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

该项目始于1834年英格兰和威尔士新济贫法的引入，这有助于在日益城市化的世界中巩固官方对贫困病人的医疗控制，并于1948年建立了国家卫生服务体系，这在当时受到批评，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，医学专业化有许多重大发展：例如，从1858年创建合格全科医生的国家注册到允许妇女从事助产士和护理以外的所有许可职业。但是，尽管在外科手术、麻醉剂、防腐剂和疫苗方面取得了相当大的进步，直到20世纪30年代抗生素的发展预示着一场“治疗革命”，正统医学的有效治疗范围是有限的--就像人们对疾病原因的理解一样。在普通人看病和行医的难易程度方面，也存在着持久的地区差异，新兴的医疗保健行业对医疗机构（医院、收容所、药房）的兴起和国家权力的扩大持矛盾态度。因此，这项研究建议超越这一时期的标准医学史，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，一些人仍然寻求替代的非官方疗法来治愈。除非我们评估整个非官方医疗市场，否则我们无法充分理解医学的大众体验和经济性，而在这个国家，这样的任务还有待完成。通过充分利用从世纪中期开始产生的档案资源--济贫法记录、地方报纸、医学期刊、人口普查、卫生委员会报告、民间传说和口述历史记录--该项目将研究城镇和乡村非官方治疗者的繁荣经济，包括草药医生、接骨师、堕胎师、水施术者、割文师、蠕虫医生、蟾蜍医生、非官方的助产士，狡猾的人，魔术师，信仰治疗师，催眠师和磁力师，顺势疗法，专利药品供应商和后街药剂师。此外，还普遍使用商业产品和民间疗法进行自我治疗，而这些尚未从家庭经济角度加以考虑。我们不应该把这种“大众医学”看作是过时医学思想的残余。当时的许多人认为它们是现代的，是官方医疗保健的补充，此外，这个项目并不关心测试非官方疗法的疗效。从患者和医生的角度来看，该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。这是一个正在进行的社会经济医学多元化的研究，以及它的原因，而不是记录线性概念的科学进步和强加的官方结构的医疗保健。

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.