Falling from horses: medical controversy in early eighteenth-century England

• Published in: Medical history Vol. 64; no. 4; pp. 478 - 493
• Main Author: Pender, Stephen
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.10.2020
• Subjects: 18th century; Abnormalities; Ammonia; Autopsies; Autopsy; Brochures; Cerebellum; Extravasation; Fatalities; Fractures; Horses; Illnesses; Knots; Medical personnel; Physicians; Physiology; Surgeons; United Kingdom > UK; England; Medicine; Medical controversy; Rhetoric; Pulse; Apoplexy
• DOI: 10.1017/mdh.2020.42
• ISSN: 0025-7273

On Tuesday, 12 April 1726, Robert Worger fell from his horse at Barnham Down, Kent, hitting his head on the ground ‘with strong Force’. Unconscious, he was taken to Bridge, a nearby village, and laid out at the home of Sarah Knot, ‘Nurse and Landlady to the Patient’, bled several times, given ‘volatile mixture’ (ammonia, salt, opium) and treated with purgatives and clysters. He vomited as many as five times over the course of his illness and delivered ‘half a score [of] very foul, stinking, loose Stools’. Worger died, ‘without … Agony’, at 5 am, Thursday, 21 April 1726, after living for 8 days in the care of Knot, his wife, two surgeons, an assistant, an apothecary and two physicians, Christopher Packe and John Gray. An autopsy was performed – the next night, by the light of a single candle – and, although there was little extravasation and no severe fractures or depressions in the skull, slight abnormalities were found: the cerebellum ‘Turgid with Blood’, two small fissures appeared on the os frontis. Worger’s illness and death spurred months of rebarbative public controversy: in order to exonerate themselves, both physicians published pamphlets and letters, secured affidavits, importuned surgeons and Worger’s relatives for support, vied for authority and mastery over the circumstances of the case and argued about propriety, professionalism and conduct. This paper explores Worger’s case – controversy about diagnosis and prognosis, concern with ‘knowledge and deportment’, with the status of medical offices and medical jurisprudence and with relationships between physicians, patients, surgeons – as an instance of learned medical controversy in early eighteenth-century England.