Returning Patients to the Community: disability, medicine and economic rationality before the Industrial Revolution

This paper offers an interpretation of physical impairment in eighteenth-century Britain which challenges the view that disability was largely a product of industrial capitalism. After reviewing the historical models of Finkelstein, Stone and Oliver, in which this position is put forward, attention turns to a case study of the General Infirmary at Bath, founded in 1739 to grant 'poor cripples and other indigent strangers' access to the spa waters. Dedicated to the prevailing moral economy of mercantilism, the Bath Infirmary sought to return its patients to the community in a state of physical and moral fitness. The economic implications of this objective are discussed in relation to the work imperative, the therapeutic performance of the institution and the age/sex characteristics of its clientele. The political implications are discussed in relation to the practice of medicine and the pursuit of an orderly society. It is concluded that medical charity points to incompatibilities between impairment and economic rationality in advance of the Industrial Revolution.