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!

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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.

 

 

 

Robbing the Doctor: 17th-Century Medics as Victims of Crime

During the sixteenth and seventeenth centuries, a common complaint against medical practitioners was that they effectively picked the pockets of the sick, whilst doing little for them in return. As the Helmontian physician George Starkey remarked in the middle of the seventeenth century, the patient was “like to pay the price of the doctor fully with his life” – which Starkey regarded as a brave acte’!

But medics, just like anyone else, could sometimes be victims of crime. The records of the Old Bailey contain a fascinating list of these unfortunate practitioners, and the list of crimes and calumnies they suffered. More than this, however, they can offer an alternative glimpse into the world of early modern medical practice.

Old Bailey in the 19th century

(Old Bailey in the 19th century – image from Wikimedia Commons)

Sometimes, for example, physicians and other practitioners found themselves the victims of petty crime. In 1686, Edward Newgent of St Clement Danes pinched the periwig of an unnamed ‘Doctor of Physick’. The good doctor testified that he had been walking along the street in the evening, when the assailant whipped off his hat and wig, and pelted away down the street with them. The doctor gave chase and had the thief arrested. For this seemingly innocuous crime, the unlucky Newgent was sentenced to death!

Another victim of circumstance was Richard Allen of Holborn. In 1675, hearing a disturbance in the street, Allen, ‘by profession a Sea-Chirurgeon’, opened his door and was attacked by a mob (including bayliffs on the hunt for a person to serve a writ). Allen, was set upon by the men, ‘they hacking and hewing him without any mercy, that they left him dead upon the place’. So ‘mortal and dangerous’ were his wounds, that a ‘good part of his skull was taken clean off’.

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(Image from Wikimedia Commons)

At other times, the medicines or very tools of their trade might be targets for thieves. Surgeons, and their instruments, seem to have been a particular target. Instruments, especially high end examples, could be expensive and decorous, and were therefore worth taking. Consider the case of William Marriott, surgeon, whose house was broken into in October 1693 by the terrible trio of Batson, Dando and Bedford, ‘about 3 o’clock in the morning in a rude manner’. Swearing ‘great oaths’ and ‘offering to send his Soul to Hell’ they relieved him of £42 in cash, a gold locket and ‘a pair of forceps val. 4s, and other surgeons instruments besides’. All were acquitted.

March 1679 saw a “mischievous youth” slip into a barber-surgeon’s shop and observing that the barber was in another room, he made off with a “case of instruments, most of them tipt with Silver”. Crime didn’t pay for the errant youth; he was burnt in the hand for his trouble. A trio of thieves also relieved a London practitioner Peter Hillery of a “case of Chirurgeon’s Instruments” along with his sword. Hillery testified that he was “drinking in a Brandy shop” with one of the thieves, when he found the items missing. Quite why he felt the need to take his instruments to the pub with him is, unfortunately, not recorded.

Highway Robbery

(Image from Lewis Walpole Library)

Accosted by the highway robber, Daniel White, one John Delaphont was forced to stand and deliver ‘two boxes of surgical instruments, together with his hat, coat and shirt!

As well as the crimes themselves, some cases offer us a view into the world of what might be termed ‘irregular’ or ‘unorthodox’ practice. The descriptions of individuals are sometimes telling. In October 1679, for example, “several Bottels of a medicine called Elixar Vite” (otherwise known as ‘elixir vitae’ – a strong distilled water) were stolen from “a very ancient Itallian Gentel Man who has long professed Physick in this Kingdom”. The Italian was Salvator Winter, one of a string of European itinerant practitioners, who toured Britain in the mid seventeenth century, peddling their wares. In other sources, Winter was described as a ‘medical licentiate’, and signed letters testimonial to the skill of other practitioners. The servant of the unfortunate Winter was indicted, but later acquitted.

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(Image from Wikimedia Commons)

Another ‘unorthodox’ practitioner named Blagrave – “a pretender to physick” was relieved of a “Gold chain, a Medal, divers pieces of plate, several rich Cloaths, some Money &c”. The richness of the pickings from Blagrave highlights what a lucrative profession the practice of medicine could potentially be. To possess this level of goods suggested a man of means.

It wasn’t all one-way traffic however. As the records sometimes tell, medical practitioners could sometimes be tempted away from the path of righteousness. The exotically-named Toussaint Felix Urvoy was indicted of the heinous crime of stealing three china dishes in 1760. The case was complicated since Urvoy was owed money by the complainant, and claimed the dishes had been lent to him. Another witness described him as ‘a quack doctor’ who had befriended him in a public house (a pattern seems to be emerging here!) and said he ‘had some particular nostrums by which he could cure several disorders’.

Consider, though, the cautionary tale of the surgeon Stephen Wright, born to a wealthy Irish family, given a good education, versed in arithmetic and classics and sent to Dublin to be apprenticed to a prominent Irish surgeon. All was going well until…

“Unhappily for Stephen he chose to go by the Way of London, and to acquaint himself a little with England, the Place of his Nativity, whence his Forefathers came; tho’, as he said, his Father had a pretty good Estate, besides a handsome Sum of Money in Ireland, to which he was Heir, but by his desperate Misbehaviour, he has effectually prevented his inheriting either one or the other. For some Time after his coming to England, he served a Surgeon in the Country in Surrey, and might have done well, had he kept to his Business and been industrious, as he had good Education, and seemed capable of his Profession. His Friends had advanced to him 180 l. to bear his Expences at the Colleges in Paris. But he not content with that, resolved to improve this Sum, tho’ the Project he fell upon was wrong and foolish, and had no Success answerable to his Desire. In Effect he went to a Gaming-House in Covent-Garden, where in two or three Days, or at most a few Days, he lost the 180 l. designed to bear the Expence of his Travels, and then having no Money left, and not knowing what to do, but being destitute of the Grace of God, he resolved upon desperate Courses of Robbing.”

Given that so much focus is often upon the occupational lives of medical practitioners, it is interesting to see glimpses of their world through another lens. Lists of stolen items, for example, can be extremely useful in gauging what sorts of equipment physicians and surgeons owned, and where they took them. The terms by which medics were referred to and known is also revealing, not least in the colourful characters who sometimes inhabited the margins of medicine. The reason that I particularly like these records, though, is that they offer an intimate insight into the daily lives, frailties and misfortunes of a group of individuals, showing us a side of their lives not often reflected in the usual records of their medical occupation.

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
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
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.

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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.

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.

The Great Georgian Snuff Debate

We’re used to debates about tobacco. In any given week it’s a fair bet that smoking/cigarettes/e-cigarettes will be food for editorial thought. What the UK’s Guardian recently called a ‘global epidemic of tobacco’ is, according to their statistics, a bigger killer than Malaria, TB and AIDS…combined. Recent scare stories have surrounded e-cigarettes, prompting tabloids to ruminate over the question of whether they might even act as baby steps to full-strength cigs. The central problem with tobacco is its undoubted potential to kill. We think of this as a modern debate about a modern affectation. But, in fact, debates about the healthiness of tobacco have raged for centuries. Three hundred years ago, snuff was at the centre of the storm.

One of the most quintessential emblems of the eighteenth century dandy or fop is the snuffbox. By the mid eighteenth century the practice was ubiquitous…and not to everyone’s taste. In 1754 a disgruntled reader known only as ‘T’ wrote to the editors of the Connoisseur magazine, complaining about the practice.

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“Dear Sir, I know not if you yourself are addicted to a filthy practice frequent amongst all ranks of people. The practice I mean is that of snuff-taking…[everyone] appears obliged to cram his nostrils with a quantity of scented dirt to fence them from the disagreeable effluvias of the rest of the company…

It is indeed impossible to go into any large company without being disturbed by this abominable practice. The church and the whole playhouse continually echo with this musick of the nose, and in every corner you may hear them in concert, snuffling, sneezing, hawking and grunting like a drove of hogs’.

To illustrate his point further, ‘T’ claimed to have witnessed ‘a whole congregation suddenly raised from their knees in the middle of a prayer by the violent coughing of an old lady, who has been almost choaked by a pinch of snuff in giving vent to an ejaculation’! Any lady who succumbed to this vile practice was, in their view, no better than a serving wench. Why, then, was snuff so apparently popular?

Snuff first came to Europe in the 16th century and was first advocated as a medicinal product, being used to treat headaches and other conditions. Snuff was manufactured from cured and Tobacco leaves were slowly cured and fermented, and certain ‘flavours’ could be added. Snuff quickly found favour amongst wealthy elites, with prominent advocates including Queens, Popes, nobility and prominent society figures. By the eighteenth century everyone from George IV to Samuel Johnson were hawking vast quantities of powdered tobacco up their nostrils.

Snuff takers

Advertisments promoted special types of snuff. The ‘Golden Snuff’ advertised in the Daily Courant in 1704 counted headache, drowsiness, dullness of hearing and humours in the eye amongst the list of afflictions readily cured. Also of use in ‘Gouty and Rhewmatick paines and for asswaging swellings’, its manufacturers also claimed that ‘it never decays’.Medical authors were divided on the subject. Thomas Apperley’s Observations in Physick considered the potential benefits of a small pinch of snuff against certain conditions, but was cautious of the effects in ‘one not accustomed to it’. In a 1790 Account of Several Excellent and Genuine Patent and Public Medicines a writer known as ‘Castor’ extolled the virtues of the ‘Cephalic Snuff’ in treating ‘hysteric and paralytic complaints’ as well as the ‘Complaints of the Head that Painters &c are subject to’!

Others were far less than convinced. In his 1799 Essay on Regimen James McKittrick Adair railed against the practice of snuff taking, since ‘encrusted snuff impedes the breathing’ while ‘acrid, poisonous oil’ produced by nasal mucous could be highly injurious to the stomach. Adair suggested that the ‘use of tobacco in any form is a vile practice’ and that sniffers of snuff should cleanse their nostrils and wash their mouths with warm water. Dr Allen’s Synopsis of Medicine from 1730 condemned the ‘inordinate use of snuff’ for apoplexy and others cautioned people to beware of the damage that ingesting snuff could cause.

In 1720 an anonymous Dissertation on the Use and Abuse of Tobacco in relation to the Smoaking, Chewing and Taking of Snuff, and was ‘humbly subscrib’d to the Ladies and Gentlemen who use it in the Above ways’. In 1760 Edward Baynard wrote a whole book of poetry about snuff, titled Health: to which are added cautions agains the immoderate use of snuff, devoting 36 densely written pages to his task. Snuff was under attack.

Part of the problem for naysayers of snuff was its popularity. Snuff had become a social ritual, and one popular at all levels of society. Taking a pinch had become embedded in popular culture, and with it came a secondary market in snuff paraphernalia. Snuff boxes, for example, became increasingly elaborate and ornate. As such they were high up the list of desirable items for pickpockets. In 1688 one Claudius Bertin was relieved of a gilt ‘Princes Mettle snuff box’ valued at thirty shillings. Two snuff boxes stolen from the house of the wealthy Don Diego Capyllar in September 1692 were valued at over £5 alone – then a princely sum.

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Jewellers and makers made a wide variety of boxes in precious metals and bedight with jewels and ornamentation. In 1765 a Mr Burnsall of London begged leave to keen to acquaint the public of the wide range of goods, including ‘Agate snuff boxes richly set in gold’ that he had for sale in his London shop.

Fans of the product even took to the newspapers to defend their favourite ‘tipple’. A poem found inside an 18th-century recipe collection provided, taken from the Chester newspaper of 1761, proselytized about the power of snuff to lighten the day and preserve the health. The first three verses should be enough to give a flavour:

‘Six reasons for taking a pinch of snuff
When strong perfumes and noisome scents
The suffering nose invade
Snuff, best of Indian weeds presents
Its salutary aid

When vapours swim before ye eyes
And cloud the Dizzy breath
Snuff, to dispel the might applies
Its quick enlivening grain

When pensively we sit or walk
Each social friend away
Snuff best supplies the want of talk
And cheers the lonely day’.

Woman taking snuff

Snuff-taking continued unabated into the nineteenth century; ‘celebrity’ snuffers included Benjamin Disraeli, but the practice gradually declined as it became increasingly viewed as an antiquated relic of the past. Whilst it is still possible to buy snuff today, it is unlikely, given its many nasty side effects including mouth and throat cancer. Unless someone bothers to invent ‘e-snuff’, which seems equally unlikely, then it seems best to consign it to history. Nonetheless, it does provide us with a useful means to look at how people dealt with addictions, and in particular tobacco use, in the past.

‘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!