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!

17thc Wales

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.

Cunning folk

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!

Welsh registers

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.

Pontrobert today

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

The Case of the Severed Finger: Callow vs Heane, 1634

In my last blog post I looked at a libel case between two Exeter medical practitioners. It was interesting to see how professional reputations were at stake and the ways in which practitioners called each other’s skills into question. For this post I’m staying on a similar theme, but this time a medical practitioner plays the part of a key witness in a bitter dispute between two ‘Gentlemen’ from the Welsh marches in the 1630s.

In September 1634, members of the families of Heane and Callow were enjoying an evening’s revelry in an alehouse in Brockweir, Gloucestershire. No doubt oiled by good sack, a discussion about the wardship of a young member of the Heane family quickly became a debate….and inevitably a dispute which quickly got out of hand.

Alehouse

At some point a £10 wager was made and a member of the Heane family declaimed, loudly, that ‘the Heanes were as good men or better’ than the Callows and challenged them to back up their boasts with weapons. That did it. Rowland Callow called Walter Heane a ‘base rogue and a Villaine’ (strong stuff in the 17th century) and promised to ‘have Heane’s hart’s blood’. Callow made a grab for Heane’s sword, pulling it partly out of its scabbard, but things didn’t quite go his way. In pulling out the sword he severed one of his own fingers!

Meissonier_La-Rixe_Brawl

As was often the case, this one single flashpoint was the catalyst for a bitter feud that spilled over into other arenas and quickly came to court. Aside from the question of injury, both to Callow’s fingers and also to the reputation of both men, a variety of other petty accusations began to fly. Callow accused Heane of failing to present one of his nephews for the crime of trespass on Lord Pembroke’s estates. Heane called Callow’s witnesses ‘infamous and of no credit’, and others of taking bribes, living incontinently with a woman in Ireland and keeping an unlicensed alehouse. The stage was set for a court battle of epic proportions.

In January 1635 depositions began to be heard in Monmouth and a commission was further held in St Briavels in May 1635. It is interesting to examine some of the evidence that was heard before the commission. The defence was based on whether certain actions and words had taken place. Had, for example, Callow called Heane a rogue and a villain. Had he indeed threatened to have Heane’s blood and had he, as some witnesses had it, struck Heane, drawing blood and then, in a Tyson-esque show of fury, bitten off a piece of Heane’s ear?

17th century tribunal

Callow’s severed finger was the subject of much debate amongst witnesses. Robert Ellice of Deane Magna, Gloucestershire, a victualler, testified that Callow had come to him for ‘chuirurgerie and shewed him his hand whereon he had an hurt on the little finger and a scarr on the finger next to it, and he saith that the bone of the little finger was scaled and could not be cured, but that the scale must be by force pulled off or by corraisive plaister eaten off.’

John Morgan, a Malster also of Dean Magna, suggested a different course of events. As Callow had no weapon of his own, Morgan ‘Saith that Walter Heane did then draw his sword out of the scabbard and did strike Rowland Callow and cutt his little finger so much that it hanged downe’, and Morgan ‘was fayne to splint it up; and had done him further hurt if the company had not stopped and prevented him, by which Rowland Callow has lost the use of his finger’.

Here the finger was purposefully severed by Heane, rather than a result of Callow’s misjudged grab! Other witnesses testified to the finger ‘hanging down’ after the scuffle but other embellishments began to enter, such as Heane taking up a ‘great stone with an intention to throw it at Callow’s face’ and then ‘did buffet [Callow] on the face with his fist so that his face therewith brused and grew black and blew’.

One of the most interesting witnesses (for me as a researcher on Welsh medical practitioners!) was Thomas Evans of Trelleck in Monmouthshire, described as a barber surgeon aged about 30. Evans testified that ‘He had known Callow for 4 years ‘and in that tyme hath heard him called Mr Callowe and taketh him to be reputed a gentleman’. He did not know Heane. About 23 October last he was sent for to come to Callow’s house at Llandogo, co. Monmouth where he saw Callow’s wounded finger and was desired to cure it. He searched the wound ‘and was faine to take a bone out of it; and a weeke after he did take another bone out of Mr Callowe’s finger.’

St_Briavels_Castle_Victorian_print

The case dragged on, with testimony after testimony beginning to test the patience of the commissioners. Debate moved from the original incident to claim and counter claim, questions of ‘gentlemanliness’ and reputation, accusations of impropriety, and on it went. Finally the commissioners had enough. Sentence was due to be passed in May 1636 but was first referred to arbitration…which dragged on until January 1637. Frustratingly the final judgement is not recorded but something of the exasperation of the authorities can be gleaned from the comments of Sir Richard Catchmay, bailiff and local process server. Perhaps without much sarcasm he suggested that the two men should simply settle matters by seeing ‘which of them could leap furthest into the River of Wye’!

(The full details of this case and testimonies are available at the University of Birmingham’s great site and database relating to the early modern court of chivalry, available at: http://www.court-of-chivalry.bham.ac.uk)

The 1381 Peasants’ Revolt…in 5 tweets!

Today is a special post to honour a promise made to my fab groups of University of Exeter History students. Yesterday’s session was all about the 1381 peasant’s revolt. We looked at the various ways in which the rioters were depicted in chronicles, and the many striking similarities in the ways that rioters in recent years have been portrayed in the press. If the Daily Mail had reported on the Peasant’s Revolt, Wat Tyler would doubtless have been depicted in a hoodie!
The students were split into two groups, peasants and nobles, and challenged to report the revolt from their point of view in five tweets…complete with hashtags. Both groups did a brilliant job: enjoy!

Richard_II_meets_rebels

GROUP 1

Peasants:

1) Not paying tax, time to act hashdaretoTyler
2) Bally said let’s go nuts hashriots hashpolo
3) Lord chancellor seems to have lost his head hashescalating quickly
4) Just met the king hash king hash midget
5) Well that ended well hash awks hash lolz hash hanging

Nobility

1) Heard some aggy plebs rebelling against a system in place 100s of years #feudalbants #1381 #goodluck
2) Bloody gatekeepers have let them in #getoutofourgrill #pray for Richard
3) Alright boys, jokes over now, back to the fields you go #classlessscum #pipedown
4) Ok peasants you win #Smithfield #winkwink #snake #asif
5) Laters Wat #peak #wasteman #Wotusayin

GROUP 2

Peasants:
1) Axes on our taxes #thirdwholetax
2) Burning down the house #burnbabyburn
3) We’re coming to get you @simonsudbury @roberthales #offwithyourheads
4) Our captain is dead, our leader has been treacherously killed #shoot #bows #it’snotover #yesitis
5) RT @JohnBall when Adam delved and Eve span who is then the gentleman? #orderdisorder

Nobility
1) The pessies are outside #offyoupop
2) Never seen so many poor people in my life f#irstworldproblems
3) #ripArchieB You’re not getting your hands on my records #can’ttouchthis
4) Wat Tyler 6 feet under #winning #thuglife
5) Have fun in your mud huts you scum #steaknight #
champersforus

“By the King’s Special Grant”: A Venetian Quack in Early Modern Britain

Among the most colourful characters in early modern medicine were the ranks of medical mountebanks and quacks that traversed the country selling all manner of dubious pills, potions and preparations. A vast range of medical substances were available with everything from the ‘Catholick Pill’ to the ‘Hercolean Antidote’ offering frightened (and gullible) patients a chance to escape the heavy burden of their conditions. The subject of quacks has been well covered over the years – perhaps most famously by the late Roy Porter – and quack remedies are always appealing to a popular audience. There is perhaps something within us that sympathises with the sheer cheek of these characters, even though we might question their motives as well as their remedies.

The Quack

It was common for quacks to move around; in fact it was common sense. Once people realised that they had been duped it was probably not a good idea to hang around. Robert Bulkeley of Dronwy in Anglesey encountered one such figure on the road in the early seventeenth century. Bulkeley was suffering from toothache and a ‘mountebank’ offered to cure it for a penny. Unsurprisingly, two days later Bulkeley was a penny down but still had the toothache. But some ‘medical entrepreneurs’ travelled further than most. On occasion, foreign characters visited British shores, carrying with them a whiff of exoticism and something different to the travelling tinker’s pack. Some even achieved some measure of fame and renown as they moved around. One such was Vincent Lancelles, reputed to be Venetian, who appeared in Britain in the mid seventeenth century.

Mountebank of Old London

We know something about Lancelles from the flyer that he sent around to advertise his current or future presence. It was nothing if not confident:

“By the King’s Grant and Speciall Approbation, be it knowne that there is arrived in this towne M. Vincent Lancelles, Physician and Chyrurgeon, Spagyrique and a very expert operator, and one of the King’s most excellent Majesties Servants, and approved by the Colledge of Physicians of London, and by His Majesties Physitians in ordinary…”

Perhaps he had seen the King. Perhaps all the doctors of England did indeed laud him for his skill. Perhaps the august College of Physicians were falling over themselves trying to add him to their members. Perhaps.

The flyer then went on to list over 100 maladies that Lancelles unselfconsciously claimed to have mastered. These included epilepsy, melancholy, ‘hydropsie’, ulcers of the lungs, heate of the liver, flux, paine of the kidneys, cholick, worms…the list went on. And on. In addition to ailments he could also ‘helpe the blinde’, perfectly draw teeth and make hair grow again. Faced with such expertise, who would not want to flock to see Signor Lancelles?

John-Taylor-the-Water-Poet

In the mid seventeenth century Lancelles begins to be mentioned in various sources around the country. In 1652 he was in Chester. We know this because the so-called ‘Water Poet’, John Taylor was also there whilst on one of his many perambulations around the country. Whilst lodging at the Feathers in Watergate Street, Taylor “met with two brothers of mine acquaintance thirty years, they brought me to the chamber of a reverend Italian physician, named Vincent Lancelles, he was more than 80 years of age, yet of a very able body,and vigorous constitution”. Taylor was clearly impressed by the old man:

He helped such as were grieved for three several considerations —

First, He cured the rich, for as much as he
could get.

Secondly, He healed the meaner sort for what
they could spare, or were willing to part withal.

Thirdly, He cured the poor for God’s sake, and gave them money and other relief, as I myself (with thankful experience) must ever acknowledge : For he looked upon my lame leg, and applied such medicine, as did not only ease me, but I am in hope will cure me, the grief being nothing but a blast of lightning and thunder, or planet stroke, which I received nine years past at Oxford.”

It is clear that Lancelles was either in Britain for some considerable length of time, or alternatively left and came back. In either case he can be placed at Oxford in 1652 before seemingly moving north later on, making his way to Ashbourne in Derbyshire and Wrexham. It was there that an unfortunate incident probably brought him to the attention of the diarist Philip Henry.

200px-Philip_Henry_(1631–1696)

In June 1663 Henry wrote an entry in his diary: “This week dyed in Chester a servant to an Italian Mountebank known by the name of his Apothecary, who received some blows about 3 weekes since upon ye stage in Wrexham, in a scuffle with Mr Puleston of Emeral”. In the entry the mysterious Italian is referred to as Giovanni, but the balance of probability points to Lancelles. And what of his servant, killed in a scuffle with the over-excited crowd?
Perhaps the incident was too much for Vincent who, if it is the same man, would be in his 90s by then! Whatever the reason, this is possibly the last reference to the enigmatic Italian mountebank.

Early modern Britain was replete with medical practitioners of many different qualifications, motivations and skills. All appealed to a common human trait, that of trying to rid the body of ailments and restore balance and health. They are some of the most fascinating body of historical actors that you could hope to find.

The Medical Case for Beards in the 19th Century

As Christopher Oldstone-Moore has argued in his excellent article about the Victorian ‘beard movement’, the middle years of the nineteenth century witnessed an abrupt volte-face in attitudes towards facial hair. The eighteenth century had been one where men were almost entirely clean-shaven. The face of the enlightened gentleman was smooth, his face youthful and his countenance clear, suggesting a mind that was also open. Growing a beard at this point would have been a deliberate act done purposefully to convey a message. John Wroe, for example, leader of the Christian Israelite group, let his beard grow wild to signify his withdrawal from society.

Image http://www.wakefield.gov.uk/CultureAndLeisure/HistoricWakefield/People/JohnWroe/default.htm
http://www.wakefield.gov.uk/CultureAndLeisure/HistoricWakefield/People/JohnWroe/default.htm

By the mid-Victorian period, however, the beard came back into fashion with remarkable swiftness. Part of the reason for this was changing ideals of masculinity. This was the age of exploration, of hunters, climbers and explorers. As rugged adventurers began to tackle the terra incognita of far-flung continents, they would immerse themselves in wild nature, letting their beards grow thick. The beard became a symbol of rugged manliness and men began to emulate their bewhiskered heroes.

John Hanning of Speke, Explorer and discoverer of Lake Victoria
Explorer and discoverer of Lake Victoria

Another element of the rise of the beard, however, was the supposed medical benefit of facial hair. In the sixteenth and seventeenth centuries, facial hair had been viewed as a form of bodily waste. It was regarded as resulting from heat in the liver and reins, and was partly a signifier of a man’s virility. Equally though, as a waste product, shaving it off might be seen as healthy as it was another way of ridding the body of something potentially harmful.

By 1850, however, doctors were beginning to encourage men to wear beards as a means of warding off illness. As Oldstone-Moore points out, the Victorian obsession with air quality saw the beard promoted as a sort of filter. A thick beard, it was reasoned, would capture the impurities before they could get inside the body. Others saw it as a means of relaxing the throat, especially for those whose work involved public speaking. Some doctors were even recommending that men grew beards to avoid sore throats. Clergymen who shaved, according to one correspondent in the Hampshire Advertiser in 1861, invited all sorts of ‘thoracic and pectoral woes’!

Image carefully selected fromhttp://www.lakelandwildlife.co.uk/images/mcpherson.jpg
http://www.lakelandwildlife.co.uk/images/mcpherson.jpg

The 1894 edition of the Gloucestershire Notes and Queries contains an interesting example of this practice, but actually goes further by claiming that the county of Gloucestershire was in fact the first in Britain to fully embrace the beard! In a letter headed up ‘The Moustache and Beard in Gloucestershire’ the journal reported that ‘the custom among the civil population of wearing moustaches was first started in Gloucestershire’.

The article included a letter from a Mr William Johnston to the Gloucester Chronicle of 23 January 1892 who stated that he believed he was ‘the first individual of the city of Gloucester (and perhaps in the county) to grow the beard and moustache. I was induced by my medical man, the late Mr J.P. Hearne, about 42 years ago, to give up shaving and let my beard and moustache grow. I had been a terrible sufferer for a good many years with very sore throat. I was just getting the better of a very severe attack when the old doctor remarked to me ” Johnston, I advise you to give up shaving and let your beard and moustache grow, which, if you do, I believe you will not suffer again with such bad sore throat.”

I took his advice, and have not had a sore throat since, and it was the opinion of many of my friends and acquaintances in Gloucester that the moustache and beard was a great improvement to my looks and added immensely to the dignity of my countenance, so much so that a great many of them began to cultivate the beard and moustache, and amongst them a very prominent druggist (Mr Tucker) and woolen draper (Mr F.C.Newman) and within a very few years beards and moustaches were cultivated by hundreds in Gloucester and neighbourhood, and are now almost universal’.

Beard generator

Thanks to Prof. Jonathan Barry for passing this example to me. You heard it here first though; Gloucestershire was the beard progenitor of Victorian Britain. Whatever the truth of the matter, the medical aspect of beards and facial hair is one that invites more study. Were there any quack medicines, for example, that used the supposed medical benefits of beards as a selling point. I’ve only found one so far – the so-called ‘beard generator’, and this was more an aid for beardless boys who were lacking in the chin-whisker department. Yet another reason to continue research into this fascinating, and often overlooked, aspect of the history of masculinity and the body.

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

Reading between the lines: reconstructing lives from parish registers

I’ve recently returned from a research visit to Ruthin archives to look at the Denbighshire parish registers. The purpose of the visit was to trawl through every one of the hundreds of parish register transcriptions, looking for medical practitioners. With two bookcases full of volumes, each containing many individual registers, this was always going to be a long task. The registers for the town of Wrexham alone took two days, and monotony soon sets in when faced with page after page after page of names and bare information.

Parish registers are commonly the domain of genealogists and family historians, perhaps researching their own family history. Through the popularity of television shows like Who Do You Think You Are researching your own family tree has never been so popular, aided by the growing availability of source material online. Historians too are making use of parish registers. In aggregate they can reveal a whole range of demographic information, allowing assessment of long and short term population changes, marriage, birth and death patterns and so on.

But parish registers are generally deficient in detail, and even more so the further back in time you go. In the register of marriages in the seventeenth century you may get no more than the names and locations of both parties. The same for births. The burials registers give you name and parish, and sometimes the name of the father if the deceased was a child. In some cases occupations are given, but unevenly and sometimes selectively. So much depends on the diligence of the parish notary. As such, individual registers are generally unsatisfactory as qualitative evidence for the lives of individual people. If, however, as I was able to do, you search through a large number of records, then it is often surprising what extra information is able to be gleaned. In fact, the marginal comments made by the register creators often contain nuggets of extra information that can reveal much not only about their own prejudices, but of wider attitudes in society.

Parish registers were legal documents. As such they were deliberately formulaic and only required the bare minimum of information. With no legal reason or administrative need to add in anything else, many notaries didn’t bother. But it is the very fact that extra comments were not necessary that renders them more interesting.

One thing that becomes clear is the disapproval levied against anyone who was perceived to have transgressed in some way. Some women in the Denbighshire burials registers, for example, were obviously held in low regard by the local clergyman. Several entries appear with the appellation ‘harlot’ written in the margin, ‘whore’ and even one recorded as being a ‘wich’.  Here was an indictment of loose morals writ large and preserved forever in legal documents. Whoever wrote these remarks was making a definite statement and was fully aware of the stain that they were forever putting against these parishioners names. Being ahistorical for a moment, it is sad to reflect that perhaps these women’s only appearance in the record is coloured in this way. Perhaps the worst (or best) example I have come across is poor Barbara Roberts, buried in Denbigh in 1832 and, according to the vicar, “The dirtiest woman in the neighbourhood”!

There is an obverse to such pejorative comments though, and this is the sometimes laudatory comments that could be made. Those who left money to the parish poor or were well known for their good deeds might forever be bestowed with comments such as ‘a well liked body’ or ‘a person of good repute’. Here again we can encounter glimpses of personal affiliations. It is no coincidence that gentry and other clergy were often well reported in parish registers!

Accidents and other notable or lamentable deaths were often remarked upon and these are often touching in their brevity. ‘An infant died on the road in the arms of its mother’ is a typical example which says so much but also so little. Registers are full of drownings, deaths in fires and other accidents that reflect the dangers of hard rural lives, belying any depictions of a romantic rural idyll. People who were extremely old (‘110 by common repute’) were likely to be remarked upon, as were women like Jane Reece of Holt in Denbighshire who died aged 58 in 1696 “pregnant for the 100th time”.

Even occupations were not free of the individual foibles of recorders. In some parishes certain occupations might be recorded where others were ignored. This might mean that weavers or glaziers might be recorded while apothecaries or barbers could go unremarked. This is only one of the frustrating problems facing anyone looking for occupational data. ON the other hand they can throw up surprising little quirks. In Denbighshire alone I found evidence of three ‘Aquavitae’ men,  in different parishes, all of whom were known only by their first names and who had died on the road. These were travelling salesmen selling what was a semi-medicinal strong brew. Of no fixed abode they probably succumbed to the harsh life of travelling. Given what they were peddling this seems a fitting case of ‘Physician heal thyself’.

Registers can be frustrating documents but they are often well worth spending time with. By reading against the grain it is possible to learn much about early modern life, as well as the characters of individual clergy as they wrote their sometimes barbed observations. I think that more qualitative work on early-modern registers is badly needed.

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.

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.

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

“This book I had from — a resident of this parish (Bettws in Monmouthshire), who swears it was the book of Sansom Jones a physician of this county, some two hundred years ago”.

This note, dated around the early twentieth century, appears in the front cover of an intriguing manuscript – Cardiff public library MS 2.126. Since I first came across the document in 2005, it has fascinated me as it represents something of a mystery. It is, or at least appears to be, a remedy collection dating to around the early seventeenth century. It looks and feels ‘right’. The palaeography is consistent with a document of that age. The layout is what you’d expect from an early modern receipt book and the remedies are neatly written and ordered. And yet it is one of the most frustrating sources I have ever looked at.

It should be a fascinating view into the medical world of that most rare of creatures – the early modern Welsh doctor. We even have his name – relatively unusual for sources of this type. Except, so far, “Sansom Jones” has eluded every attempt I have made to find out more about him…or even to establish whether he even existed. He highlights one of the big problems for historians in trying to piece together individual lives through scattered documents. We have a few pieces of the jigsaw, but not the final picture. It also raises the danger in assuming that documents in local or county archives are necessarily from their own area.

Let’s start at the beginning of the ‘Jones’ document. The first couple of pages are interesting. The book begins with a list of standard apothecary measures – a common enough inclusion, especially if this were the book of a practitioner. Lists of scruples, drachms and other measures were necessary and useful in compounding the correct measures and dosages of remedies. But then the plot thickens, and the name ‘Bethia Marsh’ is written in bold script, suggesting authorship or ownership; more about that later. But also prominently written is the following heading:

Noblest teaching of urine to know the proffices thereof for the nature of man and woman which is known through urines. Through which urines the sicknesses of men are knowne, translated out of lattine (sic) into English. By mee Alexander Spraggot. 1569. May ixiiii”.

So the plot thickens. Here we appear to have the title page of a published book by the eponymous Mr Spraggot. We have an exact date and so, at least, a starting point. Looking at the book as a whole, it does ‘feel’ very much like a published work. It is very neatly set out and has, quite unusually, a complete alphabetical index at its end.

There is a section on uroscopy (the diagnosis of medical conditions by the appearance, smell and taste of human urine), followed by some general notes on life and health. These include “To knowe life or death/tokens of death”, “A treatise of Hypocras”, with astrological notes on sickness and other general observations including notes on why students are unhealthy – essentially because they spent so much time in motionless reading! The rest of the volume is given over to medical remedies, generally set out in order of different parts of the body.

For headaches, for example, there are remedies for “headach proceeding of a cold cause”, “headache proceeding of heate”, “for the mygrim or rigrim” and so on. Several pages deal with purges for various conditions, including “melancholie”, “palsey” and also specific diets, e.g. for the “rhewme”. There are sections on obstetrics and childbirth as well as conditions relating to both men and women. Given the standard practice of using animal, plant, and any number of other materials (!) in remedies of this time, there is ample evidence of a full range, and nothing out of the ordinary.

In many ways, there is much to support a theory of this as being the book of a practitioner; it contains just the sort of useful information that a practitioner might rely upon in his daily work. There is little evidence to suggest attributions in the book. In ‘domestic’ remedy collections (i.e. those used in families) it is common to find recipes gifted from others – e.g. my aunt’s remedy for a cold, Mrs x’s receipt for the gout, and so on. But this book has none, suggesting a more formal purpose. The fact that it is written in fair hand also supports a deliberate and disciplined document.

But if we look deeper at the document, what else might it reveal? Firstly, who was Alexander Spraggot? Did he indeed write a book called ‘noblest teachings of urine’, or might this be an unpublished manuscript from 1569? The answer to the latter is no. In terms of the date, I was partly lucky, since the paper was watermarked…but even this is slightly mysterious. Having sent a copy of the watermark to a colleague who specialises in this area, the watermark turned out to be from an unusual source for an early modern Welsh document…it was from Russia. Not only this, it dated no earlier than the mid seventeenth century, meaning that, at the very least, any copy from Spraggot’s original must have been done nearly a century later.

Searching under the name Alexander Spraggot reveals few likely candidates. Perhaps the most likely seems to be ‘Alexandrus Spraggot’, appointed the vicar of Martocke church in Somerset in 1564 – not a great distance from South Wales. But did Spraggot ever author a work of this name? Not as far as I can tell. There are no records in the British Library of a book by this title or author, so here the trail runs cold.

So what of the second name mentioned in the book – Bethia Marsh? Here again, I’ve drawn something of a blank. A lady of this name was born near Salem, Massachusetts in 1650 – roughly around the date of the creation of the book (or at least its paper), making her an unlikely candidate. The name isn’t especially Welsh either. One possibility is that Bethia was, at some point, the owner of this book which, after all, contained a large number of useful remedies. It was common for people to write their names in such books to assert ownership, and also for remedy collections to move across families as they were gifted, especially to newlyweds.

What, finally, of Sansom Jones, the mysterious Welsh practitioner of Bettws, south Wales? Is there anything to suggest that he was the true owner of the book? Sadly not. Having looked for the relatively unusual name of Sansom in likely parish records, I can find no trace…so far. He was not, at least as far as the records suggest, a licensed physician. His name doesn’t appear on any list of known doctors, nor does he appear to have been apprenticed or trained. None of this, of course, means that he never existed. He could, as many Welsh practitioners did, have simply carried on his medical practice to the local population unhindered by the need to obtain a licence, being so far from the centre in London. With such an indistinct date, he might have been of a later time period, with a misjudged attribution by the note writer. Another possibility is that he was actually from a different ‘Bettws’ than the one in Glamorganshire; there are several across Wales.

And so the search continues. As I turn my attentions back to Welsh medical practice (after a hiatus studying shaving and rupture trusses in the eighteenth century) the need to find out more about the daily life and work of Welsh doctors will again become paramount. If Sansom Jones was there, and if this was indeed his book, I want to find him, as ownership of these types of documents does much to provide an alternative to depictions of Welsh doctors as obsessed with folklore and magic.

p.s. If anyone can shed any light on any of this, I’d be very grateful.