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

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

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

Old Bailey in the 19th century

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

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

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

Surgeon01.jpg

(Image from Wikimedia Commons)

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

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

Highway Robbery

(Image from Lewis Walpole Library)

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

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

A_quack_doctor_treating_her_patient's_chilblains._Engraving_Wellcome_V0011085.jpg

(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.

Technology, Self-Fashioning and Politeness in Eighteenth-Century Britain

9781137467478.indd

Last month saw the publication of my new bookTechnology, Self-Fashioning and Politeness in Eighteenth-Century Britain: Refined Bodies (London: Palgrave, 2015). By way of introducing it, I thought I’d write a post to introduce some of its main themes.

The eighteenth century saw dramatic changes in attitudes towards bodily alteration. Once, impaired bodies were viewed as a fait accompli, their owners condemned forever to endure whatever vagaries God or Nature had seen fit to send. In the early part of the century, debates raged about the dangers of pride and vanity, as well as the morality of trying to interfere with God’s work. But by the mid 1750s there were changes in attitudes. Where once managing appearance, including treating deformities and visible impairments, symbolised vanity and pride, new enlightened themes like ‘improvement’, self-control and mastery made conquering the body a noble and justifiable endeavour.

At the same time as these broader social and cultural changes, new technologies in metallurgy opened up a range of possibilities for products aimed at shaping the body. What might be termed ‘technologies of the body’ proliferated. These encompassed everything from large apparatus for altering bodily shape, posture and gait, as well the smallest, quotidian items of personal grooming such as tweezers and nail nippers. In some cases new technologies transformed the design of instruments; in others, it was the instruments themselves that took on important new meanings as vectors through which individuals could aspire to changing ideals of the body.

This was the age of ‘politeness’, where ‘polite’ manners and behaviours were entwined with the ownership of the right goods, wearing of the right clothes and attendance of the right social events. Whilst conversation, education and manners were essential to early conceptions of polite behaviours, appearance and form were also important. In this sense dress, appearance and adornment acted as vectors to project politeness onto the body. Could, however, politeness extend to the bodily fabric itself?

Artofdancing

(‘The Art of Dancing, 1724)

Some like the Swiss physician Samuel Tissot thought so, and he dedicated an entire chapter to ‘disorders most frequent in people of fashion’ and drew a distinction between the hardy body of the labourer, through its constant exposure to the harsh elements, versus the somewhat slight, fey body of the gentleman. If this latter was physically slighter, however, it was also delicate and refined.

While contemporaries never directly referred directly to bodies as being polite, they did acknowledge the role and importance of the body in articulating it. An essay on the characteristics of politeness in the Universal Magazine in 1775 argued that it was a holistic concept governing not only ‘temper of mind and tenour of conduct’ but bodily appearance, posture and mien. A polite gentleman (the essay was addressed to men) should embody the posture of a fencer, the gait of a dancer, the ear of a musician and the mind of a philosopher. Such a person ‘walks by rules of art, dictated by nature’.

But as well as being informed by politeness, other characteristics were prized. Neatness, elegance and harmony of appearance, were central in conveying inner character and sensibility. The body’s surfaces should be kept neat, clean, plucked and shaved. For both sexes the removal of facial hair and management of facial features such as eyebrows showed fastidiousness and a desire to create a body that was socially pleasing. As attitudes towards the smile changed, management of the teeth became important. Likewise, as the appearance of hands was held to imply character and breeding, the care of hands, especially fingernails, was vital.

But Nature was also at the heart of debates about bodily form. Some saw it as a body closest to the state of nature, in the bodies of the poor, or inhabitants or far-flung nations whose bodies had been untouched by artificial devices. Indeed, some even saw viewed interference with, or alteration of, the body as inherently unnatural. This was reinforced by the twisted and bent bodies caused through over zealous use of trusses, bandages and stays. On the other hand, much effort was expended in attempting to ‘correct’, conceal or otherwise give the illusion of a ‘natural’ form – a claim made by the makers of many postural devices. Paradoxically, therefore, a ‘natural’ body often required unnatural means to achieve.

Central to the question of technologies is the role of steel. Technological innovations between the 1680s and 1740s made steel an increasingly abundant and important good, but also a component in the fashioning of a new, refined self. While crucible (or cast) steel is understood as an innovative industrial process, its uses are rarely considered. Yet steel was vital for some of the most personal rituals of everyday life. It was the metal with which people had the closest, even the most intimate, physical contact.

Cast steel’s physical properties allowed people, for example, to fashion their bodies in new ways, to reflect changing ideals of bodily shape and form. A range of corrective devices was available to correct posture, utilising the tensile strength of steel. Visible deformity and disability were not only uncomfortable to the sufferer, but carried pejorative connotations that left the ‘crooked’ open to ridicule. If there was an ideal human form it was generally straight, erect and symmetrical. Whilst the treatment of hernias had brought about the introduction of a range of elastic and steel trusses, the period also witnessed a burgeoning market for devices to improve posture. These included items worn within or underneath clothing, such as back ‘monitors’, large metal plates inserted into clothing. Steel collars thrust the chin upwards to give the illusion of a straight posture. But there were other more radical treatment, such as ‘neck swings’. These involved locking the patient’s head into a steel apparatus, and suspending them off the ground, where they would remain dangling for hours at a time. These were even available for people to use in their own homes.

Sheldrake illustration
The neck swing, from Timothy Sheldrake’s ‘Essay on the Various Causes and Effects of the Distorted Spine’, 1783

One of the primary audiences for such devices was children whose parents, recognising the social limitations arising from deformity, were keen to mould the bodies of their offspring into an acceptable form. In the name of fashion, children’s bodies were trussed, bandaged, bound, calipered and twisted. Adults were also prepared to take steps to intervene in the shaping of their own bodies. As advertisements from the manufacturers of postural devices attest, a new domestic market was emerging, which targeted individuals who sought to ‘treat’ themselves without recourse to a medical practitioner.

Neatness and elegance of appearance were exemplified in the face and, in particular the vogue for shaving, and the almost total disappearance of facial hair from men’s faces. New types of steel razors were instrumental in this process. Where once the barber had been the sole provider of shaving services, the period saw men beginning to shave themselves. Razor makers took advantage of newspaper advertising space to puff their new products, using both the language and imagery of polite consumption, but also foregrounding their metallurgical expertise in manufacturing. The use of cast steel in razors became a selling point, along with references to the scientific and philosophical credentials of the manufacturer.

Holmes

(Trade card of Holmes and Laurie, London Truss Makers, author’s image)

Personal grooming was growing in importance in the broader context of the eighteenth century obsession with the body beautiful. As increasing attention was paid to the minutiae of appearance, so different parts and surfaces of the body came to prominence, as did the instruments used to transform them. Regarded by the orthopaedic specialist Nicholas Andry as the ‘Principal organs of touch’, hands and fingernails were seen as important symbols of beauty and virtue. Mangled and bitten nails were hardly aesthetically pleasing. The old fashioned way was to pare nails with a penknife – a process that could be dangerous, and caused several deaths!

New types of nail nippers were safer, and began to carry more ornate designs, belying their quotidian function. On the face, the most public of bodily surfaces, eyebrows were seen as barometers of character, and tweezers to maintain them were important items of toilette. It is interesting to note that 18th-century tweezers often included ear spoons for digging out unsightly wax, combining two grooming routines into one. As changing attitudes towards the smile rendered the teeth more visible, toothpicks and brushes were also essential pieces of kit. All could be purchased in kit form and could be hung on elaborate and delicate chatelaines about the person, making them at once public and private goods.

Spectacles offer a different outlook on the public projection of the polite self. Steel-framed spectacles, for example, began to appear around the mid eighteenth century, makers such as Benjamin Martin and James Ayscough utilised the springy strength of steel to transform the design of spectacles from their traditional armless Pince Nez design, to a new form with side arms that used pressure to stay tightly adhered to the wearer’s temples. Martin’s new ‘Martin’s Margins’ spectacles, introduced around 1760, could be highly polished to give a pleasing appearance, whilst other sorts of ‘wig spectacles’ were designed to help myopic macaronis attend society functions in comfort and safety. As spectacles became more decorous they also became more public. The growth of reading and coffee house culture placed spectacles at the heart of intellectual debate. Vision and sight exemplified the quest for knowledge. Once a symbol of deficiency, whilst never becoming desirable items of fashion, spectacles shook off pejorative connections and became connected with learning, sagacity and the enlightened search for knowledge through reading and ‘seeing’ the world.

Martins

(A pair of ‘Martin’s Margins’ spectacles, with spring-loaded temple pieces. c. 1760. Image © College of Optometrists, MusEYEum)

At all points, objects were playing a significant part in the purposeful management of the body. Some important questions must be raised, however. First, if there was some understanding of a polite body ideal, then how widespread was it? Was it an elite, metropolitan phenomenon? The problem with nearly all of the routines discussed here is that individuals seldom discuss them. In the normal run of things there would be little need to write down how well you shaved, plucked your eyebrows or how comfy your brand new Martin’s Margins specs were. The limited evidence available suggests that devices were available across Britain – and not just in major towns. Second, though, to what social depth did it apply? Again, evidence is lacking, but if we consider debates about emulation, there is little to suggest that bodily refinement was merely the preserve of elites. What may be different are the social and public contexts of the body across different levels of society.

The eighteenth century was an age when bodily technologies proliferated. But cultural and religious shifts also meant that intervening to alter the shape of the bodily characteristics that God had bestowed on a person was no longer taboo. As new corporeal ideals were defined, people had both the motivation and the means to transform their own bodies, through the introduction of cast steel. If this was the age of the body beautiful, however, it was also a time when the body was a site of transformation.

 

 

 

 

 

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

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

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

Image from Wikimedia Commons
Image from Wikimedia Commons

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

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

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

Image from Wikimedia Commons
Image from Wikimedia Commons

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

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

L0011748 Title page: Report of the Society...recovery of persons

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

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

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

Edging the Competition: Surgical Instruments in the 18th-Century

As I’ve written about in other posts about razors and posture devices, in the second half of the eighteenth century, the introduction of cast steel transformed products for the body. Steel had many physical properties that rendered it very useful across a range of instruments. Unlike its predecessor, blister or shear steel, which was of uneven quality and could be brittle, cast steel was durable and capable of carrying a very sharp edge. It could also be polished to a mirror-like shine, making it very attractive to wear as ‘brilliant’s – imitation diamonds.

Many of the instruments I’ve written about, from razors to spectacles, were things that people bought to use upon their own bodies. But there was another group of instruments that was transformed, but one which people generally did their best to avoid – surgical instruments.

The surgeon’s knife held something of an ambiguous position within medicine. For patients the briefest glimpse of a scalpel or, worse, an amputation knife, was enough to send them into a swoon. Some surgeons argued that people would much rather subject themselves to the dubious ministrations of the quack than to the slice of the blade. Surgeon’s instruments also suffered from the taint of the manual craft. It was argued that almost anyone could wield a knife or a saw, without any need for theoretical knowledge of the body. As such, surgical instruments were little more than tradesmen’s tools.

Nevertheless there was an increasing demand for instruments in Britain in the later eighteenth century. Across Europe numbers of medical students were swelling. In France the numbers of surgeons nearly tripled between 1700 and 1789. By the early years of the nineteenth century, around 300 students per year were enrolling in London hospitals, as well as Edinburgh and Glasgow. As well as the increasing numbers, medical education was changing, especially in the matter of dissection. Before the 1750s, anatomisation was generally a theatrical event where the dissection was carried out by a surgeon, watched over by a crowd of enthralled and doubtless, sometimes, nauseated crowd.

But changes in medical education meant that trainee surgeons were increasingly given access and encouraged to get their hands dirty. Reading books about anatomy was fine as far as it went, but could never replace empirical observation and experience. This was also an age where views of the body were changing, and the human form was likened to a machine. As Thomson’s The Art of Dissecting the Human Body, in a plain, easy and compendious method dissection manual put it, there were only two possible ways to discover the workings of a machine. One was to be taught by its creator…difficult in this case! The other was simply to take it to bits and put it back together again.

Surgical manuals began to set out the requisite kit for the gentleman surgeon. One was to purchase a set of pocket instruments containing the most commonly-used items. The German anatomist Lorenz Heister advocated a pocket set including lancets for opening veins and abcesses, straight and crooked scissors, forceps, probes, a razor and needles. A similar kit was popular in London, containing knives ‘made of best steel’, lancets and scissors, as well as a salvatory and plaster box. Clearly some surgeons were apt to keep buying until they had amassed a huge number of instruments. The surgeon and author Benjamin Bell cautioned against such acquisitiveness, arguing that too many instruments confounded the surgeon under the pressure of the operation.

Image from http://collectmedicalantiques.com/gallery/cased-surgical-sets
Image from http://collectmedicalantiques.com/gallery/cased-surgical-sets

The increasing demand for instruments opened up a range of new opportunities for the makers of instruments. Traditionally cutlers had been the mainstay of surgical instrument manufacture. With their experience in making edged tools and of tempering metals to exact requirements, they were the best qualified. But by 1763 the Universal Director, a directory of London trades, was describing surgical instrument manufacture as ‘a distinct branch from the common cutler’. By 1800 the first dedicated surgeon’s instrument catalogues were being produced by prominent makers such as J.H. Savigny of the Strand in London. Savigny’s catalogue contained a wide variety of different instruments from knives and saws to catheters, tourniquets and even apparatus for the recovery of the apparently dead!

Image from Savigny's instrument catalogue, 1800
Image from Savigny’s instrument catalogue, 1800

Surgical instrument makers were also keen to puff their products in newspapers. The market for these products was fairly narrow and specialised; these were not items marketed for the public. Nevertheless it is noticeable that makers did their best to clothe their advertisements in the language of polite commerce, and include popular and elegant designs in their trade cards. The language of advertisements was all polite puffery. The tone of advertisements for ‘Thurgood’s Surgeon’s-Instrument Manufactory’ in Fenchurch Street was deferential, seeking to reassure ‘any professional gentlemen’ that ‘nothing shall be wanting on his (Thurgood’s) part to render full satisfaction’. Many other adverts were targeting ‘gentlemen of the faculty’ and seeking to encourage their business.

Advertising also offered opportunities for illustration. The trade card of John Chasson of London depicts a variety of amputation knives, saws and other instruments set against an elegant rococo surround. The razor and surgical instrument maker Henry Patten’s card shows a range of instruments, including lancets, hanging from branches of its elaborate frame. Given their associations with manual trades, it is noticeable that advertisements began to pay attention to the form as well as the function of instruments. John Chasson’s instrument cases, for example, could be bought in elegant boxes covered in fashionable shagreen (sharkskin). The handles of knives and saws began to change from traditional wood and bone to more exotic and expensive products like ebony, ivory and tortoiseshell.

M0015899 Surgical instrument maker's trade card, 18th century.

Image courtesy of Wellcome Images
Image courtesy of Wellcome Images

Perhaps the most surprising claim made by some makers, however, was that their products lessened pain and improved the experience of patients. In 1778, J. Savigny advertised his newly-invented lancets to the faculty. Stressing his metallurgical skills, Savigny argued that they were ‘wrought to such a degree of accuracy, as will greatly lessen the pain of the patient, and totally remove all apprehension of disappointment in the operator’. In another, he argued that the ‘extraordinary degree of accuracy’ in their edge would lead to the ‘approbation of the patient and reputation of the phlebotomist’. It’s interesting to note that the patient comes first. Many surgeons agreed that speed was of the essence in any surgical technique, and that this could only be achieved by keeping instruments maintained since, as Benjamin Bell noted, they were ‘injured with every use.

Amputation

The late eighteenth century, then, was something of a golden age in the manufacture of surgical instruments. As the medical faculty sought desperately to separate itself from accusations of quackery and establish itself as an learned profession, the need for new instruments, based on the latest scientific and philosophical principles, was key. Likewise, with an expanding market and greater opportunities to promote their products, surgical instrument makers were continually engaged in developing and refining their products. Whether it would be of any comfort to a poor patient to know that the knife about to saw their leg off was made of the latest cast steel, however, is a moot point!