Medical practice in early modern Wales – revision time!

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.

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Inside a seventeenth-century Welsh barber-surgeon’s shop.

Much of the work I’ve been doing recently on the history of shaving and masculinity in the enlightenment has concentrated on self-shaving…technically called auto-pogonotomy. The mid eighteenth century was really the first time when men started to eschew the barber and do the job themselves or, if they were well off, get their servant to do it. Some advertisements for male servants even stipulated that the prospective applicant had to be proficient in shaving.

Through my work on medical history, though, I’ve also been interested in the shops and contents of medical practitioners, especially doctors and apothecaries, but also barbers. One way of looking at this is through probate inventories. When people died, as part of the probate process, an inventory was made of all their possessions, and these can often reveal a great deal about material culture and individual lives. Often they are not detailed, and simply lump the goods together under generic titles like ‘household stuff’ or ‘brass and pewter’. But sometimes they are more thorough, and list individual items. In the case of inventories for shop owners, they can give us a real insight into not only what was being sold, but the appearance and layout of the shop itself.

One of the inventories I looked at when researching my book was that of a Wrexham barber-surgeon, James Preston, who died in 1681. (For anyone who might want to see the original, it is in the National Library of Wales, reference  MS SA/1681/216). The makers of Preston’s inventory were extremely diligent, and listed the entire contents of his shop. By looking at this closely, we can learn a lot about what it must have been like to walk into his shop in the late seventeenth century.

Like many shopkeepers of the time, James Preston lived above his shop, and appears to have been fairly well off by the standards of the time. Amongst his furniture were ornate “turkey worke” chairs and cushions, some leather chairs and other pieces of furniture including chests and glass cases. In another room over the shop were several feather beds, trunks of linen and a range of housewares including fine cooking utensils and dinnerware. Preston was clearly a man of some standing, since much of what he owned was expensive and out of reach to those on lower incomes.

Preston was described on his inventory as a “Chirurgeon Barber”, and barbering was clearly a large part of his business.  Visitors to his shop would have been greeted by an array of shaving equipment, some hanging on the wall, others ready to use. There were, for example “One case of trimming instruments with razours and coumbs”, along with a “douzen and a halfe of washboales”. Clearly this was a business set up to deal with a number of customers at once.

Another entry suggests the process of shaving itself. Amongst the shop items was “Jesamy butter” – a type of unguent soap, presumably applied to soothe recently scraped faces, as was “agyptiacum”. A similar function was performed by the “halfe a pound of damask powder” in Preston’s inventory- the early modern equivalent of a splash of aftershave! The customer would have seen a row of pewter and brass basins, and a set of fifteen razors and scissors. After the deed was done, they might inspect their freshly shorn visage in one of the looking glasses that were present in the shop.

It is also interesting to note that the shop contained six chairs and “instruments of music”. Margaret Pelling’s work on early modern barber and apothecary shops has suggested that these establishments could become places for social gatherings, as well as functional premises, and this might include the playing of music and merrymaking. To find this in a provincial Welsh barber’s shop is interesting.

But, also like many of his contemporaries, James Preston was a medical practitioner, and his inventory shows evidence of debts owed to him for treatments. One Hugh Roberts of the Swan Inn owed Preston £1 for “the dressing of his legg”, and a further seven shillings for “the dress of a quinsy”. He provided a “searcloth” – a type of plaster/bandage for another customer, while he charged two shillings and sixpence for curing a “bustion” on a housemaid’s finger.  In all, there are well over twenty ‘cures’ listed, including local elites as well as the poor and servants, and Preston treated everything from broken limbs to sore throats.

It might seem unusual that a barber might administer cures, but it was in fact common. The classification used on probate inventories (in this case “Chirurgeon-barber”) gives a clue – surgeon is put first here. But the makers of inventories often just used the main type of employment of the deceased, even though they might have performed several functions. There was a close relationship between barbering and medicine anyway; facial hair itself was regarded as a form of bodily excreta, so getting rid of it was part of the wider bodily rituals of letting blood and purging.

This is just one source, and even in a few brief paragraphs we can begin to build up a picture of something of the life of just one early modern barber. Used carefully, probate inventories can be fantastic sources, giving us a window into the insides of people’s houses, and the accoutrements of their lives.

The ‘heroic sufferer’; sickness narratives in early modern letters

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!

Apologies.

Apologies for the lack of bloggage in recent weeks. In line with my academic colleagues, I’m currently locked away with piles of undergraduate essays to mark. Once all is done, like Fu Manchu, I shall return!

Constructing the Sufferer (part 1)

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!