Someone call an apothecary

When you read a regency and someone falls ill and calls for an apothecary, do you wonder, “Why don’t they call a real doctor?” We modern readers need to readjust our assumptions that Georgian-era physicians were more capable than apothecaries, and even the idea that a doctor of any sort would have been better for the patient than doing nothing at all.

Physicians had a higher social status than their colleagues and college training that granted them the title of ‘doctor’, but apothecaries were often the first recourse in medical situations, especially outside of London. The ratio of elite physicians to demand was low, and the affordable and accessible apothecary was trusted among all social classes.

Although all of them might be referred to as doctors, the tripartite medical structure at the Georgian era was a hierarchy of university-trained physicians at the top, and then surgeons, and then apothecaries, but in reality it was not a neat ladder. Some surgeons were also apothecaries, some apothecaries became physicians, some apothecaries rose in the local social strata. They were all doctors, but there were still quacks at all levels who took advantage.

Even in the best of cases, sometimes medical care consisted of guessing until the patient either recovered or died. In Sanditon, Lady Denham doesn’t think much of Mr. Parker’s intention to find a doctor for the resort:

“Here have I lived seventy good years in the world and never took physic above twice and never saw the face of a doctor in all my life on my own account. And I verily believe if my poor dear Sir Harry had never seen one neither, he would have been alive now. Ten fees, one after another, did the man take who sent him out of the world. I beseech you Mr. Parker, no doctors here.”

Apothecaries were trained by apprenticeship for years, and they successfully lobbied in 1815 to pass the Apothecaries Act to ensure all apothecaries were licensed and credentialed. These medical professionals dispensed drugs and advised patients, and in this period more often took on the role of surgeons. In a way, apothecaries and especially surgeon-apothecaries resembled a combination of pharmacist and modern-day general practitioner. In this time they couldn’t charge for giving advice, only for dispensing or for performing a procedure.

There was no guarantee that a specialist from the Royal College of Physicians was more likely to cure you than the village apothecary. This was a time with no anesthesia, no antiseptics, no antibiotics. They knew anecdotally that a surgeon removing a bullet had fewer infections if he washed his hands first even if they didn’t know why, but there were no policies in place based on this knowledge. They understood angina, inoculations against small pox, and how to try to resuscitate a drowning victim. But they still got things horribly wrong, like assuming that a sudden transition from heat to cold caused illness.

But that didn’t stop country gentry from relying on apothecaries. Mr Jones visits Jane when she has a cold in Pride and Prejudice. Mr Woodhouse relies heavily on Mr Perry. In Sense and Sensibility, the Palmers’ apothecary tends to Marianne, and in Persuasion Mr Robinson sets little Charles’s collarbone.

Mr Jones has a larger role in An Affectionate Heart than in Pride and Prejudice. He’s frequently called to Netherfield’s small rented lodge by the Darcys and Mr Jones is a trusted community member. In this scene, Elizabeth enters his shop after finally deciding that she ask Mr Jones about her recently heart troubles.

Elizabeth entered the apothecary’s shop where Mr Jones’s co-partner Mr Lynn was helping the apprentice roll pills, and Mrs Baker was at the counter complaining about her shortness of breath until she was red in the face. She makes Mr Darcy seem agreeable by comparison.

She had time to doubt the necessity of seeing the apothecary while Mrs Baker blamed Mr Jones for her sweating sickness along with her other paralytic heart complaints. Elizabeth could afford to consult Mr Jones; she would only owe a fee if she purchased physic from him, not for service in examining her. Mr Jones was a knowledgeable doctor, after all.

Do I suffer from what killed my father?

“Mrs Baker, you have your pills, and I would guard you against mental agitation.” Mr Jones’s voice was calm, although he looked as though he wished to shrug his shoulders or rest his forehead on the counter. “If you have no bilious or feverish complaints, I will call on you on Monday, as always.”

Mrs Baker must be in fine health if she has the strength to berate the person she came to consult and call his credentials into question. The apothecary bore it all, knowing, as did all of Meryton, that for all her raging against him, Mrs Baker could not go a week without demanding Mr Jones’s attention.

She turned from the counter, and glared at Elizabeth. “How d’ye do, Miss Bennet? My, how old are you now? Have you not managed to catch a husband like your sisters?”

Elizabeth endeavoured to answer without raising her voice. “How do you do, ma’am? Please, do not let me keep you from your errands.” Mrs Baker may be ill, but she was too ill-natured for Elizabeth to make attempts at good-humour. Mrs Baker huffed and shuffled away, and Elizabeth approached the counter.

“Mr Jones, I wondered if I might consult with you?”

“Certainly; I can call at Longbourn at your convenience.”

She had not anticipated this; the last thing she wanted was her mother or the Collinses to suspect she was ill. They would confine her to Longbourn even further, and they would intrude on her every decision and thought even more than they already did. “I would prefer to hear your advice privately.”

Mr Jones raised an eyebrow, but invited her to his consulting room. The last time she was here she was nine and had fallen off the tollgate, and a shopkeeper carried her in. She now felt foolish for fearing her heart ailment was serious. Behind the curtained entry, she sat on a hard-backed chair and bit her lip and twisted her fingers until the apothecary invited her to speak.

“I fear that I have some disorder of my heart, not unlike what took my father to death. I often feel a pressure, a heaviness centred around my heart that oppresses me.”

“Angina pectoris among women is uncommon, especially as young as you are. Has this happened more than once? Do you suffer a sudden pain across the chest and arm, and a difficulty breathing, particularly after eating or exercise?”

“The paroxysm recurs, and it does not matter what I am doing.”

He tilted his head thoughtfully. “Are you afflicted by it while walking or at rest?”

“Both.”

Mr Jones then asked her symptoms, and Elizabeth described how her chest would tighten, how her legs and fingers lost feeling as heart palpitations made it hard to stand, but would continue even after she sat. The pain squeezed around her heart until, after it was finally gone, an exhaustion took its place.

“And for how long? I mean, not how long does the pain last, but for how long has it troubled you?”

“More than a year.”

Mr Jones frowned. “This disorder is marked with strong and peculiar symptoms, and there is considerable danger belonging to anything regarding the heart. Why have you waited so long to seek a remedy?”

Read An Affectionate Heart to learn why Mr Jones is visiting the renters at Netherfield’s lodge, what is wrong with Elizabeth's heart, and if she’ll always think that Mr Darcy is so disagreeable.