Religion & the Sickness Experience in Early Modern Britain.

Over the years, a number of studies have been made of the sickness experiences of clergymen and religious figures as recorded in their diaries. One of the most well known is that of the diarist Ralph Josselin, vicar of Earl’s Colne in Essex. Another, lesser known, diarist I studied in the course of researching my book was Phillip Henry of Broad Oak in Flintshire, a puritan minister whose mid seventeenth-century diary covers a time of great religious upheaval, but also goes into great detail about his sicknesses. I also uncovered the records of an eighteenth-century Welsh Methodist preacher, who recorded the behaviours of his sick parishioners, naturally viewed through the lens of his own religious beliefs.

In every case, it is clear not only how central religious beliefs were in interpreting and understanding sickness, but how individual experiences could be affected by denomination.

For Puritans like Phillip Henry, for example, sickness was a test from God and it was up to the individual to interpret the message being given to them. In many ways sickness was to the body what sin was to the soul – both needed firm and definite action. As Henry wrote in 1657 “They that are whole need not a Physician…sin is the sickness of the soule, and sin-sick soules stand in great need of a Physician, and that Physician is none other than Jesus Xt”.

(c) Mansfield College, University of Oxford; Supplied by The Public Catalogue Foundation

When ill, Henry constantly monitored his symptoms and looked for causes in his behaviour. If he had a cold, he might wonder whether this was a result of the sin of pride. In other cases he felt that illness had been brought on by his over-attachment to wordly goods, or laxity in prayer. In almost every case, he viewed his body as the instrument through which God was correcting him.

If anything impressed the Godly in the sickness behaviours of others it was fortitude and stoicism. If people were penitent, so much the better. The clergy were especially pleased when the sick attended church, despite their afflictions, even if they had to be carried in, and limped out!

In the 1730s, John Harries, Methodist rector of Mynydd Bach and Abergorlech in Carmarthenshire, kept a journal in which he recorded his visits to sick parishioners (National Library of Wales MS 371B, Register of Mynydd Bach Chapel). Harries paid careful attention to the behaviour and comportment of the sick. When Morgan Evan Morgan ‘departed this life 23rd December 1736/7’, Harries noted that he had ‘behaved himself very sivil and sober’ despite being in a ‘lingering distemper about eight years’. Catherine Richard likewise ‘behaved herself inoffensive’, while Joyce Evan ‘was very cheerful…expected but to live, but hoped to be saved’.

In other cases, however, it is clear that Harries was looking to the sick for signs he could interpret of his own destiny. When Mary John died in October 1737 he noted that she ‘relied wholly on Jesus X for her soul and behaved very patient’ but also noted that she was the first received to communion at the same time as him. As he noted, ‘I shuld take this into consideration’. Those who did not conform to expectation troubled him. When Mary Richard died in July 1742, Harries was keen to stress that ‘she was very wavering and inconstant in her profession [of faith], sometimes in and sometimes out’.

M0018191 Dying man in bed.
Credit: Wellcome Library, London. Wellcome Images
images@wellcome.ac.uk
http://wellcomeimages.org
Left: a dying man in bed. Original Negative is a Vinegar Negative CAN NOT BE RESCANNED
Woodcut
circa 1531 By: Hans BurgkmaierOfficia M.T.C.
Cicero, Marcus T.
Published: 1531
Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

He took comfort in those whom he felt offered a glimpse into his own fate. The last moments of Ann Rees showed a woman who ‘behaved herself very lovely [and] told me a few hours before she dyed that shee hoped for salvation for God’s mercy’. Reflecting on this Harries wrote that ‘the Lord prepare me for death and judgement. I see both young and old are carried away to another world unobserved’.

Constantly keeping company with the dying and dead could actually have an effect on the health of ministers. Welsh Methodists were apparently prone to depressive illness, due to their intensive introspection and concentration upon their own failings and weakness. Phillip Henry reported his unease at having attended three dying parishioners within a few days in January 1651, and worried that this was leaving him was a diminished sense of his own spirituality. Other ministers like the Manchester Presbyterian Henry Newcome, found the continual round of deathbed sittings and funerals overwhelming.

But it was not only ministers who applied their religious tenets to sickness. A lucky find in Cardiff University library’s collection was a transcription of the diary of Sarah Savage, Phillip Henry’s daughter. (J.B. Williams, Memoirs of the Life and Character of Mrs Sarah Savage, London: Holdsworth and Hall, 1829). Like her father, Sarah was quick to seek the hidden meanings in her symptoms. In 1691 she was “all day at home having got an ill cold in my head”. Clearly feeling ill she fretted that “My heart was a little let out in love and praise to my Redeemer”, but reassured herself that this was “but a fit [and] soon off again”.

An attack of the smallpox the following year placed her and her family in mortal danger. Her daughter Ann, also a diarist, wrote that ‘when I had received the sentence of death within myself, surely the Lord as ready to save me”. Ann also felt that the experience had taught her a valuable lesson: “the mercies, the sweet mercies which I experienced in the affliction, I shall never forget”.

Lawrence Stone’s (now much criticised) book on early modern family life suggested that people were reluctant to invest much love in their offspring since they stood a good chance of losing them. A wealth of evidence has been put forward to refute this. Puritans, often portrayed as the most stony-faced of all Christian denominations were as troubled as anyone by illness in children. In July 1663 Henry visited a local household where a child was ‘ill of the convulsion fitts. I went to see him & O what evil there is in sin that produces such effects upon poor Innocent little ones’. With a troubled conscience he reflected ‘if this bee done to ye green tree what shall be done to the dry?’.

L0043760 Memento Mori
Credit: Wellcome Library, London. Wellcome Images
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The head and shoulders of a ‘memento mori’ corpse. These statues were used to remind people of the transience of life and material luxury.
16th century Published: –
Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

When family members, especially children, were ill, even the strongest of faith could be tested. After witnessing the sickness of other people’s children, he was forced to confront the death of his own young son from measles. It is one of the starkest and most moving diary entries I have ever encountered, and conveys the conflict between religious conviction and a parent’s desperation. Perhaps most strikingly, Henry looks to God to show him where he (Phillip) had strayed to be punished thus.

“At Sun-Sett this day hee dy’d, our first born and the beginning of our strength, a forward child, manly, loving, patient under correction. O that I could now be so under the correcting hand of my heavenly Father. Lord, wherefore is it that thou contendest, show mee, show mee? Have I over boasted, over loved, over prized? My heart bleeds. Lord have Mercy”.

Religion was a central part of the sickness experience, and coloured not only hopes and expectations of recovery, but also the actual, physical experience of illness. Ministers and lay individuals alike, albeit perhaps to different extents, looked to God to explain how they were feeling and what this might suggest about their own conduct.

Good and Bad Deaths in the Seventeenth Century

Whilst living well was clearly a primary concern for people in the past, dying well was equally, perhaps even more, important. A whole literature existed – the Ars Moriendi, or Art of Dying, printed in the 15^th century, which sought to instruct people in how best to conduct themselves in their last mortal moments on earth. This was an age of extremely high death rates. Death was highly visible. Unlike today where death is sanitised and usually takes place outside the home, in the early modern period sickness and death were domestic events. It would even have been common for children to have seen a corpse, and spent some time around it.

Image from Wikipedia Commons

The so-called ‘good death’ has a long history. Before the Reformation, the way a person behaved in their final moments was of signal importance since it could influence their final destination. But what constituted a good death? Ideally the sick person should firstly have prepared their soul well before. They should already have lived as a good Christian but, when sickness was upon them, they should act to ensure their affairs were in order.

The dying person should be surrounded by their family and friends who would monitor their behaviour, and take comfort at signs of piety. For example, the dying person should be humble and contrite, and show readiness to meet their God. If possible they should, out loud, confess and repent of their sins and forgive any sins against them. Finally, they might take time to speak to each of their family, expressing love and hoping to meet them on the other side. Such a death would reassure family members that their loved one was bound straight to Heaven, and that they should not worry about their soul.

After the Reformation things changed markedly in terms of attitudes towards final conduct. No longer was it firmly believed that behaviour could influence whether a person went to Heaven or Hell. But this is not to say that the ‘good death’ was not still extremely important. Protestant belief in predestination, in other words that people were already marked out before birth for either the Pearly gates or the River Styx, meant that people were ever watchful for signs that they, or their families, might be one of God’s elect. A good death might be just the sort of proof they sought.

Even in the seventeenth, and into the eighteenth, centuries people still monitored the behaviour of the dying and looked for possible messages. In 1668, John Gwin wrote in his notebook that “My wife’s mother died 25^th May, the last words she spake O Dduw Kymer Vi [Oh God, come for me/take me] for w(hi)ch words and others we received coserninge her we yield all praise to God etc” For Gwin, the old lady’s final message was Godly and pious, displaying a readiness to submit to judgement. His note about reports from others about her conduct is also telling.

When Robert More died in 1670, his brother Giles reported with satisfaction that “after a quiet night] he sent forthe with great earnestnesse 3 or 4 most Divine shorte prayers…he died at 1 in the afternoon”. David Jones, The rector of Mynydd Bach in Abergorlech, Carmarthenshire in the 1730s kept a close eye on the conduct of his sick parishioners. Of one he wrote (with more than a hint of his Welsh accent) that, despite her pain she ‘behaved herself lovely’. Of another, although she was ‘hoping to live but expecting to die’ she ‘hoped she had been a good Christian.’

Copyright Wellcome Images

But the other side of the coin was the bad death. Whilst many people would surely have preferred their final moments to be peaceful and orderly, life was seldom that straightforward. Some people died suddenly, robbing them and their relatives of the chance to prepare. Victims of murder were denied a good death, prompting some speculation that ghosts were the souls of those troubled by not having had chance to prepare themselves. Some people simply died alone. For others, bouts of sickness took away the power of speech. Such an occurrence was especially troublesome to families since their loved one was physically with them but unable to communicate their feelings.

But there is another, often overlooked, group of people who simply wanted to be left alone to die in their own way. Imagine the scene. You are in the last hours of your life, perhaps gasping for breath, in pain and misery. Your family surround you, all constantly watching you, hanging on your every word and, perhaps, prompting you to hold forth with a stream of pious utterances. Some could clearly bear it no longer.

Image from Wikipedia Commons

Others had long since abandoned any pretence at caring. In 1598 died Lord Burghley after a long sickness, and surrounded by children, family and friends who had spent several hours praying, crying by his bedside and trying in vain to save him. Burghley’s last words? “Oh ye torment me…For Godes sake let me dye quietlye’! Perhaps a similar bout of lectures, lessons and spiritual moralising prompted Elizabeth Angier, the wife of a Puritan minister to ask her doubtless devoted and panicked husband ‘Love, why will you not let mee goe?’.

Some took it a stage further and decided that misanthropy was the only way. If they were going to die, why keep up social pretences?! Reports of the death of Sir William Lisle in 1681 noted that he “Died privately in a nasty chamber – he allowed nobody to visit him, no not even his wife and children”. The last words here should fittingly go to ‘Old Duckworth’ of Yorkshire who also died in 1681. “He died miserably in poverty] his toes rotting off, he slighting it said they never did him any good, he stank that nobody could abide to come to his house, in a dreadful state”

The Agony and the Ecstasy: Hunting for 17th-century medics with few sources!

At the moment I’m once again on the hunt for elusive Welsh practitioners in the early modern period. The idea is to try and build up a map of practice, not only in Wales, but across the whole of the country. Once this is done we should have a clearer picture of where practitioners were, but also other key factors such as their networks, length of practice, range and so on.

Working on Welsh sources can at times be utterly frustrating. For some areas and time period in Wales sources are sparse to the point of non-existence. Time and again sources that yield lots of new names in England draw a complete blank in Wales. Ian Mortimer’s work on East Kent, for example, was based on a sample of around 15000 probate accounts. This enabled him to draw important new conclusions about people’s spending on medical practitioners in their final days. For Wales there are less than 20 probate accounts covering the early modern period!

Wales had no medical institutions or universities, so there are no records of practitioners’ education or training. Welsh towns were generally smaller than those in England – the largest, Wrexham, had around 3000 inhabitants by 1700 –and this had a limiting effect on trade corporations and guilds. As far as I can tell there were no medical guilds in Wales between 1500-1750. It is also interesting to note that relatively few Welsh medics went to the trouble of obtaining a medical licence. A long distance from the centres of licensing in London, it could be argued that a licence was simply not necessary. Coupled with this was the fact that there was virtually no policing of unlicensed practice in Wales…only a bare few prosecutions survive.

The common perception has long been that there were simply few practitioners in early modern Wales. In this view, the vacuum left by orthodox practice was filled by cunning folk, magical healers and charmers, of which there is a long Welsh tradition. When I wrote Physick and the Family I suggested that there was a hidden half to Welsh medicine, and that if we shift the focus away from charmers etc then a much more nuanced picture emerges. When I began my search in earnest on this project, I was (and still am) confident that Welsh practitioners would soon emerge in numbers.

At the moment, however, the number stands at around the 600 mark. This includes anyone identified as practising medicine in any capacity, and in any type of source, roughly between 1500 and 1750. So, 600 people engaged in medicine over a 250 year period, over the whole of Wales. Admittedly it doesn’t sound much! As a colleague gently suggested recently, this puts the ratio of practitioner to patient in Wales at any given time as roughly 1-50,000!

Here, though, the question is how far the deficiencies of the sources are masking what could well have been a vibrant medical culture. How do you locate people whose work was, by its nature, ephemeral? If we start with parish registers, for example, their survival is extremely patchy. For some, indeed many, areas of Wales, there are simply no surviving parish records much before 1700. Add to that the problem of identifying occupations in parish registers and the situation is amplified. How many practitioners must there be hidden in parish registers as just names, with no record of what they did? It is also frustrating, and probably no coincidence, that the areas we most want to learn about are often those with the least records!

Records of actual practice depend upon the recording of the medical encounter, or upon some record of the qualification (good or bad), training, education or social life of the practitioner. Diaries and letters can prove insightful, but so much depends on the quality and availability of these sources. There are many sources of this type in Wales but, compared to other areas of the country with broader gentry networks, they pale in comparison.

All of this sounds rather negative, and it is one of the signal problems in being a historian of medicine in Wales of this period. In a strange way, however, it can also be a liberating experience. I have long found that an open mind works best, followed by a willingness to take any information – however small – and see where it can lead. Once you get past the desperation to build complete biographies of every practitioner you find, it is surprising what can actually be recovered.

In some cases, all I have is a name. Oliver Humphrey, an apothecary of a small town in Radnorshire makes a useful case in point. He is referred to fleetingly in a property transaction of 1689. This is seemingly the only time he ever troubles the historical record. And yet this chance encounter actually does reveal something about his life and, potentially, his social status and networks. The deed identifies him as an apothecary of ‘Pontrobert’ – a small hamlet 7 miles from the market town of Llanfyllin, and 12 from Welshpool. Immediately this is unusual – apothecaries were normally located in towns, and seldom in small, rural hamlets.

The deed involved the transfer of lands from Oliver and two widows from the same hamlet, to a local gentleman, Robert ap Oliver. Was this Robert a relative of Oliver Humphrey? If so, was Oliver from a fairly well-to-do family, and therefore possibly of good status himself? Alternatively, was Robert ap Oliver part of Humphrey’s social network, in which case what does this suggest about the social circles in which apothecaries moved?

Where there is a good run of parish registers, it can be possible to read against the grain and find out something of the changing fortunes of medics. Marriages, baptisms and deaths all point to both the length of time that individuals can be located in a particular place, and how they were identified. In some cases, for example, the nomenclature used to identify them might change; hence an apothecary might elsewhere or later be referred to as a barber-surgeon, a doctor or, often, in a non-medical capacity. This brings me back to the point made earlier about the problems in identifying exactly who medical practitioners were.

An example I came across yesterday was a bond made by a Worcestershire practitioner, Humphrey Walden, “that in consideration of the sum of £3 he will by the help of God cure Sibill, wife of Mathew Madock of Evengob, and Elizabeth Havard, sister to the said John Havard, of the several diseases wherewith they are grieved, by the feast of the Nativity of St John the Baptist next ensuing, and that they shall continue whole and perfectly cured until the month of March next, failing which he shall repay the sum of £3”.

Apart from the wonderful early money-back guarantee, this source actually contains a potentially very important piece of information. It confirms that a Worcester practitioner was treating patients in Wales – Evenjobb is in Radnorshire. Walden may have been an associate of John Havard and been selected for that reason. Alternatively, he may have had a reputation along the Welsh marches as a healer for certain conditions, and been sought out for that reason. It strongly suggests the mutability of borders though, and the willingness of both patients and practitioners to travel.

In other cases practitioners pop up in things completely unrelated to their practice. The only record I have of one Dr Watkin Jones of Laleston in Glamorgan occurs because he was effectively a spy for the earl of Leicester, being called upon to watch for the allegedly adulterous activities of Lady Leicester – Elizabeth Sidney. At the very least, however, it confirms his presence in the area, his rough age, and the fact that he was connected to a gentry family.

And so the search continues. My list of potential source targets is growing and I’m confident that a great many more Welsh medics are still there to be found. If, as I suspect, the final number is still relatively small, I still don’t accept that as conclusive evidence of a lack of medical practice in Wales. As the old maxim goes absence of evidence is not evidence of absence. What it might call for is a revaluation of Welsh cultural factors affecting medical practice and, perhaps, a greater and more inclusive exploration of medical practice, in all its forms in Wales.

Physick and the Family: health, medicine and care in Wales, 1600-1750 (Manchester: Manchester University Press, 2011)

2013 EAHMH Book Award for Physick and the Family

Ok, ok, this is self-promotion of the worst kind but, if you can’t do a little self-publicity on your own blog then what is the world coming to? To be fair, this is a special post for me. I’m absolutely delighted to have been awarded, last month, the 2013 European Association for the History of Medicine and Health Book award for my book Physick and the Family: health, medicine and care in Wales, 1600-1750.

The prize is awarded biennially for the best medical history monograph relating to Europe in the preceding four years to the award. It’s only the second time that the award has been made and the first to a work of British history. I’m obviously very proud. Here is a link to the Association’s website with the details of the prize. http://www.eahmh.net/index.php?option=com_content&view=article&id=57&Itemid=62

Aside from the prize itself though, I’m very proud that my little book about Welsh medicine has punched above its weight and, I hope, it goes some way towards demonstrating the value of regional histories. The book grew out of my PhD research and is indeed based on my thesis. From the outset the whole point of the book was not simply to say ‘here are a load of Welsh sources, I hope you enjoy them’ but rather to use Wales to explore broader questions and issues within medical and social history of the early modern period. As such the books addresses an undeniable gap in Welsh history but has always been intended as a book about medicine, the family, care, the community and so on more broadly.  That it has been awarded such a prestigious prize hopefully means that objective has been realised.

Onwards and upwards and, heartened by this, I need to do better in updating the blog more often!
p.s. Oh what the Hell, let’s go the whole hog – ‘Physick’ is just out in paperback at £14.99

http://www.amazon.co.uk/Physick-Family-Health-Medicine-Wales/dp/0719085462

Pig boys and boar bites: a seventeenth-century medical consultation

What did medical practitioners actually do in the past? Or, put another way, what sorts of things were they consulted for? Given the vast numbers of pages devoted to medical practice over the past few years this might seem to be a slightly redundant question. But, in fact, individual consultations are remarkably obscure. Physicians’ casebooks can be revealing, but the nature of these often means elite doctors and wealthy physicians. Also, whilst letters from patients can often give amazing insights into the sorts of diseases and maladies that afflicted them, it is less common to find evidence of the sorts of routine things to which practitioners could be called to attend for.

One little source in Glamorgan Archives (MS D/DF/215) gives us a fascinating insight into the day to day work of an early-modern doctor. It is a receipt for medical services to the Jones family of Fonmon Castle in Glamorganshire from Dr John Nicholl. The Joneses were a wealthy family who had supported Cromwell in the civil wars. Colonel Phillip Jones bought the castle in the mid seventeenth century, adding and rebuilding parts of it. By the early eighteenth-century it was a magnificent country house. Of the doctor, John NIcholl, we know very little. It is likely that he was the same man whose will was proved in 1726, listed as a surgeon of Llanbydderi in Llancarfan – a few miles from Fonmon Castle. Nicholl was clearly fairly affluent, owning lands and property in Glamorgan which he bequeathed to his family.

Fonmon Castle today. Picture from hha.org – copyright belongs to them

The source itself is a bill giving a brief description of the conditions treated between May and July 1715, together with the prices charged. The bill was sent to the house steward, and a note on the back states that it was paid in full at the end of the year. In a largely cashless society, it was common for people (and especially large households) to have services on account which could then be settled at intervals. It is also common in large houses for the same practitioners to be continually employed over periods of time. What sorts of things did Nicholl treat though?

The first ‘cure’ referred to is a visit to ‘Madam Jones’ for an unspecified condition, for which Jones charged several shillings. Which ‘Madam Jones’ is referred to here is unclear, but likely to be the house matriarch. The next recipient of medical attention was in fact a kitchen maid, Anne Cornish. Again, Anne’s condition is unspecified but required a second visit and “blooding hur”.

Another is to the unfortunately-titled ‘pig boy’, who occurs twice in the receipt. It is clear that the boy had fallen foul of his porcine charges since the receipt reveals that he was bitten by a boar! This necessitated two visits by the doctor, one of which was to dress his leg. Pig bites are in fact incredibly painful and, while the incident might appear faintly comical, could potentially be dangerous due to the risk of secondary infections entering through the open wound, or from the animal itself.

The medical treatment of servants is interesting. Domestic servants were part of the early-modern household family. Whilst their working lives were doubtless hard, it should not be forgotten that many employers were in fact fairly benevolent to their young employees. In these cases, for example, the servants were clearly given more than a cursory look over; both were given treatment by an apparently ‘orthodox’ medical practitioner (as opposed to a cunning man or empirick). We cannot know their social status, but it is no stretch of the imagination to suggest that they might usually not be able to afford such treatment. Servants were valuable commodities though and, as such, needed looking after. I have found other examples of servants being paid even when sick, and allowed other ‘perks’ like being given money to go to a fair, or to purchase new clothes or shoes. We should not necessarily view early modern servanthood as a life of drudgery.

(image from costumehistorian.blogspot.com…a great site and well worth a visit)

The last example contained in the receipt again concerns ‘Mrs Jones’ but this time gives us a little insight into an accident that could only really befall someone of higher status. At some stage in midsummer 1715 Mistress Jones was clearly abroad in her coach, no doubt enjoying views of the beautiful Vale of Glamorgan. Whilst comfortable standing still, the suspension systems of early-modern coaches were rudimentary at best and did not cope well with rough tracks. Perhaps it was an encounter with a wheel rut or some other type of obstruction that caused poor Madam Jones to hit her face and bruise her nose. No doubt nursing wounded pride as well as a bloody nose she clearly called for Doctor Nicholl!

Even in small, apparently limited, sources like these it is often possible to recover tantalising glimpses not only of healing practices, common (and in this case elite!) maladies and individual patients, but even something of the social attitudes towards sickness in a society and at a time where records of medical encounters are frustratingly rare.

For an interesting blog post on the Joneses of Fonmon see – http://huwdavidjones.wordpress.com/2012/10/07/keeping-up-with-the-joneses-paintings-at-fonmon-castle/

Polite Sickness: Illness narratives in 18th-century letters

I have always found letters a brilliant source of information about patients. If writing to friends, relatives and business contacts was commonplace, then one of the most common topics was the writer’s health. Illness was a natural topic to discuss. It was a worthy news item and served to keep the recipient updated with the latest symptom or condition. It could be pragmatic; some sufferers wrote directly to doctors and procured their medicines by post. But others used letters as a means to gather information about their illnesses, not from doctors but from others in their social networks. These would often elicit a stream of responses with favoured recipes, which had never yet failed or were ‘probatum’ (proved) to work.

But letters worked on another level. They gave sufferers the chance to assemble their illness into narrative, and sometimes even episodes. As I have argued in my book Physick and the Family, the eighteenth century  in particular witnessed the rise of what I term the ‘heroic sufferer’. Here, rather than simply listing symptoms, or providing a description, letter writers began to create sickness stories with themselves often as the hero. Sometimes the letters have a resigned air; the missives of the Morris brothers of Anglesey are a good case in point. Their letters commonly contain entries along the lines of ‘the end is near, remember your dear brother’, sometimes suggesting that this might be their last letter and, inevitably, carry on as normal thereafter. Also interesting in their case is the virtual competition that seemed to exist among them as to who could be the most ill! Another common trope was to represent oneself as the battered victim of sickness, nonetheless heroically battling on in the face of almost insurmountable misery.

Depending on the writer though, some sickness narratives take an almost humorous view of their symptoms, treating the reader to a light-hearted walk through what were almost certainly unpleasant episodes. To me these are the most engaging. One set of letters I came across in my research for my PhD fits into this category. They are letters from a Breconshire attorney, Roger Jones of Talgarth. I haven’t researched much about the man himself (maybe I will one day) but he was clearly a ‘man about town’ – in eighteenth-century parlance, a Beau Monde. One particular run of letters were fired off in rapid succession following an abortive trip to Hay on Wye. In February 1769 he wrote to his brother, clearly in some distress.

“Dear Brother…on the fifth day of last month I was visited with a palsy which advances upon me…I was going to the Hay market and before I went halfe a mile off I was taken with a numbness and a kind of stiffness(?) in my left hand. It surprized me much and I turned home. I was immediately bled and sent for my apothecary in ye town of Hay whose advised to contact a physician. I directly sent for Dr Applby(?) of Hereford who attended me on Saturday. I have been bled, cupped, blister’d [and purged] and yet without effect. My disorder has advanced that it now affects all of my left side, both arm and leg.”

Poor Roger. Advised by his physician to eat nothing but puddings(!) he was forced to cancel a trip to Bath, and asked his brother, a clergyman, to pray for him.  Judging from other letters, he was not a man who held physicians and their prescriptions in any great esteem.  In July 1770 he wrote to his brother that he was again “greatly afflicted in both mind and body”, and felt that his body was “gradually wearing out” and that he now had a most “melancholy life”. Despite this, some of his accounts are also comedic. Struck down with an attack of some mystery condition, he attempted to get his servant, Morgan, to help him take a vomit. Unfortunately, Morgan was ‘thick of hearing’ and clearly failed to grasp what his ailing master was trying to tell him. In the end Roger was forced to repair to the local inn, the Lyon, where a Mrs Morgan assisted in giving him “the puke”.!

A sample of Roger Jones’s spidery writing. Copyright for this image belongs to the National Library of Wales. Please do not use without their permission.

In August 1770 he was again sick and ailing at home, this time under the stewardship of a Dr Isaacs. He was first prescribed ‘opening pills’, presumably purgatives to try and drive the malady out of him. When these failed to take effect, Dr Isaacs subjected Roger to a veritable barrage of the 18^th-century’s most potent medicines. He took a glister (an enema) which, as he ominously reported “worked”, which was repeated with a purge daily for a week! It is difficult to imagine today a treatment regime that subjected the already weak patient to seven days ‘worth of self-inflicted diahorrea and vomiting. Roger’s verdict? “I think I am rather better but am grown a great deal thinner”!

Through the words of Roger’s letters we get a very intimate and human image of him; something of the character of the man comes out and he speaks to us very directly through more than 200 years’ distance. As we read letters from patients like Roger it is striking how little human nature has changed. We are all still obsessed with our symptoms and will readily tell everybody about them. What has changed are the means of communications; the quick-fire nature of texts and emails are not suited to the construction of sickness narratives. But next time you are in a doctor’s waiting room, see how willing complete strangers are to tell others all about their symptoms and treatments, maybe share the name of a favourite tablet! Treatments might have changed; we haven’t

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.

How Welsh medicine helped to create America!

How is Welsh medicine linked to the establishment of a global superpower? On the face of it the two don’t appear to have much in common! As an historian of Welsh medical history it’s not often that I can make grandiose claims about Welsh practitioners. One of my colleagues once suggested that Galen was actually a mistranscription and that the supposed Graeco-Roman physician was actually G. Allen from Cardiff. Wales, and not ancient Greece, in his view, was the true seat of medical knowledge. With the subject of this post, however, Wales (and Welsh medicine) can lay claim to an important figure in the early history of the United States – Thomas Wynne of Ysceifiog, Flintshire.

Wynne was born in 1627 in Bron Vadog in the parish of Ysceifiog in North Wales, the son of a freeholder. Details of his early life are sometimes obscure. It seems that his father died when he was 11 and that, sometime after that, and perhaps even affected by it, his religious views began to shift. In the religious turmoil of the 1640s (this was the decade of the English Civil Wars and the ‘world turned upside down) he became increasingly dissatisfied with the poor quality of religious teaching. He felt that those responsible for his spiritual welfare were “of low degree” and had let him down. He was, as he later wrote, spiritually “at the mercy of the wolf”.[1]

Ysceifiog (image available under creative commons licence)

Matters came to a head in the 1650s when he underwent a profound religious experience. As he later wrote: “the heavenly power wounded as a sword, it smote like a hammer at the whole body of sin, and it my bowels it burned like fire”.  Wynne had become a Quaker – and was one of the earliest and staunchest members of the Welsh Society of Friends. He wrote pamphlets including The Antiquity of the Quakers Proved out of the Scriptures of Truth…in 1677, and was imprisoned for his Quaker beliefs. It was the persecution of the Quakers in seventeenth-century Britain that led to their search for a new land that offered peaceful settlement and the opportunity to set up a community of like-minded individuals. When William Penn was given a grant of land by Charles II in 1681, Thomas Wynne was one of twelve individuals who formed a committee to meet Penn in London. Along with John ap John of Llangollen, Wynne took up a patent for 5000 acres of land in Pennsylvania, for which he paid £100, and reputedly built one of the first brick houses in Philadelphia.[2]

Portrait of William Penn

How did Wynne’s medical practices colour his life both in Wales and America? It is possible to piece together something of his medical life from a collection of sources – perhaps most important of which is his own testimony. This quote from Wynne is reproduced from John Cule’s Wales and Medicine (1973).

“My genious from a child did lead me to surgery, insomuch that before I was ten years old, I several times over-ran my school and home when I heard of anyone’s being wounded or hurt, and used all my endeavours to see Fractures and Dislocations reduced and wounds dressed…my parents thought they had lost me forever for which I received severe correction. My Father died before I was eleaven years old and my Mother [was] not able to produce so great a sum as to set me to chirurgery…until I became acquainted with an honest friend, and good artist in Chyrurgery whose name was Richard Moore of Salop, who seeing my forwardnesse to Chyrurgery, did further me in it”. By the completion of his training he was regarded as an expert “in the use of the Plaister Box and Salvatory, the Trafine and Head Saw, the Amputation Saw, and the Catling, the Cautery, Sirring and Catheter”.

Richard Moore, from whom Wynne learned his trade, was a surgeon and fellow Quaker. He was originally from Shrewsbury and clearly regarded him highly enough to apprentice his own son Mordecai to Wynne to learn the craft of surgery.

Wynne’s was a typical story of ‘on-the-job’ training, familiar to many families of rural areas. Unable to afford the large sums needed to fund a university education, Wynne was fortunate in finding a sympathetic teacher with whom he seems to have undergone an ad-hoc apprenticeship. Describing himself as “an expert in Drills and handy in Knife and Lancet” he constructed a model skeleton of a man. Despite the fact that his studies were interrupted for nearly six years by his imprisonment, his skill in physic was enough to be considered sufficient to obtain a medical licence, although there is no evidence to suggest that he did so. Licensing in Wales was increasing by the end of the seventeenth century, but many Welsh practitioners simply didn’t see the need since the attainment of a licence was not especially valued by ‘ordinary’ people, and the lack of others with licences didn’t engender the need to get one to compete.

Where exactly Wynne practised medicine is unclear. He is reported as a ‘practitioner in physic” in London for a time. Peter Elmer also suggests that he may be the same Thomas Wynne who served as a surgeon’s mate to one Walter Thompson among English forces in Scotland in 1651. It is also clear that his pamphleteering didn’t always win him friends. In answer to The Antiquity of the Quakers Proved, one William Jones accused Wynne of being “ignorant in his very trade of Quack-Chyrurgery”.

Once settled in Pennsylvania Wynne became an important figure. He bought and erected property in Philadelphia and took several office-holding positions including speaker of the first two Pennsylvania Assemblies and a Justice of the Peace, but ultimately living in America for only nine years. He is buried in the Friends’ burial ground at Duckett’s Farm, Philadelphia.

And so it was that the boy from the tiny parish of Ysceifiog rose to prominence in the nascent American colonies. As a Welsh medical practitioner of note Wynne is remarkable enough; but as an early Welsh progenitor of a global superpower he is a figure of great historical importance.

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[1] For more on Wynne’s religious beliefs and conversion see Geraint H. Jenkins, “From Ysceifiog to Pennsylvania: The rise of Thomas Wynne, Quaker barber-surgeon”, Flintshire Historical Society Journal, 28, (1977), pp. 39-40

[2] See John Cule, Wales and Medicine (Llandysul: Gomer Press 1973), p. 13

“The infamous Dr Foulkes”: The ‘black villain’ of 18th-century physick

National Library of Wales Ty Coch 22 Add. MS 836d (also known as ‘Piser Sioned’) is, like so many other early modern ‘miscellanies’ an absolute treasure trove of information. Attributed to various authors over a period of several decades, it contains everything from family records to poems, and quotes from Tyco Brahe.

In the first few pages are records of ‘unfortunate days of the year’, alongside remedies for sore tendons and records of books that the anonymous author had lent to Arthur Jones. One of my particular remedies in the book is this one:

“An approved imparabl’d medicine to eat anie overgrown film over an eye

R;/ The green part of a goose dung fresh (or at least very juicy) it will not be fitt after 16 or 24 hours, drop the juice thereof into the Eye with the dew that falls on the first, second or third day of june, wch you must provide or procure in that season. The first does the effect, the second clears the Eye, it does nt smart at all, and nothing has been found better as yet”

Needless to say that putting fresh, “green” goose dung into your eyes is probably best consigned to the book of history. Let’s just take it as read that people at the time believed it would do them good, and leave it at that!

Elsewhere in the document, however, is a record that is starkly at odds with the more generic and haphazard notes that make up the majority. It is unsigned, making it difficult to verify the allegations being made, but appears to relate to someone who has first-hand knowledge of the events being described. First taking the form of a vernacular poem, the verse is dated 1716 and headed:

“To the infamous Dr Foulks, Dr of Physick and Rector of Llanbedr in Denbighshire”.

It is worth quoting the first two verses to get a flavour of the allegations.

Thou Holy letcher thou religious cheat

How shall I halfe thy horrid guilt repeat

Now but my colours strong enough to paint

The blackest villain in a seeming saint

Doe lay thee open to a publick vicar

For greater crimes than ever Judas knew

Thou art, what shall I say, thou art alone

Whose sins epitome, all sins in one

…

And yet

Thou art too vile to live too bad to die

Nor canst thou from deserved vengeance fly…

 

by philtrers force and sympathetick charms

Oh! Black physician to the fernal Tribe

Who canst for soul and body to prescribe

But such designs thy medicine impart

That both are ruined by the cursed art

 

“Quick, Strait, begone from Wallia, Fruitful Isle

To some far distant unpregnated soile”

 

Strong stuff. “The blackest villain in a seeming saint”, “Black physician to the [in]fernal tribe”. Clearly he was a notorious figure in Llanbedr. But who was this “Dr Foulks…and what had he done?

The Reverend Robert Foulkes of Llanfrothen, Merionethshire, was indeed an M.D. who had graduated from Oxford in 1725. This Dr Foulkes was a correspondent of some of the most eminent physicians of his day and, in 1718, had set up his own physic garden at Cambridge. He wrote to Welsh luminaries such as Edward Lhuyd (then at the Bodleian) on the subject of botany, and was considered to be an authority in his field. Reportedly of delicate health he died young. All in all, this does not sound like the sort of man to inspire the vitriol of the ‘Piser Sioned’ author.

By incredible coincidence, however, there was another Robert Foulkes, also a vicar and physician, at roughly the same time, and it is this man who is the more likely candidate. The Reverend Robert Foulkes of Llanbedr Dyffryn Clwyd, Gwynedd, indeed seems to be the subject of the poem but he is a shadowy figure. Little can be found about either him or his medical practice so we have only the poem to shed light. What had he done to elicit such contempt? Luckily for us the poet left a few lines of narrative to fill in the blanks. At the very end of the poem, written in the margin, is the following note:

“The subject is now too well known but futurity may drown it in oblivion, unless it be commemorated in writeing as thus,

The s(ai)d doctor was guardian to the young ladies of Llanerch in Flintshire with(?) the Davises. He debauched one at 13 years of age and gave her physick to prevent conception. He lay with her 15 or 20 years, at last she refuted physick and conceived, she was delivered privately, he disowned the childe, but s(ai)d he had to do with her mother and did not know(?) but the child might be his grandchild – a black villain”

 

So Dr Foulkes’ sins were laid bare. It is unclear whether this poem was ever published but it would fit the sort of libel that could be distributed around a local area or pinned up in prominent places. Since the “subject [was] now too well known” it seems that Foulkes already had a soured reputation. That he was a vicar, entrusted with the moral and spiritual health of his parishioners, would have been difficult for them to accept. That the sins occurred with young women with whom he had been entrusted with their care would surely have been worse. Even when faced with the allegations and the presence of an illegitimate child Foulkes seemingly refused to take responsibility.

I’m still on the hunt for information about this ‘black villain’ and it would be interesting to find out more about him. Vicars who practised medicine were not uncommon, but those who inspired such venom as did Dr Foulkes certainly are. Sadly, it seems that figures of authority or fame who used their positions to exploit or abuse others are not just a modern phenomenon.

A Welsh doctor, Sir Hans Sloane, and the disappearing catheter!

**WARNING: CONTAINS SOME GRAPHIC DESCRIPTION OF A PARTICULARLY UNCOMFORTABLE SURGICAL TECHNIQUE**

In 1720, Dr Alban Thomas was something of a high-flyer. The son of a Pembrokeshire cleric and poet, Alban first matriculated from Oxford in 1708, became librarian of the Ashmolean museum, assistant secretary of the Royal Society and, if that wasn’t enough, obtained his doctorate in medicine from Aberdeen in 1719. At a time when Wales was still a largely rural country, with no medical institutions of its own and fairly poortransport and road infrastructures, these were exceptional achievements for a boy from Newcastle Emlyn.Also unusual was that Alban appears to have returned to Wales to set up his medical practice; many Welsh practitioners who had trained in Oxford or London chose not to return, choosing the potentially more lucrative market of the larger English towns. Nonetheless, especially in and around the growing Welsh towns, there was still a relatively wealthy Welsh elite to cater for and some, like Alban, positioned themselves to serve the denizens of large estates and houses.

It is clear, though, that Alban still had connections. One of his correspondents was no less a luminary than Sir Hans Sloane, the Irish physician to the fashionable and, indeed, the royal and, later, president of the Royal Society. Surviving letters from Alban Thomas to Sloane suggest that theirs was a fairly regular correspondence, with Sloane acting in an advisory role for particular cases. It is one particular case that interests us here.

Sir Hans Sloane

In November 1738, Alban Thomas wrote to Sloane regarding a patient, Sir Thomas Knolles of Wenallt, Pembrokeshire, who was causing him concern. Knolles, although “a person of great worth, candour and humanity” was also “a person of very gross habit, of body an unusual size and make and about 20 stone weight with an appetite to his meat but very moderate in his drinking”. Knolles enjoyed exercise but, due to his size, this was often done on horseback.

At some stage, Knolles had become ‘dropsicall’ and suffered from swollen legs. The doctor used a combination of diuretics and tight, laced stockings to countermand this with, he reported, some success as Knolles returned to health, requiring only the odd purge as a ‘spring clean’. About four years previously however Knolles had begun to complain of a swelling in his scrotum, which Alban Thomas assumed to be hydrocele – a condition causing grossly swollen testicles (sometimes treated by injecting port wine into the testicles). After drawing off “about a quart of limpid serum” from the stoic Knolles testicles, followed by a dressing and strict recovery routines, the doctor hoped that he had cured the condition for good. This proved to be premature.

A selection of bladder stones and calculus

When Knolles began to complain sometimes of not being able to pass urine at all, at others a few drops and occasionally losing his bladder control entirely, he took it upon himself to get a second opinion from an unnamed doctor in nearby Haverfordwest. This physician prescribed a ‘Turbith vomit’ which wrought well and even caused Knolles to void a stone about the size of a kidney bean. Rather than being put off by this occurrence, Knolles was encouraged and began to pester Dr Thomas to give him more of these treatments. Unimpressed and undeterred,Thomas decided on a more proactive course. After putting Knolles on a course of diuretic medicines, liquors and balsams for a week he brought in to his consulting room. What happened next highlights the particular horrors of early modern surgery.

When Knolles arrived, Dr Thomas first applied a Turbith vomit, hoping that “so rugged a medicine” would clear the blockage without the need for more invasive procedures. It didn’t. In fact, the symptoms grew worse. It was at this point that Dr Thomas reached for his catheter and introduced it into the unfortunate Sir Thomas’s member. Expecting some resistance, he was surprised to find that the catheter went in without resistance. “On the contrary it seemed to force itself out of my fingers after passing the neck of the bladder as if it was sucked in, which I thought was owing to the pressure of his belly, the crooked end was now upward”. Yes, you read it right. The catheter was ‘sucked’ out of the doctors fingers and upwards further into the bladder! Now, any male readers may want to cross their legs!

In an attempt to probe for the stone that he feared was lurking in the bladder, and to release some water, Dr Thomas decided to turn the catheter around. At this point, the poor patient “cryed out with some violence…TAKE IT OUT I CAN BEAR IT NO LONGER”. Happily for Knolles the catheter came out “with as much ease as it went in without one drop through it or immediately after it”.

Three months later, the patient was still suffering, with the addition of great pain, defying all attempts for his relief. Despite being a “hail, hearty man having good lungs but lyable to hoarseness” and the occasional cold, Alban Thomas perceived him to be a healthy man. His efforts to treat Knolles had so far failed and he appealed to the eminent Sloane to help him “form a right judgement in this case”.

And so we leave the story there. What happened to Knolles is unclear, but the pain of his condition can only have been matched by the pain of his treatment. Suffering a succession of violent vomits, pills, electuaries and, finally, a wandering catheter, it is almost amazing to think that he ever went near Dr Alban Thomas again. Such (uncomfortable) cases remind us of the situation facing patients in the early modern period. For some the decision to see a doctor must have been a balancing act between bearing their illness or facing treatment.