Woodlands Medical Practice, London, United Kingdom (Summer 2013)
Portrait of John Wesley
John Wesley was an 18th century Anglican priest, Fellow of Lincoln College and Oxford don, with an intellect and energy that resulted in over 400 publications and the riding of a quarter of a million miles to preach forty thousand sermons.1 The movement he reluctantly founded, disparagingly called “Methodism,” channelled the energy of the poor into revival rather than revolution and had profound effects upon England for generations. However, the focus on Wesley’s social impact has distracted attention from his love of scientific inquiry. The fascination with medicine and a vocation to serve the poor encouraged him to become a skilled amateur physician and therapeutic entrepreneur who popularized self-help and established a network of free health care. His writings give insight into how theological beliefs and scientific enthusiasm motivated him to challenge accepted standards and provoke change.
Wesley was a well-read polymath proficient in eight languages who discussed contemporary scientific developments including the work of Boerhaave, Heberden, Bacon, Franklin and Priestley. He annotated Bartholin’s Physica and read Drake’s Anatomy claiming that “For six or seven and twenty years, I had made anatomy and physick the diversion of my leisure hours.” Wesley admired the famous contemporary physicians Sydenham and Dover, and was greatly influenced by Cheyne’s Book of Health and Long Life.2 His Journals carefully record clinical information including symptoms, signs, diagnoses, and treatments. Death and suffering are often placed in a spiritual context, with people who were terminally ill described as having no fear of pain and dying, and mourners touched by God. Such pathographies are consistent with the deathbed accounts published in his Arminian magazine. These record instances of victorious prayer, the subjection of pain leading to a triumphant death, and not surprisingly are full of the spiritual assurance arising from his evangelical theology.3Although Wesley believed that people should involve God in their suffering at an early stage of an illness, there is no evidence that Wesley held any “anti-doctor” bias. On the contrary he was content to visit physicians with his own complaints and urged others to copy his example. For instance, after consulting three eminent Edinburgh physicians, Hamilton, Gregory and Monro, who were also his personal friends, Wesley accepted their advice and had a hydrocele drained. He discussed medical practice with an uncle who was a London doctor, and while on a missionary journey is reputed to have jointly performed the first recorded post-mortem in the state of Georgia!
Sympathetic to the majority of contemporary practitioners who did not share his university experience, Wesley nonetheless complained that many doctors put profit before patients. He considered the profusion of prescriptions generated by such ill-trained professionals as expensive, complicated, and irrational, and attacked those individuals he believed to be ignorant or unethical. Wesley records how he delivered a man from “an egregious quack, who was pouring in medicines upon him for what he called ‘wind in the nerves’!”4 He commented on another by asking “Oh why will physicians play with the lives of their patients? Do not others (as well as old Dr. Cockburn), know that no end is answered by bleeding in a pleurisy . . . ?”5* Wesley was disappointed at the unfavorable reception given by the medical establishment to Dr. Cheyne’s A Book of Health and Long Life, and the rejection of Quincey’s demand for plain comprehensible treatments in Dr. Fuller’s Pharmacopoeia Extemporanea. He accused the profession of inflating their status by using technical terms, as well as astronomy and astrology, to deliberately confuse people. He was suspicious of doctors who prescribed compound drugs that obscured curative ingredients with exotic and dangerous chemicals, and criticized their underlying motives suggesting, “one thing will cure most disorders, at least as well as twenty put together. Then why do you add the other nineteen? Only to swell the Apothecary’s bill: nay, possibly, on purpose to prolong the distemper, that the doctor and he may divide the spoil.”6
Wesley eventually decided to advise and prescribe himself, but only by using safe preparations so that “If it does you no good it will do you no harm.“7 He asserted that God had made palliatives readily available in nature, and suggested that plants in the Chelsea Physic Garden should be thoroughly investigated. He urged people to buy remedies and ingredients only from reliable sources such as Apothecaries Hall.
Wesley’s theology accepted that human perfection had become marred by disease and sin, and that physical and spiritual health could be restored. His desire to see both medical as well as spiritual help accessible to the poor is evident in the words of his hymns:
Giver and Lord of Life, whose power
And guardian care for all are free8
And in another:
Abroad thy healing influence shower,
O’er all the nations let it flow.9
Wesley followed Cheyne in perceiving the body as a carefully designed mechanism that is sustained by a disciplined lifestyle,10 and zealously advocated the use of Cheyne’s “non-naturals”—sleep, diet and regular bowel habits.
In 1747, to provide trustworthy advice for his followers, Wesley went one step further and published Primitive Physic, a cheap formulary that would supply the owner with a “Physician always in his house.”11 This paperbound volume of 119 pages cost one shilling and became one of the most popular books of its time, with 20 editions required by 1781 and 36 by 1840. Primitive Physic advocated fresh air, cleanliness and readily digestible food, and specifically omitted potentially toxic substances such as opium and quicksilver that were in common usage and recommended by contemporary medical works. The remedies, compiled rather than devised by Wesley, are arranged alphabetically according to 288 symptoms or illnesses with 824 points in total, spanning baldness to apoplexy, bruises to breast cancer. Footnotes enable symptom recognition and treatment, and describe disorders such as diabetes, asthma and sciatica. Wesley recommends his readers to use readily available herbs, flowers, and household products rather than rarities. Finally, he itemizes specific recipes for common proprietary medicines to be made cheaply at home. Some suggestions, undoubtedly peculiar from a modern viewpoint, are found in similar works written by Wesley’s medical contemporaries. Primitive Physic was intended to be a self-help manual. Wesley quoted many well-known doctors to give the poor the benefit of their otherwise unattainable advice. This immensely popular book at first provoked little reaction from the profession. It was only with the publication of the 16th edition that Dr. Hawes made a public attack having discovered the lay status of its author. Wesley’s typically generous reply was in Lloyd’s Evening Post dated 22 July 1776:
My bookseller informs me that since you published your remarks on the Primitive Physic . . . there has been greater demand for it than ever. If, therefore, you would please publish a few further remarks, you would confer a farther favour upon your humble servant.12
Wesley’s emphasis on lifestyle issues has allowed him to be described as the greatest health educator in 18th-century Britain.13 This was typified by his well-known but often misquoted phrase “cleanliness is indeed next to godliness,”14which possibly originated either from the writings of an ancient rabbi or a sign at the public baths in Dublin! Wesley was deeply concerned with the social aspects of health. He expressed indignation at how easily unwanted relatives could be incarcerated in a lunatic asylum, and frustration when the interaction of mind and body was ignored:
Reflecting today on the case of a poor woman who had catarrhal pain in her stomach, I could not but remark the inexcusable negligence of most physicians in cases of this nature. They prescribe drug upon drug, without knowing a jot of the matter concerning the root of the disorder. And without knowing this they cannot cure, though they can murder, the patient. Whence came this woman’s pain (which she would never have told had she never been questioned about it)? From fretting for the death of her son. And what availed medicines while that fretting continued? Why, then, do not all physicians consider how far bodily disorders are caused or influenced by the mind. . .?15
As part of his wider investigations, Wesley became fascinated by the work of Franklin and Priestley on the clinical value of electricity, and used a friction machine (still to be seen at Wesley’s Chapel in London), for therapeutic purposes seven years before the Middlesex Hospital. Wanting to do as much good as possible, he rejected the notion that only qualified physicians should electrify and treated 3000 patients in ten years. Wesley also wrote The Desideratum or Electricity made Plain and Useful, which was praised by Priestley.
Samuel, John’s brother, was a founder of the precursor to Westminster Hospital, and may have inspired the decision to establish free dispensaries in London and Bristol. Already raising considerable sums through his church network to distribute coal, bread and clothes, Wesley wrote, “I mentioned to the society my design of giving physic to the poor. About thirty came the next day, and in three weeks about three hundred. This we continued for several years, till, the number of patients still increasing, the expense was greater than we could bear.” He estimated that 600 patients attended in the first six months, with 200 improved, 51 cured, and 20 remaining the same. Wesley often visited hospitals such as St. Bartholomew’s and St. George’s, applauded their efforts, and organized his followers so that “Visitor of the Sick” became a recognized office within congregations.
Bertucci suggests the link between Wesley’s medical and religious work has been highlighted only recently,16 yet it permeates his writings, by indicating a divinely ordained universe in which empirical observation generates faith, and an understanding of natural order leads to the recognition of all forms of authority, including that of medical orthodoxy. Wesley did not object to the profession, only to those who were ignorant or greedy, and was willing to embrace standard medical practice as long as it advocated a rational therapeutic approach.17 Instances of poor advice and naivety occur in his works no more and probably far less than in those of contemporary physicians.
Although formally unqualified, Wesley displayed features desirable in a modern practitioner—keeping informed, writing accurate records, using reliable cost-effective treatments, looking for evidence, referring for specialist opinion, maintaining integrity and accountability, encouraging patient education, auditing results, seeking funding, recruiting staff and volunteers, and establishing a framework of health provision. Significantly, it was a physician, John Whitehead, who gave Wesley’s funeral ovation, executed his will, and prepared the first biography. Wesley’s considerable intellect, energy and theology were channelled into a desire to alleviate suffering, typified by his deathbed letter that encouraged Wilberforce to persist in his abolitionist crusade, and prompted The Gentlemen’s Magazine to declare that “his personal influence was greater perhaps than any private gentleman in the country.”18
*Dr. Cockburn, a school friend of brother Charles, had influenced Wesley against this common practice.
- John Telford, The Life of John Wesley (London: Wesleyan Methodist Book Room, 1902).
- AW Hill, John Wesley among the Physicians. A study of eighteenth century Medicine (London:
The Epworth Press, 1958).
- RJ Bell, “Our People die well. Deathbed scenes in John Wesley’s Arminian magazine,”
Mortality, 10 (2005): 210-23.
- John Wesley, The Journal of the Rev John Wesley, A.M., ed by Nehemiah Curnock, 8 Volumes, Standard Edition, (London: Robert Culley, 1909): Vol VI 4 July 1781.
- John Wesley, The Journal of the Rev John Wesley, A.M., ed by Nehemiah Curnock, 8 Volumes, Standard Edition, (London: Robert Culley, 1909): Vol IV 5 April 1756.
- John Wesley, Primitive Physic or An Easy and Natural Method of Curing Most Diseases (1747; London: The Epworth Press, 1966): 28.
- John Wesley, Primitive Physic or An Easy and Natural Method of Curing Most Diseases (1747; London: The Epworth Press, 1966), 27.
- John Wesley, The Methodist Hymn Book (1933; London: Methodist Conference Office, 1972): 51.
- John Wesley, The Methodist Hymn Book (1933; London: Methodist Conference Office, 1972): 687.
- Philip W Ott, “Medicine as Metaphor: John Wesley on Therapy of the Soul,” Methodist History 33 (1995): 178-91.
- John Wesley, Primitive Physic or An Easy and Natural Method of Curing Most Diseases (1747; London: The Epworth Press, 1966), 27.
- Deborah Madden, “Contemporary Reaction to John Wesley’s Primitive Physic: Or, the Case of Dr
William Hawes Examined,” Social History of Medicine 17 (2004): 365-78.
- RH Parry, The Medical Officer, 12 October 1956.
- John Wesley, The Works of the Rev John Wesley, A.M., ed by Thomas Jackson 14 Volumes 3rd edition (London: Wesleyan Methodist Book Room, 1831), Vol VIII: 263.
- John Wesley, The Journal of the Rev John Wesley, A.M., ed by Nehemiah Curnock, 8 Volumes, Standard Edition, (London: Robert Culley, 1909): Vol IV 12 May 1759.
- P Bertucci, “Revealing sparks: John Wesley and the religious utility of electrical healing,” British Journal of the History of Science 39 (2006): 341-62.
- JW Haas Jr., “John Wesley’s Views on Science and Christianity: An Examination of the charge of Antiscience,” Church History 63 (1994): 378-92.
- Gentleman’s Magazine, Volume LXI, 282-284 quoted in Maldwyn Edwards, John Wesley and the Eighteenth Century (London: Epworth Press, 1955).
PAUL DAKIN, BSc MB BS, MA FRCGP is a general practitioner in North London. He trains postgraduate doctors and medical students, facilitates the local trainers’ workshop and is a member of Council of the Association of Medical Humanities. He has a Master’s degree in literature and medicine.