Dr Richard Moore interview: The GP historian

Shropshire GP Dr Richard Moore has published a book about the evolution of general practice.

Surgeon bleeding a patient (from The Coalbrookdale Doctors)
Surgeon bleeding a patient (from The Coalbrookdale Doctors)

What first inspired your interest in medical history?

My family has been in medicine since 1750 and two of my granddaughters are the ninth generation, so I wanted to explore what medical practice had been like for our forebears.

I discovered so many interesting people and events that I wrote a book about us all, entitled Leeches
to Lasers.

I enjoyed that so much, I decided to learn a bit more about medical history, and contacted the Department of Medical History at the University of Birmingham.

I was persuaded to study for a PhD, which was risky as I am no academic, but fortunately, I was successful.

This proved to be a fascinating and stimulating experience.

What prompted you to write The Coalbrookdale Doctors?

A condition of writing the PhD was that the subject must be Midlands-based, so I researched the development of medicine in Shropshire (where I practised and still live) between 1740 and 1870.

This was particularly interesting because the Salop Infirmary is one of the very earliest voluntary hospitals, and something of a pioneer. Shropshire doctors were also very active in agitating for the 1858 Medical Act.

I subsequently rewrote the material of my thesis for general readership, as Shropshire Doctors and Quacks. In the course of that research, I came across family correspondence of the Coalbrookdale doctors, which forms the basis of this book.

What is the book about?

The Coalbrookdale doctors were four men in three generations of one family, in practice for a hundred years from about 1770 to 1870.

Successive generations experienced increasingly detailed education, from a five-year apprenticeship, to apprenticeship followed by a two-year curriculum for their licentiateship, and eventually, university medical schools.

The third generation comprised two brothers, one 16 years younger than the other, who had very different educational experiences.

All of this was in the context of developing industry, Napoleonic war, recession, industrial strife, and social and political change.

Each generation also witnessed great new projects, including the Iron Bridge, the first steam locomotive running on rails, scientific progress and the shaping of today’s medical profession.

Are there lessons from history for modern GPs?

The doctors were, of course, in private practice, although poor patients sometimes paid in kind, not cash (one even paid with a garden rake). This called for commitment, because there were competitors nearby
who would readily take on any dissatisfied patients.

Scientific knowledge was changing fast even then, so adaptation to new techniques was important.

Perhaps from the comfort of retirement I should not say this, but I think the long-term and personal commitment of those days compares favourably with the tendency to fragmented care and no night work of today’s general practice.

What aspect did you most enjoy – research or writing?

Reading and research are interesting and have something of the chase about them. Writing and research are inseparable.

How did print-on-demand publishing work for you?

It was very good. Years ago, authors often published their work at their own expense. The arrival of print-on-demand allows as many or as few books to be produced as authors require, thereby reducing costs.

The YouCaxton system is flexible. Authors can choose how much is done, including marketing, book launch and an author’s web page.

The author pays the costs, but has the advantage of control and freedom from the impositions of a commercial publishing house.

Where is your book on sale?

As for all books, a bookshop should be the first port of call, although they may have to order it for you if they do not stock it. You can order it in the comfort of your own computer from Amazon, Abebooks or
YouCaxton (@YouCaxton.co.uk).

Do you have further writing projects in hand at present?

Researching and writing a book, even a relatively short one such as The Coalbrookdale Doctors, is hard work, although it is also good fun.

As I approach my late eighties, it may be sensible not to embark on another lengthy project, but I hope
to dabble in the archives, write the occasional essay or give a talk on medical history now and then, if asked. Who knows? There may be life in the old dog yet.

The doctors were in private practice, although poor patients sometimes paid in kind, not cash (one even paid with a garden rake)

  • Dr Richard Moore, GP historian and author
Exclusive excerpt from The Coalbrookdale Doctors by Dr Richard Moore

Benjamin Wright was born in 1745 into a changing world. As he was growing up, old certainties were being challenged everywhere. At home, new ideas in agriculture, commerce and politics were changing social structures while, overseas, merchant adventurers were exploring the world.

Radical thinkers were challenging the hegemony of monarchies and aristocracies and proclaiming the benefits of democracy. More belligerently, in America the British colonists were fighting their French and Spanish rivals before rebelling against their king.
The principal characters in this book, Benjamin Wright, his son-in-law William Edwards and his grandsons Edward and Benjamin Edwards, were real people who experienced both the thrills and threats of those exciting times. They were doctors in the village of Coalbrookdale in Shropshire, which in 1837 was described as ‘the most extraordinary district in the world’ because of the major advances in the manufacture and use of iron that were made there as the Industrial Revolution gathered pace.

Benjamin Wright set up his business as surgeon-apothecary in 1770, treating the sick and injured, delivering babies and selling medicines, though usually in the vain hope that they would be effective. The business, later to be renamed ‘the practice’, was continued by his family for nearly a hundred years. At the same time, a new era of power, transport, travel, comfort, communication, speed and noise began to merge the self-contained and slowly changing communities of the world into what now seems to be an ever-changing global village. Progress may appear faster today than ever before but the changes experienced by those who lived between 1750 and 1850 were arguably even more extreme. It was an exciting time to be alive.

Life in Britain was simple when Benjamin was born. Most people lived and died within a few miles of their childhood homes and, though some were rich from inheritance or became wealthy through trade and enterprise, standards of living for the majority were low and often bleak. Most houses could hardly keep out the winter cold and were dimly lit by feeble candles and their sanitary systems were malodorously foul. For many people, the diet was plain and meat was a rarity.

Disease was common and lives were short, even for those who survived the perils of birth and infancy. The everyday things of twenty-first century life – warm homes, electric power, transport, travel and communication – were not even the stuff of dreams.
Benjamin did not stay where he was born, however, because as the fourth of the seven sons and one daughter of Benjamin and Mary Wright, farmers of Tattenhall in Cheshire, he had to find his own living. He was apprenticed to a surgeon-apothecary in Broseley, Shropshire, to learn that trade, exchanging rural Cheshire for the clamorous world of industry and commerce.

In Benjamin’s youth there were no newspapers or broadcasts to tell him of the political upheavals and wars in which Britain, France and Spain engaged in a global struggle to defend their interests. In America the British colonists who sought religious and political freedom fought for their new homeland against their French and Spanish rivals, threw off the shackles of taxation without representation and declared themselves to be a new nation. Despite Britain losing the consequent War of Independence, the many successes of the Royal Navy ensured the security for Britain of the prosperous trade routes to the West Indies, Africa and India that made Britain the richest nation in the world. The fortunes of its citizens were soon to prosper as never before.

While all this was happening abroad, Benjamin Wright established himself as the surgeon-apothecary of Coalbrookdale. In 1766, at the age of twenty-one, having served his time as apprentice, he would have been free to work on his own account. His marriage in 1768 to Frances, daughter of the ironmaster, John Guest of Broseley, suggests that he was soon in a favourable position to start his own business.

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