Call for Papers: International Conference: Medical Practice in Early Modern Britain in Comparative Perspective

Papers are invited for an international conference to be held at the University of Exeter (UK) on 4-6 September 2017, funded by the Wellcome Trust Senior Investigator Award for the project ‘The Medical World of Early Modern England, Wales and Ireland 1500-1715’ led by Professor Jonathan Barry and Dr Peter Elmer at Exeter (see the project website at http://practitioners.exeter.ac.uk/). This conference will consider the outputs from this project, in particular the database which has been created of more than 30,000 medical practitioners operating in the period, and the opportunities this offers for new research in the field. It will also consider comparative perspectives on early modern Britain, both spatially and temporally, and so welcomes papers from colleagues working on medical practice in other parts of Europe or its colonies, on other cultures (Islamic, Indian, Chinese etc) and also on the periods either side of our 1500-1715 focus, so that we can place the findings of the project in the widest possible context. Proposals for panels will be welcomed, but so will individual paper proposals, including from research students (for whom bursaries covering the cost of attendance will be available). Those attending will be given exclusive access in advance of the conference to research findings from the project database, which they will be encouraged to consider in their contributions, which we expect to be pre-circulated to encourage the highest level of focused debate during the conference. Senior scholars willing to act as commentators on papers are also encouraged to express an interest in this role, as well as in offering their own papers.
Major themes for consideration include the following:

  • Continuity and change in the character and scope of medical practice, including the impact of war and imperial expansion on pre-existing medical culture,
  • the influence of new ideas and/or persistence of established approaches across the period, as well as the significance of attempts at regulation.
  • Trends in education, training and career patterns, encompassing hereditary succession, patronage, apprenticeship and university study, and levels of provision in different regions and types of settlement.
  • The roles played by women, in popular and domestic medicine and beyond, and by other alternatives to orthodox male practitioners, and by the growth of new methods fro the production and sale of medicines.
  • The place of medicine within processes of social and cultural change in the British Isles more generally, and the wider parts played by medical practitioners in scientific, intellectual, political, military, confessional and other spheres.
  • The opportunities for comparative research across national boundaries, both in tracing the movement of medical practitioners and in comparing levels and types of medical provision in different cultures.

If you are interested in participating please send an email to Professor Jonathan Barry at J.Barry@exeter.ac.uk, with an abstract of c. 200 words indicating the proposed topic of any paper or panel, preferably by 15 September 2016.

Working Paper number 5 now available – by Dr Margaret Pelling

We are pleased to announce the fifth in our series of Working Papers:
`The Life and Times of Dr Richard Frewin (1681-1761): Medicine in Oxford
in the Eighteenth Century’, by the late A. H. T. Robb-Smith. This was
originally the fifteenth Gideon de Laune lecture, given to the
Worshipful Society of Apothecaries of London in 1972. It has been edited
for publication, with a bibliography, by Margaret Pelling. Frewin was a
successful rather than a remarkable physician, and the value of
Robb-Smith’s work lies in its being about a provincial practitioner’s
career and interconnections with the university milieu around him. Much
is revealed about how the eighteenth-century university operated, its
personal politics and scandals, the failings of its medical faculty, and
how physicians of that date educated themselves and then tried to get on
in the world.

To see the paper, click on the ‘Working Papers’ tab above, and scroll down the list for a detailed synopsis, and link to a PDF of the papers itself.

Alun Withey.

New: Working Paper Number 4 – by Dr Peter Elmer

We are pleased to announce the latest in our series of working papers. This new paper, ‘East Anglia and the Hopkins Trials, 1645-1647: a County Guide’, by Dr Peter Elmer, offers a county by county gazetteer of seventeenth-century witch trials. It offers new perspectives on the role and significance of Matthew Hopkins, and locates the trials within the broader context of attempts by puritan minorities to rid the country of perceived enemies.

The link to the full paper can be found under the ‘working papers’ tab, by scrolling down the list.

The Medical World of Early Modern Ireland – Conference 3-4th September 2015

Conference: The Medical World of Early Modern Ireland, 1500-1750

This conference is taking place at Trinity College Dublin on 3-4 September as part of the Early Modern Practitioners Project. It will feature papers on a broad range of topics, including natural history, midwifery, witchcraft and Gaelic medicine. The research team from Early Modern Practitioners will also be presenting an overview of key aspects of their work.

Professor Marian Lyons of Maynooth University will deliver a keynote address on ‘The Professionalization of Medical Practice in Seventeenth-Century Ireland’.

To view the full programme and to register for this conference, please visit: http://humanities.exeter.ac.uk/history/research/centres/medicalhistory/newsandevents/
events/medical_world_early_modern_ireland/

If you have any queries about the event, please contact Dr John Cunningham at cunninjo@tcd.ie.

Working Paper Number 3 now uploaded.

We are delighted to have a brand new working paper – Professor Christopher Whitty’s hand list of medical texts published in Britain, in English, between 1475 and 1640. The list, together with an introductory essay by Dr Margaret Pelling, will be of interest not only to scholars of the history of medicine, but also anyone interested in vernacular publishing and the place of medical texts within the broader catalogue of published books.

To see the hand list and other materials click on the ‘Working Papers’ tab.

Working paper number 2 now uploaded

Professor Jonathan Barry’s essay ‘John Houghton and Medical Practice in William Rose’s London’, about the early modern apothecary, journalist and Fellow of the Royal Society John Houghton, has now been uploaded to our ‘Working Papers’ series.

For a link to the full paper, plus an introduction by Professor Barry, click the ‘Working Papers’ tab.

 

A New Addition to the Site: Working Papers

As part of the project’s commitment to disseminate the findings of our research, we have set up a new section of the website where we will post working papers, drawing out key themes or promoting new research findings.

The first of these papers, a study of barber-surgeons’ ordinances by Dr Margaret Pelling has now been uploaded and can be accessed through the link under the ‘working papers’ tag.

Researching Medical Practitioners in Early Modern Ireland

In October 2013 I joined the team on the Early Modern Practitioners project as a relative newcomer to medical history. Since then I have enjoyed the opportunity to approach early modern Ireland from what is, for me, a new and rewarding direction.

In my previous research, encompassing landownership, politics, religion and various other subjects, I had frequently come across medical practitioners. For example, at least four Catholic physicians were among those who received assignments of land in the transplantation to Connacht, the scheme that was the focus of my doctoral thesis. Another physician, William Petty, played a fundamental role in the implementation of the Cromwellian land settlement.

Image from Wikipedia Commons

Image from Wikipedia Commons

While figures such as Petty need no introduction, the vast majority of medical practitioners enjoyed far less contemporary prominence. The evidence that has survived concerning this majority varies greatly in content and extent. Still, there can be few, if any, historians of early modern Ireland who have not encountered a medical practitioner of one kind or another at some point in the course of archival research.

When addressing the issue of archival resources for the history early modern Ireland, it is always tempting to focus on gaps and absences. After all, a few well-known disasters have served to deprive scholars of an enormous body of source materials. In a western European context, the Irish archive can appear meagre in some respects, especially when compared to England.

Within the Early Modern Practitioners project, the evidence available from wills provides one of the more striking contrasts between Ireland and England. All but a handful of Ireland’s surviving prerogative and diocesan wills were destroyed in 1922, and many of the surviving indexes lack occupational data. Identifying and analysing what has survived in miscellaneous copies and genealogical abstracts is a challenging task, but also a very worthwhile one. Among the more useful resources is the collection of transcripts of medical wills made by Sybil Kirkpatrick in the Public Record Office in 1910-11 and now housed in the Royal College of Physicians of Ireland.

Image copyright National Library of Ireland

Image copyright National Library of Ireland

The problem of gaps and absences is not simply due to the subsequent destruction of archives. It is also worth keeping in mind that the administrative and corporate structures that generated some important sources for medical history in other early modern states were sometimes lacking or ineffective in Ireland. For example, ecclesiastical licensing of medical practitioners does not seem to have been widespread. This is, however, a subject that requires further exploration. The relative weakness of the Church of Ireland and the fact that most of the population adhered to Catholicism was undoubtedly of importance in this context.

This very brief recital of some of the limitations imposed by the available sources is not intended as an exercise in pessimism. It is helpful, I think, to go about establishing where the existing boundaries are and where they might usefully be pushed back. Drawing contrasts with the richer source bases often available for other countries and regions is part of the task of locating and making sense of the medical history of early modern Ireland in wider contexts. There is plenty of work to be done and much to be optimistic about. Stay tuned.

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!

17thc-wales

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.

cunning-folk

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!

welsh-registers

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.

pontrobert-today

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.

(This post originally appeared on Alun Withey’s blog dralun.wordpress.com – apologies for cross-posting)

Landscape of Occupations April 2014 – Conference Report

The ‘Landscape of Occupations’ workshop, held at the University of Exeter on the 8th and 9th of April 2014, featured presentations from fifteen scholars, covering an exceptionally wide range of perspectives on the theme of work and occupational identity in late medieval and early modern Europe. Fields examined ranged from agriculture to fine art, and of course included medical practice in many of its early modern forms, in a context which highlighted the parallels, dependencies and contexts which connected them all. Perhaps more importantly the ‘landscape’ of occupations was considered on a range of scales, from macroeconomic surveys spanning centuries and nations, to microeconomic considerations of occupational communities, and nano-studies of family economies.

Combining such diverse perspectives and examples, we were able to reflect upon historians’ approaches to occupational history, and two distinct conceptions of the term ‘occupation’. Many papers approaching the subject from the perspective of economic history emphasized ‘occupation’ as a description of work, while historians working from a social and cultural tradition have focused upon ‘occupation’ as a self-defined, or indeed projected, label of identity. While this might appear to be a paradox, both definitions are naturally equally true, and both reflect the consistent desire, both amongst early moderns and historians, to reduce identity to a simple term, especially when responding to, or describing, change. Attempts at fixing occupational identities to single work activities occurred notably during periods of economic anxiety, including the failed statute regulating ‘one man, one trade’ of 1363, and during the 1560s. Yet, in parallel with contemporary reactionary attempts at regulating social and moral capital through sumptuary legislation, they were both exceptional, and unsuccessful. Thus historians examining either definition face the same challenges in interpreting the complexities and inconsistencies inherent in understanding ‘occupation’.

The presentations all addressed a core set of questions, which while widely shared, pose challenges in reconciling the divergent conclusions that emerge. The questions can be grouped into three broad areas:

  • Structural Change. Macro-economic approaches focus upon change over time in large samples, often working with an implicit Smithian notion of specialisation and increasing economic complexity, and relying upon occupational description as an indicator of change.
  • Representation and Portrayal. The position of work within the formation of wider entities, as well as the variability of terminology throughout time, location, and as markers of status and power.
  • Networks and Lifecycles. Occupation as a fluctuating identity, reflecting changing circumstances of individuals, local communities and especially households.

These approaches each offer compelling conclusions, but the big question that emerged during the workshop is how they might speak to each other. There is a tendency for answers to one of these questions to present challenges to the others. For example, mixed or changing identity is a source of uncertainty in studies of structural change, just as the dynamic of structural change unseats attempts to explore ‘identity’ over time or space. Hopefully, by bringing together scholars working from these contrasting approaches, we can move towards new ways of addressing the question of historical occupations which might address these challenges.

For instance, the core approaches highlighted all emphasize the fact that occupation is less of a matter of individuals, but is rather a subject permeated by external factors including markets and employment structures, social and religious affiliations, changes in circumstances, abilities, and strength, and, perhaps especially, the influence of institutions. Papers examining the medieval period cast these external influences in a particularly clear light, including bakers’ delicate balancing of completing influences of market and assize, while the occupational origins of late medieval archers revealed the vexed questions of formal and implicit feudal obligation, age and strength. Less overt, but equally important, were questions of social credit, reputation, and brand, as seen in discussions of craftspeople operating in the fields of scientific instruments and fine art, as well as those facing failure in business and seeking to escape their debts.

The ‘landscape’ of occupations was highlighted in the sense that work and occupation can best be understood within the contextual environment of the other occupations and identities with which it co-existed. Moreover, occupational identities were negotiated, in all respects, in unique circumstances, and just as different terms could be used to describe the same ‘work’ in different contexts, so too could the same label carry different meanings in, for example, urban and rural settings. Papers focusing upon local case studies, such Newcastle keelmen, and Bristol medical practitioners highlighted the importance of contextual understanding and local variation to draw together these multiple and shifting influences, even when following broadly quantitative approaches.

Again addressing questions of both ‘work’ and ‘identity’ is the question of the skill content of occupations. On one level skill can be classified and ascribed to occupational identity, and was in many cases judged as such by contemporaries, as seen in the context of Portugal’s remarkably centralised yet contentious system of medical licensing. Yet, as Margaret Pelling emphasized in the keynote lecture, the varied nature of skills transmitted through apprenticeships included the ‘soft’ skills of social interaction and successful business judgement. How effective, and how definitive, was apprenticeship as the dominant western European means of occupational education?

While there seems little prospect of a single economic theory of occupation, as some might wish for, the workshop served as a wonderful opportunity to re-examine familiar people, trends, and events, in new lights. From the perspective of the ‘Medical World of Early Modern England, Wales and Ireland’ project, we have resolved both to increase the depth of local case studies to investigate qualitative differences within ostensibly equivalent occupational identities, and to exploit data that we have already collected to refocus upon medical practitioners as part of household and familial economies, as well as occupational inheritances and the lifecycle of medical training and occupation.

Full list of speakers and papers:

Human capital formation from occupations: The ‘deskilling hypothesis’ revisited
Alexandra M. de Pleijt, (Utrecht University) and Jacob L. Weisdorf, (University of Southern Denmark, Utrecht University and CEPR)

Civilians at war: English archers and their occupations 1350-1415
Sam Gibbs (University of Reading)

Debt and Occupation: The Trades of Debtors Imprisoned and Absconded in the 1720s
John Levin (University of Southampton)

‘Working lives and the historical record in Newcastle upon Tyne, 1600-1710’
Andy Burn (Durham University)

Movement and interconnectivity in the ‘scientific’ instrument trade of early modern London
Dr Alexi Baker (University of Cambridge)

Bakers and Occupational Specialisation, 1350-1550
James Davis (Queen’s University Belfast)

Managing uncertainty and privatizing apprenticeship: status and relationships in English medicine
Margaret Pelling (University of Oxford)

Medical career trajectories in Early Modern Portugal
Laurinda Abreu (University of Évora)

Medical Practice in Bristol, c. 1500 – c. 1800
Jonathan Barry (University of Exeter)

Plotting Practitioners: GIS and Spatial Patterns in Early Modern Medical Provision in England and Wales
Justin Colson (University of Exeter) and Patrick Wallis (London School of Economics)

Working from the local to the national. Reconstructing labour relations in the Northern Netherlands, c. 1600-1800

Daniëlle Teeuwen (International Institute of Social History, Amsterdam)

Early modern rural by-employments: a re-examination of the probate inventory evidence
Sebastian A. J. Keibek (presenting) and Leigh Shaw-Taylor (University of Cambridge)

‘The Honest Tradesman’s Honour’: Work and Identity in Seventeenth-Century England
Mark Hailwood (St Hilda’s, Oxford)

Occupational and religious identities: the example of the Johnson Company 1542-c.1557
Laura Branch (NUI Gallway)

Mary Beale, Artist 1633-1699
Sarah Birt (Birkbeck College)