A provincial surgeon and his obstetric practice: Thomas W. Jones of Henley-in-Arden, 1764-1846.

Recent research has revealed a small but growing quantity of casebooks and personal papers kept by obscure provincial medical practitioners in the eighteenth century, although the survival rate remains disappointingly low when contrasted with other archive sources for the period. We will never know how many Georgian surgeon-apothecaries in an age of low bureaucracy kept case notes on their patients and we can only guess at the motivation of those who did, although some famous medical teachers of the period certainly encouraged pupils to do so. It seems that the majority of provincial practitioners would know their patients personally and remember their earlier treatments. Written records were obviously of far greater importance as medical partnerships evolved and, by the nineteenth century, when there was more use made of practitioners' services by patients of all social classes, and perhaps practice was more impersonal. The variety of medical conditions, the frequency of treatments, the fees, practice areas, and social status of a practitioner's patients remain aspects of medical history for the eighteenth century about which so little is know when both practitioner and patient were undistinguished, although, of course, certain famous men and eminent sufferers are well documented, both subjectively and objectively. A practitioner's motivation to keep records may have been a desire to communicate his findings to one of the provincial scientific societies that were well established by the later eighteenth century. Even if a society were not named as a medical organization, a glance at its membership reveals a substantial number of practitioners attending meetings. Again, a publication such as the Philosophical Transactions frequently carried reports of recent medical discoveries or new theories, sometimes as a series of letters between practitioners, and the writers of case notes may have wished to publish their work in this way. However, practitioners' casebooks do survive, usually by accident. One country surgeon-apothecary, Thomas Jones, kept such a volume, relating to over four hundred deliveries during the last decade of the eighteenth century, which he entitled 'Women Delivered, Management &c'. In the volume, 6j inches by 8, rather too large for a pocket-book, he entered on the left-hand page the patient's name, (often in the form 'John Stanley's wife'), her place of residence, date of delivery, and whether the child were male or female. On the opposite page, Jones noted details of the labour, even if