Nendick’s Pill: Selling Medicine in Rural Britain

17th Century quack

(Anon, ‘Quacksalber’ – image from Wikimedia Commons)

Even as late as the 1970s it was largely assumed that people in rural England and Wales had little contact with medical practitioners or medicines for sale. As such, they were portrayed as being reliant upon ‘irregular’ practitioners such as charmers and cunning folk, and forced to make their own ineffectual medicines from the plants, animals and substances around them.

Recent work, however, has done much to explode this notion, showing instead that people in rural Britain were actually surrounded by medical practitioners of various kinds (see my previous blog post on the subject here) and could buy a variety of ingredients from apothecary shops which, if not on their doorstep, could be found in market towns nearby. Little work has yet been done, however, on the rural medical marketplace.

When I was writing my book on medicine in seventeenth-century Wales (a rural area if ever there was one!) I wanted to look at medicines for sale, and medicines advertised. In seventeenth-century London medical advertising proliferated. All manner of medical entrepreneurs took advantage of cheap print to peddle their wares to sickly Londoners, deploying tactics still familiar to advertisers today.

But how did this process work in areas far outside London? Did medical practitioners, and sellers of proprietary (ready-made) remedies even bother with the provinces? In fact, as I discovered for Wales, adverts for medicines reached far across the country, and remedy sellers and makers took advantage of local contacts to market their products.

A useful case in point is that of ‘Nendick’s Popular Pill’. Nendick was a London practitioner, described across various sources as a doctor, barber-surgeon, surgeon and ‘empiric’. He was based at the White Ball Inn, near to St Paul’s Churchyard. (For anyone interested in unusual wills, his final testament -National Archives PROB 11/496 – was virtually a mini theological treatise, on which he set forth his somewhat idiosyncratic views on the last judgement and resurrection, influenced by his work on chemical medicines.)

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(Image from Google Books)

Nendick published various books in his lifetime, but these were usually dedicated to promoting his ‘miraculous’ cure-all pills. In 1677, for example, he published ‘A Book of Directions and Cures done by that Safe and Successful Medicine called ‘Nendick’s Popular Pill. Although it claimed special dominion in the cure of scurvy, the book claimed that the pill cured everything from wind and cold to headaches and pimples, ‘cleansing the blood and purging gently by urine and stool’.

In line with the standard form of medical advertising for the time, the pamphlet gave detailed directions for use, a long list of claims for efficacy, and the place in London from where it could be purchased, along with warnings to customers to beware of fake pills! Perhaps more interesting, however, the pamphlet also gave a long list of sellers in towns around Britain, and even Ireland, from whom the pills could be bought. Nendick had managed to establish a network of agents around the country. These naturally included large towns like Bristol, Dartford, Plymouth and Ipswich but also much smaller market towns like Ledbury, Tenby and Kington in Somerset. Given the logistical difficulties of locating potential sellers, and maintaining supply and payment, this was an impressive undertaking.

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(Image from Google Books)

Looking down the list also tells us something about the sorts of places that might sell medical remedies. Some were medical practitioners. Mr Mainstone in Monmouth was a barber surgeon; Mr Betts in Guildford, Mr Ady in Chipping Sodbury and Mr Penny in Braton were barbers, and often interchangeable with medical services. Mercers, like Mr Northcote in Plymouth, and Mr Button in Taunton, often combined their trade with that of an apothecary, and so were common suppliers of medicines. But the connection with others was less clear. What of Mr Hill of Ryegate, the shoemaker, or Mr Lunt in Ledbury, a bookseller? The pill could also be found at a distiller’s, a coffee house and an inn.

But what if people wanted to buy pills and were not near enough to one of the warranted sellers to make the journey? Nendick had this covered. For three shillings a box of thirty pills could be dispatched by post, or would happily be provided to a messenger sent by a potential customer. Medicine by post was actually fairly common in the early modern period; it was even possible to send a flask of urine to a physician to be tested if a personal consultation was not possible. The state of the bottled piss by the time it had made the journey by coach of perhaps a day or two can only be guessed at!

Another clever device used by Nendick (and others) was to use testimony from local people to assure them that this ‘foreign’ pill could work for them. Examples from Wales are a case in point.

‘A poor Woman came from Kilgarren in Wales to lie in Cardigan, to get Cure of a sore Distemper, but to compleat her misery, she was left penniless, and uncured; yet by a Box of my Pills, which were given her by Mr. Griffith in Cardigan, she was Cured; they did expel wind, brought away store of Gravel, Water, and Blood, and she returned home well, that in three years before had not had the right benefit of Nature, much more might be said…’

Whereas poor Mr Whetnal of Presteigne, a gunsmith, could scarcely sit upright, much less leave his house before sending for Nendick’s products, a few pills later and he ‘now rode about the countrey’ through the miraculous power of the pill.

It was not only Nendick who employed this tactic. ‘Dr Salmon’s Pills…so famously known throughout England’ could be found everywhere from a Monmouth apothecary to a Gloucester bookseller as could ‘Dr. Stoughton’s Elixir Magnum Stomachicum, Or, the Great Cordial Elixir’, made by the Surrey apothecary Richard Stoughton and ‘Bromfield’s Pills’.

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(Image from the Anderson-Harvard Theological Library http://hdslibrary.tumblr.com/post/123373454944/who-knew-we-had-a-pamphlet-on-scurvy-spoiler)

Sometimes, though, the relationship could go wrong, as it did with Charles Taylor of the Kings Arms in Monmouth. Taylor was an agent for Anthony Daffy’s famous ‘Daffy’s Elixir’, a cure-all popular from the late seventeenth century. It seems that Taylor enthusiastically ordered a large stock of elixir to sell to his eager Welsh customers, but proved less enthusiastic in paying for them, leading to a lawsuit!

What these advertisements show, though, is that London medicines could be bought all across the country, in large and small towns alike. People from rural areas had ready access to them and, importantly, from local shopkeepers that they knew. The fact that they could read testimonials by locals – perhaps even neighbours – reinforced the safety and efficacy of the remedy. Also even if they could not get to town they even had the option to send for the pills by post. All of this reminds us that people in the past were by no means as cut off from medical provision as they were traditionally portrayed to be. Like us, they had access to a variety of medical goods, services and choices.

**(The full academic article I wrote on this topic in the Bulletin of the History of Medicine is available free on Open Access here)**

Touching the Past: Why History Is Important?

I was talking to a colleague recently about what first got us fired up about history. I’ve loved history since childhood, and it was probably inevitable that it would end up as a career. As an undergraduate, though, I vividly remember a turning point – a brilliant lecture I attended on life in the South Wales coalfields, which began with an image of a miners’ protest in the early 20th century. The lecturer began with a simple question: ‘what was it like to be there?’ He went on to talk about the men, the town and environment, the sights and smells and the conditions they lived in, bringing it all vividly to life.

But why does history matter? What is the ‘point’ of history? What is the value of humanities in a modern society? Depressingly, these are questions that historians increasingly have to face, and face them we do. A recent post by Laura Sangha gives a great response to just these sorts of questions.

Despite abundant evidence of the public appetite for ‘popular’ history, academic historians are under constant pressure to defend our discipline in the face of threats to funding, the need to recruit students and bring in research income. Sometimes it is easy not only to lose touch with why history matters, but what it was that got us enthused about it in the first place. For me, though, a chance encounter in an antiquarian bookshop in London last week has gone a long way towards bringing back the excitement I first felt when I first became interested in the past, and the people who inhabited it.

I wasn’t even to go in to the shop. But, with a little time to kill before lunch, I wandered in, and asked the owner if he had a section on health and medicine. He looked apologetic and said he had a few on some shelves at the back of the shop, but “mostly vintage stuff’”. What he actually had were two bookcases full of treasures; all manner of 17th and 18th-century medical and surgical treatises, histories of the body, anatomical works, medical lectures, books of remedies and pharmacopoeia…for a historian of medicine, a little shop of dreams!

One, in particular, caught my eye – an original 1667 copy of John Tanner’s Hidden Treasures of the Art of Physick. I pondered for a little while about whether to buy it…I’ve long worried about buying these old books (especially from places like Ebay) and whether it is right to own something that should ideally be in a museum. But, before long, it was coming home with me!

IMG_2913.jpg

Unwrapping the book from its packaging at home gave me time to look at it in detail, but also to reflect on the incredible journey that it’s had. More than that it reminded me of exactly why I fell in love with history in the first place. Here, on my desk, next to me now in fact, is a tangible artefact – a survivor from another world.

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(Thomas Wyck – ‘Old St Paul in Ruins’, Image from Wikimedia Commons)

It rolled off the press in Clerkenwell, London one day in 1667, in a city still in shock after the dual calamities of the plague and the Great Fire of the previous year. What would an imaginary visitor to London that year have seen? Everywhere were burnt-out buildings, piles of rubble and devastated streets still in the process of being cleared. In January that year Samuel Pepys noted that there were still ‘smoking remains of the late fire’ with ‘the ways mighty bad and dirty’. Even as late as the 28th of February Pepys was still having trouble sleeping because of ‘great terrors about the fire’, and observed ‘smoke still remaining of the late fire’ in the City. On the skyline was the devastated, but still recognisable, symbol of old London – the first St Paul’s Cathedral, whilst the once noted sea of church spires across London was diminished. Clerkenwell itself, however, largely escaped the fire. It was a fairly upmarket area, containing some affluent houses and businesses. Clerkenwell green was a fashionable area, home to some of the nobility.

What, then, of the book’s author and publishers? John Tanner who, according to the blurb, was a ‘student of physick and astrology’ wrote it. In fact, Tanner was a practising physician who resided in Kings Street, Westminster. In other sources he was referred to as a ‘dr in physic’ and a ‘medicus’, possibly even a member of the Royal College of Physicians in February 1675. When he died in 1711, Tanner had done pretty well for himself, leaving gold, silver and money, together with valuable goods, to his children. In his house, according to his inventory, were a ‘Physick room, Chirurgery room and still house’, the last used to distil waters for medicinal use. Tanner was the author of ‘my’ book, but he likely never touched it.

Someone who potentially had more to do with the physical book, however, was its publisher John Streater, a prolific producer of medical texts and brother of Aaron Streater, a noted physician and ‘divine’. Streater often worked in tandem with the bookseller George Sawbridge ‘at his House on clerken-well-Green’. Sawbridge was an eminent bookseller and publisher of medical books by luminaries such as Nicholas Culpeper. According to Elias Ashmole, Sawbridge had been a friend of the ‘English Merlin’ (or the ‘Juggling Wizard and Imposter’, depending on your source!) William Lilly. When he died, Sawbridge was worth around £40,000 – a colossal amount of money in the seventeenth century. It’s not too much of a leap of imagination to picture Sawbridge in his shop, surrounded by shelves and shelves of leather and calf-bound volumes, handing the book over to its first owner.

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Who owned it? It’s impossible to say, but let’s speculate. A book like Tanner’s Treasury was meant for a general readership. It’s aim was to help the ‘diligent reader’ attain a good understanding of physick and the body, synthesising a range of different authors. Its medical content might have made it appealing as an easy reference work for a medical practitioner, but far more likely is that it found its way into the library of a local gentleman…perhaps even one of the Clerkenwell nobility who lived hard by. Medical texts were common inclusions amongst the libraries of gentlemen; medicine was one of the accepted intellectual pursuits of elite men. In fact there is only one signature inside the book, which is now, sadly illegible. Only the word ‘boak’ (book) and the date 1726 are now discernible, but show that it was still being used, or at least referred to, at that date. There is also only one slightly unclear annotation, which appears to say ‘used above [unclear] but are fare’. I’ve included the image below.

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This copy of Tanner’s Treasury has had a long journey to this point. It has been passed down – perhaps gifted, bequeathed, sold, resold, lent, scores of times. At some point it ended up in a Birmingham library, and was potentially read by countless scholars, before its journey took it back to where it began – a London bookseller, where an interested party (me!) couldn’t leave it on the shelf. Rest assured that it’s found a good home, and will be carefully looked after.

To me, things like this little book are the reasons I love doing what I do. To be sure, the contents are important, giving us a window into the medical worldview of the time, and the sorts of individuals practising, writing and publishing medicine. The remedies are fascinating (and indeed one of my academic research interests). But there’s more to it than that. The book itself lets us literally touch the past and make contact with an object that was actually there. The people who wrote, sold, bought and passed it on have long gone, but we can still hold and appreciate something that was once important to them. It’s a line of direct contact back through the centuries. For all the academic theorising about grand narratives, discourses, theories and the rest, it’s nice to be reminded now and again of the simple, visceral thrill of letting a source fire up your imagination of what it was like in the past.

And that is why I think history is important.

 

 

 

Zounds how you scrape! Being shaved in Georgian Britain.

Last week, for the first time in my life, I was the lucky recipient of a wet shave with a cut throat razor. As part of my duties as a BBC/AHRC ‘New Generation Thinker’ I was making a short film about shaving in Georgian Britain, the conclusion of which sees me having my beard shorn off in the Pall Mall barbers in Fitzrovia, central London, a traditional barbers’ shop with a history dating back to the nineteenth century. http://www.pallmallbarbers.com/  (I don’t usually go in for endorsements in the blog, but will make an exception here and say a big thanks to Richard and his team for looking after us. Much appreciated guys).

For someone who has always used safety razors, I must admit that I was slightly nervous. After all, sitting recumbent in a chair while someone sweeps a lethally sharp blade over your neck might not immediately seem like a good plan. I needn’t have worried. My barber, Michael, was an expert and, after a bit of preparatory work with hot towels and various creams and lotions, six months’ worth of beard was gone(smoothly and painlessly) in less than half an hour.

Under the knife!

But the experience was interesting for me on another level. Having been researching and writing in various ways about shaving for the past five or six years, this was a chance to get close to the experience of men in the past. Maybe sixty or seventy years ago, the cut throat razor was still extremely popular. Today, being shaved by a barber is something of a luxury. As I sat there in the comfortable chair, being shaved with a modern blade that was…well…razor sharp, I was reminded that this wasn’t always the experience of stubbly men in the past.

In Georgian Britain, shaving could be an extremely uncomfortable experience. Steel razors were already in use in the first half of the eighteenth century. These were often made of a type of steel called ‘shear steel’, which was made through an older process involving heating iron with layers of charcoal so that it absorbed the carbon. Whilst tough, this type of steel was prone to be brittle and not best suited to holding an extremely sharp edge for long. It needed constant re-sharpening with a strop –a leather strap which was held while the razor was swept up and down in long strokes.

After 1750, a new type of steel – cast steel – began to be introduced. Cast steel was more uniform in quality, capable of carrying a sharper edge, and had the added benefit of being capable of carrying a high polish. This meant that razors could look good, as well as working well. This is a model by the prominent razor maker and metallurgist James Stodart.

Image from http://www.taylors1000.com/index.htm, used with permission.
Image from http://www.taylors1000.com/index.htm, used with permission.

But even despite the availability of new razors, and the increasing habit of auto-pogonotomy (shaving yourself!), the barber was still the mainstay of shaving services. The problem was that the quality of barbering was, like the razors, not always uniform in quality. In fact, unlike today, barbers had something of a bad reputation for the treatment sometimes meted out to men coming into their shop for a shave!

Part of the problem was the routine use of blunted razors. Anyone who has ever tried to use a razor with modern disposable blades one too many times will probably sympathise with the uncomfortable rasping feeling as the blade scrapes, rather than cuts through the beard. So it was with a blunted cutthroat. Unlike today, there were no ‘lubricating strips’ in razors to help it glide. Shaving soaps and powders were used, and doubtless helped a bit but the poor customer was in for 30 minutes or so of severe discomfort if the barber had ignored the strop. The caption in this cartoon says it all: “Zounds how you scrape!”

Image courtesy of Wellcome Images
Image courtesy of Wellcome Images

Even once the shave had finished the ordeal might not be over. Many would have left with a prodigious shaving rash, not to mention the nicks and cuts that would be difficult to cover.  By the 1780s, some perfumers like Robert Sangwine of the Strand were beginning to sell various pastes and potions to soothe smarting skin.

18th-century classified ads...see if you can find Sangwine's advert!
18th-century classified ads…see if you can find Sangwine’s advert!

On a more serious note, a visit to the barber could be a threat to health. Razors might be washed between customers, but not in clean water. Matter such as blood and debris left on the surface of the razor, and its handle, could easily be transferred to the next customer, perhaps even into a cut, leaving them susceptible to infection.

It is also likely that, even with well-sharpened cast steel razors, the shave would not be as close as those experienced by modern men. It is also unlikely that the majority of men either shaved themselves or visited a barber more than a couple of times a week. As such, even though beards were extremely out of fashion, a few days growth of beard could well have been the norm. It is interesting to note, though, that a ‘five o’clock shadow’ could render you a target. The prominent Whig politician Charles James Fox was almost always depicted with heavy stubble, partly to highlight his status as a ‘man of the people’. If nothing else, this does suggest that ‘ordinary’ men, especially lower down the social order, were routinely stubbly. Fox is the figure at the far left.

Image courtesy of Wellcome Images
Image courtesy of Wellcome Images

But barbers were sometimes unpopular for other reasons. A raft of satirical cartoons poked fun at barbers who paid little attention to the sufferings of their customers or, worse still, paid little attention to their customers at all! In this cartoon, the barber is lost in his own conversation, talking about an acquaintance in Amsterdam. ‘Hulloa there’ cries the poor customer, ‘don’t you know that you’re about to cut off my nose?”!

Barber

This was also a time when barbers were in a period of transition. After splitting from the barber-surgeons’ company in 1745 to create their own occupational identity, the shift away from medicine was also marked by a move towards specialisation in hair dressing. Indeed, the term ‘hairdresser’ was increasingly becoming common towards the end of the eighteenth century. The extent to which hairdressers still provided shaving services for men is one of the questions I’ll be addressing in my new project on the history of shaving in Britain between 1700 and 1918.

In any case, I’m getting used to beardless life again after six months of facial hirsuteness. Many times in the course of my work as a historian of seventeenth-century medicine and surgery I’ve had cause to be thankful for modern biomedicine. My experience at the hands of a modern barber has given me the same feeling with my work on the history of shaving!

Good and Bad Deaths in the Seventeenth Century

Death of a pope

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 15th 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
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 25th 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
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
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

10 Seventeenth-century remedies you’d probably want to avoid!

Whilst I strongly advocate not poking fun at the medical beliefs and practices of our ancestors, now and again it does no harm to remind ourselves of just how…unusual they could sometimes appear. And so I give you my top ten early modern recipes!

10) An excellent good medisian for an Eye that is bruised or blood shott by any crust
Take ass soon as the eye is hurt; take a house pidgin & cut ye vain that is under the winge & let it bleed into a sauser: and while it is hot wett some cloth and presently lay it to ye eye: and the next day dress it in like manner and with out doubt it will help you”

9) For the bloody flux (ie. Dystentry or severe diarrhoea)
Take A handkerchief dipped in the blood of a hare harte newly killed, dry this handkerchief in ye sun & after straine your beer being at least three weeks ould always through it and drink of it every morning and evening a pint’

Image from http://www.doctorwellgood.com/clinic-a-z/diarrhoea.html
Image from http://www.doctorwellgood.com/clinic-a-z/diarrhoea.html

8) Aproved thing for the Collick
Distill hens codds (testicles!) and and when they are pretty tender do then with a soft fier: not burn it: and when the collick troubles you take two spoonfuls of this — with a little sugar to make it pleasant to your taste.

7) How to make a water to kill the worems in hollow teeth;
buy three pence of Mercury and grinde it smale on a stone, then put it in a glass bottle or other glass: and stir it well then let the pacient get a quill of a goose and drop some of it therin and put it in to the holow tooth :3: times and use it two or :3: dayes and it will kill the worem and the tooth actch and never troble you ageine but in any wise let the pacient take heed (not) to swalowe any of it downe, but spitte it out

(so, just to be clear, dropping mercury straight into your teeth. Although there are mercury fillings today, probably not a good plan!)

6) Excelent for a consumption, Dropsey, Scurvey or Most Sickness whatever
Take cow dung fresh in May, dry it in ye oven to a fine powder, Give as much as will lye upon a sixpence in a draught of warme stronge beer 3 times a day, or you may distill cow dung in an ordinary still & take half a gill of ye water at a time, more or less three times a day

Image fromhttp://www.bioenergyconsult.com/anaerobic-digestion-of-cow-manure/
Image fromhttp://www.bioenergyconsult.com/anaerobic-digestion-of-cow-manure/

5) To make oyle of swallowes
Take as many swallowes as you can gette as 20 or 25, and put unto them lavender cotton, spiked, knotgrasse ribworte Balme valerian, rosemarie topps, strings of vines, cothan, plantain, walnut leaves sayd of virtue, mallows, alecroft etc etc

4) To Cuer the dead Palsey
Take a Fox, cleanse him, mince the flesh very smalle then dress a goose, pull out the Gutts; putt all the flesh of the fox into the goose and sowe her upp close; then roste them whilest any moisture will dropp out. Take the dripping and putt into it Rosemary; Lavender; Sage; Bettiny; The Weight of Ffower pints of each of them powdered, Anniseede; Ffennellseede, nutmeg, mace, Cloves, Pepper, ginger, Ffrankencence, the weight of sixpence of a peece of each of them Powdered, Boyle all twoe or three wallmes on a softe fire, put itt being strayned and Cooled into a pott. Annoynt the partye on the place grieved therewth and Rubb it in well before the fire.

Image from Wikipedia - creative commons
Image from Wikipedia – creative commons

3) For the falling sicknesse (epilepsy)
Take a live mole and cut the throat of it into a glass of white wine
And presently give it to the party to drink at the new and full of the moon
(viz) the day before the new, the day of the new, and the day after, and soe at the full. This will cure absolutely, if the party be not above forty yeares of age.

2) For the Frenzie or inflammation of the cauls of the brain,
Cause the juice of beets (beetroot juice) to be with a syringe squirted up into the patient’s nostrils, which will purge and cleanse his head exceedingly, and then give him posset ale to drinke in which violet leaf and lettice has been boiled and this will suddainly bring him to a verie temperate mildness’

And this week’s number 1…

1) For the bloody flux,
take a stag’s pizzle dried and grate it and give it in any drink, either in beer, ale or wine and it is most sovereign for any flux whatsoever.

Image fromhttp://www.nhm.ac.uk/natureplus/blogs/whats-new/2011/02
Image fromhttp://www.nhm.ac.uk/natureplus/blogs/whats-new/2011/02

Narrowly missing out were directions for constipation, which involved the aggrieved person squatting over a bucket of boiling milk ‘for as long as the party can bear it’…

And the cure for hydrocele (grossly swollen testicles) which involved injecting port wine into the affected parts!

Overcrowded and Underfunded: 18th-Century Hospitals and the NHS Crisis

The problem of overcrowded hospitals in Britain is now an annually recurring one. Every year, especially in winter, operations are cancelled, treatments postponed and patients sent home because there simply isn’t bed space for them. A combination of increased admissions of the elderly in the winter months, seasonal outbreaks such as flu and norovirus, and the impact of weather-related accidents all serve to pile on the pressure to an already-embattled healthcare system.

Embattled Doctor!

According to the BBC, NHS and social care services are ‘at breaking point’, with an open letter warning the government that ‘things cannot go on like this’.http://www.bbc.co.uk/news/uk-29501588. The story is now a perennial one. Every year (and in fact every couple of months) a mix of underfunding, overcrowding and staff stress puts the NHS in the headlines. Winter almost always exacerbates the problem. A year ago the outgoing NHS Chief Executive David Nicholson warned that the “toxic overcrowding” of accident and emergency departments in Britain not only impacted upon service levels but could have far more serious effects including higher levels of patient mortality and unsustainable levels of staff stress. The president of the ‘College of Emergency Medicine’ went even further, stating that the whole system was sailing dangerous close to complete failure. With the Daily Telegraph claiming that many patients were afraid to ask for help from staff pushed almost to their limits, the United Kingdom is perhaps still in the midst of what it last year called, “David Cameron’s care crisis”.

Ann-NHS-demonstrator-dres-007 Image from http://www.TheGuardian.com

It is indeed easy to think of this situation as a uniquely modern one, linked to the seemingly continual squeeze on budgets. Surely this wouldn’t have happened in the past, where well-run hospitals staffed by starchy matrons ran their (spotlessly clean) wards with military precision? In fact, if we peer back through time to hospitals even before the NHS, the situation can look remarkably familiar.

In 1772 Dr John Sharp, a philanthropist and trustee of the charity established by the late Lord Crewe, established a charitable infirmary in the impressive medieval castle at Bamburgh on the north east coast of England. Sharp’s brother William was a celebrated surgeon at St Bartholomew’s hospital in London and so the infirmary was able to benefit from the advice of a top medical man. As such it was equipped with the latest medical technologies, from mechanically operated hot and cold seawater baths to electrical machines and even an infirmary carriage to take invalid patients down to the beach for a restorative dip. In terms of many other institutions this was state of the art.

Dr Sharp

Many hospitals of the time relied on subscriptions – donations by wealthy benefactors – for their building and running. For patients to be admitted required a letter of recommendation from a subscriber. It was therefore very difficult just to turn up and ask for treatment. Bamburgh was different. Funded completely by the charity it had an open surgery – effectively an accident and emergency centre – on weekends, which meant that anyone, but especially the poor, could attend and be seen with relative ease. A quick note from a local clergyman confirming their status as a poor ‘object’ was sufficient. Unsurprisingly, though, this very accessibility meant that it was extremely popular.

In the first year of the charity, the numbers of patients through its doors was a modest 206. In 1775 this had more than doubled, and in 1781 it treated 1106. By the end of that decade, the infirmary was regularly treating more than 1500 patients every year, and was expending more than £250 every year on treatments and drugs. As well as outpatients, the infirmary contained around 20 beds. To give some perspective, these numbers were at times comparable with some of the ‘flagship’ hospitals in major Georgian towns such as Bath and Birmingham.

Bamburgh Castle

A staff consisting of a surgeon, two assistants and several ancillary staff, alone catered for the influx of patients. On any given attendance day between 60 and 100 patients could attend, and this put immense strain on both facilities and staff. In 1784 a freezing winter and ‘melancholy weather’ caused many poor people to perish, and admissions to rise dramatically. Outbreaks of infection also increased the pressure. The ‘malignant smallpox’ in neighbouring parishes was a constant threat to families, while the winter of 1782 also brought an outbreak of influenza at the neighbouring military barracks at Belford. This elicited a plea for infected soldiers to be treated at Bamburgh – a request declined by Dr Sharp for fear of infecting the rest of his patients.

The resident surgeon, Dr Cockayne, keenly felt these increasing pressures. Writing to Dr Sharp in the 1780s he noted both the continual increase in duties and the ‘vast number of patients admitted’ all of which added to his great worry and trouble. In the politest possible terms he asked for a rise in his wages, a request that led to him moving from ad hoc payments to a permanent wage.

The overcrowding at Bamburgh certainly chimes with the problems faced by the NHS on a daily basis. In simple terms there are simply too few staff to look after too many patients. The demands of an ever-changing medical environment increase the workload for staff, and these lead to further questions about pay and conditions. But it is interesting to consider that while Bamburgh infirmary faced the same socio-medical conditions as do hospitals today the question of funding was markedly different. Bamburgh was a well-funded institution. It had abundant money to spend on facilities and equipment and did so. And yet, the pressures of increasing numbers, and the unpredictability of admissions, still threatened to overwhelm it. Does this suggest that at least some problems are not simply reducible to finance?

Many suggestions have been put forward, from streamlining the allocation of beds to increasing the range of conditions treatable by pharmacists and GPs and even treating some conditions in the patient’s own homes. Whatever the answer it is clear that hospital overcrowding is not a new problem. Medical professionals in the past were all too familiar with the challenge of meeting increasing and uneven demand with limited resources.

‘He is gone from his service before his time’: Medical Apprenticeships in Early Modern Britain

One of the biggest frustrations in studying Welsh medical history is the lack of institutions. In the early modern period Wales was unique amongst the individual nations of the British Isles in having no universities and no medical training facilities. Unlike England, Scotland and Ireland there were no colleges of physicians or surgeons. Why was this? One of the main reasons was the lack of large towns. Wrexham, in north Wales, was by far the largest town in early modern Wales, with a population of around 3500 in 1700. There were many other smaller Welsh towns but, without large populations to cater for, there was no need for practitioners to form trade gilds or corporations.

Over the past few weeks, however, I’ve been turning my attention to the Welsh Marches – the border between England and Wales – and doing some research on large towns such as Shrewsbury and Chester, which were important centres for Welsh people and, it seems, for Welsh practitioners too. One area that I’ve been particularly interested in is that of medical companies and trade guilds. As part of our project in Exeter, we’ve been looking in more detail at the role of barbers and barber surgeons in medicine, both in terms of what they did and how they were described, but also exploring the important question of medical apprenticeships. One company in particular, the Chester Company of Barber Surgeons and Wax and Tallow Chandlers is a particularly rich source of evidence.

L0048991 Arms of the London Barber Surgeons' Company. Engraving

The Company were responsible for the regulation of barbers, barber surgeons as well as chandlers who made candles and soap. The relationship between the trades may not immediately be apparent but, in fact, was often interchangeable. People described as barbers were commonly medical practitioners as well as hair cutters and beard trimmers. Barber surgeons often ran barbering shops. The gap between them was extremely fuzzy.

But also, for reasons that are less clear, barbers might also make and sell candles. In the records, barbers can be found referred to as wax chandlers (ie those making wax candles), or as both. Wax candles were relatively expensive since they burned for a long time. Interestingly, however, there appears to be no overlap between barbers and tallow chandlers. Tallow was animal fat, used in candle production. Although tallow candles were cheap, and as bright as wax candles, (around half the price of wax, or less) they burned for only around half the time, so were less effective.

Tallow candles

In conjunction with the borough the Company regulated trade and practice, laid out rules for members and also oversaw apprenticeship. Membership bestowed certain rights but also carried responsibilities. Brethren who did not abide by the rules risked censure and fines…and the list of rules was long!

Some orders were routine and concerned attendance and appearance. Every member was expected to attend all meetings unless they had a valid reason, and to wear their gown. They should ‘behave themselves orderly’, not disturb or interrupt meetings and should always call their fellow members by their proper names…on pain of a fine. Other rules related to respect and civility. One brother of the company should not ‘dispraise anothers work’ nor lodge any lawsuit against a fellow member. Neither should they disclose any secrets of their work to lay people, nor give out details of the meetings.

All fees (fines) were to be promptly paid and recorded in the register. These paid for the costs of meetings and food, but also for the burial of departed bretherin. Rule number 14 provided for ‘the decente and comely burial of any of the saide companye departed’ and it was expected that every member should ‘attend the corpse and burial’ unless they had good reason. The fine for non-attendance was a hefty 12 shillings!

Popular culture and religious belief also features strongly. An ‘order against trimming on Sundays’ forbade the cutting of hair on the Sabbath day, again for a fine of 20 shillings. Every year the company also participated in a popular midsummer parade and festival in the city. This involved a procession of decorated carnival floats, and was a throwback to an ancient pagan ceremony. Unusually, it continued long after the Reformation and also survived the Puritan assault on popular revelries. In 1664, an order stated that money should be set out for the stewards to arrange for a small boy (a ‘stripelinge’) to be dressed and ride Abraham, the Company’s horse, in the procession, and to ‘doe their verie best in the setting forth of the saide showe for the better credit of the said societie and company’.

Chester midsummer festival
(Left image: public domain; right licensed under Creative Commons-Attribution-Noncommercial-Share Alike 2.0 Generic)

Perhaps one of the most important aspects of the Company’s function was apprenticeship. The rules of apprenticeship were clearly set out, and this sheds light on a very important and under-researched area of medicine. Only freemen of city, and Company bretherin, were allowed to take on apprentices. Apprenticeships were usually for seven years, but this could vary according to individuals. According to the company rules, no brother should take on another apprentice until his current one was within the last year of his service. The fine for disregarding this rule was a ruinous £10! All apprentices were to be entered into the register or risk a 30 shilling fine.

Why people sent their children to be apprentices in medical professions is not always clear. Medicine was not regarded as a prestigious occupation and, indeed, surgery was sometimes analogous with butchery. Nonetheless an established business in a town could be lucrative, especially given the range of services that barbers provided. As such, the decision to enrol children with urban medics could be pragmatic.

Barber-surgeon with Scared Patient

A brief glance at the apprentice registers reveals a number of interesting points. Firstly, it is clear that apprentices were often drawn from a town and its hinterlands. Although some came from further afield, the majority were local or lived within roughly a twenty-mile radius. On 18th Feb 1615 Richard Howe was apprenticed to Edward Wright, barber and wax chandler of Chester, for 8 years. Nicholas Halwood of Chester joined Robert Roberts, Chester tallow chandler for 7 years, while Robert Shone of Broughton’s apprenticeship to a Chester chandler was for 12 years.

In some cases family connections were clearly important, and parents might apprentice their child to a brother, cousin or more distant kin. This was a useful means of drawing on connections to further a career. James Handcocke was apprenticed to his uncle William Handcocke, a barber and wax chandler in September 1613, while Robert Glynne was apprenticed to Richard Glynne to learn the art of barber surgery. Fathers might also take on their own sons as apprentices, a situation that must sometimes have led to fraught relations. Nicholas Cornley was apprenticed to his father Richard for 7 years in 1626, while others such as Robert Thornley, a barber surgeon and painter (!) took their sons to follow in their footsteps.

The conditions in which an apprentice lived and worked depended so much on their masters. While many were well-treated and provided for, which was in fact a central condition of apprenticeship, some masters could be cruel and neglectful of their young charges. Robert Pemberton’s service to Randle Whitbie ended 3 years into his 10-year indenture when he was found to be ‘gone from his service’. John Owen of Cartyd, Denbighshire, ‘ran away before his time ended’ as did Philip Williams, apprentice to Raphe Edge, who took to his heels after a year. Nothing is given as to the circumstances of their treatment; it was not unknown for apprentices to complain of ill treatment, however, and authorities took this seriously. In other cases the stark phrase ‘Mortuus est’ (he is dead) indicates another reason for the termination of an apprenticeship.

The number of entries and records for the company is huge, and will take a concerted programme of research to thoroughly investigate. It will also be interesting to compare these sources with other similar companies across Britain to build up a bigger picture of the activities of medical trades in early modern towns. Once this is done we should have a much broader picture of the role, function and daily activities of medical practitioners in the past.

‘Worems in the teeth’: Toothache, dentistry and remedies in the early modern period.

According to an article on the BBC Website today, dentists are now beginning to think that drill-free dentistry may soon be possible. Emerging technology will use electricity to force minerals into enamel and encourage the tooth to repair itself. Eventually teeth may even be able to regrow. For the thousands of people with a genuine fear of visiting the dentist, this would be a welcome development.
http://www.bbc.co.uk/news/health-27866399

The poor quality of people’s teeth in the past has long been acknowledged. In the seventeenth century, mouths full of blackened, rotting stumps would not be uncommon. As sugar became more common in the eighteenth century, dental decay became even more problematic, especially amongst the well to do. There is a good reason why people in portraiture do not often display a toothy grin; in many cases their teeth would have looked like a row of condemned houses! Here’s Jean-Etienne Liotard’s engagingly honest self-portrait!

Jean Etienne Liotard self portrait

Tooth care was rudimentary and a range of medical interventions existed to try and soothe smarting teeth. In the seventeenth century, it was widely believed that toothache was the result of worms in the teeth. In fact, a condition called ‘teeth’ was a recognised medical affliction and was regularly quoted as a cause of death in the Bills of Mortality. Sometimes they were as high as the fifth or sixth highest cause of death!

As with many aspects of early modern medicine, prevention was better than cure, and a range of techniques were used to keep teeth clean. One method to whiten teeth was to make a mixture of vinegar, honey and salt, add it to a cloth and rub vigorously…but not enough to make the gums bleed. For daily maintenance things like rubbing the teeth with tree bark or chewing herbs such as parsley offered ways to get problematic bits out of the teeth, or to sweeten the breath. The toothbrush did not appear until the end of the eighteenth century in Britain, being an imported fad from France. People were thus forced to use other means.

Once toothache had taken hold, a large body of remedies existed to try and relieve the pain. The popular author Gervase Markham recommended taking daisy roots, stamping them in a cloth before adding salt and liquid, putting this into a quill and ‘snuff it up into your nose’.

Remedies for toothache seem to have attracted some fairly dangerous substances. Mrs Corlyon, author of a domestic remedy collection dating from 1606 advocated boiling sliced henbane roots in vinegar, then heating the roots from underneath to cook away most of the moisture, before holding one of the slices between the teeth until the remaining liquid dripped onto it. Henbane, also known as ‘Stinking Nightshade’ is poisonous and can cause hallucination and some severe psychoactive effects!.

tooth drawer

Another remedy, this time from the commonplace book of a Welsh gentleman, Phillip Howell of Brecon, c. 1633, appears even more risky. His remedy involved taking 3 drams of mercury, grinding it on a stone and putting it into a glass bottle. The patient then needed to drop some of the mercury ‘granules’ into the afflicted teeth 3 times a day over two or three days ‘and it will kill the worm and the tooth ache and never troble you ageine’. The patient should take care, cautioned Howell, not to swallow any of it, but spit it out. An early mercury filling…but potentially offering bigger problems than the toothache.

As is also common, remedies did not necessarily have to be applied to the body part afflicted. One recipe for toothache involved putting some ‘Burgamy pitch’ onto leather, sprinkling some nutmeg over it and then applying it to the soles of the feet.

If you had loose teeth and wanted them to stay in your mouth, then Markham suggested first letting some blood through the gums, before taking hartshorn or ivory and red pimpernel (a type of the herb saxifrage), bruising them together in a linen cloth and then laying the cloth to the teeth, promising that this would ‘fasten the teeth’. He neglected the rather vital instruction of how long the patient should do this for however!

Removing teeth was obviously problematic…and painful. Recognising this, some medical writers turned to medical preparations to loosen teeth without the need to forcibly pull them. ‘To Draw Teeth Without Iron: Take some of the green of the elder tree, or the apples of oak trees and with either of these rub the teeth and gums and it will loosen them so as you may take them out’.

If the worst came to the worst though, a range of practitioners were ready, willing and able to pull the offending tooth out. Whist there were no specific dentists, specialist tooth-drawers were often on hand to do the job. Some advertised their services, emphasising their skill in removing teeth without pain. In the 1760s, R. Maggerrus advertised his services in the Public Advertiser as an ‘Operator for the Teeth’ having an ‘infallible method’ and ‘cureing the poor gratis’.

But there were other less obvious candidates. Blacksmiths often ran a lucrative sideline in tooth-removal; they had the upper body strength to pull the offending tooth out, together with the metal instruments to deal with any stubborn ones. Travelling mountebanks criss-crossed the country offering to cure symptoms. Robert Bulkley, a 17th-century Anglesey diarist, noted that he had paid one such figure a penny to cure his toothache. Two days later the mountebank was long gone, but Bulkeley still had his toothache.

Tooth extractor

Perhaps the day of the ‘regrowing tooth’ is not far away and, for many, this will be a relief. Next time you grin for the camera, though, spare a thought for our ancestors…and offer up a silent prayer that you live in an age of relatively pain-free dentistry!

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)

“Master Docturdo and Fartado”: Libellous Doctors in Early Modern Britain

I’ve just returned from a great conference at the University of Exeter – the Landscape of Occupations – organised by the project on early-modern medical practice of which I’m a part. There were a great variety of papers and many different aspects of occupation, occupational titles and identities and a range of other factors relating to ‘work’ in early-modern Europe.

One of the papers I was struck by was given by Professor Laurinda Abreu of the Unviersity of Evora, Portugal. Her paper explored something of the power struggles between the Portuguese crown and medical faculty for the assumption of medical authority and control over medical licensing. While the topic of conflict will be a familiar one to anyone studying early modern medical practice in Britain, it was really interesting to explore the same themes in a different context.

The relationship between different types of medical practitioner in the past has often been fraught. I’m oversimplifying here but, in general, physicians did not like surgeons as they saw them as low-status butchers who got their hands dirty. For their part, surgeons did not like physicians, whom they viewed as arrogantly adopting a position of superiority, often without basis. Apothecaries were not popular with either group since they often dabbled in physic and surgery – something they were not supposed to do. Quacks, cunning folk, ‘old women’ who healed and other types of ‘irregular’ practitioner, were pretty much attacked by all other practitioners!

17Th Century English Apothecary Shop

This apparent antipathy worked on a macro level, with entire groups entering paper wars and public slanging matches. But it is also clear that individual practitioners were prepared to take each other on if they thought that their territories were being invaded. I was reminded of a particular dispute between Exeter practitioners that was so vociferous that it ended up becoming a libel case in the Star Chamber court.

17thc Exeter

On May 10th 1604, the Exeter physician Thomas Edwards accused one of his colleagues – and possibly former friend – John Woolton of libel. The two men came from different backgrounds. Woolton was an Oxford graduate, son of a former Bishop of Exeter, holder of a medical licence and, later, an MD. In this respect he was about as ‘orthodox’ a physician as it was possible to be and was a leading physician in the town. Edwards, by contrast, had come to practice through the more usual route of apprenticeship and learnt his trade by observing his master, Francis Pampergo. Although he briefly went to Oxford, Edwards returned and established an apothecary business in Exeter.

Problems began to arise when Edwards, the apothecary, began to practice medicine, as well as selling drugs in his shop. Apothecaries were nominally banned from practising medicine, so Edwards was effectively breaking the law. In so doing, though, he also brought himself into direct competition with the prominent Woolton – a competition that Woolton was not prepared to tolerate.

Some time late in 1603, Woolton wrote a letter to Edwards which, even by the libel standards of the day was couched in the bitterest terms. Woolton began by addressing Edwards as ‘Master Docturdo and Fartado’ – hardly endearing terms to begin with. He went on, though, to launch a series of attacks on Edwards’ credibility, character and reputation. Edwards was accused of everything from dishonest dealings with his suppliers to the excessive bleeding and purging of one of his patients – Sir William Courtenay. Interestingly, Courtenay had originally been one of Woolton’s patients, so was he bitter at losing this prominent member of the Devonshire gentry to a mere ‘empirical’?

Dispute

The crux of the complaint, however, lay in Woolton’s objections to Edwards’ practice. “Your master taught you not to go beyond your mortar and pestle [and so] you aught not to minister so much as a clyster or open a vein’. Woolton backed up his objections by stating that Edwards was using dangerous substances in his ‘desperate practice’, including mercury, ratsbane, brimstone and aqua fortis, all of which were part of the chemical arsenal of Paracelsian physicians and which, argued Woolton, Edwards had insufficient knowledge of’.

Woolton made several copies of his letter, keeping one for himself, sending one to Edwards and passing on some to ‘divers others’ who published them, making the allegations widespread. The result of this was inevitable; Edwards was enraged. Reports suggest that tensions elevated and Edwards went looking for the doctor, with his rapier drawn. Woolton spotted him and shouted that he should ‘go back to his pestle and mortar’.

The battle lines were drawn and Edwards sued for libel. These were serious allegations the ‘publishing [of which] doth provoke malice and breach of the peace’. Edwards’ reputation was in the balance and everything hinged on whether the judges and court were sympathetic to the word of an apothecary against a prominent, university-educated physician.

17thc Westminster court

The judgement was conclusive, and Woolton was censured…in fact severely! The Lord Coke ‘began a very sharp sentence, and the greatest number agreed. He would spare Woolton corporal punishment because of his degree (!), but he fined him £500’. This, at the time, was an immense sum. The other libellers and publishers were also fined £40 a piece and Edwards was awarded £200 damages.

But still Lord Coke had not finished. Speaking ‘very sharply of the sin of libel’ he decreed that Woolton should ‘at a public market at the next general assizes’ be made to stand and publicly confess his faults. For a man of such eminent background as Woolton, the shame of this punishment, not to mention the financial penalty, must have been enormous.

Conflict in medicine has been a constant factor across time, but it is interesting to see the level of acrimony that individual disputes about medical authority could engender. The ruinous outcome for one of the parties here demonstrates the intolerance of the courts for those who resorted to publicly defaming rivals, but this did not stop practitioner squabbles from continuing well into the eighteenth century.
(For more on this case see R.S. Roberts, ‘The Personnel and Practice of Medicine in Tudor and Stuart England: Part 1, the provinces’, Journal of Medical History, 6:4 (1962)