The providers of medical treatment in mid-nineteenth-century Bristol.

MEDICAL PRACTICE in Bristol during the nineteenth century has been discussed from several points of view. These are histories of the hospitals and of the practitioners closely connected with them, and brief descriptions of the local dispensaries,1 while a detailed account ofpauper medical relief in Bristol has been given by Hodgkinson who quotes figures for the numbers receiving this relief in 1850-51.2 The present paper describes a survey in which attempts were made to identify the various groups supplying medical treatment in mid-nineteenth-century Bristol, outside the provisions of the voluntary organizations and pauper relief. Information about the "regular practitioners" is easily obtained but is relatively sparse about the various groups without formal qualifications. The survey has therefore relied mainly on the enumerators' books for the 1851 census in the hope ofobtaining a more comprehensive view and of providing data about the suppliers of medical treatment in the contexts of their households and of their location in the city. In theory, the physicians provided advice rather than treatment but, as pointed out by Holloway,3 such a distinction was not often the case in practice and they are therefore included in the survey. Problems arise in classifying the heterogeneous group of those described as "surgeons" so an attempt has been made to distinguish those working mainly as general practitioners from those working, at least partly, as consultants. McKeown4 has pointed out the usefulness of such an approach and the emerging distinction had been recognized at the time, the introduction to the medical directory of 1847 noting that medical practitioners were "by force of a public convenience they cannot withstand, being gradually classed into Consulting and General Practitioners."5 If the regular practitioners acted for the richer sections of the population, the poor could obtain medical relief under the New Poor Law but this had drawbacks6 and they often had recourse to various types of "irregular practitioners". Among these the