'A little learning': knowledge and health in the 18th century.

Many high minded, improving physicians in 18th century England became convinced that the physician's vocation went beyond the merely clinical. It was the doctor's duty (they argued) not merely to attend individual patients but to address the ills of society at large. As Christopher Booth has shown so well, energetic figures such as John Fothergill, John Haygarth, and John Coakley Lettsom, fired by a philanthropic zeal and a non-conformist conscience, applied themselves to social reform and improvement.' They devoted their energies to good causes, from the small scale, such as the founding of dispensaries, to the visionary (for instance, the abolition of the slave trade). They passionately subscribed to the Enlightenment conviction that the advancement of knowledge both in medical science itself, and in terms of the broader education of the public must make its contribution to the progress of health, well being and decency. 'For observant men in the eighteenth century . . . the most tangible cause for confidence lay in medicine', concludes the eminent historian of the Enlightenment, Peter Gay: for such spokesmen, 'medicine was the most highly visible and the most heartening index of general improvement'.' Throughout 18th century Europe, philosophers, propagandists and reformers pointed to the general stimuli to betterment: the spread of trade, industry, liberty, toleration, literacy, education, and breakthroughs in technology and science. Progressive doctors naturally believed these developments would be consolidated in improvements in health. Take Thomas Beddoes, contemporary of Lettsom, radical physician, vocal supporter of the French Revolution (his activism required him to quit his chemistry chair at Oxford University), and crusader against dogmatic authority, tradition and ignorance. Enlightenment, conviction and revolutionary ebullience sparked in Beddoes a faith in a medical millennium. In his published Letter to Erasmus Darwin (1793), he proclaimed that 'a great revolution in this art [medicine] is at hand', thanks largely to discoveries in pneumatic chemistry. His own researches on gases, he explained, were about to lead to the conquest of tuberculosis. 'In a future letter,' he went on, 'I hope to present you with a catalogue of diseases in which I have effected a cure', concluding by stating his