Apologies for the flagrant self-promotion but, if you enjoy the blog, you might be interested in coming along to my session at Hay this year, based around my book and research. Talk of dangerous and disgusting remedies will abound, as will unusual doctors and nasty diseases!
Hope to see you there:
http://www.hayfestival.com/s-306-friday-31-may-2013.aspx?genrefilterid=0&categoryfilterid=
What was the position of the practitioner within the seventeenth-century community? How did people regard both them and the services they provided? It has often been said that doctors were unpopular. It was, after all, the local doctor’s prescriptions that commonly made you either violently sick, gave you diarrhoea or otherwise left you similarly disadvantaged or distressed. ‘Damn the Doctor’ ran the title of one seventeenth-century satire. Advice given to Lord Herbert about his health in 1681 suggested that he “never see a damn’d doctor again as long as ye shall live”. According to the poet Bernard Mandeville, “Physicians value fame and wealth/above the drooping patient’s health”. Were doctors really disliked that much?
(Courtesy of Wellcome Images)
In fact, there is much evidence to show that people appreciated the services of their local practitioners. This was, remember, a world of sickness. Danger lurked in bad airs, unwholesome environments, noisome streets, unwashed bodies and verminous bedding. It has even been argued that most people felt ill in some way for most of the time. The local doctor was by no means the answer to all of this; but, (s)he was one weapon in the continuing war waged upon sickness and disease.
It is difficult to access ‘ordinary’ people’s views about practitioners. One way we can do this is through their testimonies in prosecutions, giving a rare chance to hear the actual voices of patients. But, obviously, these only tell us of cases that had gone wrong. Finding testimonies to practitioners who had obviously done well is more challenging. One possible way to do this, though, is through the surviving records of community testimonials to the skills of their local practitioner.
For some doctors, to achieve some level of legitimacy (perhaps more for themselves than their patients) meant obtaining a licence to practice from either the Royal Colleges, the Archbishop of Canterbury or one of the various diocesan bishops. In theory, and indeed in law, all physicians should have obtained a licence, but this was neither practical nor easy to enforce beyond London and its surroundings. Nevertheless, one aspect of applying for a licence was providing some sort of proof of good, charitable or successful practice in a particular neighbourhood.
(Picture courtesy of Wellcome Images)
When David Davies of Llangurig applied for a licence to practice from the Bishop of Bangor in 1749, no less than three local vicars testified that the “said David Davies is a very usefull person in his neighbourhood, has performed several cures in surgery, and (as far as we are judges) we think him a person worthy to be licens’d”. (National Library of Wales MS Bangor Episcopal B-SM-2). The supporters of Richard Davies of Llanynys stressed that he was a “person of good character” and “hath performed several cures in surgery”. (NLW MS Bangor Episcopal B-SM-3). When Benjamin Powell of Brecon applied for a licence in 1708, a list of local parishioners supported his application, stating that he was “a p(er)son who is commendably instructed both in the art of Phisick and Chirurgery and is very much Experienced in both the sayd arts, as being one who hath undergone and p(er)formed severall great and desperate cures”. (NLW, Church in Wales Diocese of Llandaff episcopal 1, MS 1194).
It is worth mentioning too that it was not only men, nor ‘orthodox’ practitioners who could rely upon the support of their communities. In fact, where an unlicensed practitioner faced prosecution, the people of Ledbury in Herefordshire intervened and petitioned the Bishop of Hereford to try and save her from prosecution:
“Sir,
The bearer is an honest poor woman of ye parish of Ledbury, who is as far as we are informed, cited into your court for practising surgery. She sometime ago cured a pauper of our parish who had at that time seven small children of a sore breast, without any prospect of reward; and ye parish, hearing of ye service she had done them, ordered ye overseers of ye poor to give her five shill: wch is ye only act of this nature of we can hear she ever did. This matter being so very malitious, we request the favour she may be discharged. She is very poor therefore we hope it may be with as little expence as possible…” (NLW Bodewryd (2), MS 380)
In terms of financial gain, not all doctors were out to fleece their patients. It was not uncommon for practitioners to tailor their bills towards the financial means of their patients. A poor patient might even be treated free, or for a few pennies; a wealthy yeoman might have to spend a few shillings. Also, the local parish authorities could intervene to either bring a practitioner to attend to a sick parishioner or, alternatively, send a parishioner to a large town to secure the services of a well-known or well-respected doctor.
It is worth mentioning too that early-modern people had perhaps a different level of expectation with regard to what the doctor could do. Today, we go to the doctor and expect to be diagnosed – instantly – and sent on our way with a prescription for a ‘cure’. This worked slightly differently in the seventeenth century. When people went to the doctor, they engaged in a two-way dialogue to agree diagnosis and secure a receipt or preparation. Once this was obtained it is questionable whether the early-modern patient expected to be cured. Rather, they hoped to be cured but, if this didn’t work, there were plenty of other doctors and receipts to try – often gleaned from friends and neighbours. If they did recover, naturally they might attribute that recovery to the doctor and his preparation. This would then be retained for future use as a ‘probatum’ (proven) remedy. In this sense, the doctor might easily escape sanction if his cures failed, as the patient was only using his services as one of a range of options in any case.
Before we write off early-modern practitioners as figures of distrust, dislike or ridicule, it’s worth remembering that they were often valued members of a community whose efforts to help their fellow parishioners were appreciated. Often treating the poor for free, and providing an important source of medical knowledge and goods, they offered some degree of comfort in a world where sickness was ubiquitous.
What exactly is a ‘recipe collection’? The most obvious answer is something like the example shown below, a formal ‘receptaria’ book of medical receipts and remedies. In the early modern period, and across Europe, these types of collections were fairly common, and especially in wealthier households. These were often carefully constructed documents, containing indices and sometimes containing groups of remedies according to various types of remedy, or parts of the body. In many ways these were the high-end of domestic medicine.
But were such formal collections necessarily representative? In other words, did everyone (or at least everyone capable of writing remedies down) collect their medical information this way? No. As a great deal of recent work by historians is revealing, the committal of recipes to paper was often a much more haphazard, and far less regimented, process.
For a start, paper was an expensive commodity in the early modern period. It could often be bought easily enough; apothecaries often sold reams or ells of paper, as did other retailers from merchants to haberdashers. But it was nonetheless quite costly. Unlike today, where scribble pads and notebooks can be bought for pennies, the buying of paper, or a bound book of notepaper, would have been something out of the ordinary, especially for those on low incomes.
Firstly, the recording of remedies was an expedient and often pragmatic process. Remedies usually spread firstly by word of mouth, with people passing on their favourite receipts to friends, neighbours and acquaintances. As Adam Fox’s work on early modern oral culture has shown (Oral and Literate Culture in England, 1500-1700 (Oxford: Clarendon, 2000)) people had a strong ability to commit information to memory, and this made sense at a time when the majority of the population couldn’t read or write. Nevertheless, for those wishing to record the remedy accurately for future use, there was a need to do so quickly, and often using whatever was to hand.
As such, many ‘remedy collections’ are little more than assemblages of roughly scribbled notes, sometimes on torn bits of paper, sometimes on the back of unrelated documents, and sometimes even including a variety of other information on the same page. In fact, the very survival of many remedies is probably attributable to the fact that they have been incorporated into other, non-medical, documents.
Nevertheless, the recording of remedies in certain types of document was often a more deliberate decision. In Wales, for example, there were several instances of medical remedies being written on notepaper purloined from a church. In one sense this was pragmatic and reflected the simple availability (and probably abundance) of paper, given the needs of the church to keep records. But some were written inside church documents. In parish registers, for example, it was not uncommon to find receipts. A common example was that of a ‘receipt for the biteinge of a mad dogge”, often originally attributed to the register of Cathorp Church in Lincolnshire, but which seemed to move around the country. An example of the remedy, occurring in the Monmouthshire church of Llantillio Pertholey, can be seen here: http://www.peoplescollectionwales.co.uk/Item/7637-a-recipe-to-cure-the-bite-of-a-mad-dog-llanti
In another sense, though, putting remedies in amongst religious verses, as often occurred in commonplace books and notebooks, was a way of allying the remedy to the power of religion. If it was next to God’s word on paper, perhaps it would have more power?
Above all, for the remedy to be of any use, it had to be easy to find when needed. Some, for example, kept remedies within the pages of their business ledgers. Here, the regimented layout perhaps suited ease of future reference. But perhaps most common was to keep remedies within the pages of personal sources. Many diarists noted down examples of favoured remedies, especially when they had suffered from an ailment and attributed their recovery to the taking of a particular remedy.
Commonplace books, notebooks and copy books were also common places for the jotting down of useful information, and could be easily referred to if needed. It was not uncommon to put remedies within pages of miscellany, including accounts, quotes, poetry and family records, locating it firmly within the context of ‘useful’ information. Many literate families also kept letters. Health was a regular topic of conversation amongst letter writers, and it was common to fire off a few missives seeking potential remedies from within one’s social network. When a reply duly came, here was a ready-made receipt that could be kept without needing to write it down again. Prescriptions and directions from practitioners might be especially prized as they represented a virtual consultation, specially tailored to the recipient’s humoral constitution.
One often-overlooked method, however, were medical almanacs. It’s worth looking at a typical example of how these sources could be used. Cardiff Public Library MS 1.475 is a small memoranda book dating to around 1708, and seemingly originating from London, with the names John and Elizabeth Price prominent. A little list of family notes inside the front cover reveal a touching and tragic tale.
“February 10th 1708/9
Married then to the pretty, the charming Mrs Elizabeth Price by the Rev’d Dr Typing of Camberwell.
My daughter Anne was born the 17 of April 1712 about twenty min(utes) after eight in the morning and baptised the 1. of May
She was a very beautifull, lovely child but God was pleased to take it May 3. 1712”
Much of the document, however, is actually drawn on the reverse side of copies of almanacks. These were part-astrological, part-magical and part-news documents which contained everything from prognostications and predictions to religious dates, weather information and medicine. The first almanac in this document is ‘Merlinus Liberatus, being an alamanack for the year of our Blessed Saviour’s Incarnation, 1708…by John Partridge, student in Physick and Astrology at the Blue Ball in Salisbury Street in the Strand, London”. Partridge was clearly an entrepreneur; the very next page of his almanck is dedicated to ‘Partridges Purging Pills, useful in all cases where purging is required”!
A second almanac pasted into the book is “The Country Physician; or a choice collection of physic fitted for vulgar use: Containing 1) a collection of choice medicaments of all kinds, Galenical and Chymical, excerpted out of the most approved authors 2) Historical observations of famous cures collected out of the works of several modern Physicians 3) A Cabinet of specific, select and practical chymical preparations in two parts, made use of by the Author, by W. Salmon M.D”
This sort of document was a cheap means of buying a ready-made remedy collection, complete with the latest thinking and couched in terms of the layman. There were many self-help volumes of family physick available, but these cheaper almanac and chapbook style documents were easier to read and easier to keep. It is also clear that the spaces on the back of pages were useful places to note down other remedies as they accrued.
For example, the Prices noted down a number of receipts on the back pages, including a receipt “To prevent a return of the ague”, another for the “dead palsy”, including mistletoe, oak and saffron, and another for “flushings in the face”. Here, then, the printed and the written remedy intertwined to become a completely distinct and individual family collection. In many ways this was as formal a collection as a ‘receptaria’, and probably included many of the same sorts of remedies, but in a different form.
The recording of remedies, and the idea of a ‘remedy collection’, therefore, shouldn’t necessarily be limited to a single, formalised and regimented document. These were organic documents, sometimes constructed carefully, but often just growing as collections of rough notes. Remedies might be deliberately placed within documents, or they might be the result of a roughly-scribbled note. Equally, people might keep ready printed or written remedies, and simply add their own notes as required. In this sense, there is no single ‘remedy collection’ document; instead, there are a myriad different ways in which people collected remedies.
It has long been argued that the early modern home was a medical hub. And, in many ways, so it was. Sickness was first and last a domestic experience. It was almost always treated in the home and, given the range of potential conditions, the presence of one or more sick members of the family was doubtless a fairly regular occurrence.
In the main, it was women who were expected to take responsibility for medicating the household. Women were assumed to be natural carers, and also to have acquired some skill in the preparation of medical recipes, and their application, by the time they reached the age of consent to marry. There were books dedicated to schooling literate women in the art of physick, many including what was effectively a ‘starter’s collection’ of remedies to enable them to treat a large number of common conditions. Indeed, medicine was part of the wider role of ‘housewife’, and ‘huswifery’ meant looking after the inhabitants, as well as maintaining the living space.
The role of men in household medicine is far less defined. There were, for example, no books specifically written to help men cope in the case of domestic illness. And yet they clearly did cope. Diaries, such as those by Phillip Henry of Broad Oak in Flintshire, and Robert Bulkeley of Dronwy, Anglesey, both note sickness episodes of their wives, and suggest that they played a part in caring for them. It is also clear that men played a part in the acquisition of ingredients, often keeping records of where they found herbs for sale cheaply, or which apothecary they regularly purchased from. In this sense, medicine still fitted in to the patriarchal male family role, since it involved a broader input into the physical care and support of the family.
One question that remains largely unresolved, however, is that of how well equipped the early modern home was to cope with sickness. The contents of domestic recipe books suggest not only that a very broad range of skills were needed to be able to concoct remedies, but also that a range of equipment would also be necessary. How well equipped were ‘ordinary’ homes to meet these needs?
One body of sources that lets us peer back inside the early modern home are probate records. When a person died, the probate process often required a list of their household contents to be made to allow their estate to be valued. For the study of the material culture of this period, these sources are incredibly valuable. They are, however, often frustratingly vague, and all depends on the diligence of the individual surveyor. For example, a detailed record might list every individual possession, room by room, including furniture, ornaments, valuables, but also sometimes even book titles and foodstuffs held in storage. Much depended on the intrinsic value of the goods; if they had a resale value, they might be worth including. In less detailed inventories, however, a whole room might be listed under a single entry, with a generic term like ‘household stuff’.
In terms of medical items, this causes a problem. Things like herbs and, perhaps, individual jars of ointments or medicines were too impermanent to list, so don’t appear in the inventories of ‘ordinary’ households and very seldom even in elite household inventories. Equally, finding any equipment that can be definitely be classified as ‘medical’ is problematic, since many had dual usage. Nevertheless, it is still worth speculating based on available evidence, to see if any hints about the material culture of domestic medicine can be gleaned from these sources.
Whilst writing my PhD thesis, to try and address this question, I looked at over 1300 inventories from 82 parishes in the county of Glamorgan in South Wales. I decided to look for two items of equipment in particular – the pestle and mortar, and the brewing still. Many seventeenth- and eighteenth-century self-help books extolled the virtues of a well equipped kitchen. For the seventeenth-century medical writer Thomas Brugis, top of the list of items desirous for those people wishing ‘to compound medicine themselves’ were ‘a great mortar of marble and another of brasse’. A long list of other items were included, from ‘copper pannes to make decoctions’, ‘glasses for cordiall powders’ and a range of medical implements. The popular medical author Gervase Markham, also entreated his idealised English housewife to ‘furnish herself of very good stills, for the distillation of all kinds of waters…for the health of her household’, and the emphasis all round lay firmly with a well-equipped kitchen, able to minister autonomously to sick family members within a household.#
As a baseline test, over 91% of the inventories contained at least one item of kitchen equipment, including pots, pans, crocks and so on. Overall, the suggestion was that the vast majority of homes had at least the ability to concoct basic remedies. As Elaine Leong has recently noted, for example, boiling was needed in around 20-30% of early modern remedies.
But what of more specialised equipment? The results were interesting. Out of 1248 inventories, only 148 (11%) had listed a pestle and mortar. Before 1635, there were no occurrences whatsoever, and a peak of ownership didn’t seem to occur until the early eighteenth century. Whilst this figure of 11% should definitely be taken as a bare minimum to allow for inevitable under-recording, this still seems surprisingly low. What was also clear, though, was that the item was more common in better-off households, and also in urban areas. The pestle and mortar would have been a basic utensil for grinding herbs and spices into powder. Whilst not owning one certainly can’t be used as evidence to say that a home wasn’t ‘medical’, its lack of appearance is still noteworthy.
Turning to the ‘still’ or ‘limbeck’ the results were even more striking. A still was a multi-purpose item, which could be used for home brewing, as well as the distillation and fermentation of substances for medical recipes. It has recently been calculated that around 10% of remedies required a still in this period. Despite this, the Glamorgan inventories yielded a total of only 41 references in 1248 inventories, giving an average of less than 3%. Here again, ownership was general limited to wealthier households.
[A full statistical analysis, including comparisons with other Welsh counties was included but, for the sake of brevity, it’s not detailed here. See Alun Withey, Health, Medicine and the Family in Wales, 1600-1750 (Swansea University, Phd Thesis, 2009)]
It is also worth noting (albeit perhaps unsurprisingly as noted earlier) that no inventories contained any reference to medical remedies, ingredients or substances, and only a bare few contained items which could be construed as ‘medical’, such as a blood dish in one home, and a ‘nurseing chayre’ in another.
What do these results tell us? They certainly don’t tell us that early modern homes did not manufacture their own medicines, nor that they were incapable of doing so. Even the most basic of utensils could be used in this process, and the majority of homes possessed these.
They also don’t reveal much physical evidence of medicine, such as a ‘storehouse’ of remedies or ingredients, but this is, in many ways, entirely logical. Medicine was transitory and pragmatic. Recipes were often concocted as and when needed. Some, like ointments, could last for years and be kept, but many were too impermanent to keep. Also, just because they weren’t listed, doesn’t mean they weren’t there. Whilst some historians are beginning to question the extent to which each household physically grew its own herbs, it’s plausible that many did.
But what is also interesting is the availability of ingredients for remedies in even the smallest rural shops. People could purchase exotic herbs and spices from their village shop, as well as compound remedies such as plague water and Venice Treacle. It is entirely possible that the extent to which domestic production was intertwined with the medical marketplace has yet to be appreciated.
In any case, there is a need for more studies into the material culture of early modern domestic medicine. If the early modern home was indeed a medical hub, a wider study should give us a broader understanding not only of what medicines people used in their homes, but how they made them.
“This book I had from — a resident of this parish (Bettws in Monmouthshire), who swears it was the book of Sansom Jones a physician of this county, some two hundred years ago”.
This note, dated around the early twentieth century, appears in the front cover of an intriguing manuscript – Cardiff public library MS 2.126. Since I first came across the document in 2005, it has fascinated me as it represents something of a mystery. It is, or at least appears to be, a remedy collection dating to around the early seventeenth century. It looks and feels ‘right’. The palaeography is consistent with a document of that age. The layout is what you’d expect from an early modern receipt book and the remedies are neatly written and ordered. And yet it is one of the most frustrating sources I have ever looked at.
It should be a fascinating view into the medical world of that most rare of creatures – the early modern Welsh doctor. We even have his name – relatively unusual for sources of this type. Except, so far, “Sansom Jones” has eluded every attempt I have made to find out more about him…or even to establish whether he even existed. He highlights one of the big problems for historians in trying to piece together individual lives through scattered documents. We have a few pieces of the jigsaw, but not the final picture. It also raises the danger in assuming that documents in local or county archives are necessarily from their own area.
Let’s start at the beginning of the ‘Jones’ document. The first couple of pages are interesting. The book begins with a list of standard apothecary measures – a common enough inclusion, especially if this were the book of a practitioner. Lists of scruples, drachms and other measures were necessary and useful in compounding the correct measures and dosages of remedies. But then the plot thickens, and the name ‘Bethia Marsh’ is written in bold script, suggesting authorship or ownership; more about that later. But also prominently written is the following heading:
“Noblest teaching of urine to know the proffices thereof for the nature of man and woman which is known through urines. Through which urines the sicknesses of men are knowne, translated out of lattine (sic) into English. By mee Alexander Spraggot. 1569. May ixiiii”.
So the plot thickens. Here we appear to have the title page of a published book by the eponymous Mr Spraggot. We have an exact date and so, at least, a starting point. Looking at the book as a whole, it does ‘feel’ very much like a published work. It is very neatly set out and has, quite unusually, a complete alphabetical index at its end.
There is a section on uroscopy (the diagnosis of medical conditions by the appearance, smell and taste of human urine), followed by some general notes on life and health. These include “To knowe life or death/tokens of death”, “A treatise of Hypocras”, with astrological notes on sickness and other general observations including notes on why students are unhealthy – essentially because they spent so much time in motionless reading! The rest of the volume is given over to medical remedies, generally set out in order of different parts of the body.
For headaches, for example, there are remedies for “headach proceeding of a cold cause”, “headache proceeding of heate”, “for the mygrim or rigrim” and so on. Several pages deal with purges for various conditions, including “melancholie”, “palsey” and also specific diets, e.g. for the “rhewme”. There are sections on obstetrics and childbirth as well as conditions relating to both men and women. Given the standard practice of using animal, plant, and any number of other materials (!) in remedies of this time, there is ample evidence of a full range, and nothing out of the ordinary.
In many ways, there is much to support a theory of this as being the book of a practitioner; it contains just the sort of useful information that a practitioner might rely upon in his daily work. There is little evidence to suggest attributions in the book. In ‘domestic’ remedy collections (i.e. those used in families) it is common to find recipes gifted from others – e.g. my aunt’s remedy for a cold, Mrs x’s receipt for the gout, and so on. But this book has none, suggesting a more formal purpose. The fact that it is written in fair hand also supports a deliberate and disciplined document.
But if we look deeper at the document, what else might it reveal? Firstly, who was Alexander Spraggot? Did he indeed write a book called ‘noblest teachings of urine’, or might this be an unpublished manuscript from 1569? The answer to the latter is no. In terms of the date, I was partly lucky, since the paper was watermarked…but even this is slightly mysterious. Having sent a copy of the watermark to a colleague who specialises in this area, the watermark turned out to be from an unusual source for an early modern Welsh document…it was from Russia. Not only this, it dated no earlier than the mid seventeenth century, meaning that, at the very least, any copy from Spraggot’s original must have been done nearly a century later.
Searching under the name Alexander Spraggot reveals few likely candidates. Perhaps the most likely seems to be ‘Alexandrus Spraggot’, appointed the vicar of Martocke church in Somerset in 1564 – not a great distance from South Wales. But did Spraggot ever author a work of this name? Not as far as I can tell. There are no records in the British Library of a book by this title or author, so here the trail runs cold.
So what of the second name mentioned in the book – Bethia Marsh? Here again, I’ve drawn something of a blank. A lady of this name was born near Salem, Massachusetts in 1650 – roughly around the date of the creation of the book (or at least its paper), making her an unlikely candidate. The name isn’t especially Welsh either. One possibility is that Bethia was, at some point, the owner of this book which, after all, contained a large number of useful remedies. It was common for people to write their names in such books to assert ownership, and also for remedy collections to move across families as they were gifted, especially to newlyweds.
What, finally, of Sansom Jones, the mysterious Welsh practitioner of Bettws, south Wales? Is there anything to suggest that he was the true owner of the book? Sadly not. Having looked for the relatively unusual name of Sansom in likely parish records, I can find no trace…so far. He was not, at least as far as the records suggest, a licensed physician. His name doesn’t appear on any list of known doctors, nor does he appear to have been apprenticed or trained. None of this, of course, means that he never existed. He could, as many Welsh practitioners did, have simply carried on his medical practice to the local population unhindered by the need to obtain a licence, being so far from the centre in London. With such an indistinct date, he might have been of a later time period, with a misjudged attribution by the note writer. Another possibility is that he was actually from a different ‘Bettws’ than the one in Glamorganshire; there are several across Wales.
And so the search continues. As I turn my attentions back to Welsh medical practice (after a hiatus studying shaving and rupture trusses in the eighteenth century) the need to find out more about the daily life and work of Welsh doctors will again become paramount. If Sansom Jones was there, and if this was indeed his book, I want to find him, as ownership of these types of documents does much to provide an alternative to depictions of Welsh doctors as obsessed with folklore and magic.
p.s. If anyone can shed any light on any of this, I’d be very grateful.
I started researching Welsh medical history properly in 2004. At that point, there wasn’t really a big historiography on the early modern period for Wales…in fact there was essentially only one book. Over the years, I’ve been busy putting that to rights, and have so far published my own book, three academic articles, four book chapters and a range of other stuff. The obvious problem is that if anyone else chooses to start looking at this topic, my research is first in the firing line. But, that’s another day’s worry.
When I started working on the book, I decided to leave the issue of medical practice to one side. Physick and the Family is broadly about the experience of sickness in the early modern period. It looks at things like how people viewed sickness and how they conceptualised and described it. It looks at how well prepared people were to cope with a patient in their own homes, and also the ways in which friends, neighbours and the wider community coped with having a sick person in their midst. Except for when they became part of this sickness experience, doctors were not part of the remit. But they are now.
There has been a long-held view that Welsh doctors of the sixteenth and seventeenth centuries were part of a practice that was stagnating, backward-looking and pretty much tied to its ancient past. There are certainly reasons to support this view. Unlike England, Ireland and Scotland, Wales had no institutions in which practitioners could focus or gather. It had no universities or colleges of medicine and, as such, there was no formal medical training available. There were no hospitals aside, perhaps, from the odd lying-in room or lazar house.
Until the late seventeenth century, Welsh doctors were relatively reluctant to purse a licence, which they were at least nominally supposed to have, although the lack of policing and distance from London meant that this wasn’t so important in the Principality. Those wishing for a career as a professional physician, though, generally left Wales to train in Oxford or London, and then generally didn’t bother to return. The net result of this has been a view of Welsh practice as a vacuum of orthodox medicine, which was filled by cunning folk (in Welsh the ‘dyn hysbys’ – cunning man), and various other ‘irregular’ practitioners.
The problem with this view is that it simply isn’t accurate. It suggests firstly that there was a lack of practitioners in Wales, which isn’t the case. Secondly, the terminology itself carries baggage. When we talk in terms of ‘irregular’ and ‘unorthodox’ it automatically suggests unskilled. This too is inaccurate since much of the evidence I have looked at over the years suggests that Welsh doctors often went to extraordinary lengths to keep up with wider developments in medicine.
Books, for example, were one way that doctors could keep themselves informed, and there is evidence that Welsh practitioners sometimes purchased even esoteric Latin texts in order to access the latest thinking. The first Welsh-language medical book wasn’t even published until 1736, so they were in effect forced to engage with medical literature in English or Latin.
Secondly, it is interesting to note that Welsh practitioners, alongside their English counterparts, often adopted the title ‘Doctor’ even though they had no degree or licence. In Wales this is interesting because it is an English term; there were Welsh equivalents like “Meddyg” and “Physigwr”, but “Dr” was the preferred term. Although we can’t read too much into this, it might suggest that such practitioners wanted to feel part of a wider medical fraternity or profession.
Thirdly, all evidence points to the practice of medicine being identical in form and function to that in England and across Europe. As has long been demonstrated elsewhere, orthodox practitioners did little different in material terms to the cunning man. Whilst ‘magical’ practitioners might dress up their remedies with symbolism and esoteric language, the basic form and function was the same.
This is not to say that folklore itself was unimportant – far from it. There was an extremely lively oral tradition of medical knowledge in the Welsh language, and strong beliefs in the power of cunning folk. Wales, it must be remembered, was a largely rural country, and one of marked geographical contrasts. There were areas of agricultural lowlands, but also upland, mountainous regions, where travel was difficult. In many ways it was the perfect breeding ground for legends and magic to prosper.
But Wales shouldn’t be viewed as being cut off. It was connected in so many ways to the broader world. Shops, even in tiny villages, for example, sold a range of medical goods, imported often through large English towns such as Bristol, Chester and London, but sometimes directly through the coastal trade. People crossed the borders to visit English towns, again especially Bristol and along the marches, and Welsh accents would have been familiar in these towns. Welsh apothecaries had accounts with London suppliers, and imported proprietary medicines, meaning that Welsh people would have been familiar with popular potions like Daffy’s Elixir. They also bought newspapers and almanacks, so would have known about the lively medical marketplace developing in the seventeenth century.
Overall, Welsh medical practice is due an upgrade – if not a complete revision, and I’m ready to take on the task. I’m going to start on a new project shortly, assessing both the numbers and quality of Welsh medical practice. I have a theory that, like so many other parts of Welsh medical history, there is a lot more to discover, and some deeply-held myths to challenge.
I mentioned in my last post about the concept of the ‘heroic sufferer’. Patient narratives are very much the coming thing in medical history. ‘Off Sick’, for example, a recent collaboration between Cardiff University and the University of Glamorgan has looked at the voices of the patient over time. The historiography of disability is re-engaging with the often indistinct voices of disabled people in the past. Even in popular history, it’s often these ‘voices’ that people want to hear about – ‘Voices of the Great War’ and so on. Overall, there has been an impetus to learn about the sickness experience through those who had that experience; not those who treated them.
In my own work, I’ve looked at sickness narratives in the seventeenth and eighteenth centuries through the letters that sufferers wrote to friends and relatives. Other than actual conversation (or even perhaps more than conversation), letters allowed people to construct their own narrative; their own sickness persona. Writing it down gave sufferers power over their own image; freed from the immediacy of speech, letter-writers could fashion themselves as literary sufferers. The results were often fascinating.
What strikes me most about these letters is the construction of a distinct persona, almost the creation of a different ‘sick self’. As I said in the previous post, it’s something that we do to a certain extent when we call in sick to work. There is perhaps an innate need to engender empathy, if not sympathy, and people are often very keen to detail even the most intimate symptoms to complete strangers. This seems to have been a constant for hundreds of years.
One of the most fruitful batches of letters for my purposes were those of the eighteenth-century Morris Brothers of Anglesey – Lewis, William and John. Lewis and William, especially, were prolific letter writers and, as was common for the time, health was a regular topic of conversation. Lewis Morris was a constant sufferer of sudden fits, coughing and giddyness, sometimes so bad that he could hardly get up. What struck me, though, was how far he was prepared to defend his right to be the unchallenged winner in any competition for worst symptoms. When William suggested that he was labouring under his own cough and ‘an asthma’, Lewis wrote back swiftly: “I own your asthma is heavy, but if you had such an asthma as I have, you would be unable to go to the office or even sit there”. In other words, my cough is worse than your cough!
Lewis was also the art exponent of the good old-fashioned wallow. In one letter complaining of various maladies, aches and pains, he was “scarce alive” but, stoically, would “trudge on while I live”. Recovering from a “pleuritic fever” he told his brother he was “just returned from the shades of death”. When his brother asked him to check some papers, Lewis responded that he would do so if he recovered, having been suffering from an ague fit. Many times he began letters wearily, doubting that his life had long to run, but by the end of the letter was talking in fairly cheery terms about items of news and events.
Perhaps my favourite of all, though, were the letters of Roger Jones, an attorney from Talgarth in 1770s-Breconshire. Jones seems to have been something of a savant – a man of letters, constantly travelling around and involved in polite society (such as there was in eighteenth-century Breconshire!). His letters to his brothers reveal another side to sickness – that of the comedic narrative. Sickness was, at the time, far from funny, but Jones’s letters show a very modern sense of laughing at the profoundly un-funny, perhaps in a way to reduce its impact.
In 1771, for example, he set out on a journey to Hay on Wye, where he suddenly felt “weak and faynty and was obliged to give over”. A fever ensued, and he took pills and a glister to flush out his system. In the night he took a whey drink, which made him sweat profusely which “with the weakness occasioned by the fever, reduced me to a mere skeleton”.
Jones was certainly no fan of doctors. Whilst ill at Bath the previous year he had consulted a physician, who had prescribed glisters, opening pills, cordial drinks and purges which made him no better but a lot thinner. We can only guess at the frustration he encountered once when he lost his voice and tried to get help from his servant…who was deaf. Poor Roger was forced to repair to the local alehouse, where the landlady administered an emetic or, as he called it, “the puke”.
These are the voices of the sick in the past, speaking to us in their own terms but, importantly, terms they have selected very carefully. They tell us plenty about the experience of being ill – but they tell us more about how sufferers wanted to represent themselves to others. They are brilliant (and often under-used) sources in medical history and, one day, I can feel an article coming on!
I’ve always been interested in the ways that people construct narratives of sickness, and the sickness persona. I was watching a comedian recently who brought up the subject of the ‘phoning in sick’ voice; the slightly husky, weak and tired tone people adopt when they have to convince the boss that they really are ill, and not having a ‘duvet day’. One day there’s going to have to be a study of the language and art of phoning in sick – stuff like having been ‘up all night’ being ill, ‘really don’t think I can make it in today’, ‘see how I feel tomorrow’ are all stalwarts. But sufferers have always constructed and deployed sickness in some measure. When I was researching for my book I looked at petitions by the sick poor in the seventeenth century, written to try and convince the parish authorities to give them money.
Consider this example written to a wealthy lady in Cardiganshire in the eighteenth century – the spelling is original. (National Library of Wales, MS 182D)
“Madam Lloyd, by submission to your Honour, my little grand Child whome I nurs’d since he was a year old, happen to fell sick, this day fortneight (sic), and had been very low, I hope that he begin to recover. He is longing for rosted meat that ever he had in my cottage, and I sure that he cannot distinguies between any sort of rosted meat. If your honour please to send a bit, or order me to wait for it, I will be very glad and in so doing you will add to the obligation of your honest old shoemaker, and your most humble servant, John Jenkin, alias, little shoemaker”
Here, we have the heart-wrenching tale of a sick [and presumably orphaned] child, desperately ill and longing for something substantial to eat. The writer of the letter appeals to the charitable nature of ‘Madam Lloyd’, but it is interesting to note the language used, of the humble, honest old shoemaker, trying to use whatever personal connections he has to secure something for his grandchild.
Others appealed to the charitable nature of people in their surrounding areas to provide support or relief (National Library of Wales, MS 434B):
“To all faithfull people to whome it doth appeare or may concerne, 3rd October 1656
Whereas John Owen, being a poore ould man borne and breed in the parish of Llanfydd being grievously troubled with a disease…that he is not able to travel and seeke or get his bodily foode & sustenance by reason it is broken out in several places of his body, the quantity of seven or eight places…so beseeching all good and charitable people out of charitie to commiserate his distressed state to bestow their benevolence towards payment to the churgeon…”
Another, Mary Jones of Llandenny, petitioned the parish to offer her support as her husband had fallen sick for ‘five quarters of a year’ and was ‘sick now’. Unable to raise the money herself to feed her family, and facing eviction from her cottage on the waste by the Duchess of Beaufort “to punish the poor man in spite and malice’, Mary was forced into desperate measures.
It is interesting to note, though, that although occasionally such letters were written by the parties involved themselves, they were more often written by an amanuensis – someone who knew the people involved but had more skill in writing. These notes are usually deliberately constructed to emphasise the individual’s suffering. They often highlight the symptoms and use emotive language to highlight the particular suffering.
The reasons for this are clear; the petitioner wanted and needed money, and thus needed to convince the authorities that their need was special. They make interesting reading not just for the language of sickness, but for the ways that it could be deliberately deployed.
I think there could be another post to follow on the ‘heroic sufferer’, but enough for today!
Again last week I had to nurse a poorly toddler as he was sent home from nursery with yet another variety of stomach upset. There is, I’m told, something going around. I need to confess here to being a terrible hypochondriac. When I worked in an office I hated it when people used to come in, green-faced, and that say that they’d been ‘up all night’ being sick. In my mind, it is only a matter of time before this thing finds its way to me! If I read on the internet (as has recently occurred) that the norovirus has closed hospital wards anywhere near where I live, the sense of a creeping tide of contagion gets worse. In fact, there always seems to be something ‘going around’.
Talking to a colleague last week, we were speculating about whether the same conception was true in the early modern period – whether people believed that the same nasty bit of pathogenics was doing the rounds. It would be interesting to know whether early modern people had any sense of one particular ‘bug’.
In some ways this seems unlikely. Humoural beliefs held that illness was a personal thing; it was one’s own humoural balance that generally dictated sensitivity and vulnerability to sickness. If, for example, someone was naturally sanguine (i.e. had a predominance of blood in their humoural makeup) that made them naturally more susceptible to apoplexy, plethora and venery!
But there certainly was some conception of a sickness that moved around populations; what, after all, were epidemics of plague and smallpox if not mobile and progressive conditions? But it also seems clear that people were aware of flare-ups of particular diseases or conditions in their vicinity. The letters of Owen Davies, an Anglesey parson in the early eighteenth century, certainly reveal evidence of this, noting episodes of epidemic fevers in his area. The diarist Phillip Henry of Broad Oak in Flintshire referred to an outbreak of fever in seventeenth-century Glamorganshire, which was particularly affecting children. In fact, when we look closely, there was a constant dialogue about illness, and people were ever vigilant for what sorts of things might affect them.
If we think about domestic recipe/remedy collections (books of favoured remedies sometimes accumulated in literate households), it is possible to see them as part of a domestic arsenal against sickness. They were in some ways a pragmatic response to disease; it made sense to have some sort of weaponry in your arsenal to attack whatever symptoms you might have. In other ways though, they were also an insurance policy. They provided at least some means of recourse in an environment where sickness was almost always lurking. And it wasn’t just remedies that were written down; people simply knew remedies, and were able to memorise and internalise information in a way that in today’s internet-dominated world we would find impressive.
The terminology of sickness has certainly shifted. When people in the past referred to the local presence of conditions, it is more likely that they were referring to something deadly, rather than a minor stomach upset. Nevertheless, something of the fear of contagion must be innate. While we might not all regard ‘bugs’ to the same degree of pathological hatred as I do, we feel uncomfortable when sickness gets too close.
Now where’s my antibacterial spray? This keyboard looks filthy…
