, and the inhabitant wretched, the mortality is about nine in ten, in the first year. — in the country, where good air, cleanliness, and comfort are united, as in Normandy, the mortality during the first year is only one in eight. At the Foundling Hospital at Paris, where they were all confined to the establishment, of 7000 to 8000 received annual, there only remained 180 at the age of ten. … Hitherto these societies have invariably recommended mothers nursing their children; but it is evident that bad air, and other concomitant circumstances more than counterbalance those advantages; it is more charitable to bid them to send their children to nurse in the country [where the air is good].”
Physician William Buchan did get Georgian Era people thinking about the air they breathed. It also encouraged the practice of airing out beds, nighttime clothing, and bedrooms, a practice that continued well beyond the Georgian Era. In fact in the Victorian Era, one book titled Health for the Household that was published in 1858 was typical of the type of advice that might be given to ensure a family’s health:
“It is a very excellent proceeding always to fold back neatly all the bedclothes off the bed, upon getting up in the morning, and to leave both the clothes and the bed exposed two or three hours with the window of the chamber wide open, so that the fresh wind my blow in freely and disperse any poison-vapours that are lurking about the fibres and in the pores of clothes.”
-  W. Buchan, Domestic Medicine, Or A Treatise on the Prevention and Cure of Diseases, by Regimen and Simple Medicines: With Observations Concerning Sea-bathing and the Use of the Mineral Waters : to which is Annexed, a Dispensatory for the Use of Private Practitioners (Exeter: Thomas Tegg and Son, 1838), p. 62.
-  W. Buchan. 1838, p. 63.
-  Ibid.
-  Ibid., p. 41.
-  Kentish Gazette, “London,” March 5, 1774, p. 3.
-  W. Buchan. 1838, p. 64.
-  Windsor and Eton Express, “Dreadful Occurrence in the City,” September 15, 1838, p. 3.
-  W. Buchan. 1838, p. 64.
-  Ibid., p. 65.
-  Ibid., p. 65.
-  Ibid., p. 65–66.
-  Ibid., p. 455.
-  Ibid.
-  Belfast Commercial Chronicle, “Mortality of Infants,” September 21, 1825, p. 1.
-  Health for the Household (1858), p. 29–30.