"Survey return from Alex Shand"
Alex Shand was a church minister in Nesting.
Nesting was a parish on the Shetland Islands and contained the old parishes of Lunnasting and Whalsay and the islands of Skerries. In 1843, the population was around 2250. There were not many bridges or roads. There was not much agriculture, with fishing being the main industry. Much of the produce was exported to Leith.
To the Rev.
1. How many Medical Men practice within the Parish of Nesting Lunasting and Whalsay?
None in either of these parishes – all comprised within my ministry – nor any in the neighbouring parish of Delting – nor nearer than Lerwick – 15 miles distant.
2. The Names and Addresses of these.
The only Licensed Medical man so far as I know, in Shetland, is Mr John Cowie – Surgeon – in Lerwick. It is said that another has come there.-
3. Has the number increased or diminished of late years?
In Lerwick there were 3 Medical men till of late – when two of them died. There was also in Yell I believe an unlicensed Practitioner.
4. Have any left the Parish since you became connected with it? If so, for what reasons?
Any medical man of any respectability could never support himself in this or any other parish in Shetland, Lerwick excepted. -
5. Is there any complaint among the people of inadequacy in the supply of Medical aid?
The people having never enjoyed the benefit cannot grumble at the want of Medical Aid – but deeply do they feel it.
6. Do you know of any cases of protracted suffering, or of injury by Accident, such as might have been alleviated had proper advice been at hand?
Many - very many Cases of protracted illness:- notwithstanding the private Exertions made by some of us, to alleviate misery.
7. To what extent is the deficiency of qualified Practitioners made up by the efforts of other parties?
Chiefly made up by the Clergy. – We all or mostly all keep Medicine Chests - & the Laird of Symbister in Whalsay, does the same. -
8. Does your experience enable you to suggest any measure – of general applicability – such as would be likely to relieve to some extent the evils (if they exist) of deficiency in the supply of Medical aid?
I know not what to advise: unless to supply us, whose Incomes cannot afford large outlays, with some Simple Medicines.
9. What Heritors1 are resident, either generally or occasionally, in your Parish?
Wm Bruce Esqr of Symbister generally in Whalsay. – Robert Bell Esqr of Lunna, periodically for a week or two in Lunnasting. – No more.
N.B. The Country abounds with Ignorant Empirics3. Men of no Medical or indeed any Education. –
There was, perhaps is still, a highly respectable medl. Gentleman (Dr. Drover In the E. I. Com Service residing somewhere in the N. Isles.
Manse of Nesting Novr. 29 1850
Along with this you will receive my Answers to the Queries by the R. college of Physicians – and I beg to assure you that I shall raise no undue Expectations among the People – for this among other reasons that I am at a loss to See what Philanthropy can do for them. – The Physician of the Soul is presumed here, to be a fortiori the best physician for the body. He must prescribe and administer medicines whether he will or not. – No doubt sad mistakes do sometimes happen in consequence – for all professors are not Deacons at the trade. But so Inveterate is this notion that I have known many of them bring the Medicines they got from the regular practitioner to be first stamped with my imprimatur4, before they5 thought it safe to swallow them. – This Ignorance, prejudice and gullibility on the one hand – with the paucity of thoroughbred medical men on the other – opens the door to vast Imposition and quackery in these Islands. With a population of from 30,000 to 36,000 Souls, spread over a surface of 70 miles of mainland Length alone – exclusive of adjacent Islands – Many hands would be required instead of a Single pair cooped up in Lerwick. But then while the hands would always be furnished with abundant Employment, the mouths of the hapless Practitioners would be left to Starve. I would not guarantee the best physician in Edinburgh realizing £20 from his practice either within this ministry containing as it does 3 parishes – or in fact in any other parish or ministry that I am acquainted with in this county – Lerwick excepted.-6
Things are sufficiently bad as they are:- but were Cholera, or any other serious Epidemic to visit these shores the mortality will inevitably for the reasons already described be fearful in the Extreme. – I think it right to meet the generous Intentions of your Committee with this frank Statement of facts. Their wisdom will devise of any case, the proper remedial measures. -
I have the honour to be
Yours most respectfully
To Dr. Coldstream
R. C. of Physicians }
1. A heritor was a landowner, under Scots Law, whose holdings were sizeable enough for them to be liable for the payment of public burdens such as Poor Law rates, road and bridge assessments and the church minister’s stipend.
2. Written at the foot of the queries.
3. The term empiric was frequently used as a derogatory term, and that is how it appears to be used here. While it referred to those who relied on practical experience over theoretical teaching, commonly the term was used with similar intent to terms such as charlatan, street hawker and quack, i.e. to identify those unqualified and ineffective in the practice of medicine.
4. A person’s authoritative approval.
5. The letter continues overleaf.
6. The letter continues on the facing page.