BBC Free Thinking Feature: Bamburgh Castle Surgery, c. 1770-1800

Over the past few years I’ve been working on the records of a unique eighteenth-century medical institution. The eighteenth century saw the rise of institutional medicine, first in the form of hospitals and infirmaries, and later dispensaries. The former were large, imposing buildings in a town landscape, housing inpatients and treating surgical cases, as well as other conditions. Dispensaries were smaller, sometimes occupying existing buildings, but generally acted as outpatient services where the poor could be given medicines, patched up if necessary, and sent on their way.

Both hospitals and dispensaries were funded by subscription. Subscribers were invited to pledge an annual sum of money, put towards the building, running and upkeep of the institution. In return, subscribers had the right to recommend patients for treatment, according to the size of their donation. Unlike today, patients could not simply turn up at the doors, unless in absolute emergency. Instead, they required a certificate of permission, signed by a subscriber and, as such, could be difficult to access at times.

Image from Wikimedia Commons

Also, institutions were firmly urban in nature. They were closely bound up with the civic ambitions of Georgian towns. A hospital could be a strong statement about a town’s importance and beneficence to the poor. ‘See how kindly we look upon our poor objects’.

Unsurprisingly demand for these facilities was high. Even outside London, annual admissions could number in the thousands. Especially in the crowded and often unsanitary conditions of towns, conditions like epidemic fevers were rife.

But one medical institution stood apart – both literally and notionally – from the rest. In the 1770s, Dr John Sharp, Archdeacon of Northumberland, philanthropist, and member of a family which included a prominent surgeon and famous anti-slavery campaigner (Granville Sharp) was a trustee of a large charitable fund established by the late Nathaniel Lord Crewe. Crewe had set aside large amounts of money from land revenues, stipulating in his will that these were to be put to charitable use.

Image from Wikimedia Commons

One of the properties was the dilapidated medieval Leviathan of Bamburgh Castle. Undertaking a massive programme of restoration, Dr John Sharp adapted the castle to a variety of charitable uses, including a school, corn charity, home for shipwrecked sailors and the surgery/infirmary.

With his brother’s advice (a surgeon at St Bartholomew’s hospital in London), Sharp equipped Bamburgh with the very latest in medical technologies, including an ‘electrical machine’ for literally electrocuting patients back to health, a full stock of medicines and equipment, and other modern apparatus such as the ‘machine for the recovery of the apparently dead’ – used to try and revive the recently-drowned.

Last year I visited Bamburgh and made a short radio programme for BBC Radio 3, which is now available online.

Click on the link and then the ‘play’ icon in the new page to access the programme

For more about Bamburgh and its facilities, you can also click here for my ‘History Today’ article about Dr Sharp and his medical charity.

‘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.

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.

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’.

(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.

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!

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!.

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.

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!

Mad Dog (bites) and Englishmen: Early-modern remedies for Hydrophobia

If the sheer volume of manuscript space devoted to recipes for the bite of a ‘mad dog’ is to be believed, the pathways of early-modern Britain were dangerous places. Seemingly every bush or thicket contained a rabid hound just waiting for the opportunity to sink his teeth into the unwary traveller. Given the ubiquity of remedies, dog bites seem to have been an occupational hazard.

But hydrophobia – rabies – was a serious matter. A viral disease capable of being transmitted from animal to human, its symptoms were nasty. They began with headache, fever, muscular pain and a general sense of illness. As the disease progressed, however, the symptoms became more serious, and also more dramatic. Attacking the central nervous system the unfortunate victim suffered bouts of ‘uncontrolled excitement’ as well as involuntary movements, mania, depression and a fear of water…hydrophobia. Death was almost inevitable.

As in so many instances of early-modern treatments, however, the seeming inevitability of death did not prevent people from attempting to cure the disease – or at least to palliate the symptoms. A variety of substances and approaches were used – some based on established medical practice, others seemingly based on supposition – that all aimed to halt the progress of the disease and restore the sufferer to a state of balance.

Some took a straightforwardly herbal approach. This one, for example, is from a remedy collection dated 1781 and was made up of ‘simples’ – unadulterated herbs used ‘straight’ rather than mixed or decocted.

“A medicine for any one bit by a mad dog
Take a handful of the herb called Lady’s Bedstraw, bruise it in a mortar then roll up the leaves and juices with a lump of butter and make the party swallow it. It is reputed as an immediate cure for man or beast”

Another from around the same date used a variety of ingredients and a more complex mixing process. This example is interesting in a number of ways. Firstly it required metallic, as well as herbal, ingredients, and also included the foul-smelling resin ‘Venice Treacle’ – also known as Theriac, which itself contained 64 ingredients. Also of note is the 9-10 day duration of the cure, hinting at a recognition of the progressive nature of the disease.

For the biting of a mad dog
Take Garlick, rue, scraped pewter, of each two ounces of Venice Treakle, one ounce and quarter of Masgadin, put all these things into it & stop it close, boil it two hours in a kettle of water then par off the clearest away, and put a little dregs into the place bitten & give the patient two spoonefulls morning and evening, 9 or 10 days together.

A receipt in the recipe book of the Welsh gentry lady Catherine Nanney, dating to the early 18th century, advocated surgical intervention as well as herbal ingredients, but also included an element of symbolism. Here the issue of the fear of water, synonymous with the disease, in a procedure that would be familiar to phobia therapists today:

“A Receipt for the bite of a mad dog
The patient to loose ten ounces of Blood out of the Arm, to take of grey ground liverwort one Dram, of Black beaten pepper one Scruple in half a pint of cows milk every morning for Four day and to go into Cold Spring every morning for a month Togeth Dipping all over and staying in about four minute with the head above water, & then thrice a week for a Fortnight longe”

In other words, address the phobia head on. There were some, however, who perhaps took this to the extreme. One seventeenth-century ‘cure’ for hydrophobia advocated that the patient’s head should be held under water three or four times ‘for as long as ye party can bear it’. So, push a person scared of water under the water, and hold them there until they begin to splutter…I doubt Paul McKenna will be using that one in his next book!

So afraid of Rabies were people (and understandably so) that remedies even appeared in newspapers and were cut out and kept, or copied, by people in case they were needed. In a 1730 commonplace book of Michael Hughes of Anglesey is the note:

“An infallible cure of ye bite of a mad dog brought from Tonguin by Sir George Cobbs Bart…
Taken from ye Chester paper of ye 24th June 1760 by Michael Hughes then Plas y Brain”

The clergy even kept records in case their parishioners were struck down, and it is interesting that some of these remedies could become widely known. In the parish registers of a Monmouthshire church is a recipe for the bite of a mad dog which states that it was taken from Cathorp church in Lincolnshire where the “greatest part of the town were bit by a mad dog”.

Dog bites were a serious matter in the early modern period. People recognised the danger and were quick to act if they, or their families, were bitten. Keeping a recipe – sometimes several – in a domestic collection, learning remedies by rote or having access to them through others, was an important expedient should the worst happen. It was better to be prepared than not to have anything to fight back with.

Do you need a doctor? Applying for medical jobs in the eighteenth century

Filling in job application forms must rank as one of the world’s least rewarding pastimes…unless, of course, you get the job! There is the matter of displaying your own competence for the role, addressing your experience, evidence of your skills, ability to fit in with the recruiting organisation and, importantly, providing people who will attest to your obvious brilliance. It feels like a very modern thing to do. Whilst we increasingly acknowledge that people in the past could be ambitious, we don’t often get chance to actually glimpse the process in action – especially the further back you go. Some fantastic sources in Northumberland Archives, though, give us the chance to do just that. Better still, the aspiring job applicants were medical practitioners!

In 1774 a vacancy arose for the position of Surgeon-Apothecary at an infirmary in North East Britain. The infirmary was a charitable institution set up for the ‘relief of the sick and lame poor’, and was located in the magnificently austere Bamburgh Castle on the Northumbrian coast. The post had become available on the departure of the previous incumbent and, on the face of it, might not have seemed an ideal move. But something about this job appears to have resonated with the practitioner population of late eighteenth-century northern Britain. Perhaps it was the chance to work with the Reverend Dr John Sharp – administrator of the Lord Crewe Trust and the man who established the infirmary. Perhaps it was a genuine desire to do good for the poor people of rural Northumberland, who were far the nearest hospital in Newcastle. Or perhaps it was the lure of a decent salary and some authority within in institution, with their own staff to command! Whichever it was, news of the job appears to have spread fast, and letters poured in to Dr Sharp. Typical of the speculative applicants was Arthur Gair from Alnwick. Keeping his letter short and to the point, Gair nonetheless threw his hat firmly into the ring:

“25th June 1774. Reverend Sir, As I am informed the place of Surgeon-Apothecary for the Charity of Bambro’ Castle is now vacant, I beg leave to offer myself as a Candidate for the same & till I have the pleasure of paying my respects to you at the Castle which I intend to do on Monday next, I take this method to declare myself , reverend Sir, your most obedient and humble servant”.

(Image from the excellent Bamburgh Castle Research Project blog = http://bamburghresearchproject.wordpress.com/2012/12/07/an-18-century-bamburgh-castle-scandal/)

Others were less circumspect. Only three days later than Gair, the good Dr Sharp received the following letter from a Dr William Rennick. Unlike Gair, Rennick was not one to hide his light under a bushel.

“I beg leave to signify, that as there are rather too many physical practitioners in this place, I should be inclined to settle in Belford provided I could be favoured with the benefit, lately possessed by Mr Edmonton, at Bamborough – If you are willing to permit me to succeed him on satisfactory recommendation I should ever make it my study to merit your approbation of my conduct, and to display a grateful sense of the solicited obligation. I have been settled here as a Surgeon-Apothecary & man midwife near two years; my qualification in which professions, as well as the tenor of my moral conduct will, I flatter myself, bear the strictest enquiry. I am a native of Berwick & married. My attendance on some particular patients prevents my being able to wait on you in person.
I am with respectful esteem, Sir, your most humble servant”

Rennick’s was a slightly unusual pitch; pointing out that there was too much competition in his area was perhaps a risky pitch. But the rest of his letter is a work of polite (if slightly oily!) genius. Stressing that he would ‘ever make it my study’ to make his boss happy, it is possible to overdo it…and Rennick overdid it!

Some applicants were keen to provide character references. William Stoddart of Alnwick endorsed John Wilson’s application, stating Wilson was a “young man of sobriety and diligence in his profession. I would by no means have given you the trouble of this, but I could not tell how to deny him what I thought I might say with so much truth”. One William Green also tried his hand with a ‘celebrity’ referee – persuading a powerful local gentleman, Sir John Eden of County Durham, to write him a reference. “As there is a vacancy in the Castle of Bambrough” Eden wrote “I am desir’d to recommend to your notice Mr William Green”. That Eden was ‘desir’d’ to recommend Green suggests that his reference was not given entirely without coercion.

It is also interesting, however, just how far news spread. John Sharp’s brother Dr William Sharp was a prominent surgeon in St Bartholomew’s Hospital in London, and often advised his brother on medical matters relating to the infirmary. In September 1774, William was visited by a naval surgeon, originally from the Bambrough area, who had learned of the position and asked William to petition his brother on his behalf. Although William did not know the man personally, “appearances were in his favour”.
Ultimately all of these approaches, entreaties and salutations were in vain; the job was filled and the successful candidate was a Dr Trumbull, for a time, before the role was taken by the aptly-named ‘Mr Cockayne’!

The letters are fascinating though, as they add a further dimension to the process whereby practitioners actively sought new positions in the eighteenth century, and shed some light on the methods they used to bolster their chances. We don’t know how the post was advertised, if at all – there is some evidence that the infirmary used the Newcastle Courant from time to time to share news and progress – but it is clear that some sort of grapevine existed. Many of the applicants stress how they have ‘heard’ about the vacant position – another reminder of the power of early-modern social networks.

The next time you’re applying for a job, perhaps take a line from some of these medics. Will you try the ‘short and sweet’ approach of William Gair, or the florid prose of Mr Rennick?! In either case, may your applications be more successful than theirs!

17th-century remedies and the body as an experiment

I have long argued that, for people in the past, the body was a site of experiment. Today, we are constantly told that medicines should be handled with caution. In the accompanying (usually terrifying) leaflets included with most medicines, we are told in great detail how to use them, how not to use them and, most worryingly, the list of possible side-effects, which often seem to outweigh the benefits. One of the potential side-effects in my box of mild painkillers, for example, is a headache…the reason I usually head for the painkillers! But medicines, say the manufacturers, should only be used as directed by a medical professional. Care should be taken with the dosage, and they should not be used for more than a few days. If symptoms persist, head for the nearest A&E and don’t book any holidays!

Image from http//:www.theboredninja.com

We are a society who is certainly prepared to self-dose – something attested to by the shelves full of proprietary medicines in modern pharmacies. Indeed there is a broader issue of distrust with modern biomedicine, leading people to try out alternative and healers. The resurgence of medical herbalism in recent years, the popularity of herbal ‘magic bullets’ from Royal Jelly to Glucosamine and treatments from acupuncture to Yoga all attest to our willingness to consider alternatives.

But all of these ‘alternatives’ are controlled. When we buy over-the-counter remedies they are generally mild and, unless deliberately consumed in large quantities, not dangerous. They are also strongly regulated, and have to pass years of testing before they make it onto the shelves. Alternatives are now generally regulated, with professional practitioners, while herbal medicines from health food shops are also subject to increasing regulation and scrutiny. Alternative practitioners now have available qualifications and endorsements. All in all, while we certainly consider alternatives, we are doing so within a defined, controlled and measured environment.
Early-modern people, however, held a different view of both their bodies and the concept of how medicine worked. In their view, medicine was a process and one that required continual experimentation to find what worked and what didn’t. Even a cursory glance over an early-modern remedy collection confirms this. Some remedies are highlighted – sometimes by a pointing hand or a face, to signify their value. Sometimes words like ‘probatum’ (it is proved) attest to their efficacy, or even notes like ‘this cured me’ or, my favourite, the simple ‘this I like’. Others, however, were clearly unsuitable and might be crossed out many times with thick strokes, highlighting the dissatisfaction of the patient.

A page from Wellcome Library MS 71113, p.10. See article by Elaine Leong at http://recipes.hypotheses.org/tag/lady-anne-fanshawe

It is worth mentioning that the whole concept of ‘working’ has shifted over time. Today, a remedy ‘works’ if it makes us feel better. In the seventeenth century, however, a medicine ‘worked’ if it had an effect. Therefore if a purgative was taken as a measure against, say, a cold, then provided it made the subject purge it was regarded as having ‘worked’, regardless of whether the cold got better. In this sense medicine was experimental. People consistently adapted, modified and changed recipes, adding or replacing substances, until they found something they were happy with.

This process of experimentation was, though, potentially deadly. Use too much of the wrong type of herb, plant or substance, and the results could truly be dangerous. It is often forgotten that plants are full of chemicals. It is entirely easy to suffer an overdose using plant material as it is with modern tablets. The contents of early-modern remedies are often the butt of jokes. Using everything from animal matter, live or dead, to breast milk, spiders’ webs and so on is difficult to fathom from several centuries distance, even though it was perfectly logical to people at the time. In fact, little actual work has yet been done to assess exactly how much damage could potentially be done by people using things like animal or human dung in their efforts to make themselves better. It would be interesting to actually work out the levels of various compositions in some medical remedies, to gauge their potential for harm. This is not helped by the often vague doses provided in recipes. Whilst some directions might be fairly specific in terms of weight measurements, others might rely on including ‘as much as will lye on a sixpence’ or, worse, a handful. Depending on the size of the recipe-preparer’s hand, this could vary considerably!

But this experimentation also meant that virtually everyone was a scientist, involved in testing and measuring remedies against their own bodies. In some cases, though, the element of experiment was literal. Many elite gentlemen followed an interest in science, and especially chemistry, as part of their wider intellectual pursuits. In the early 1700s, the wealthy London lawyer John Meller, latterly of Erddig in Flintshire, kept a notebook entitled ‘My Own Physical Observations’ in which he recorded details of his chemical experiments, and sometimes upon himself! Some of his experiments, for example, appear to be related to finding substances to purge himself. On more than one occasion he seems to have gone too far and suffered the consequences. We can only imagine the circumstances which led him to record that one purge had “proved too hot” for him!
(image from education.gtj.org.uk

Our early-modern ancestors were arguably more in tune with their bodies than we are today. They continually sought new ways to relieve themselves of illnesses and symptoms, accumulating those that seemed to make things better and discarding the rest. Whilst we also do this to some degree, the stakes were much higher for them. We are protected to some degree by the various safeguards in place, and also perhaps by a reluctance to put our own health at risk.
Many early-modern remedies must, though, have been harmful and some might have resulted in permanent damage to internal organs, or even death.

Sickness and medicine are often referred to in military terms, with ‘magic bullet’ cures helping people to ‘battle’ their illnesses. In a sense though our forebears were engaged in single combat, each remedy, each experiment, carrying both high risk and high reward. Remember this the next time you reach for your packet of painkillers!

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

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

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

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

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

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

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

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

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

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

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

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

Polite Sickness: Illness narratives in 18th-century letters

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

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

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

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

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

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

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

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