What is a ‘remedy collection’?: Recording medical information in the 17th century

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 including Elaine Leong, Sara Pennell and Michelle DiMeo, Anne Stobart, Lisa Smith, Sally Osborn and others is revealing, the committal of recipes to paper was often a complex process.  (See also the fantastic recipes.hypotheses blog  and Twitter feed @historecipes)

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.

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 10^th 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.

Seeing History: The rise of spectacles in early modern Britain.

The percentage of people in the UK requiring either spectacles or contact lenses has risen over successive decades. It is difficult to put exact figures on this; some estimates suggest that over 68% of the population in Britain currently wear glasses or lenses, and this varies dramatically within age groups. Around 29% of 16-18 year olds require some sort of visual aid; a 2005 report put the figure for the age group 65 and above as high as 98%. It seems that spectacles today have largely shed their pejorative connotations and even become desirable, helped by many high-profile celebrity spec-wearers. Indeed, opticians have even reported a growth in sales of spectacles with blank lenses over recent years, to cater for those who see glasses as a fashion item. This apparent love affair with spectacles is not consistent, however.

A prosthetic eye, possible 17th century.

Until the seventeenth century, eye complaints were troublesome and painful, and effectively seen as a form of disability. The virtual plague of ophthalmic conditions in early modern Britain is attested to by the ubiquity of remedies for eye complaints in remedy collections. Common were remedies for sore eyes, which were often treated (in line with the ‘doctrine of sympathies’) by using substances of a similar constitution to the eye. Remedies using snails were popular; one common example was to impale a garden snail on a pin and let the juice run into the eye. Another recommended using fresh goose dung, its gelatinous consistency resembling the watery eye. Yet another suggested the blowing of dried hen’s dung into the afflicted party’s eye just before they went to sleep. For more on the uses of animal substances in remedies, see Lisa Smith’s excellent blog post on the subject. http://www.wondersandmarvels.com/2012/05/the-puppy-water-and-other-early-modern-canine-receipts.html

Opthalmic surgery was also in its infancy, with a procedure known as ‘couching’ or ‘cooching’ being one of the most invasive operations undertaken, being used for the treatment of cataracts. Here, a small silver instrument called an itinerarium was passed into the sufferer’s eye. The intention was to physically push the cataract film back away from the lens of the eye and thus clear the vision. This was doubtless uncomfortable and seems almost impossible to imagine – bearing in mind the patient was awake and conscious at the time. We shouldn’t assume that it was necessarily dangerous though. The seventeenth-century diarist Walter Powell of Llantilio Crossenny, in Monmouthshire, endured the procedure three times and still carried on with his diary afterwards, so presumably his vision was little worse if it wasn’t much better.

The wearing of spectacles was certainly known in Tudor times. Most typically, these were armless and sat on the bridge of the wearer’s nose. There were other types of device that could be used. Fearing he was losing his sight after years of close working in extremely bad light, Samuel Pepys tried a revolutionary new device in 1668 (the “tubespecticall”) which involved reading through three-inch long paper tubes, which eliminated glare and excess light.  Essentially, however, these were items connected with a physical disability – the same as prosthetic limbs, bandages or trusses.

The 17^th century, though, witnessed the beginning of a shift towards people being more comfortable with what was essentially a form of disability, and this was especially noticeable in portraiture. Fashion was a factor to some extent. In previous blog posts I have noted the use of steel as a desirable material, and shining steel spectacles represented a desirable fashion item. As such, steel spectacles could also be a mark of literacy and wealth.

Eighteenth-century spectacle makers also needed to adapt to the times, and produce items that could fit with current fashions. One of the most important exponents of this, and indeed in many ways a forefather of the modern spectacle designs, were ‘Martin’s Margins’, invented by the London maker Benjamin Martin. These were fairly revolutionary. Rather than sitting on the wearer’s nose, they had spring-loaded arms which enabled them to adhere seamlessly to the head, with less chance of falling off and being damaged.

Martin’s Margins

The eighteenth century was in fact an age of innovation in opthalmics. The optical instrument maker James Ayscough invented frames with long, folding arms to reach around the head, also known as ‘railway spectacles’. ‘Wig spectacles’ were designed with arms to slide into the fibres of a wig, and keep them in place – especially important given the increasingly ebalorate coiffeurs of the elites. The gradual introduction of steel springs in nose-pieces also helped fitting. The lenses of spectacles also developed through the eighteenth century. Around a third of the lens in a pair of ‘Martin’s Margins’, was filled with ox horn, to restrict light. Other developments included D-shaped spectacles in the 19^th-century, which had side visors which provided protection from dust and light. A self-portrait by Sir Joshua Reynolds depicts him wearing a pair of wig-spectacles:

Reynolds Self Portrait © PCMAG

To be depicted in spectacles drew attention to the eyes, and the vision of the subject, perhaps literally or notionally. Conversely, though, spectacles could also be used in morality paintings to emphasise undesirable traits, such as miserliness. This portrait of Benjamin Franklin shows him squinting to read a document through his new-fangled spectacles:

There was also a medical aspect to the use of spectacles: too much light was seen as potentially injurious to vision, and spectacles were sometimes designed to restrict the amount of light entering the eyes. Tinted lenses, especially green, were considered to be therapeutic in the 17^th century (note the green lenses in the ‘Martin’s Margins’ above too).

So today’s fashion for spectacles has a long gestation, and it is interesting to see how perceptions of eye complaints have shifted over time. In fact, opthalmics has tended to move away from a strictly ‘medical’ field; the optician is now a common feature of the high-street and eye-tests and fittings can be done virtually on a drop-in basis. It is also interesting to note that the wearing of spectacles for fashion is not new. I heartily recommend a visit to the MusEYEum in the Royal College of Optometrists in London, where there is a fascinating library of artefacts and books about the history of spectacles, as well as some rare portraits of spectacle-wearers through history. The blog of its curator, Neil Handley, can be found here: http://www.college-optometrists.org/en/knowledge-centre/news/blog/index.cfm/id/199E66BA-4091-4C98-A53907402DE66669

Concocting Recipes: The early modern medical home.

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.