The mystery of ‘Sansom Jones’ – the phantom Welsh doctor

“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.

There’s a bug ‘going round’.

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…

Hay Festival 3rd June 2012 – Heroes and Villains of Welsh history

Come and see the Doctor!

https://www.hayfestival.com/p-4613-ben-curtis-alun-withey-and-tyrone-osullivan-join-huw-bowen.aspx

Writing Welsh History (3)

A couple of weeks ago I took part in the ‘Writing Welsh history’ event at Swansea University. One of the main topics of the evening was how we approach Welsh history; is it somehow different to other countries or regions? Are there any specific problems facing historians that are uniquely Welsh? That last question is one that vexes me. The recent television series was titled The Story of Wales. As a participant in the television debate following the series noted, it is not The story, but A story. I believe that we are lacking a grand narrative of Welsh history. It is natural to think in terms of chronologies, but it is difficult to think of the sweep of Welsh history without using the broader British history as a reference point. In other words, could we even tell a story of Welsh history?

This problem is particularly relevant for me as I contemplate my next academic project. I’m thinking about tackling a narrative of Welsh medicine from earliest times to the present day. This hasn’t been attempted before, and there is certainly a need for such a study. The problem, though, lies in structure. From available source material, for example, is there enough evidence to fill chapters before, say, the tenth century? The obvious solution is to adopt a thematic approach, rather than a narrative chronology. But in other ways it highlights the fact that Welsh history cannot always be neatly compartmentalised.

There have been many ‘history of Wales’ volumes (I’m thinking of works by John Davies, Geraint Jenkins and Prys Morgan) and these ably take on the difficult task of constructing a narrative. Geraint Jenkins’s Concise History of Wales is excellently written on what he describes as a ‘formidable task’ of writing the entire history of a country. In terms of periodization, the first chapter, ‘the earliest inhabitants’, covers everything from Celtic and Roman Wales up until around 380AD. Chapter two covers around seven hundred years, up to 1063. But after 1063 the pattern changes to around two hundred years per chapter. This isn’t a criticism; it just underlines the reality for any chronological history of Wales that, before the 11^th century, it is difficult to go into forensic detail.

But I also think that we do need more of these types of ‘stories’ to get a more fixed idea of what our history actually consists of. In my first book, I purposefully avoided a narrative, firstly because the evidence wasn’t suited to this type of approach, and secondly because I wanted to address a number of different themes in broader medical history. But this time I’m tempted to bite the bullet and try and answer my own question of whether we should think in terms of ‘Welsh medical history’ or ‘medicine in Wales’.

Finding that one special source…

I’m sometimes asked why I became interested in Welsh medical history, and people are usually surprised when I tell them it was a complete accident. In 2003 I had just left a 10-year career with a high-street bank and had returned to study. Actually, ‘returned to study’ is a bit of a misnomer; I left school with 6 GCSEs and packed in A-levels after one year with a burning ambition to work in an office and have my own swivelly chair and desk. Suffice to say it wasn’t all I had hoped! But, after starting my degree studies with the OU I decided to take the plunge and go to Uni full time, joining in the second year.

In the summer before my final year I was on the hunt for a dissertation topic. I had little idea what I wanted to do beyond a vague notion of looking at seventeenth-century Wales and the civil wars. Aside from a little bit of reading about James Lind and the cure of scurvy, I had no experience of medical history whatsoever. I headed off for the Gwent Record Office and asked the archivist what was available. In what turned out to be a prescient comment, he said “if you’re interested in the seventeenth century, you might like this”, and produced the notebook of John Gwin of Llangwm. Tony Hopkins, I’m very grateful to you!

Gwin’s book is a miscellany. It contains everything from farming notes to accounts, from biblical verses to poetry and from family records to church seating disputes. But what caught my eye were the medical remedies.  This was my first real experience of early-modern handwriting, and at first I couldn’t make out much, and what I could see wasn’t familiar. “The sesticall stone to cure sore eyes by mistress Moone” was one. Another recorded “Mr Cradock’s directions to us for our two children being afflicted by the small pox”. One even had a receipt “to make a horse pisse”. Something about these remedies piqued my curiosity; I wanted to learn more about Gwin and the medicines he used.

It was then that the second stroke of massive good fortune occurred. Having taken a photocopy of one page to show my supervisor, Dr David Turner (later my PhD supervisor and now a good friend and colleague at Swansea), it was he who first suggested that there was little work on medicine in seventeenth-century Wales, and that this might prove a fruitful topic for research. David, I’m very grateful to you too! This led to my undergrad dissertation, to an MA and then to a PhD, funded by Wellcome…all this from one visit and one source. I often wonder what shape my academic career might have had, if any, had I not gone to the record office that day. It is a point that I often make to students looking for a dissertation topic, that it often only takes one really good source to spark off an idea.

Nearly ten years later and although my research interests have broadened, I still like to return to the Gwin book from time to time. There is a danger in over-using a source; you can become too close to them and, to use a term I hate, risk ‘valorising’ your subject. But in this case, the richness of detail in the book, its value for so many areas of Welsh history and its insight into daily life all render it an amazing – but largely unused – resource for Welsh historians.

I am part of the ‘History Research Wales’ network of historians working in Welsh universities, and we’re now into the third series of articles for the Western Mail, my first two concentrating on medicine in Wales. For this series, ‘Iconic places in Welsh history’ I thought I’d do something different. My iconic place was Llangwm – home of a certain Monmouthshire yeoman. One day I might get around to doing something more definite with the book; maybe an edited edition. But for now it was nice to revisit the book and use it for something wider than medicine. Here’s a link to the article.

http://www.walesonline.co.uk/news/welsh-history/articles/2012/03/30/welsh-history-month-llangwm-uchaf-in-monmouthshire-91466-30658342/

The NHS Bill – an historical perspective.

At the very least, the NHS Bill is provoking lively and vigorous debate. Just the other week, the proposed legislation was referred to by Ed Milliband as “David Cameron’s Poll Tax”! Objections against the changes put forward are too many and too wide-ranging to explore in detail here. But, succinctly, the main bone of contention lies in the expansion of outsourcing of NHS services to private companies – in effect the privatisation (‘modernisation’ some prefer) of the NHS – and its possible effects upon the quality and cost of patient care in England. But just what is it about privatisation in the bill that worries people?

Privatisation is certainly a loaded term; for some it carries the implicit assumption that something will be lost in the process– that things could get worse for consumers rather than better. Are we even somehow resentful of the loss or degradation of our once-proud institutions like the post office and the NHS? Given that the latter only dates from 1948, this seems less likely although there is certainly a residual fondness for what has been, for the most part, a success story of public health.

It is worth considering the provision of healthcare in Britain in the past, and especially in terms of the question of private enterprise. Four hundred years ago, the concept of public healthcare simply did not exist – this was the original ‘medical marketplace’. How, then, did this manifest itself in the sickness experiences of our forebears? How did these proto-consumers of healthcare cope with this situation, and what types of medicine and practitioner were available to them? What, ultimately, can we learn from them?

The early modern period was characterised by a diversity of medical service providers. These included university-trained and licensed physicians who often catered for wealthy clients, and who were largely based in large towns and cities. Surgery was a separate branch of medicine, while apothecaries, although nominally banned from doing so, also provided medical advice as well as remedies and ingredients as they were more accessible and more affordable for many people. At a local level were an undifferentiated mass of medical practitioners, ranging from specialists, such as occulists, bonesetters and wart-charmers, to travelling ‘doctors’ who would claim to cure anything from toothache to the ‘itch’ for a few pennies. Even the local blacksmith could be called upon to knock out a rotten tooth.

This was a true consumer market with a massive variety of choices for the early modern patient.  Most people self-medicated. Some grew their own herbs, but many remedies and ingredients were available locally, even in rural villages. Surprising as it might sound, given our perceptions of contemporary living conditions, maintaining a healthy lifestyle was also important. People invested in healthy ‘regimens’ – daily steps to staying fit from fresh air and exercise to early modern equivalents of the tonic or health drink.

So if medicine in the early modern period was fully private, was it better? Clearly, conditions in the seventeenth-century differ markedly from that which the proposed NHS bill would create. In effect, this aims to drive down costs by putting more services out to tender giving the customer – the patient – access to care through different providers but still essentially free at the point of delivery. The early modern marketplace though, was patchy and uneven, with the availability of care and cure varyying widely geographically, demographically and economically. In terms of public health, for example, authorities might intervene to contain epidemic outbreaks, but this did not generally extend to treatment or tangible support for the afflicted.

The closest thing to ‘official’ medical support could be found in local parish poor relief funds. Here the parish might pay for the treatment of a sick parishioner, sometimes even paying for them to travel if the most appropriate specialist was not nearby. Friends or neighbours might also be employed by the parish to care for a sick person. This phenomenon actually resonates with current questions surrounding the boundaries of public care provision. In very recent times, for example, the language of deserving/undeserving has returned to political discussions about welfare provision – a terminology very familiar to our forebears. Could a similar scaling back as that mooted for things like housing or child benefit eventually affect the willingness of the state to fund certain lifestyle-related conditions, say through smoking, binge-drinking or overeating?

Turning the question around, are things actually better now? Free healthcare, massively more effective drugs and treatments and a similar diversity of practitioners suggest so, but stories about people extracting their own teeth as they could neither find an NHS dentist to take them on, nor afford private care, are reminders of the failures that can still exist. According to a recent survey in a popular newspaper, four in ten adults consider dental care a luxury, while the cost of prescriptions in England is set to rise in April 2012.

Nonetheless, it is worth noting that we already engage widely with a private medical market. Like our early modern counterparts, we are vigorous self-medicators. The first recourse for many of us is the chemist (the local apothecary) where we purchase over-the-counter palliatives, despite the option of a cheaper prescription. Many visit private practitioners such as medical herbalists, whether professionals or one of the increasing number of high-street outlets.  Also, the option to purchase bespoke treatment remains a way to bypass waiting lists and, dare I say it, get a ‘better’ service, perhaps in more comfortable surroundings. ‘Lifestyle’ in the form of health food and drinks, spa treatments and even private gym memberships attest to our continuing desire to stay healthy and try and fend off illness before it arrives – a sentiment very familiar to those in the seventeenth-century. This is a market worth billions.

So to raise the question again, what are we afraid of? There is already, as these examples suggest, a broad acceptance of the idea of private enterprise in medicine. Whether alternative therapies, such as high-street herbalists, should be banned hasn’t really been debated. Whether they should be available on the NHS has. The potential problem with the intervention of the private sector, and here the experience of the early modern period does bear relevance, is the potential risk of uneven quality of care. People across the country in the seventeenth century faced widely varying quality in medical provision, based not only on their ability to pay, but on the lack of centralised training or regulation. The NHS provides a safety net that people in the past simply didn’t have. The danger in throwing the doors open to different companies, say in parallel to the privatisation of rail services, is that quality will again vary regionally and demographically; rather than having consistent levels of services across the whole country, and for people at all levels of society, patients’ care will suffer. This is something that the government will have to think carefully about. Things were not always better in the past.