Medicine on the Move: Early Modern Travel and Remedies

As my new project on the history of travel, health risk and preparation begins to get underway, one of the things that I am thinking about is the place of travel within early modern medical remedy culture. What kinds of conditions could befall travellers? What did early modern people think that the processes of travel, and different kinds of transport, could do to their bodies, and what types of remedies were available to deal with them. Research is still at a very early stage, but there are already some interesting hints that remedies were available to treat a variety of travel-related conditions. 

Before the broadening of travel in the 18^th century, many journeys were relatively short, and local. As a great deal of work has shown in recent years, the early modern population was surprisingly mobile. People travelled from parish to parish, and from rural to urban areas as they visited market towns to buy and sell goods. Perhaps the majority of journeys were taken on foot, on horseback or on a cart or, for those with means, in small carriages. By the later eighteenth century, post carriages were also available to private passengers.

William Hogarth, ‘The Stage Coach’ – Image from Wikimedia Commons

But travel of any kind was a risky business. Roads were proverbially poor, often deeply rutted in summer and reduced to a quagmire in winter, making journeys by foot, or by cart or carriage, uncomfortable at best. Falls from horses were common, leading to injury or death, and even a long time in the saddle could be painful. Travel by sea, even over relatively short distances, was fraught with danger, not only from the vagaries of the weather, but also the condition and seaworthiness of the vessel. Such was the discomfort caused by sea travel that sickness on the first journey by sea was regarded as almost inevitable, only abating once the body had become accustomed to the motion of the waves.  With all this in mind, then, what options for treatment could be found in early modern remedy culture?

Travelling of any kind was clearly seen as a tiring and enervating process, and something to which the body needed time to adjust to. Some hints of this process can be found in travel-related terms in dictionaries. The term ‘travel-tainted’ was used by Shakespeare in Henry IV, and was defined by Samuel Johnson as one who was ‘harrassed or fatigued with travel’. To be ‘unwayed’ was to be unused to travel, as opposed to a ‘wayfaring man’ who, according to John Kersey’s 1658 dictionary, was one ‘accustomed to travel in the roads’. The use of the word ‘accustomed’ suggests again a process of acclimatisation. The advice of the Sick Man’s Jewel in 1674 was that ‘such that are weary by travel or labour’ should chew tobacco in the evening, whilst Leonardo Fioravanti recommended the juice of Rose Solis to those ‘who are wearied with travell’.

A Weary Traveller, 1815 – Copyright Wellcome Images

Perhaps unsurprisingly, a variety of remedies can be found to treat sore feet. Robert Turner’s, Botanologia the Brittish physician, or, the nature and vertues of English plants advocated anointing feet with the herbs ‘ladies bedstraw or gallium’ before they undertook a journey. There was even a term for this: to ‘surbate’ was to ‘batter the feet with long travel’! Turner noted that the herb mugwort ‘is excellent good to bathe the surbated Feet of Footmen and Lackies in hot weather’, admirably giving some consideration to footsore servants.

For anyone suffering from pain and discomfort caused travelling by horseback, some potential relief could be found. Andrew Boorde’s 1587, The breuiarie of health contained a remedy for galling or chafing caused by ‘riding upon an evill horse in a naughtie saddle’. His suggestion was to ‘rub, anoint or grease the place aggrieved’ with a tallow candle…perhaps not a situation you would wish to walk in on! If the unfortunate chafed traveller possessed a pair of particularly large buttocks, Boorde suggested that rubbing between the cheeks with olive oil might be a useful expedient. 

It is harder to trace specific conditions relating to coach travel, but the health dangers of being squashed into a confined space, breathing in the noisome air and odours of fellow passengers, whilst simultaneously being joggled, bumped and bounced around for hours, was a well-known hazard – particularly into the eighteenth century. The term ‘coach sick’ appears occasionally and was regarded as occurring from the ‘swimmings in the head’ that could accompany violent motion. Some physicians advocated opening the windows to constantly refresh the air; others suggested opium!

Whilst sea travel was less common outside naval and commercial purposes, medical authors did offer some suggestions for the alleviation of sea sickness. In his 1667 Treasures of Physick, John Tanner viewed sea travel as one of the key ‘external’ causes of vomiting and advocated a range of treatments including laudanum, vegetable and herbal oils and syrups.  As John Moyle noted, in his 1684 Abstract of sea chirurgery, it was not uncommon for the abject misery of constant puking to be accompanied by the discomfort of constipation: he claimed to have ‘known some who in a whole week together have not gone to stool’. Moyle’s solution for those who were ‘sea sick and vomit much’ was a gentle purge or, failing that, a ‘clyster’, or enema.

‘Seasickness’ by G.S. Treagar – Image from Wikimedia Commons

As ever in the early modern medical marketplace, where there was demand there was likely a crafty quack chasing a fast shilling. Travel-related conditions were common amongst the efficacy puffs for proprietary pills and medicines. In 1670 the ‘English Pills for the Scurvy’ claimed to be extremely useful for sea travellers, standing them ‘in great stead in all Sea-sicknesses’, as well as ‘sickly Climates or Seasons; Calentures, Fevers, Fluxes, Poysons, Agues, Surfeits, and the like Scorbutick Diseases, which so commonly afflict such as go to Sea’. John Archer’s ‘Chymical Drops’ were of ‘great use to travellers’ in curing sickness, whilst ‘he that useth [John Headrich’s Traveller’s Salt] on the Sea Vomits not’. There are many more similar examples, and plenty more still to find. 

Health and medicine were, as they still are, then, central to travel. Even the few examples given here are revealing about the supposed effects that travel was seen to have on the body, along with the approaches taken to mitigate them. I am very much looking forward to delving more deeply into the medical history of the travelling body.  

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 – 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’.

(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.

(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.

(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.

‘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!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

He helped such as were grieved for three several considerations —

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

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

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

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

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

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

Eighteenth-Century fashionable diseases, and the dangers of crowded rooms.

“Fashion, like its companion luxury, may be considered as one of those excrescences which are attached to national improvement; Whilst one part of a polished nation is assiduously engaged in cultivating the arts and sciences, another part is not less busily employed in the invention and regulation of its fashions”.

So wrote James McKittrick Adair in 1790 at the beginning of his Essays on Fashionable Diseases. Adair was a medical luminary. According to the blurb at the start of his book he was variously a member of the Royal Medical Society, a Fellow of the Royal College of Physicians of Edinburgh, Physician to the Commander in Chief of the Leeward Islands and colonial troops, a judge on the Court of King’s Bench…the list went on.

As a physician to the wealthy Adair was in prime position to observe the types of conditions that afflicted his clients, but also the types of conditions that were becoming fashionable. The eighteenth century was perhaps the golden age of the ‘trendy’ disease. Where once sickness had been something feared and malign, some conditions were now becoming if not desirable then not unwelcome either. This was the age of the ‘heroic sufferer’; letters became filled with narratives of illness, commonly with the writer fashioning themselves into the role of embattled victim, wrestling with almost overwhelming symptoms and constantly surprised that they even had strength to hold a pen. These were the types of people who seemingly darkened the door of McKittrick Adair’s consulting rooms.

Of the evil influence of ‘fashion’, Adair was in no doubt. No longer was it just contained to dress, but influenced manners, politics, morals, religion and, worst of all in his view, even medicine was becoming enthralled to the “empire of fashion”. Whereas fashion had long influenced people in their choice of doctors, it was now influencing their choice of diseases too. This is how Adair explained the rise of fashionable diseases.

When doctor and patient were both persons of fashion, the patient would enquire of the doctor what condition their symptoms displayed. The doctor, not wishing to offend the polite patient’s ear with a lengthy medical discourse (or perhaps even not knowing!) gives the symptoms a general name – e.g. nervousness. As sickness and symptoms are a popular topic for discussion, the patient speaks to others and ascribes similarities where, Adair argued, none exist, but soon the condition becomes widespread…and fashionable!

In the early part of the eighteenth century “spleen, vapours or hyp was the fashionable disease”. Thirty years previously, a treatise on nervous diseases had been published by a professor of physic at Edinburgh. “Before this”, Adair argued, “people of fashion had not the least idea they had nerves”. At some stage an exasperated apothecary of his acquaintance, bowed under the weight of symptoms from a wealthy patron exclaimed “Madam, you are nervous!”. As Adair put it “the solution was quite satisfactory, the term became fashionable and spleen, vapours and hyp were forgotten”.  But the process didn’t end there…

The ‘faces’ of nervousness and biliousness. (Courtesy of Wellcome Images

“Some years after this, Dr Coe wrote a treatise on biliary concretions, which turned the tide of fashion: nerves and nervous diseases were kicked out of doors, and bilious became the fashionable term. How long it will stand its ground cannot be determined”.

In many ways Adair was forward looking, and questioned the role of his fellow practitioners and their ministrations. He was particularly frustrated by the old Galenic practices of bleeding and purging, which still clung on in the late eighteenth century. “The idea of bleeding and purging each spring and fall, to prevent fevers and other diseases, was formerly very general in this country”. This was due to the “ignorance and knavery” of rural medicators who, he argued, feathered their nests by “disciplining whole parishes” in this way.

Worse still, many patients who only suffered slight complaints were now given to violently purging themselves using an array of potent substances from magnesia, salts and rhubarb to James’s purging pills, which destroyed the very health that they were trying to preserve! Adair’s point was that people were simply overdoing it with medicines. Instead of the odd purge, potion or pill, people were taking them every day, ill or not, to the extent almost that the cure became the kill!

Adair had other words of warning for the fashionable, in terms of their continued attendance at packed society balls. In places like Bath, where Adair had his practice, fashionable functions were everywhere and life for the well-heeled was a constant round of parties, balls and visits. Danger, however, lurked in this lifestyle.

Just as blacksmiths, bakers and glassmakers were weakened by the excessive heat of their trades, he argued, so the cramped, airless fug of the ballroom was deeply injurious to the human body. Heat and fire could only hurt the delicate constitution so, once again, in their quest to be fashionable, the dandies and fops of Bath society were putting their health in danger.

Part of the problem was the noxious air that became trapped in crowded rooms. The smell of sweaty, unwashed bodies mixed with stale perfume, alcohol and coal smoke to produce a toxic miasma that threatened to overwhelm those delicate constitutions. The very atmosphere of Bath made the whole situation worse, surrounded by hills and therefore trapping the residual warmth and creating a cauldron-like atmosphere. The steam from the hot baths added to this, as did the fires caused by so many visitors in their lodging houses. Bath was the modern Babylon as far as McKittrick Adair was concerned.

His book is interesting as it sits right on the cusp of change. He was ‘modern’ enough to see the changes in medicine and disease, but still essentially rooted in ideas of the past, e.g. the concept of bad airs and heat. He wrote as a professional who criticised other professionals but still took the same position as did elite physicians of the 16^th and 17^th centuries, who complained constantly about quacks and empiricks.  Most of all Adair’s book fizzes with Enlightenment style and language, but also seems oddly familiar in tone. Even at 200 years distance, it feels like we could hold an interesting conversation with this man.  What stories would he be able to tell us about his clients?!

The English Priest’s Powder: A 17th-century quack doctor’s advertisement

The marketing strategies of 17^th and 18^th-century quack doctors are now familiar territory. As Roy Porter’s outstanding book Quacks did so well to bring alive, early modern Britain was a vibrant medical market, a panoply of colourful characters and dubious remedies. They were, to use Porter’s phrase, “a ragtag and bobtail army of quacks”.

Taking advantage of the newly-available cheap print, quack doctors produced reams of advertisements to peddle their wares. Ranging from brief, straight to the point details to more sophisticated means of selling, quack doctors were often skilled wordsmiths; in many ways they needed to do something to stand out from the crowd. With so many different medicines and vendors jockeying for position, they needed to be innovative. This might include elaborate descriptions of the virtues of their medicine. They often included testimonials from those who, they claimed, recovered through the use of their pill or potion. They might use imagery to embellish their advertisements. Occasionally, though, some particularly innovative strategies can be found. One of my favourite is the clever tool of selling without appearing to sell. One of the ways this was done was by disguising the advertisement in the form of a book. A case in point is the engagingly titled Riddles mervels and rarities: or, A new way of health, from an old man’s experience, published in 1698 by Thomas Mace.

Title page from ‘Riddles and Mervels’ – availble on EEBO (copyright)

At first glance this appears to be a typical ‘self-help’ book, a genre popular in the period. In his opening preamble, Mace sets out his philosophy that age and experience are better than any university-trained, licensed physician. Anticipating howls of derision from the faculty, Mace acknowledged that “I am no physician either by education, graduation, licence or practice’. And yet, he argued, a man like himself of 80 years knew his own body better than any young man of 20 or 30 who had merely spent 5 years reading books in a university. Compelling stuff!

The first hint that all might not be as it first seems occurs early on with the inclusion of the following:

“TO Prevent all Frauds, know, That This Rare Power, known by the Name of the English PRIEST’S-POWDER, is to be had No where but at These few Places Following, viz. By the Author (Tho|mas Mace) at his House in St. Peter’s Parish in Cam|bridge, near the Castle; And at Mr. Daniel Peachcy’s in St. Buttolphs Parish there: And in London, by Mr. Adam Mason at his House in Old Bedlam near Bishops|gate; And by Mr. William Pearson, Printer, at the third Door in Hare Court in Aldersgate-street near the Meet|ing House; And by Mr. John Vaughan, Milliner, at his House in Grivil-street near Hatton Garden; and by Mr. Will. Benson in the Old Baily”

Indeed, advertisements in ‘proper’ books were not unusual, but the alert reader will no doubt note the name of the creator and seller of the powder…one Thomas Mace – the man who claims to be no physician. Disguised within an ‘explication of the title page’, the sell goes on…

“Universall-Physical-Me|dicine, for all sorts of Constitutions, and all sorts of Maladies, Sicknesses, and Diseases, is a Chymical Prepar’d Powder which for some late years past I have Publish’d in the Name of the English PRIE                         T’S POWDER, and which it self is never to be Taken, either Inwardly (as Physick) nor Ap|plyed Outwardly to any Wound, Sore Scab, Bruise, Swelling, Pains, Aches, Head-Ach Rheumetick-Sore-Eyes, &c. All which, and many more, tis most Ad|mirably good for.) I say, it is never (it self) to be us’d or Apply’d (as Me|dicine) But (only) a lycture, which It sends forth, into some Certain Li|quors; into which it is to be Infus’d, for some certain Hours: And Those Li|quors, (Retaining its Virtue) are only to be us’d; And (as Physick) are to be taken, into the Body, in the way of Potion; […]ther for Vomit, Purge, Glister, or Sweat; But in the way of Chirurgery, are only Outwardly Applyed, by Washings or Bathings &c.

As the book progresses, it seems to revert to the ‘every man his own physician’ style. Mace assured the reader that his intentions were honourable and that he only wished to “Accommodate the Meaner sort of Men; but more especially the Poorest of all, who stand most in Need of Help and Comfort in their Sicknesses, seeing no Great and Skillfull-Physicians, will so much as look after Them, or scarce think of their Miseries; so that many Thousands live in Misery; Languish and Dye, for want of That which every ordinary House keeper might Easily Purchase, and not only have the Benefit of it for himself and his whole Family, during his Life, in all common Sicknesses, and Disea|ses, but might also be assisting to all his Poor Sick Neighbours round Him”

There follows a discourse on the Philosopher’s stone, including several pages of what can only be described as vernacular poetry. A short stanza should suffice:

MUch Talk has been of The Philosophers-Stone,
From Ages past; That by its livge alone,
‘Twould turn Inferiour Metals into Gold.
A Glorious Worder sure, if True; but Hold!
Where is’t? Who has’t? we no such Thing can see;
‘Tis surely Folded up in Mystery

There is even a page of music to allow the reader to literally sing the praises of the remedy!

EEBO (Copyright)

But the next sections of the book, although clothed in a discussion of the miraculous effects of the philosopher’s stone, are in fact a shining example of pure quack rhetoric. On first glance it seems that Mace is merely reporting the effects of the ‘philosopher’s stone’ on a range of conditions. But, looking more closely, his ‘priest’s powder’ has been cunningly woven into the narrative. A clue comes in the title to his first section – “The admired use of this powder (or stone)”…which one is more prominent?!

The real clincher comes in the “Eight eminent stories” of the power of the “powder (and stone)”.  Ranging from the dying man who could not sit upright but recovered almost as soon as he had taken the powder, to the cured leper, to the woman suffering from yellow jaundice, whose “foul, corrupt stomach” was poisoning her food, all were miraculously brought to recovery not only by the mysterious priest’s powder but by the personal intervention of the ubiquitous Thomas Mace…who, as he was no physician but knew his own body, clearly just happened to be passing!

This was selling by not selling. The reader, perhaps expecting a list of cures and remedies for all ailments, and lulled by the promise of being able to cure themselves of all maladies without the need for physicians, surgeons or apothecaries, was instead subject to stealth marketing. Mace provided everything about his powder, including where to buy it and how to use it, but disguised it in a discussion of the ‘Philosopher’s stone’ to try and locate his ‘Riddles and Mervels’ as a scientific discourse. Clearly this was an advertisement, but it shows the innovation of medical retailers, and the lengths to which they went to sell their goods. Little is known about Mace. By his own admission he was an old man, but was he someone with a genuine concern for his fellow man, or just another medical entrepreneur, out to make a fast buck. You decide.