|
Edited
by Frank R. Shaw, FSA Scot, Dawsonville, GA, USA
Email:
jurascot@earthlink.net
For me, one of the highlights of the recent Burns and Beyond
conference hosted by the University of Glasgow’s Centre for Robert Burns
Studies was a speech given by Sir Kenneth Calman, the university’s
chancellor. Sir Kenneth’s speech was entitled “Remember Tam o’ Shanter’s
Mare: A Study of Burns and Health.” I did not know what to expect from a
chancellor speaking about Burns, but I was certainly not disappointed – he
knows his Burns! A word about Sir Kenneth:
 Sir Kenneth Charles
Calman (1941- ) was elected Chancellor of the University in 2006. He is a
graduate who was appointed to the Cancer Research Chair of Oncology in 1974
and became Professor and Dean of Postgraduate Medical Education in 1984. He
was awarded an honorary DSc in 1996.
Calman graduated from the University BSc, MB ChB,
PhD and MD and lectured in Surgery before his appointment to the Cancer
Research Chair in 1974. In 1989 he was appointed Chief Medical Officer at
the Scottish Office Home and Health Department. He was Chief Medical Officer
at the Department of Health in London from 1989 to 1991 and worked in the
Department of Education and Science and its successors from 1991 until his
appointment as Vice-Chancellor and Warden at the University of Durham in
1998. He was awarded a KCB in 1996.
Sir Kenneth is Chair of the National Trust for
Scotland, and he is the main author of The Calman Report on the future of
public policy in Scotland which was commissioned by the Scottish Government.
The former Chancellor of Durham University, Sir Kenneth is one of the most
distinguished British academics in the field of Medicine, particularly
cancer studies. He has long been interested in the Medical Humanities and is
completing a Masters thesis on Scottish Literature & Medicine. (FRS:
3.30.11)
Photo by Susan Shaw. (L-R) Valentina Bold, Pauline Mckay, Gerry Carruthers,
Natalia Vid, Sir Kenneth Calman, Nigel Leask, Frank Shaw, and Kirsteen
McCue.
REMEMBER TAM O’SHANTER’S MARE
A Study of Burns and Health
By Sir Kenneth Calman
If you were a
group of 4th year medical students I might begin with this:
“Now, wha this tale o truth shall read,
Ilk man, and mother’s son, take heed:
Whene’er to drink you are inclin’d,
Or cutty sarks rin in your mind,
Think! Ye may buy the joys o’er dear:
Remember Tam o’ Shanter’s mare.”
Burns wrote much on health and medical issues and in this short talk I want
to concentrate on those things which struck me as especially interesting,
and for me, new. I will therefore not be able to discuss, his medical
friends, his own illness other than in passing, issues about learning, drink
or food, etc
To
begin, in Burns’ poem “Address to the unco guid, or the rigidly righteous”
he sets out a very modern view of the problems of developing a habit of
drinking to excess.
“See Social Life and Glee sit down
All joyous and unthinking,
Till, quite transmugrify’d, they’re grown
Debauchery and drinking:
O, would they stay to calculate
Th’ eternal consequences,
Or your more dreaded hell to state-
Damnation of expenses!”
It
begins with a few drinks and social mixing until it merges into debauchery.
If people would just think of the consequences, of the effects of such
habits surely they wouldn’t go to excess. Yet many of the current public
health messages reflect the same outcome. And then-
“Then gently scan your brother man,
Still gentler sister woman;
Tho they may gang a kenning wrang,
To step aside is human:
One point must still be greatly dark,
The moving Why they do it;
And just as lamely can ye mark,
How far perhaps they rue it.”
It
is a human failing, and there is no simple answer as to why they do it. Just
as importantly they are likely to rue it, and this applies equally to men
and women. The mechanism is the subject of many contemporary research
projects.
Perhaps one of
Burns’ most quoted lines fit in well here from “To A Louse”
“O wad some Power the giftie gie us,
To see oursels as ithers see us!
It wad frae monie a blunder free us
An foolish notion:”
When it comes to early diagnosis and prevention, Burns is again remarkably
positive in this quotation from “Death and Dr Hornbrook”. Burns sets
out the qualities of a local “quack” and in this section he informs us how
the “doctor” can even make a diagnosis at a distance, without ever having
seen the patient. He describes, with great accuracy, the current method of
large bowel cancer screening, though the language would not necessarily be
used in any public information campaign.
‘Ev’n them he canna get attended,
Altho their face he ne’er had kend it,
Just shite in a kail-blade, an send it,
As soon’s he smells ‘t,
Baith their disease, and what will mend it,
At once he tells ‘t.’
Here is a simple
diagnostic test which allows treatment to be prescribed, at a distance, the
forerunner of internet based testing.
He
would also have been familiar with traditional medicine of the time and had
access to contemporary books on health. For example it is worth noting at
this stage, his reference in “Death and Doctor Hornbrook”, to a very popular
medical book of the time, “Buchan’s Domestic Medicine” (William Buchan
(1729-1805) meant for use in the home.
The poem suggests that he might have seen other “medical” books by “ither
chaps.” The reference to Buchan’s book is very significant. It was an
attempt to educate the poor on health matters and to warn against the use of
herbs and unqualified practitioners. It also made the point that those
ladies and gentlemen who lived in the country had a responsibility to teach
the poor about health and sickness. It is interesting to note that in the
later editions of the book this has changed in tone, and, just as relevant,
there is a new section on the use of sea bathing and its value in health
care, perhaps a contributory factor in advancing the illness of the poet
himself. He notes,
“A
great advantage of sea-water in chronic diseases is that it may be
persevered in for a long time, without weakening the intestines or the
constitution.”
Smallpox. Burns makes no mention in his poems of smallpox and the
development of inoculation as a preventative measure. Smallpox was one of
the most prevalent infectious diseases at the time and it perhaps surprising
that there is no reference to it. Evidence that he knew about the procedure
for inoculation, comes from several of the letters between him and Mrs
Dunlop. On four occasions inoculation and smallpox are mentioned. Burns
replies on several occasions. On the 25th of January 1790 he
writes to Mrs Dunlop, for example:
“I
am every day expecting the doctor to give your little godson (His second son
Francis) the smallpox. They are rife in the country, and I tremble for his
fate.”
These comments are of some interest for several reasons. First, Dr Edward
Jenner from Gloucester is credited with the discovery of vaccination when he
inoculated the boy James Phipps on the 14th May 1796, from the
hand of a dairy maid who had cowpox. The inoculations referred to in Mrs
Dunlop’s letter, comment on the use of smallpox itself as the agent used, a
quite different and dangerous method of prevention. The second interesting
link is that Anne Hunter, a correspondent with Burns, who was married to
John Hunter (1728-93), an old colleague of Jenner’s and who famously wrote
to him regarding hedgehogs when he said, “But why think. Why not trie the
expt” (2nd August 1775). Thirdly there is a whole chapter on
smallpox in Buchan, though in the early editions no mention of vaccination.
In the later editions vaccination (the cowpox method) is treated as a
separate subject, and one which is admired by Buchan. Finally, Buchan and
Burns shared the same printer, William Creech, in the earlier editions.
Robert Burns and the Statistical Account of Scotland. It is of
interest to note that Burns was familiar with Sir John Sinclair’s work on
Scottish Statistics, gathered from parishes across Scotland. Sir John
Sinclair (1754-1835) was born in Thurso and had a remarkable career which
included agricultural reform and was the first person to use the term,
statistics, and to carry out this work on such a grand scale. The
Statistical Account of Scotland was published in 21 volumes between 1791 and
1799 and was a major step forward in recording and planning communities and
nations. Burns was clearly familiar with the work, and he comments on some
of the findings, for example in a letter to Mr Thomson 7th April 1793. Burns
refers to Sir J Sinclair’s Statistical Volumes in which he picks up a
comment as to whether Aberdeen or Ayrshire has the honour of originating the
song “The Lass o’ Patie’s Mill.”
In
another letter, undated, he writes directly to Sir John Sinclair about “an
issue omitted in the Statistical Account transmitted to you of the parish of
Dunscore in Nithsdale...To store the minds of the lower classes with useful
knowledge is certainly of very great importance, both to them as
individuals, and to society at large. Giving them a turn for reading and
reflection, is giving them a source of innocent and laudable amusement; and
besides, raises them to a more dignified degree in the scale of rationality.
Impressed with this grand idea, a gentleman in this parish, Robert Riddel,
Esq, of Glenriddel, set on foot a species of circulating library, on a plan
so simple as to be practicable in any corner of the country. ….Mr Riddel got
a number of his own tenants, and farming neighbours, to form themselves into
a society for the purpose of having a library among themselves…”
The significance of this is his knowledge of the Statistical Account and his
wider interest in the culture of Scotland.
Medicine and Doctors. There are a numbers of references to doctors
and to clinical practice. Proponents of “Evidenced Based Medicine” will be
delighted to agree with Burns in his two lines in “A Dream”:
“But facts are chiels that winna ding,
An downa be disputed:”
The most obvious reference to doctors is in “Death and Doctor Hornbrook”.
Dr Hornbrook is a caricature of a local quack, based on a schoolteacher,
John Wilson, who dabbled in medicine. Wilson was a Glasgow Graduate and who
taught first at Craigie in Ayrshire and in 1781 was appointed schoolmaster
in Tarbolton.
In another
reference to diagnostic techniques, he refers in the “Epistle to James
Goldie, in Kilmarnock”, to the testing of water, a reference to urinary
testing:
“Poor gapin, glowerin Superstition!
Wae’s me, she’s in a sad condition!
Fye!, bring Black Jock, her state physician,
To see her water!
Alas! There’s ground for great suspicion
She’ll ne’er get better.
Enthusiasm’s past redemption
Gane in a gallopin consumption:
Not a’ her quacks, wi’ a their gumption.
Can ever mend her;
Her feeble pulse gies strong presumption,
She’ll soon surrender.”
The “Black Jock” who tests the urine, referred to is the Reverend John
Russell an “Auld Licht” minister with whom Burns disagreed. There is an
interesting reference here to a “weak pulse” and Burns’ own condition after
rheumatic fever with its effect on the heart would have made him aware of
this.
Other notable medical names. One of the most significant was Dr John
Moore. He studied medicine in Glasgow and Paris, and practiced in Glasgow.
He lived first in Donald’s Land, Trongate, opposite the Tron Steeple, and
afterwards in Dunlop Street. His son, Sir John Moore of Corunna was born on
Donald’s Land. He was a friend of Tobias Smollet, who was a little older
than he was, and who was learning his medical trade in Dr Gordon’s surgery
in Gibson’s land at the corner of Saltmarket and Prince’s Street, where
Moore had also been an apprentice. Moore travelled to the continent with the
8th Duke of Hamilton, and then settled in London.
Dr James Currie. A Burns’ first biographer Currie was one of the most
influential of all Burns medical contacts.
Illness. References to illness and old age reflect the medical
practice of the times. But even here Burns is remarkably modern, with his
thoughts on psychosomatic illness in “The Twa Dugs” he notes.
The key lines
however must be,
“But human
bodies are such fools
For a’ there colleges and schools
That’s when nae real ills perplex them
They make enow themsels to vex them”
What insight into
human behaviour.
The “Address to
the tooth ache” is a classic, but covers more that just the teeth.
When fevers burn, or ague freezes,
Rheumatics gnaw, or colic squeezes,
Our neebors sympathise to ease us,
Wi pitying moan;
But thee! – thou hell o a’ diseases –
They mock our groan!”
The reference to “ague” is of interest. It is a term not used nowadays, and
refers to a fever, recurring every 3 or 4 days (tertian or quartan)
generally covering any illness, such as typhus, enteric fevers or malaria.
There is evidence that malaria occurred in Scotland, especially in marshy
areas, and the mosquito vector is still present.
Abortion is another subject which is dealt with in a poem called “The
Fornicator’s Court”, or sometimes called “Libel Summons” or
“The Court of Equity”.
That ye hae made repeated trials
Wi drugs and draps in doctor’s phials,
Mixt, as ye thought, wi fell infusion,
Your ain begotten wean to poosion.
And yet ye are sae scant o grace,
Ye daur to lift your brazen face
The details given in this poem suggest that this was common knowledge and
that process of abortion, no matter how offensive and frowned on it might
be, was a recognised procedure.
Old age is beautifully covered, perhaps especially in “John Anderson, My
Jo”. Here the life long relationship between a man and wife is described
with a picture painted in words of the aging process; the change from young
to old, but the retention of the love between them. The last verse:
John Anderson my jo, John,
We clamb the hill thegither,
And monie a cantie day, John,
We’ve had wi ane anither;
Now we maun totter down, John,
And hand in hand we’ll go,
And sleep thegither at the foot,
John Anderson my jo!”
Another way is describing the problems of old age are wonderfully recorded
in “What can a young lassie do wi’ and auld man”.
“He’s always compleenin frae morning to eenin;
He hoasts and he hirples the weary day lang;
He’s doylt and he’s dozin, his blude it is frozen –
O, dreary’s the night wi a crazy auld man!”
Death of course was the poor man’s friend, and this is noted in “Man was
made to Mourn”. It links poverty to death. And death comes as a relief.
In “Tam
Sampson’s Elegy” similar sentiments are expressed:
“In vain auld age his body batters,
In vain the gout his ancles fetters,
In vain the burns cam down like waters,
An acre braid!
Now ev’ry auld wife, greetin, clatters:
‘Tam Samson’s dead!”
The reference to a battered body, gout, and urine dribbling out related to
prostatic hypertrophy (“burns cam down like waters”) is a remarkably good
picture of old age.
Death was common, and within families it would not be unusual to lose one,
or several, children. A glance at the tombstones in any old kirkyard will
confirm that. It was familiar, and at the same time released people,
especially the poor from misery.
Quality of Life and Happiness. In “Contented wi’ little and
canty wi’ mair” Burns sets the scene and the theme which is
re-stated on many occasions; that quality of life and happiness are not only
associated with wealth, riches, status and power. It is more than material
matters and concerns much more.
“Contented wi little, and cantie wi mair,
Whene’er I forgather wi Sorrow and Care,
I gie them a skelp, as they’re creepin alang,
Wi a cog o guid swats and an auld Scottish sang.
In “A man’s a man for a’that” he
goes even further.
Here is an impassioned plea for equity, and an emphasis on honesty, sense,
worth, and independence of mind. Hard work has its own rewards, and even if
these rewards are meagre they still matter in crystallising quality of life.
This is even more
explicitly set out in the “Epistle to Davie, a brother poet.”
“It’s no in titles nor in rank;
It’s no in wealth like Lon’on Bank
To purchase peace and rest,
It’s no in makin muckle, mair;
It’s no in books, it’s no in lear,
To make us truly blest:
If happiness hae not her seat
An centre in the breast,
We may be wise, or rich, or great,
But can never be blest!
Nae treasures nor pleasures
Could make us happy lang;
The heart’s ay’s the part ay
That makes us right or wrang”
But perhaps most
poignantly are the lines in “To A Mouse”,
Still thou are blest, compar’d wi me!
The present only toucheth thee:
But och! I backward cast my e’e,
On prospects drear!
An forward, tho I canna see,
I guess an fear!”
It
is difficult to predict the future, and our plans sometimes go haywire. But
the mouse, now dead, is blest compared with the ploughman. The troubles of
the mouse are over, but the man looks ahead to poor prospects, and while it
is not possible to see into the future, it is full of fear.
He recognises how
evanescent pleasure and happiness can be in “Tam O’Shanter”
“But pleasures are like poppies spread:
You seize the flow’r, its bloom is shed;
“Auld
Lang Syne” has two relevant verses, not often sung, but poignant
reminders of what happiness was, what pleasure we had, and why friends and
memories matter.
“We twa hae run about the braes,
And pou’d the gowans fine,
But we’ve wander’d monie a weary fit,
Sin auld lang syne.
We twa hae paidl’d in the burn
Frae morning sun till dine,
But seas between us braid hae roar’d
Sin auld lang syne.”
So
how would Burns have defined happiness and quality of life? How do his
writings help us to improve both? Are there any clues to a way forward? It
is clear that Burns considers that it is possible to be happy without rank,
power, learning or wealth. Ambition can get in the way, as can a search for
fame. A search for pleasure will not satisfy entirely and is evanescent. On
the other hand his comments on poverty suggest that at the extreme this too
is not conducive to happiness.
So
what is it? Honest toil, friendship, family and a nice warm fire? Is that
all? He makes the point that happiness is deep inside and we can never be
best unless the heart feels it. This echoes a contemporary, Adam Smith, in
the “Theory of Moral Sentiments.”
“How selfish soever man may be supposed,
there are evidently some principles in his nature, which interest him in the
fortunes of others, though he derives nothing from it but the pleasure of
seeing it.”
In
the poem “Epistle to Robert Graham” there are numerous interesting
references to law, medicine and divinity, for example. And in particular to
the “martial phosphorus” is of particular interest. How could such an
“Unlettered ploughman” know about such an element and its properties? There
may be a clue in the letters between Burns and Mrs Dunlop.
This is perhaps Burns at his most passionate about learning. All he needs is
a “spark of Natures fire” to help him write his muse. In clinical
terms it is the same. A problem presented and unsolved, symptoms not
understood, a chance observation, a curious mind, have all set off voyages
of discovery and inventions. Curiosity remains an instinct to be instilled
in all those interested in improving health and quality of life. It is
reflected in a passion for life long learning.
Conclusions. Burns in his poems and letters shows remarkable insight
into the human condition and the problems of health and illness in 18th
century Scotland. Of particular interest are his views on quality of life
and happiness. There is much to learn from Burns on such matters. |
