Dr Matthew Henry Grattan – Ongar GP from c.1864-1908

The confidential nature of medical practice makes it very difficult to build a picture of the working life of a GP from a past era, particularly in the absence of any contemporary letters, diaries or day books. Fortuitously Martyn Lockwood’s recent acquisition of a photograph of “Dr Grattan of 7 High Street, Ongar” followed my attempt to uncover something of his working life as a GP. No known medical records have survived but local newspaper reports throughout his working life provide a surprising amount of detail about his day-to-day work. Nothing like this will be available to assist a future historian of twenty first century medical practice! However, these newspaper reports do give a very one-sided view, as they relate almost exclusively by accidents, disasters, deaths, and criminal or anti-social activities, so they provide few clues about the inner workings of his medical practice or the sort of care that he provided to the more run-of-the-mill patients. Though I trod in his footsteps three generations later, I never met anyone old enough to have any memory of him.

Early life

Dr Grattan was born in Ireland in about 1840, probably in Edenderry, not far from Dublin. He qualified in Ireland as licentiate in medicine and surgery, a joint exam administered by the Irish King and Queen’s College of Physicians and the Irish Royal College of Surgeons. He had settled in general practice in Ongar by August 1864. It is not known how and why he came to this town. If he had set up independently he would have expected a long slow struggle to attract patients from his established rivals in the town. It is more likely that he bought into an established practice. The latter seems to be confirmed by the fact that he was advertising a property to let within two years of his arrival. This was a good sized semi-detached house with four bedrooms, three sitting rooms, kitchen scullery and cellar, stabling for three horses, a coachhouse, a wood and coal house – perhaps his first home at 7 High Street. A GP at that time would have required stabling for several horses, as much of his work would have involved visiting patients in their homes in the surrounding rural area, sometimes travelling surprising distances. By 1872 he had moved to the Manor House (where his son was born) and at a later date moved to Ongar House which was sued by one of the town’s practices until 1976.

His Ongar practice

Dr Grattan came to Ongar as a ‘physician and surgeon’, a designation which survived until very recently in the Yellow Pages of the telephone directory, and still survives in a doctor’s qualifying degrees (MB, BS, bachelor of medicine and surgery). The Medical Act of 1858 which required all new doctors to have recognised academic qualifications. Up to that date the local surgeons, such as Mr Potter, would have served a working apprenticeship with another surgeon but were permitted by the 1858 Act to continue in practice, though this route onto the Medical Register was no longer be permitted for new entrants to the profession. It is possible that Dr Grattan’s impressive new qualification gave him a competitive advantage over the established local surgeons.

Accidents

In his early years in Ongar, however, Grattan would doubtless have respected and valued the experience of such men when treating the sort of serious trauma which today would go straight to a district hospital. In December 1867, for example, he sought Mr Potter’s opinion about a man who had been seriously injured after slipping under a moving train at Ongar station. The patient was revived with sal volatile and brandy, but the doctors decided that he was not strong enough to undergo amputation and had him taken home to die. Two years earlier, Grattan had sought assistance from another surgeon to reduce the dislocated shoulder of a man who had been injured when his carriage overturned. At a time when anaesthetics were little used, reducing this dislocation would have required experience, as well as considerable force. Hospital admissions were a rarity, through a few of the injured were taken to be nursed at the workhouse infirmary at Stanford Rivers. A man who was severely concussed when loading large tree trunks in the Ongar goods yard was taken by train to the London Hospital. He did not survive. In 1902 a badly injured cyclist was transferred to the London Hospital in the same way. Compound limb fractures (where the broken bone had pierced the skin) usually necessitated amputation to avoid fatal complications from infection.

Post mortems and a heart-sink patient

Later in his career Dr Grattan does not appear to have sought assistance or a second opinion, though in 1902 an Ongar colleague, Dr Spurgin, performed a post mortem on an infant delivered by one of Grattan’s patients. This would normally have been done by the responsible GP. However, this delegation was perhaps necessary for medico-legal reasons, as Grattan must have had had long-standing difficulties with the family. On this occasion he had refused an aggressive demand to attend a confinement. The father had then threatened Dr Grattan with the police, but the doctor had replied that he “could go where he liked but he would not attend his wife”. It is likely that there had been a long history of provocation for the doctor to have refused to attend, and to use such unprofessional language! In the days before the NHS, non-payment of medical bills could result in considerable strain on the doctor/patient relationship.

Road traffic accidents

As our source of information is entirely gleaned from newspaper reports, it is inevitable that all that almost all that we know of Dr Grattan’s work relates to accidents, deaths and suicides. Though we may think that road accidents are a modern phenomenon, there were numerous reports in Dr Grattan’s time of those caused by horse drawn vehicles overturning, or running over their attendants, as well as horse riders being thrown off their mounts, either on the road or when following the Essex Hunt. Pioneer cyclists were injured in falls from their machines in the 1890s, and from collision with a motor cycle in 1907. In the same year a horse was spooked by a motor car, and threw its rider near the Kings Head.

Suicides

Inevitably a number of suicides were recorded by the press, some of whom Dr Grattan had already been treating for “melancholia” (what we would now call depression). The method usually chosen by suicides was the desperate one of cutting the throat with a sharp knife, but this is not easy to do successfully, and several unfortunates had to endure being stitched up and then handed over to the police and remanded in custody to face trial in Chelmsford quarter sessions. Suicide remained a criminal offence (at least technically) until 1961. Those of my generation will remember that the offence of suicide was usually softened by the coroner’s face-saving verdict of ‘took his own life while the balance of his mind was disturbed.’ By no means all failed attempts in Dr Grattan’s time ended up in court, so even then the law was not enforced literally and some discretion must have been exercised in deciding who to prosecute. Suicide by poisoning seems to have been unusual. Though suitable substances could be purchased easily from the town’s chemists, it was necessary to sign for them in the poisons register, and perhaps this acted as a deterrent. The only case of arsenic suicide that I found was the local taxidermist who had legitimate access to the poison which was traditionally used in the preparation of specimens.

The demon drink

It is no surprise that the misuse of alcohol contributed to accidents and violent misbehaviour. In 1873 the landlord of the White Bear inn at Stanford Rivers refused to serve one of his customers who was the worse for drink and who promised “I’ll lay in wait for you and give you a hot ‘un”. As good as his word, he later attacked and laid out the landlord. Dr Grattan was summoned and found the publican unconscious and bleeding freely from a scalp wound. The victim survived, but the assailant rightly ended up before the magistrates.
It was concern about the antisocial effects of alcohol that led to the first attempt to suppress the annual Ongar fair in 1872 when Dr Grattan was called to give evidence on behalf of the petitioners. He told the court that over the previous ten years he had attended accidents caused by drunkenness at every Ongar fair, and that two years earlier he had amputated the arm of a very inebriated man who had fallen under a cart while walking home to Shelley. He also noted that alcohol-fuelled rows at night prevented people from sleeping, and that card sharpers were relieving drunken labourers of every halfpenny of their money, leaving them unable to pay their rent (or their doctor!). He was certainly opposed to the Ongar fair, and later proposed the vote of thanks to the chairman who had called the meeting to consider applying to the Home Secretary for its abolition.

Medical officer to the Ongar Union workhouse

Dr Grattan was appointed MO in August 1864, retiring from the post 40 years later. The newspapers reveal very little of his work there though the workhouse records may reveal much more. In 1891 he was summoned by the Board of Guardians to explain why he had failed to notify a case of enteric fever, and why he had engaged a professional nurse without consulting them. On the first count, he expressed his regret, and on the second, he explained that the resident workhouse nurse had refused to care for the patient, and that the urgency of the case made it impossible to consult with the Board. The lack of a local infectious disease hospital was a serious concern during the national 1901 smallpox outbreak, as the workhouse infirmary was completely unsuitable for isolating the cases from the other rersidents. He was asked to investigate the possibility of sending cases to London, or whether any other local arrangement could be made. Soon after, the Ongar smallpox hospital was established, consisting of nine tents which could be erected when needed on land close to the workhouse.
In the same year, Dr Grattan asked the Guardians for an increase in his salary. He was vigorously supported by the Reverend John Howard,” the outspoken rector of Beauchamp Roding”. Somewhat unprofessionally (one would have thought!) the rector expressed his view that the MO should be paid at least £5 more than the chaplain, as “a doctor of bodies was more necessary than a doctor of souls”.
In 1903 Dr Grattan was pressing the Guardians for a full-time nurse.

Medico-legal cases

Some shameful and damaging aspects of human nature do not change. In 1866, Dr Grattan was asked to give evidence in the case of an assault on a 15 year old girl. The defendant claimed that “the connection” took place at the girl’s solicitation but, in this case, the press was unusually discrete and did not reveal the nature of the medical evidence, or the outcome of the case. In another incident in 1903, a 15 year old boy had invited a 6 year old girl to go mushroom picking with him, assaulted her, then gave her a halfpenny and told her to keep quiet about it. Dr Grattan examined the girl and found “certain injuries”. The young man was committed for trial at the Chelmsford Assizes on two sureties of £20 each.

In 1888 Dr Grattan was waiting for a down train at Epping station, and observed a man nearby beating a horse mercilessly after it had damaged the cart. The doctor subsequently found and reported this incident to the owner, and the driver was taken to court and fined 20 shillings.

Summary

Much of Grattan’s work would seem very familiar to a late twentieth century GP, though he or she would feel very grateful for the benefits of modern drugs and vaccines, ready access to well-equipped hospitals and a working ambulance service. He or she would be pleased to be spared post mortems, and the problems and hazards of relying on horses every working day.

Notice is hereby given that the Partnership heretofore subsisting between us the undersigned, carrying on business as Physicians and Surgeons, at Ongar, in the County of Essex, under the style or firm of GRATTAN and WILSON, has been dissolved by mutual consent as from the thirty-first day of August, one thousand nine hundred and eight. All debts due to and owing by the said late firm will be received and paid respectively by Dr. G. R. Wilson, who will continue to carry on the said business. Dated the 31st day of August, one thousand nine hundred and eight.
Matthew Henry Grattan
Geoffrey Remington Wilson.
The London Gazette September 18, 1908.
Death
The funeral of Dr. Matthew Henry Grattan, late of Ongar House, whose death occurred on Friday at the age of 84, took place at noon on Wednesday. A service was held the Parish Church, the Rev. E. E. Barber and Rev. Canon E. H. L. Reeve officiating.
The interment was in Ongar Cemetery. The chief mourners were: Col. H. W. Grattan, D. S. O., son Mrs. Trowell and Mrs. Arnold Richardson, daughters; D. G. R. Wilson, son-in-law; and Miss Wilson. There were many others' present. Dr. Grattan practised in Ongar for over 40 years and retired in 1908. He was held in high esteem.
Chelmsford Chronicle 23rd November 1923