England, Health Records - International Institute

Short History
Prior to the dissolution of the monasteries by Henry VIII in the 1530s monks and nuns had provided some care for the sick and those with then-incurable diseases such as leprosy. Most people’s health care came from folk remedies administered at home or by ‘wise women’, and most households had a herb garden wherein many of the ingredients were grown; and others were collected in the fields and woods. Ashley provides a useful history of old remedies. Along with the genuine healers there were large numbers of quack doctors, often touting their own concoctions as magic cure-alls. Advertisements for these are common in newspapers until the late 19th century.

The elite London College of Physicians was founded in 1518, whilst the ‘inferior’ Surgeons’ and Barbers’ Companies, formed in the late 15th century, merged about 1540. There were also apothecaries who dispensed medicines.

Until well into the 18th century there was frequent use of blood-letting, purges and emetics but a few scientific advances were being made particularly inoculation, and in 1798 vaccination, for smallpox. It was not until the mid-19th century that anaesthetics and antiseptic procedures allowed major internal operations to be performed. Pasteur’s work on the microbial etiology of disease came in the late 1860s and Koch’s in 1881-2, but antibiotics were not discovered until 1928. A succinct history of medical practice was given by Dr. Porter of the Wellcome Institute for the History of Medicine.

Anatomists and Resurrectionists
A necessary part of medical education was anatomical dissection, although it was repugnant to many. Henry VII allowed the Barber-Surgeons’ Company to have the bodies of four executed felons annually for dissection. To satisfy greater demand there was a good trade in ‘fresh bodies’ supplied by body snatchers or resurrectionists. Occasional references to missing bodies or apprehension of the perpetrators can be found in parish registers, parish chest materials and newspapers.

The demand for corpses for dissection was greatest in Edinburgh’s renowned university medical school, and it was here in 1827-28 that the infamous Burke and Hare developed the resurrectionist’s trade into murder. Their story is told at Scottish History Online.

In 1831 a similar case occurred in London and forced parliament to change the law. In 1832 it became legal for anyone in legal possession of a body to hand it over for dissection, provided the person had not expressly stated before he died that he did not wish to be anatomised. Workhouses were also allowed to assign unclaimed bodies to medical schools. The supply now kept up with the demand and grave-robbing became unnecessary.

Tom Wood (2002) in Family Tree Magazine notes that 750 bodies were needed annually for the London hospitals, and refers to Richardson’s book on the subject. Details on modern regulations regarding the supply of bodies and some conjectures on past usage by a chief anatomy technician were related by Wood (2003, Family Tree Magazine). The anatomy database provides details of bodies donated to medical science since 1992. The older companionanatomy registers at TNA commenced in 1832, those up to 1971 are in class MH/74 (Sandford).

Post-Mortems and Inquests
There was less popular aversion to autopsies or post-mortems to decide the cause of death. Coroners, formerly crowners as they were on crown business, have had the duty to investigate the circumstances of sudden, unnatural or suspicious deaths since 1194, and deaths in prison and during hospital operations were added to this list later. Before 1926 all inquests were held before a jury and one sees reference to twelve men sat on the body of the deceased. Thomas Hood’s Faithless Nelly Gray includes the lines:

A dozen men sat on his corpse, To find out why he died -

Some examples of coroner’s orders can be found below.

Chart: Examples of Coroner’s Orders

The result of the post mortem and/or the verdict from the inquest, was included in the cause of death column on the death certificate. This would be followed by the phrase Inquest/Post mortem (or PM) held and sometimes its date(s) as well. If the wording isInquest adjourned then it means that someone has been charged with the death, and it may or may not give the name of the accused, or may say by person or persons unknown. Examples of such certificates are shown in the course English: Civil Registration Records including Wales.

Any mention of a post-mortem, inquest or coroner’s certificate should be followed up in:


 * Newspapers. Depending on the nature of the demise there could be considerable coverage in the local and/or national newspapers.
 * Coroners’ records. Surviving records of coroners’ hearings usually include the individual inquest or inquisition which gives the verdict, name, date, time, cause of death and the signatures of the jurors. Unfortunately in most cases the fascinating supporting evidence has been discarded over the years.

The National Archives contains much material before the mid-18th century, but after that only if the inquest resulted in a murder or manslaughter trial. Details of what TNA holds can be found in their leaflet L30. Most surviving material after 1750 is held in county archives, the finding aid being Gibson and Rogers. There is a 75-year closure period but exceptions can be made if you contact the local coroner’s office.

Nurse Children
A nurse child was one sent out to a woman paid to care for it, either by wet-nursing a baby, or dry-nursing an older infant, the latter term formerly meaning a child up to age 7. It was very popular amongst the middle and upper classes, although it was also used for foundlings, for example those from the Foundling Hospital and Christ’s Hospital in London. Those living in crowded cities would typically send their children to the far healthier countryside for their first three years or so. London parishes often had special ties with a certain village(s) in the home counties or even slightly further afield and children from that parish were nursed there over many years. Alternatively, the city family may have had a familial or trade tie with a country parish, perhaps the place of origin of the husband or wife and found a suitable wet- or dry-nurse through their own contacts.

Burial registers of the nurse-parish can provide much information about the child’s family. Infant mortality being much higher than it is today, many of the thousands of nurse-children died in their early years and were usually buried in the nurse-parish. Their burial entries often have more information than is usual at the time since:


 * Outsiders were normally given a greater write-up than parishioners.
 * Both the parent (or foundling hospital) and the nurse needed a record of the date on which payment for services should end.
 * If they were from upper class families this would be reason for more detail to be given.
 * Children of members of the City of London Livery Companies would often have the name of their father’s company recorded.

In addition to the child’s name and date of burial other details may be recorded such as:


 * A nurse-child from [London].
 * The specific address or parish they were from.
 * Name of the father (and sometimes mother).
 * The father’s occupation.
 * The father’s livery company.
 * Name of the nurse.

This information may not have been given at the time of the child’s christening, usually in its home parish, or indeed anywhere else!

Clark’s two articles on nurse-children and their nurses make interesting reading; her period of study was 1540-1750, but the practice continued much later, nurse children being commonly found throughout the 19th century census returns as well. An index to nurse child burials is being compiled through the Society of Genealogists. This will be of obvious value in providing clues to the origins of city inhabitants.

The brutal methods of baby rearing in the 17th-18th centuries are described by Wood (2000c)—it’s a wonder that any of our ancestors survived!

Family Nutrition
In the mid-19th century the staple diet was bread and potatoes; fresh fruit and vegetables would only be available in season, and the protein portion was meagre. A typical list of weekly expenditures was given by Grindrod.

Chart: Typical Weekly Budget for Mid-18th Century Family with Several Children

Since there was no Old Age Pension until 1912, the elderly continued working as long as they could, and when incapable of working they went into the workhouse unless they had family or other support.

During the Second World War the population was probably better nourished than at any previous time because of public diet education and rationing of foods to the essentials. The latter continued for eight years after the end of the war, with more and more items coming off ration as the food supply got back to normal. My last ration book is shown below and indicates that the proteins (meats, eggs, cheese and bacon), fats and sugar were the last items to be rationed as they are on the only page used.

1953-54 British Ration Book

(From the personal collection of Dr. Penelope Christensen)

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Information in this Wiki page is excerpted from the online course English: Education,Health and Contemporary Documents offered by The National Institute for Genealogical Studies. To learn more about this course or other courses available from the Institute, see our website. We can be contacted at [mailto:wiki@genealogicalstudies.com wiki@genealogicalstudies.com] We welcome updates and additions to this Wiki page.