by Mellany Ambrose
John Keats spent five years, a fifth of his tragically short life, studying and training to be an apothecary. In the early 19th century, many boys left school at fourteen or earlier to start apprenticeships, and Keats was no different. His family was middle class; his grandfather and father had run a coaching inn, the Swan and Hoop at Moorgate. Although he had a small inheritance, there wasn’t the money for him to continue boarding at the progressive Clarke’s school in Enfield studying the Latin, literature, geography, history and astronomy he loved, or attend university. He was an orphan and needed to be able to support himself and help his younger brothers George and Tom and sister Fanny.
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Blue plaque on the site of Thomas Hammond’s house and surgery in Edmonton
His father had died after a fall from his horse in 1804 when Keats was eight years old. His mother Frances had remarried but then disappeared and the Keats children were looked after by Alice Jennings, their maternal grandmother, who lived at 3 Church Street, Edmonton, a village near London. In 1809, when Keats was thirteen, his mother returned but she was ill. The local apothecary surgeon, Thomas Hammond, who lived at a house called Wilston two doors down, attended her. In his school holidays John nursed his mother, cooked for her, read novels to her, and administered Mr Hammond’s medicines. Frances Keats’s health deteriorated and she died in March 1810 of a decline, probably tuberculosis, which later killed Tom, then John and even George years later. When he was told of her death John hid in a hollow under his teacher’s desk.
By August of that year, aged fourteen, John was apprenticed to Thomas Hammond to learn to be an apothecary. No one knows who suggested this, but it might have been Mr Abbey, whom his grandmother had appointed as the children’s guardian, or perhaps it was even Thomas Hammond. It’s unclear whether Keats wanted to pursue this career. He might have felt forced into it, as some of his friends and acquaintances claimed many years later, or he might have been determined to study medicine and care for patients like his mother. He would be near his grandmother and sister and on his afternoon off be able to walk several miles back to Clarke’s school to see his brothers and discuss literature with his friend, the teacher Charles Cowden Clarke.
Abbey paid 200 guineas from Keats’s inheritance to Hammond. Keats would have promised not to marry, gamble or visit inns or playhouses. In return Hammond was to provide instruction, food and lodging, and medicine in case of illness. Keats’s five-year apprenticeship to be an apothecary had begun.
In the late eighteenth and early nineteenth century there were three main groups of medical practitioners. University-trained physicians treated internal diseases and prescribed medicines prepared by apothecaries. They weren’t very hands-on but might sniff or inspect urine. Few in number, they treated the rich, who might invite them to dine with the family.
Surgeons trained at the London hospitals and were licensed by the Corporation (later Royal College) of Surgeons. They treated external disorders of teeth, eyes and skin, and venereal disease. If something needed practical interference that was their remit: setting bones, dressing wounds or ulcers, incising abscesses, and amputations.
Apothecaries treated the poor. They undertook a five-year apprenticeship, but it was unregulated until 1815. Apothecaries could treat people but only charge for the medicines, not the advice. They often had a shop. There were also unqualified quacks, charlatans, mountebanks, bonesetters and some patients even consulted the horse doctor. Women could practise as midwives but not train to be physicians, surgeons or apothecaries. Many did practise healing, either in their own homes or communities, but not in an official role.
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Apothecary jars at the Royal Pharmaceutical Society Museum
Keats’s master, Thomas Hammond, was destined to practise medicine. His grandfather and father were both apothecaries. Thomas, his two brothers, two of his sons and his nephew all trained as apothecary surgeons. He was born in 1766 and probably apprenticed to his father in Edmonton for five years. He studied at Guy’s hospital from 1785-87 where he would have been a contemporary of Astley Cooper, a surgeon’s apprentice who was to become the most famous surgeon in the land and attend to George IV. Thomas was dresser to William Lucas Senior, one of the Guy’s surgeons. A dresser admitted patients, accompanied the surgeon on ward rounds and as the title says, dressed the wounds of patients. These wounds would have often been smelly and festering.
Thomas passed the exam of the Corporation of Surgeons in 1787. In January 1790 he married Susannah Bampton, the wealthy widow of a confectioner. His father died soon after Thomas took over his practice in Edmonton at a large house called Wilston, 7 Church Street. Wilston was demolished in 1931 but the site is marked by a plaque above an estate agents on Keats Parade in what is now Edmonton Green, London.
Hammond was trained as a surgeon and an apothecary, hence the title apothecary surgeon, and would also have learnt obstetrics in his time at Guy’s. Irvine Loudon writes that in 1783, 80% of medical men in provincial England were apothecary surgeons. These apothecary surgeons evolved into general practitioners. The earliest use of the term “general practitioner” was in 1809. Thomas Hammond was one of the first GPs in England.
There is little historical record of Keats’s apprenticeship years. Most biographers agree he started his apprenticeship in 1810 (although the blue plaque on the site says 1811). The accepted version was that he studied with Hammond until 1815, and Charles Cowden Clarke later described the ‘arrangement’ with Hammond as ‘the most placid time in [Keats’s] painful life.’ But in September 1819 Keats wrote to his brother George, ‘Seven years ago, it was not this hand that clench’d itself against Hammond,’ which has been taken as evidence of conflict between them. Nicholas Roe argues the apprenticeship ended in autumn 1812 and Keats possibly attended lectures informally at Guy’s from 1813-15. There are recollections and statements from friends and acquaintances hinting that the time wasn’t happy, but these date from years after Keats’s death.
Other biographers have argued the apprenticeship must have been for five years because to be granted a licence to practice as an apothecary, which Keats eventually obtained, a testimonial of five years’ experience as an apprentice was needed. Without firm evidence I believe all we can assert is that Keats studied for a minimum of two years and a maximum of five years.
Hammond’s surgery was a brick building with a pan-tiled roof, separate from the house. Keats took his meals in the house but slept above the surgery. Hammond may well have had two apprentices during this time. It’s unclear whether patients would have attended the surgery or only been seen on home visits. It would have made sense to see the walking-wounded at the surgery to save time.
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A horse was essential for an apothecary surgeon
Medicine in Georgian times was brutal. There was no anaesthesia, antibiotics or antisepsis, leeches were used for bleeding, and medicines could poison rather than cure. How did such a supposedly sensitive young man, the champion of beauty and truth, survive? Modern biographers argue the portrayal of Keats as a delicate soul, killed by hostile criticism of his work, is a posthumous myth and he was actually a much more rounded character: energetic, pugnacious, political, philosophical, supportive of his brothers, a good friend, ambitious, resolute, entertaining, colourful and playful.
Many of an apprentice’s duties would be dull chores: sweeping the surgery and dusting shelves, painting the glass bottles black as some medicines degraded in light. He would also be expected to tend the horses. A horse with or without a carriage was vital to an apothecary surgeon to carry out visits, especially in rural areas. The apprentice would also write up case notes and prepare bills. He had to learn the apothecary’s system of weights and measures: grains, drachms and scruples. Recipes were often written in Latin, but that wasn’t a problem for Keats.
The apprentice would be instructed how to mix medicines and make pills. He would observe his master and then be allowed to bleed with leeches and lancets, cup and blister. He would also learn how to lance abscesses, dress wounds and ulcers, pull teeth, set broken bones and assist in childbirth. He might vaccinate patients against smallpox by scratching cowpox into their skin. There might even be an amputation to assist with.
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Surgical instruments
The master would teach the apprentice how to recognise and diagnose conditions. A list of complaints seen and treated might comprise fevers – intermittent, continued and eruptive; smallpox, measles, scarlet fever and typhus; typhoid and dysentery; gout, lumbago and rheumatism; dyspepsia, colic and jaundice; tumours; rashes; bladder stones and strangury; convulsions, palsy and paralysis; quinsy and chincough (whooping cough); asthma; apoplexy; insanity; rickets and fractures; scrofula, consumption, phthisis (wasting) and pleurisy; and not to be forgotten lice, ticks and worms.
What about the poetry? Keats discussed literature and poetry with Charles Cowden Clarke, a teacher at his old school, during these years. He was eight years older than Keats but had taken him under his wing and supervised his learning from the time Keats’s father died. Keats read Shakespeare, Milton, Tasso, Spenser and Cowper. Cowden Clarke wrote poetry and knew Leigh Hunt from 1812, four years before Keats met him. Keats started writing poetry during his apprenticeship, although none of his best-known poems are from that time. He wrote his first surviving poem, An Imitation of Spenser, early in 1814.
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Charles Cowden Clarke
When Keats signed his indentures, he expected to do five years then be able to practise as an apothecary, but in July 1815 the Apothecary Act was passed requiring an apprentice to have reached the age of twenty, to have spent a minimum of five years as an apprentice, and to have studied at a London teaching hospital for at least six months (twelve to qualify as a surgeon). Keats registered at Guy’s in October 1815 and signed on for a year, which suggests he intended to also qualify as a surgeon. In July 1816 he obtained the Licentiate of the Society of Apothecaries.
Keats continued studying surgery, but never took his surgeon’s exams and by early 1817 had chosen to follow poetry over medicine. Why did he abandon medicine for poetry? Perhaps he could no longer stand the butchery of surgery. Perhaps he decided he could better heal suffering as a poet, but his motives were probably far less noble. Poetry was his passion and when he saw he might make a living from it as his mentor Leigh Hunt did, he took the chance.
Did his apothecary years influence his poetry? Edmonton was surrounded by countryside with fields, lanes, brooks, birds and wildlife, which can be seen in the love of nature expressed in his poems. The plants he made into medicines also appear, such as the “fox-glove bell” in O Solitude. In Ode to a Nightingale “palsy shakes a few sad, last grey hairs”.
Perhaps his poetry was an escape from the suffering he saw and also experienced in his own family, allowing him to immerse himself in an imagined world, and maybe in some way he hoped it would also give comfort to others. Despite the fact that he abandoned medicine, Keats did connect medicine and poetry, and wrote in The Fall of Hyperion, “a poet is a sage; A humanist, physician to all men.”
For more on his time at Guy’s see Suzie Grogan’s blog Keats at Guy’s Hospital and her review of Nicholas Roe’s John Keats and the Medical Imagination
Sources
Burnby, Juanita. The Hammonds of Edmonton. Edmonton Hundred Historical Society, 1973.
Loudon, Irvine. Medical Care and the General Practitioner, 1750-1850. Oxford University press, 1987.
Motion, Andrew. Keats. Faber and Faber Ltd, 1998.
Roe, Nicholas. John Keats. Yale University Press, 2013.
Keats, John. John Keats: The Complete Poems. Edited by John Barnard, Third Edition. Penguin Books, 2006.
Crosse, V. Mary. A Surgeon in the Early Nineteenth Century: The Life and Times of John Green Crosse, 1790–1850. E. and S. Livingstone, 1968.
Image may be NSFW.
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Mellany Ambrose worked as a hospital doctor and general practitioner in the NHS for nearly thirty years. Her interest in Keats’s medical career arose when she discovered he’d trained as an apprentice close to where she was working as a GP. She is the author of the historical novel Mr Hammond and the Poetic Apprentice, which imagines the years Keats spent training in medicine, told from the viewpoint of Thomas Hammond, the apothecary surgeon training him. There is more about Keats and Georgian era medicine on her website mellanyambrose.com
The post “I shall try what I can do in the Apothecary line”: John Keats’s medical years appeared first on Wordsworth Grasmere.