The Health Risks of Travel in Early-Modern Britain

As I start to make some progress on my new research project on travel, health and risk I am turning my attention to the sorts of things that early modern travellers were fearful of. As a bit of a nervous traveller myself, it’s quite comforting to know that there is actually a long history of travel-related anxiety.

From the early modern period, domestic and international travel were beginning to increase due to many factors including commercial expansion and the Atlantic economy, religion and mission work, military and diplomacy, as well as technological developments and the growth of travel infrastructure. For the first time in history, large numbers of travellers were beginning to explore both their own countries and wider world, encountering new countries, environments, and peoples.

Unlike today, when it’s entirely possible to have breakfast in London, lunch in Milan and be back at home in time for supper, travel in the early modern period was no easy undertaking. More than this, it was widely acknowledged to be inherently dangerous. What, then, were the perceived risks? Even a brief survey tells us a lot about how travel was regarded in health terms.

(Image from Wikimedia Commons)

First was the risk of accident or death on the journey. In the seventeenth century even relatively short distances on horseback or in a carriage carried dangers. Falls from horses were common, causing injury or even death. As Roy Porter noted, when the wife of Justinian Paget was thrown from her horse in October 1638,  it was said to be the ‘cause of all her future sickness’. In Monmouthshire in 1657, one Francis Bradford was killed as his horse bolted, throwing him over its neck with his feet caught in the stirrups. ‘His wyfe was with hym and she presentlie alighted from her horse and cryed for helpe’. Many drownings occurred as people tried to cross rivers on horseback and fell in or were swept away. 

JMW Turner ‘The Shipwreck’ – Image from Wikimedia Commons

Travel by sea, even around local coasts, carried its own obvious risks of storm and wreck. So common and widely acknowledged were the vagaries of sea travel that a common reason for making a will in the early modern period was just before embarking on a voyage. The language used in these formulations is telling. In 1638, Edward Harthorpe, Richard Veesey, Michael March and Thomas Huckleton, ‘with divers others’, made their will, ‘being bound to take a voyage to Canady (sic) in America, w(hi)ch being a daingerous voyage, and they putting theire lives to hazard therein, did consider their mortalitie’.

This was a common theme, and the prospect of the impending journey, and the not-unreasonable assumption that they might not return, led many to consider putting their affairs in order. This anxiety was neatly articulated by Thomas Youngs in 1663, ‘Being bound upon a voyage to sea, and calling to remembrance the uncertain state of this transitory life, and that all fleshe must yielde undo death…’. One intent on the journey, travellers wanted to be prepared in body and soul.

Image from Wikimedia Commons

Once abroad, too travellers were at the mercy of a bevy of dangers, from unfamiliar territories and extreme landscapes to harsh weather and climate, their safety contingent on the quality of their transport and the reliability of their guides. In 1793 Useful Instructions for Travellers contained chapters advising travellers as to how to deal with the many and various dangers to life and health that they might face. These included the necessity to frequently open carriage windows to refresh the air, the need to take a small medicine chest to attend to wounds (including falls from horseback), and various preparations to treat the haemorrhoids that often accompanied long periods in a sitting position.

Knowledge of the conditions, climates and environments of intended destinations was also key. Ideally, a traveller should be able to ‘cure himself of some distempers’, be wary of the change of air and the hazards of the journey, and to take their own store of medicines in case they were hard to procure once abroad.

But some even considered the whole process of travel itself to be potentially harmful to the body. Even in the sixteenth century, ‘The Hospitall for the Diseased, wherein are to bee founde moste excellent and approued medicines’ included a list of things considered bad for the heart. As well as what the author viewed as deadly vegetables such as beans, peas and leeks, further heart problems might be caused by ‘too much travell’, or even ‘drink[ing] cold water after travell’. Similarly, in a section about things that are ‘ill for the brain, A.T.’s 1596 A.T., A rich store-house or treasury for the diseased  noted “Overmuch heate in Trauaylinge”.

Scurvy was another condition firmly linked to travel. In 1609, Petrus Pomarius’, Enchiridion medicum viewed scurvy as an occupational hazard for ‘those that trauell by sea, by long voyages; and our fishers that travel to the Newfound-lands’. As well as the perils of the long journey, the problems could arise due to the ‘stincking waters, & especially in an hot aire’ that travellers were exposed to. Climate – and particularly heat – was considered risky. In the 1793 Etmullerus abridg’d: or, a compleat system of the theory and practice of physic, Michael Etmuller stated that travelling in a hot climate could cause wakefulness and perturbation of the mind.

Even ‘foreign’ food and drink could be risky. Thomas Tryon’s Miscellania (1696) noted the dangers of ‘intemperance’ and of misjudging the effects of climate upon the body in regard to drinking alchohol. According to Tryon, many English travellers were ‘much Distemper’d, and many die when they Travel into the West and East Indies, because they take wrong measures, continuing the same disorder and intemperance as they did in their own Country’.

Travel, then, was a risky business, and one that individuals would not have undertaken lightly. There were a range of factors to consider, from basic risks of life and death to the dangers of particular conditions and climates, food and illness. 

Fowl Medicine: The early modern ‘pigeon cure’

In October 1663 news spread around London that Queen Catherine was gravely ill. Fussed over by a gaggle of physicians and priests, things got so bad that Her Majesty was even given extreme unction in the expectation that she might not pull through. In an effort to turn things around, as Samuel Pepys noted in his diary on the 19^th October, “pigeons were put to her feet”. In another diary entry in 1667, Pepys recorded visiting the dying husband of Kate Joyce who was in his sick bed, his breath rattling in his throat. Despairing (for good reason) for his life his family “did lay pigeons to his feet while I was in the house”.

(Image from Wikipedia)

Pigeons? Laid to the feet? Was Pepys mistaken, or was there a misunderstanding of his complicated shorthand? Actually, pigeons were a surprisingly common ‘ingredient’ in medicine and were even recommended for various conditions in the official pharmacopoeia (catalogue) of sanctioned remedies. But what were they used for, and how?

Remedies for the treatment of the plague certainly called for the use of pigeons. No less a publication than the London Pharmocopoeia issued by the College of Physicians in 1618, contained a remedy for the plague which involved pulling off the feathers of living pigeons, holding their bills shut and holding the bare patch to the plague sore “until they die and by this means draw out the poison”.

William Kemp’s 1665 ‘Brief Treatise of the Nature and Cure of the Pestilence’ noted that some writers advised cutting a pigeon open, and applying it (still hot) to the spine of a person afflicted with melancholy, or to a person of weak intellect. The English Huswife of 1615 advised those infected with the plague to try applying hot bricks to the feet and, if this didn’t work, “a live pidgeon cut in two parts”. Even the by-products of pigeons could come in useful. Physicians treating the ailing Charles II applied a plaster to his feet containing pigeon dung.

(Image from Wikimedia Commons)

Several sources suggest that the ‘pigeon cure’ was often a remedy of last resort. Writing of the last illness of her father in 1707 (dying of a “broken heart, which the physicians called a feaver”, Alice Thornton reported that, just before his death, pigeons were cut and laid to the soles of his feet. Seeing this her father smiled and said “Are you come to the last remedy? But I shall prevent your skill”. The diarist John Evelyn, in the ‘Life of Mrs Godolphin’ noted that ‘Neither the cupping, nor the pidgeons, those last of remedyes [my emphasis], wrought any effect’.

The ‘cure’ was evidently so popular that it made its way into popular culture, such as in Webster’s ‘Duchess of Malfi’. Speaking to the ‘Old Lady’, the character Bosola says that he would “sooner eate a dead pidgeon, taken from the soles of the feete of one sicke of the plague, than kiss one of you fasting”.

What were the perceived medical benefits of the pigeon and its various products? Some prominent physicians had plenty to say on the matter. William Salmon’s Pharmacopoeia Londonensis, Or the New London Dispensatory in 1716, (p. 200) held that “cut in the middle and laid to the feet, [pigeons] abate the heat of burning fevers, though malignant, and so laid to the Head, takes away Headaches, Frenzy, Melancholy and Madness. On the matter of pigeon dung, Dr Alleyne’s Dispensatory of 1733 stated that “we may judge of the nature of this [dung] from that of the birds…consists of subtle hot parts, which open the pores where it is applied, and by rarifying and expanding them, occasion a greater flux of fluid that way”. In other words the hot dung caused the body to open its pores and expel the bad humours causing the illness.

Saint Gregory (and a pigeon!) – image from Wikimedia Commons

The particular significance of the pigeon is interesting too. One hint is given by the apparently strong connections in folklore between the pigeon and death, ranging from the belief that pigeons flying near a person – or indeed landing on their chimney – were supposed to indicate approaching death, to the “common superstition” (recorded in 1890) that no one can die happy on a bed of pigeon’s feathers. The symbolic power of the pigeon may therefore have been applied in reverse. Killing the bird perhaps imparted its vital power onto the dying person. Beliefs in the power of ‘anima’ – the vital life spirit – being able to be transferred from animals to humans were common in the early modern period.

If some of this seems like it belongs firmly to the 17^th century, it is worth mentioning that the ‘pigeon cure’ was still apparently in use in Europe in the 20^th century. A fleeting and poignant reference in Notes and Queries refers to a woman in Deptford in 1900, who unsuccessfully attempted to use the cure on her infant son when the medical attendant pronounced that there was no hope for him. He died shortly afterwards of pneumonia.

An article in the Pall Mall Gazette in 1900, though, reported that a Paris physician was casually told by one of his patients that she had “tried the pigeon cure for meningitis”, with some success. The physician, one Dr Legue, expressed his ignorance of the cure, and the patient described it to him.

“The head of the patient to be treated is shaved, and then the breast of the (freshly-killed) pigeon is ripped open by the operator, and the warm and bleeding carcass immediately applied to the bared skull”.

More than this, Dr Legue apparently discovered a shop in the city’s Central Market, where a Madame Michel ran a shop selling nothing but live pigeons, specifically for the purpose of the cure. On interviewing Madam Michel, the good doctor ascertained that she was on the point of retirement after making a “small fortune” from her business, since “the pigeon cure is considered a sovereign remedy for Influenza”, and she had been struggling to keep up with demand. The term ‘sovereign remedy’ takes us straight back to the 17^th century but, before the article finished, Madam Michel mentioned one last use for the pigeons. In the case of Typhoid fever, she suggested, two pigeons were necessary. And they should be tied to the soles of the feet.

(Wikimedia Commons)

As uncomfortable as they might sometimes appear to our eyes, early modern medicine involved all manner of plants, animals and substances, alive or dead. Rather than viewing them as ‘weird’, people at the time saw them as valuable ingredients, often with special properties, which they could use to help them in the fight against disease.

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

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

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

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

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

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

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

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

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

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

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

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

Image from Wikipedia – creative commons

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

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

And this week’s number 1…

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

17th-century remedies and the body as an experiment

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

Image from http//:www.theboredninja.com

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

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

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

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

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

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

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

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

The early modern remedy that should have been!

Just a little light relief to stave off the joint miseries of man flu and a rainy day.

What is a ‘remedy collection’?: Recording medical information in the 17th century

What exactly is a ‘recipe collection’? The most obvious answer is something like the example shown below, a formal ‘receptaria’ book of medical receipts and remedies. In the early modern period, and across Europe, these types of collections were fairly common, and especially in wealthier households. These were often carefully constructed documents, containing indices and sometimes containing groups of remedies according to various types of remedy, or parts of the body. In many ways these were the high-end of domestic medicine.

But were such formal collections necessarily representative? In other words, did everyone (or at least everyone capable of writing remedies down) collect their medical information this way? No. As a great deal of recent work by historians including Elaine Leong, Sara Pennell and Michelle DiMeo, Anne Stobart, Lisa Smith, Sally Osborn and others is revealing, the committal of recipes to paper was often a complex process.  (See also the fantastic recipes.hypotheses blog  and Twitter feed @historecipes)

For a start, paper was an expensive commodity in the early modern period. It could often be bought easily enough; apothecaries often sold reams or ells of paper, as did other retailers from merchants to haberdashers. But it was nonetheless quite costly. Unlike today, where scribble pads and notebooks can be bought for pennies, the buying of paper, or a bound book of notepaper, would have been something out of the ordinary, especially for those on low incomes.

The recording of remedies was an expedient and often pragmatic process.  Remedies usually spread firstly by word of mouth, with people passing on their favourite receipts to friends, neighbours and acquaintances. As Adam Fox’s work on early modern oral culture has shown (Oral and Literate Culture in England, 1500-1700 (Oxford: Clarendon, 2000)) people had a strong ability to commit information to memory, and this made sense at a time when the majority of the population couldn’t read or write. Nevertheless, for those wishing to record the remedy accurately for future use, there was a need to do so quickly, and often using whatever was to hand.

As such, many ‘remedy collections’ are little more than assemblages of roughly scribbled notes, sometimes on torn bits of paper, sometimes on the back of unrelated documents, and sometimes even including a variety of other information on the same page. In fact, the very survival of many remedies is probably attributable to the fact that they have been incorporated into other, non-medical, documents.

Nevertheless, the recording of remedies in certain types of document was often a more deliberate decision. In Wales, for example, there were several instances of medical remedies being written on notepaper purloined from a church. In one sense this was pragmatic and reflected the simple availability (and probably abundance) of paper, given the needs of the church to keep records. But some were written inside church documents. In parish registers, for example, it was not uncommon to find receipts. A common example was that of a ‘receipt for the biteinge of a mad dogge”, often originally attributed to the register of Cathorp Church in Lincolnshire, but which seemed to move around the country. An example of the remedy, occurring in the Monmouthshire church of Llantillio Pertholey, can be seen here: http://www.peoplescollectionwales.co.uk/Item/7637-a-recipe-to-cure-the-bite-of-a-mad-dog-llanti

In another sense, though, putting remedies in amongst religious verses, as often occurred in commonplace books and notebooks, was a way of allying the remedy to the power of religion. If it was next to God’s word on paper, perhaps it would have more power?

Above all, for the remedy to be of any use, it had to be easy to find when needed. Some, for example, kept remedies within the pages of their business ledgers. Here, the regimented layout perhaps suited ease of future reference. But perhaps most common was to keep remedies within the pages of personal sources. Many diarists noted down examples of favoured remedies, especially when they had suffered from an ailment and attributed their recovery to the taking of a particular remedy.

Commonplace books, notebooks and copy books were also common places for the jotting down of useful information, and could be easily referred to if needed. It was not uncommon to put remedies within pages of miscellany, including accounts, quotes, poetry and family records, locating it firmly within the context of ‘useful’ information. Many literate families also kept letters. Health was a regular topic of conversation amongst letter writers, and it was common to fire off a few missives seeking potential remedies from within one’s social network. When a reply duly came, here was a ready-made receipt that could be kept without needing to write it down again. Prescriptions and directions from practitioners might be especially prized as they represented a virtual consultation, specially tailored to the recipient’s humoral constitution.

One often-overlooked method, however, were medical almanacs. It’s worth looking at a typical example of how these sources could be used. Cardiff Public Library MS 1.475 is a small memoranda book dating to around 1708, and seemingly originating from London, with the names John and Elizabeth Price prominent. A little list of family notes inside the front cover reveal a touching and tragic tale.

“February 10^th 1708/9

Married then to the pretty, the charming Mrs Elizabeth Price by the Rev’d Dr Typing of Camberwell.

My daughter Anne was born the 17 of April 1712 about twenty min(utes) after eight in the morning and baptised the 1. of May

She was a very beautifull, lovely child but God was pleased to take it May 3. 1712”

Much of the document, however, is actually drawn on the reverse side of copies of almanacks. These were part-astrological, part-magical and part-news documents which contained everything from prognostications and predictions to religious dates, weather information and medicine. The first almanac in this document is ‘Merlinus Liberatus, being an alamanack for the year of our Blessed Saviour’s Incarnation, 1708…by John Partridge, student in Physick and Astrology at the Blue Ball in Salisbury Street in the Strand, London”. Partridge was clearly an entrepreneur; the very next page of his almanck is dedicated to ‘Partridges Purging Pills, useful in all cases where purging is required”!

A second almanac pasted into the book is “The Country Physician; or a choice collection of physic fitted for vulgar use: Containing 1) a collection of choice medicaments of all kinds, Galenical and Chymical, excerpted out of the most approved authors 2) Historical observations of famous cures collected out of the works of several modern Physicians 3) A Cabinet of specific, select and practical chymical preparations in two parts, made use of by the Author, by W. Salmon M.D”

This sort of document was a cheap means of buying a ready-made remedy collection, complete with the latest thinking and couched in terms of the layman. There were many self-help volumes of family physick available, but these cheaper almanac and chapbook style documents were easier to read and easier to keep. It is also clear that the spaces on the back of pages were useful places to note down other remedies as they accrued.

For example, the Prices noted down a number of receipts on the back pages, including a receipt “To prevent a return of the ague”, another for the “dead palsy”, including mistletoe, oak and saffron, and another for “flushings in the face”.  Here, then, the printed and the written remedy intertwined to become a completely distinct and individual family collection. In many ways this was as formal a collection as a ‘receptaria’, and probably included many of the same sorts of remedies, but in a different form.

The recording of remedies, and the idea of a ‘remedy collection’, therefore, shouldn’t necessarily be limited to a single, formalised and regimented document. These were organic documents, sometimes constructed carefully, but often just growing as collections of rough notes. Remedies might be deliberately placed within documents, or they might be the result of a roughly-scribbled note. Equally, people might keep ready printed or written remedies, and simply add their own notes as required. In this sense, there is no single ‘remedy collection’ document; instead, there are a myriad different ways in which people collected remedies.

Seeing History: The rise of spectacles in early modern Britain.

The percentage of people in the UK requiring either spectacles or contact lenses has risen over successive decades. It is difficult to put exact figures on this; some estimates suggest that over 68% of the population in Britain currently wear glasses or lenses, and this varies dramatically within age groups. Around 29% of 16-18 year olds require some sort of visual aid; a 2005 report put the figure for the age group 65 and above as high as 98%. It seems that spectacles today have largely shed their pejorative connotations and even become desirable, helped by many high-profile celebrity spec-wearers. Indeed, opticians have even reported a growth in sales of spectacles with blank lenses over recent years, to cater for those who see glasses as a fashion item. This apparent love affair with spectacles is not consistent, however.

A prosthetic eye, possible 17th century.

Until the seventeenth century, eye complaints were troublesome and painful, and effectively seen as a form of disability. The virtual plague of ophthalmic conditions in early modern Britain is attested to by the ubiquity of remedies for eye complaints in remedy collections. Common were remedies for sore eyes, which were often treated (in line with the ‘doctrine of sympathies’) by using substances of a similar constitution to the eye. Remedies using snails were popular; one common example was to impale a garden snail on a pin and let the juice run into the eye. Another recommended using fresh goose dung, its gelatinous consistency resembling the watery eye. Yet another suggested the blowing of dried hen’s dung into the afflicted party’s eye just before they went to sleep. For more on the uses of animal substances in remedies, see Lisa Smith’s excellent blog post on the subject. http://www.wondersandmarvels.com/2012/05/the-puppy-water-and-other-early-modern-canine-receipts.html

Opthalmic surgery was also in its infancy, with a procedure known as ‘couching’ or ‘cooching’ being one of the most invasive operations undertaken, being used for the treatment of cataracts. Here, a small silver instrument called an itinerarium was passed into the sufferer’s eye. The intention was to physically push the cataract film back away from the lens of the eye and thus clear the vision. This was doubtless uncomfortable and seems almost impossible to imagine – bearing in mind the patient was awake and conscious at the time. We shouldn’t assume that it was necessarily dangerous though. The seventeenth-century diarist Walter Powell of Llantilio Crossenny, in Monmouthshire, endured the procedure three times and still carried on with his diary afterwards, so presumably his vision was little worse if it wasn’t much better.

The wearing of spectacles was certainly known in Tudor times. Most typically, these were armless and sat on the bridge of the wearer’s nose. There were other types of device that could be used. Fearing he was losing his sight after years of close working in extremely bad light, Samuel Pepys tried a revolutionary new device in 1668 (the “tubespecticall”) which involved reading through three-inch long paper tubes, which eliminated glare and excess light.  Essentially, however, these were items connected with a physical disability – the same as prosthetic limbs, bandages or trusses.

The 17^th century, though, witnessed the beginning of a shift towards people being more comfortable with what was essentially a form of disability, and this was especially noticeable in portraiture. Fashion was a factor to some extent. In previous blog posts I have noted the use of steel as a desirable material, and shining steel spectacles represented a desirable fashion item. As such, steel spectacles could also be a mark of literacy and wealth.

Eighteenth-century spectacle makers also needed to adapt to the times, and produce items that could fit with current fashions. One of the most important exponents of this, and indeed in many ways a forefather of the modern spectacle designs, were ‘Martin’s Margins’, invented by the London maker Benjamin Martin. These were fairly revolutionary. Rather than sitting on the wearer’s nose, they had spring-loaded arms which enabled them to adhere seamlessly to the head, with less chance of falling off and being damaged.

Martin’s Margins

The eighteenth century was in fact an age of innovation in opthalmics. The optical instrument maker James Ayscough invented frames with long, folding arms to reach around the head, also known as ‘railway spectacles’. ‘Wig spectacles’ were designed with arms to slide into the fibres of a wig, and keep them in place – especially important given the increasingly ebalorate coiffeurs of the elites. The gradual introduction of steel springs in nose-pieces also helped fitting. The lenses of spectacles also developed through the eighteenth century. Around a third of the lens in a pair of ‘Martin’s Margins’, was filled with ox horn, to restrict light. Other developments included D-shaped spectacles in the 19^th-century, which had side visors which provided protection from dust and light. A self-portrait by Sir Joshua Reynolds depicts him wearing a pair of wig-spectacles:

Reynolds Self Portrait © PCMAG

To be depicted in spectacles drew attention to the eyes, and the vision of the subject, perhaps literally or notionally. Conversely, though, spectacles could also be used in morality paintings to emphasise undesirable traits, such as miserliness. This portrait of Benjamin Franklin shows him squinting to read a document through his new-fangled spectacles:

There was also a medical aspect to the use of spectacles: too much light was seen as potentially injurious to vision, and spectacles were sometimes designed to restrict the amount of light entering the eyes. Tinted lenses, especially green, were considered to be therapeutic in the 17^th century (note the green lenses in the ‘Martin’s Margins’ above too).

So today’s fashion for spectacles has a long gestation, and it is interesting to see how perceptions of eye complaints have shifted over time. In fact, opthalmics has tended to move away from a strictly ‘medical’ field; the optician is now a common feature of the high-street and eye-tests and fittings can be done virtually on a drop-in basis. It is also interesting to note that the wearing of spectacles for fashion is not new. I heartily recommend a visit to the MusEYEum in the Royal College of Optometrists in London, where there is a fascinating library of artefacts and books about the history of spectacles, as well as some rare portraits of spectacle-wearers through history. The blog of its curator, Neil Handley, can be found here: http://www.college-optometrists.org/en/knowledge-centre/news/blog/index.cfm/id/199E66BA-4091-4C98-A53907402DE66669

Concocting Recipes: The early modern medical home.

It has long been argued that the early modern home was a medical hub. And, in many ways, so it was. Sickness was first and last a domestic experience. It was almost always treated in the home and, given the range of potential conditions, the presence of one or more sick members of the family was doubtless a fairly regular occurrence.

In the main, it was women who were expected to take responsibility for medicating the household.  Women were assumed to be natural carers, and also to have acquired some skill in the preparation of medical recipes, and their application, by the time they reached the age of consent to marry. There were books dedicated to schooling literate women in the art of physick, many including what was effectively a ‘starter’s collection’ of remedies to enable them to treat a large number of common conditions. Indeed, medicine was part of the wider role of ‘housewife’, and ‘huswifery’ meant looking after the inhabitants, as well as maintaining the living space.

The role of men in household medicine is far less defined. There were, for example, no books specifically written to help men cope in the case of domestic illness. And yet they clearly did cope. Diaries, such as those by Phillip Henry of Broad Oak in Flintshire, and Robert Bulkeley of Dronwy, Anglesey, both note sickness episodes of their wives, and suggest that they played a part in caring for them. It is also clear that men played a part in the acquisition of ingredients, often keeping records of where they found herbs for sale cheaply, or which apothecary they regularly purchased from. In this sense, medicine still fitted in to the patriarchal male family role, since it involved a broader input into the physical care and support of the family.

One question that remains largely unresolved, however, is that of how well equipped the early modern home was to cope with sickness. The contents of domestic recipe books suggest not only that a very broad range of skills were needed to be able to concoct remedies, but also that a range of equipment would also be necessary. How well equipped were ‘ordinary’ homes to meet these needs?

One body of sources that lets us peer back inside the early modern home are probate records. When a person died, the probate process often required a list of their household contents to be made to allow their estate to be valued. For the study of the material culture of this period, these sources are incredibly valuable. They are, however, often frustratingly vague, and all depends on the diligence of the individual surveyor. For example, a detailed record might list every individual possession, room by room, including furniture, ornaments, valuables, but also sometimes even book titles and foodstuffs held in storage. Much depended on the intrinsic value of the goods; if they had a resale value, they might be worth including. In less detailed inventories, however, a whole room might be listed under a single entry, with a generic term like ‘household stuff’.

In terms of medical items, this causes a problem. Things like herbs and, perhaps, individual jars of ointments or medicines were too impermanent to list, so don’t appear in the inventories of ‘ordinary’ households and very seldom even in elite household inventories. Equally, finding any equipment that can be definitely be classified as ‘medical’ is problematic, since many had dual usage. Nevertheless, it is still worth speculating based on available evidence, to see if any hints about the material culture of domestic medicine can be gleaned from these sources.

Whilst writing my PhD thesis, to try and address this question, I looked at over 1300 inventories from 82 parishes in the county of Glamorgan in South Wales. I decided to look for two items of equipment in particular – the pestle and mortar, and the brewing still. Many seventeenth- and eighteenth-century self-help books extolled the virtues of a well equipped kitchen. For the seventeenth-century medical writer Thomas Brugis, top of the list of items desirous for those people wishing ‘to compound medicine themselves’ were ‘a great mortar of marble and another of brasse’. A long list of other items were included, from ‘copper pannes to make decoctions’, ‘glasses for cordiall powders’ and a range of medical implements. The popular medical author Gervase Markham, also entreated his idealised English housewife to ‘furnish herself of very good stills, for the distillation of all kinds of waters…for the health of her household’, and the emphasis all round lay firmly with a well-equipped kitchen, able to minister autonomously to sick family members within a household.#

As a baseline test, over 91% of the inventories contained at least one item of kitchen equipment, including pots, pans, crocks and so on. Overall, the suggestion was that the vast majority of homes had at least the ability to concoct basic remedies. As Elaine Leong has recently noted, for example, boiling was needed in around 20-30% of early modern remedies.

But what of more specialised equipment? The results were interesting. Out of 1248 inventories, only 148 (11%) had listed a pestle and mortar. Before 1635, there were no occurrences whatsoever, and a peak of ownership didn’t seem to occur until the early eighteenth century. Whilst this figure of 11% should definitely be taken as a bare minimum to allow for inevitable under-recording, this still seems surprisingly low. What was also clear, though, was that the item was more common in better-off households, and also in urban areas. The pestle and mortar would have been a basic utensil for grinding herbs and spices into powder. Whilst not owning one certainly can’t be used as evidence to say that a home wasn’t ‘medical’, its lack of appearance is still noteworthy.

Turning to the ‘still’ or ‘limbeck’ the results were even more striking. A still was a multi-purpose item, which could be used for home brewing, as well as the distillation and fermentation of substances for medical recipes. It has recently been calculated that around 10% of remedies required a still in this period. Despite this, the Glamorgan inventories yielded a total of only 41 references in 1248 inventories, giving an average of less than 3%. Here again, ownership was general limited to wealthier households.

[A full statistical analysis, including comparisons with other Welsh counties was included but, for the sake of brevity, it’s not detailed here. See Alun Withey, Health, Medicine and the Family in Wales, 1600-1750 (Swansea University, Phd Thesis, 2009)]

It is also worth noting (albeit perhaps unsurprisingly as noted earlier) that no inventories contained any reference to medical remedies, ingredients or substances, and only a bare few contained items which could be construed as ‘medical’, such as a blood dish in one home, and a ‘nurseing chayre’ in another.

What do these results tell us? They certainly don’t tell us that early modern homes did not manufacture their own medicines, nor that they were incapable of doing so. Even the most basic of utensils could be used in this process, and the majority of homes possessed these.

They also don’t reveal much physical evidence of medicine, such as a ‘storehouse’ of remedies or ingredients, but this is, in many ways, entirely logical. Medicine was transitory and pragmatic. Recipes were often concocted as and when needed. Some, like ointments, could last for years and be kept, but many were too impermanent to keep. Also, just because they weren’t listed, doesn’t mean they weren’t there. Whilst some historians are beginning to question the extent to which each household physically grew its own herbs, it’s plausible that many did.

But what is also interesting is the availability of ingredients for remedies in even the smallest rural shops. People could purchase exotic herbs and spices from their village shop, as well as compound remedies such as plague water and Venice Treacle. It is entirely possible that the extent to which domestic production was intertwined with the medical marketplace has yet to be appreciated.

In any case, there is a need for more studies into the material culture of early modern domestic medicine. If the early modern home was indeed a medical hub, a wider study should give us a broader understanding not only of what medicines people used in their homes, but how they made them.