Roles of the Edinburgh, Kelso, and Newcastle dispensaries in charitable relief, 1776-1810
This thesis explores late eighteenth- and early nineteenth-century British charitable medical provision through a comparative study of the Edinburgh, Kelso, and Newcastle dispensaries. It is situated within historical scholarship concerned with institutional histories, charitable relief systems, and medical therapeutics. The research draws on a range of sources, including records which have not previously been studied such as dispensary patient case notes. It also contextualises dispensary provision by studying alternative sources for medical relief for the poor in surrounding districts, including poor relief systems, infirmaries, and other charitable bodies. By adopting both statistical and narrative approaches this thesis demonstrates the variation in models of dispensary management and treatment and considers the impact on dispensary provision of local factors such as harvest failures, epidemics, and employment models. It considers the differences between the theoretical approaches of these dispensaries as presented in annual reports, newspapers, and promotional publications, and the practical realities of their provision. It also looks beyond the administrative models of the dispensaries to explore the employment, age, and gender of dispensary patients. The dispensary outpatient model of treatment often provided for a distinctly different demographic of society than other relief systems such as infirmaries and workhouses. This thesis, therefore, provides insight into sickness experiences which have previously been largely unexplored. This research considers the practical application, as well as theoretical frameworks, of medical treatment during the late eighteenth and early nineteenth centuries. By giving priority to practice over theory this thesis provides insight into the medical treatments which were commonly adopted by practitioners. In doing so it uncovers the context of these treatments, not only which diagnoses they aimed to ameliorate, but the patients’ symptoms and the identified outcomes of these treatments. This approach also enables analysis of the reception of these treatments by patients. It contributes to existing scholarship by considering ideas around patient agency and concepts of shame, particularly in relation to the diagnosis and treatment of genito-urinary complaints.