Healers, healing, and the unofficial medical economy in England and Wales, 1834-1948

该项目始于1834年在英格兰和威尔士引入的《新贫困法》，该法律有助于在日益城市化的世界中巩固对患病穷人的官方医疗控制，并以1948年创建国家卫生服务结束，该服务在当时受到批评，但它定义了我们今天的日常医疗体验。在官方医疗保健的这两个里程碑之间，在医学职业化方面出现了许多重大发展：例如，从1858年创建全国合格全科医生注册到允许妇女进入除助产和护理以外的各种有执照的职业。但是，尽管在外科手术、麻醉剂、杀菌剂和疫苗方面取得了相当大的进步，但在20世纪30年代抗生素的发展预示着一场“治疗革命”之前，正统医学的有效治疗方法范围有限--人们对疾病原因的普遍理解也是如此。在普通人看病和就医的难易程度方面，也存在持久的地区差异，新兴的医疗保健专业对医疗机构(医院、精神病院、药房)的崛起以及国家的覆盖范围和权力的扩大持矛盾态度。因此，这项研究建议超越那个时期的标准医学史，并认识到，即使今天的医疗保健取得了令人印象深刻的进步，一些人仍然在寻找替代的、非官方的治疗方法。除非我们对非官方医疗市场的整体进行评估，否则我们不能完全理解医疗的流行经验和经济，而这项任务在这个国家还没有进行。通过充分利用19世纪中叶以来产生的丰富的档案资源--贫穷的法律记录、地方报纸、医学期刊、人口普查、卫生委员会报告、民俗和口述历史记录--该项目将考察城镇和乡村非官方治疗师的蓬勃发展的经济，包括草药师、接骨师、堕胎者、水工、切割者、虫子医生、蟾蜍医生、非官方助产士、狡猾的人、符号师、信仰治疗师、催眠师和磁力师、顺势疗法、专利药品小贩和后街药剂师。还普遍采用商业产品和民间疗法进行自我治疗，这在家庭经济方面尚未得到考虑。我们不应该把这种“大众医学”视为过时医学观念的残余而不屑一顾。在这一时期，许多人认为它们是当代的，是对官方医疗保健的补充，此外，这个项目并不涉及测试非官方疗法的有效性。从患者和从业者的角度来看，这个项目将为非官方医疗市场如何在不断变化的世界中发展、衰落和适应提供一个有价值的历史基准。它是对正在进行的社会经济医学多元化及其原因的研究，而不是记录科学进步的线性概念和强加医疗保健的官方结构。

The project begins with the introduction of the New Poor Law in England and Wales in 1834, which helped consolidated official medical control over provision for the sick poor in an increasingly urban world, and it ends with the creation of a National Health Service in 1948, which was critiqued at the time, but which defines our everyday medical experiences today. Between these two landmarks in official healthcare there were numerous significant developments in the professionalisation of medicine: from the creation, for example, of a national register of qualified general practitioners in 1858 to the admittance of women to the full range of licensed professions beyond midwifery and nursing. But while considerable progress was made in terms of surgery, anaesthetics, antiseptics, and vaccines, until the development of antibiotics in the 1930s heralded a 'therapeutic revolution' the range of effective cures in orthodox medicine was limited - as was popular understanding of the causes of illness. There were also enduring regional differences in the ease of access for ordinary people to doctors and doctoring, and the emergent healthcare professions had ambivalent attitudes to the rise of medical institutions (hospitals, asylums, dispensaries) and the extending reach and power of the state. This study proposes to look beyond the standard histories of medicine in the period, therefore, and recognises that even with the impressive advances in healthcare today, some people still seek out alternative, unofficial therapies for healing. We cannot fully understand the popular experience and economy of medicine unless we evaluate the totality of the unofficial medical marketplace, and such a task has yet to be undertaken in this country. By taking full advantage of the wealth of archival sources generated from the mid-nineteenth century onward - Poor Law records, local newspapers, medical journals, the censuses, sanitation board reports, folklore, and oral history recordings - the project will examine the thriving economy of unofficial healers in town and country, including herbalists, bone setters, abortionists, water casters, wen cutters, worm doctors, toad doctors, unofficial midwives, cunning-folk, charmers, faith healers, mesmerists and magnetisers, homeopaths, patent medicine vendors, and backstreet druggists. There was also a widespread resort to self-treatment using both commercial products and folk remedies that has not yet been considered in household economic terms. We should not dismiss such 'popular medicine' as the rump of outmoded medical ideas. Many people in the period saw them as contemporary and complementary to official healthcare, and, besides, this project is not concerned with testing the efficacy of unofficial therapeutics. Taking a patient and practitioner perspective, this project will provide, instead, a valuable historical benchmark for how unofficial medical markets develop, decline, and adapt in a changing world. It is a study of ongoing socio-economic medical plurality, and the reasons for it, rather than chronicling linear notions of scientific progress and the imposition of official structures of healthcare.