Name and Shame: performance and reputation in early modern medicine

Last week the issue of the performance of surgeons came under scrutiny. The health secretary, Jeremy Hunt, threatened to ‘name and shame’ any surgeons who refused to publish their performance data, including mortality rates, in league tables. http://www.bbc.co.uk/news/health-22899448 Surgeons have raised many objections to the plans including potential stigmatisation of those seen as under-performing (an issue that is itself problematic say some authorities), the potential for misleading figures and, no doubt, a dent to professional pride.

The measurement of performance  – at least in terms of quantitative measurement and aggregation – together with the publication of results are a modern phenomenon in the medical profession. It is interesting to consider the issue of performance, and of public perceptions of medical practitioners in the past.

In the early modern period, for example, reputation was most certainly a central factor in people’s choice of medical practitioner. They wanted at least some reassurance that the man about to lance their boil or cut for the stone was not some cack-handed amateur who would leave them bleeding to death on the kitchen table. But reputation worked at a deeper level than this. In rural communities, for example, people effectively became healers by reputation; once a cure had been attributed to them, word of the power of the healer would spread and a position cemented. This was generally the way that so-called ‘cunning folk’ and ‘irregular’ healers gained prominence.

It is interesting to consider early-modern perceptions of ‘performance’ though. If we were to apply a modern measure to seventeenth-century practitioners, what sorts of figures would emerge? For many reasons we have no means of accurately measuring the ‘figures’ for early modern doctors. Beyond parish registers there were no official figures for causes of death outside London (if we include the Bills of Mortality) and nothing like today’s patient records from which to infer case histories. Some physicians did keep case books, and these can often reveal interesting stories, but not enough to aggregate.

What does seem likely though is that, at least by modern measures, 17th-century doctors were probably highly inefficient. Mortality rates, at least for surgeons, were undoubtedly far greater than today. Major surgery (such as opening the chest cavity) was seldom done due to the overwhelming risk of losing the patient. Before anaesthetic, any surgical intervention was risky whether due to hypovolemic shock caused when the body loses too much blood, the physical trauma caused by the pain and wound infliction or, perhaps even more so, the risk of secondary infection after surgery due to unwashed hands and instruments, and dirty conditions. Even relatively minor procedures such as bloodletting carried the risk of introducing infection, and a certain amount of deaths must surely have been attributable to blood poisoning or infection caused in this way.

All of this begs the question of why, if it was so risky, did people elect to visit surgeons at all? Why did some surgeons, especially into the eighteenth century, gain prominence and even fame if they stood a fair chance of killing their patients? Surely people would not have given such people the time of day if it were proved that they responsible for the deaths of far more people than they saved?

The answer is that people simply had a different expectation of what medicine and surgery could do for them. This was a world of sickness in which the patient, while by no means powerless, relied on an array of defences to support them in their fight to return to health. These included domestic medicine, family and friends, books – if they were literate, and also medical practitioners. Rather than one consultation with one general practitioner, as today, people commonly consulted many healers until they found one they were happy with. They might combine treatments and seek the opinions of several, whilst still falling back on their own tried and trusted remedies.

But did they expect practitioners to heal them? They certainly hoped that they would, but also understood that they might not. Let’s imagine for a moment that an early-modern person learned that the mortality rate amongst the patients of their prospective surgeon were in excess of 70% A surgeon with those sorts of rates in today’s league tables might well not last long on the register. But a seventeenth-century person might well view things a bit differently. Whilst acknowledging the potential danger, they could well view this as a risk worth taking – as a last-ditch effort to make them well again.

This explains why people went to doctors at all, and brings us back to reputation. If a practitioner had healed at least some people then they were potentially worth visiting. The fact that many people died under their ‘care’ was not necessarily viewed as their fault; it was an artefact of living in what everyone acknowledged were dangerous times for the sick. Therefore, doctors who had had at even some success were a potential lifeline. More than this, they could be held up as figures of approbation, despite what might be seen as a good record of not curing! What they did, however, was offered some degree of hope where otherwise there might be none. In that case, half a loaf was better than none.

Performance, even today, relies on much more than bare statistics. The reputation of practitioners is still important; we would all ideally want to see the ‘best’ specialist or the most eminent surgeon. It is worth considering how statistics can only tell part of the story though, and the ways in which our perceptions of reputation have shifted over time.

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Finding medical practitioners in early-modern Britain.

History has been likened to dropping a bucket over the side of a ship, attached to a long chain. What comes up is a microcosm of life deep below the waves. So it is with an historical source. It offers a tiny little glimpse – a snapshot in time – of one particular event, or one person. On its own, though, it doesn’t give us a full picture. It is a frustrating fact but many people, in fact the majority of people, left little or no trace in the historical record. Even when one or two documents survive, it is often difficult to get much more than bare facts. Does this mean, though, that we shouldn’t bother even trying to piece together the lives of people in the past?

The project I’m now working on at the University of Exeter is a study of medical practitioners in the early modern period. In fact, it is the largest concentrated study of practitioners probably yet undertaken in Britain. The aim is to try and identify all those engaged in the practice of medicine in England, Wales, Ireland and (later) Scotland between roughly 1550 and 1715. It is a massive undertaking. Who, for example, will be included? The list is enormous. Physicians, apothecaries, surgeons, barbers, barber-surgeons, chirurgeons, chymists, druggists, surgeon-apothecaries, cunning folk, medical entrepreneurs and quacks…and all points in between. Dr Peter Elmer, formerly of the Open University and now a senior research fellow at Exeter has already collected over 12,000 names, many with individual biographies. I’ve been charged with finding Welsh practitioners and, after eight months, the list already stands at more than 600 – and this for a country that reputedly had very few doctors. You can keep up with progress on the project at our website here: http://practitioners.exeter.ac.uk/

How are these people being located? The majority of my work is done in archives and on online catalogues. At the moment it is the sheer number of practitioners coming to light that is most surprising. They were, quite literally, everywhere. The problem lies in the deficiency of records and their limitations in offering much more than a glimpse of an individual’s life. Parish registers, for example, are often the only record that someone ever existed. In some cases, they might contain occupational data, and this begins to give some context. The Montgomeryshire parish registers are a useful case in point, with around 60 references to medical practitioners between the dates noted above.

Amongst the Montgomeryshire names are men like Arthur Jones of Berriew, a barber who died in 1697, Richard Evans of Brithdir “Physition” who died in 1701 and John Humphreys of Llanfechain, “chirurgeon” who died in 1660. Given that occupational data in parish registers is relatively rare, it seems fair to assume that recorded occupations suggest that these were the primary occupations of the people concerned. In each case, however, these are the only references to each man that I can find. No further evidence of their practice, their social status or indeed their lives, can be firmly established. At the very least though, and when aggregated, even this bare data does begin to allow us to see something of the landscape of medical practice in a given area. In Montgomeryshire, for example, is a rare reference to the occupation of midwife – one Catherine Edward of Glynceiriog, who died and was buried in April 1688. Midwives seldom appear in the historical record in Wales, so even brief references are interesting.

In other cases, though, it is possible to build up a broader picture of an individual practitioner’s life. The baptisms of children give both an indication of family formation as well as placing a person within a given area for a fixed number of years. Richard Ellis, for example, was a barber in Newtown, now in Powys. No record can be found for his birth or death, but the baptisms of his children William, Sarah and George between 1732 and 1737, in each of which he was referred to as a barber, tell us that he was at least practising between those dates. Also, it might be inferred (although by no means certain) that this was at the earlier end of his career given that children tended to be associated with marriage and the establishment of a household. The Newtown apothecary Thomas Kitchen provides a similar example, with the baptisms of his children Edward, Eusebius and Margaret between 1733 and 1737. Whilst we can’t tell anything about his business from this, we can at least fix him both geographically and temporally.

Other types of sources can unwittingly provide testimony to the businesses and social networks of medical practitioners. Wills and probate inventories can certainly be revealing about shop contents but, by looking further at things like the names of benefactors and even the signatories to wills it is possible to discern networks. In early-modern Wrexham, for example, a cluster of seventeenth-century wills reveal close links between practitioners in the same town, suggested by debts but also by their acting as executors or appraisers for colleagues. In some cases, for example that of Godfrey Green of Llanbeblig, died 1699, his entire shop and business found its way into the possession of another apothecary, John Reynolds, where it was still described as being the shop goods formerly of Godfrey Green when Reynolds himself died in 1716.

The best evidence can often be found where a picture can be built up using a variety of different documents. I’m currently working on an article about medical practitioners in early-modern Cardiff and especially their role within the early modern urban environment. Town records are generally better than for rural areas, but it is interesting to note the depth to which medical practitioners were often involved in town business. One Edward Want of Cardiff, an “barber-chirurgeon”, appears variously in documents in the second half of the seventeenth century. From parish registers we have his dates of birth and death, as well as the fact that he took over his business from his father of the same name. From hearth tax records we can tell that he was based in the affluent West Street area of the town, while a 1666 town survey further reveals that he was charged 6d  half a burgage in that area – the small plot probably indicating a shop. At some point he had occupied a mansion house near the corn market, a fact attested to by a land lease document, further suggesting wealth and status. References in the wills of two other Cardiff traders indeed refer to him as an Alderman, and Cardiff borough records also list him as a juror. We can also tell that his son Sierra Want was apprenticed to a Bristol barber surgeon, a common practice for the sons of middling-sort South Walians. Whilst his will contains nothing  of his medical practice, the use of a variety of documents can help us build up a real picture of the commercial and personal life of Edward Want.

In pulling the bucket up from the depths it is often difficult to glean much more than the barest facts; we often need more to really start to close in on the lives of our early-modern forebears. With practice, a little ingenuity and a great deal of luck though, even the smallest of extra facts help us to piece together a picture not just of how many people were practising medicine in Britain, and perhaps especially in rural Britain where records are fewer, but also something of their lives, occupations and statuses within their communities.

Medicine by Post: A 17th-century doctor’s directions

Medicine in pre-industrial society was loosely structured. Finding a possible practitioner to minister to your ailments wasn’t difficult; they were virtually ubiquitous. From village tooth-drawers, bonesetters, diviners and wise women across to trained, apprenticed or licensed physicians, the range of potential choices for the early modern patient were legion. And yet, this very ubiquity often serves to mask the most basic element in these encounters; what actually happened. What did the doctor say or do? What was the relationship like between treater and treated?

Early modern doctors could not necessarily command authority. Unlike today, where we go to the doctors to find out what it wrong with us, the seventeenth-century patient effectively self-diagnosed. They told the practitioner what the complaint was, and expected them to prescribe accordingly. In Galenic medicine, people knew their own humoural constitutions and largely determined – through their own knowledge and by reference to others – what this problem was.

Nevertheless, the doctor could claim to have esoteric knowledge about how the body functioned. As far as learned physicians were concerned, while the sufferer might well know what was wrong with them, they did not have the necessary understanding of the body to be able to treat it safely. It was therefore only the trained and licensed physician who was qualified to treat the sick properly…at least that was the claim of the trained and licensed physician!

One means through which we can get an idea of the early modern equivalent of the ‘doctor’s appointment’ is through the occasional letters written to patients by practitioners after such encounters. One such letter I encountered during my PhD research, and is located at Glamorgan Record Office, MS D/DF V/202. It is a letter from 1628 addressed to a ‘Mrs Bridges’ but is (extremely frustratingly) anonymous, since the last portion of the letter is missing. Below is my transcription:

‘For Mrs Bridges

When yow come home yow may begin with the Physick wch yow have from hence so soon as yow will: taking it in a manner following, Provide the like Possetale as you did here. To a reasonable draught of that Posetale yow may put two spoonefull and an half of the opening wine. Mix them and put a little sugar to them to relish them: and so drinke it in the morning fasting. Walke, or use some good exercise after it for the space of an hour and halfe, and fast after it for the space of three howers: then make a light meale of boyled meate. The like yoe may do a little before foure of the clock in the afternoons and observe the like course.

But because your body will be apt to be bounde upon the use (of) this physick, therefore I have set you down some syrupes in a glasse, wherof I would have you to take three spoonefull mixed in the former draught any morning when you please.

And, the day after that the full course of the opening wine is finished I would have you take five spoonefulls of the syrupes to a draught of the former posetale and so drinke them warme. And two houers after take a draught of warm thin broth. And at any time when you are costive you may use a suppositorys made with honey and salt boyled to a height and put a little fine powder of Aniseeds and fenell seeds to it when you make it up.

Be carefull in your diet. Eat noe meatte but flesh as is of an easy digestion: as mutton, veale, lambe, capon, chicken or the like: Avoide all raw salletts, or fruites: But for sallets use capers washed in warme water. And sallett of broome budds, or Asparagus or the topps of young hopps are good. Or Cowslipp flowers candiyed and mixed wth a little vinegar. Or rosemary flowers wth a little vinegar and sugar.

I am afrayd your body will not endure the use of wine: but if you use any Let it be onely a draught of mulled claret wine with a sprigg of rosemary, and sweetened wth sugar, and take it in the middle of your meale.

All salt meates and baked, or spiced meates are nought for you: and milk or milky meates are worse.

Yow must endeavour to be cheerefull and avoyde all passions of fear, anger or melancholye.’

There are a number of interesting elements to this letter. Firstly, it is clear that Mrs Bridges visited this practitioner. The letter itself is virtually a follow-up to the appointment, containing some record of the encounter but, more importantly, a full set of instructions and directions for her recuperation. This suggests that the face-to-face encounter was one stage in a process. Where, today, one generally leaves the doctor’s surgery armed with a prescription, this encounter was holistic, and involved a further stage. Put more simply, the ‘appointment’ didn’t end when Mrs Bridges left the physician’s premises. This, too, is an important point. In this case – somewhat unusually – she has visited the doctor, rather than the other way around. He mentions her returning home, and also the physic he sent ‘from hence’.

Also noteworthy is the emphasis upon lifestyle, much of which would seem familiar in today’s health-conscious society. Here, the advice is to eat certain foods at certain times, and then in moderation, to ‘be carefull in your diet’ and, crucially, to stay cheerful, stoic and calm. It is worth noting too that the practitioner is ‘afrayd’ that Mrs Bridges’ body would not tolerate wine, although he did leave the door slightly open for the odd tipple.

In early-modern parlance, this was known as ‘regimen’. As surprising as it might seem, given their seeming predilection for dangerous or disgusting remedies, this was a very health-conscious society. Good health was something to be cherished and maintained. It was far better to prevent illness than to treat it. Mrs Bridges’ practitioner took pains to understand her humoural makeup, and based his comments directly upon this. Medicine, in this sense, was individualistic. It is one of the many contradictions of humoural medicine that a remedy meant for one individual should not theoretically have treated another. In practice, people shared and accrued recipes vigorously.

But what this letter gives us most is a little window into the consultation process itself. It gives us some insight into the processes of consulting a practitioner, albeit at probably the upper reaches of society. Bearing in mind that the vast majority of people couldn’t write, the very fact that this letter survives marks it out as exceptional. As more of these fascinating documents are uncovered, we may start to learn more about the early modern doctor’s ‘appointment’, at other levels of society, and with other types of practitioner.

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 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.

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.