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Researching Medical Practitioners in Early Modern Ireland

Posted on 11th November 2014 by Alun Withey

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

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

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!

Posted on 24th September 2014 by Alun Withey

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Landscape of Occupations April 2014 – Conference Report

Posted on 16th April 2014 by Alun Withey

The ‘Landscape of Occupations’ workshop, held at the University of Exeter on the 8^th and 9^th 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)

Landcape of Occupations Conference – University of Exeter, 8th and 9th April 2014

Posted on 31st January 2014 by Alun Withey

Occupational identity and the economic activity of individuals have seen growing attention from historians and historical geographers over the past thirty or forty years. While earlier generations of historians, including Postan and Tawney, addressed occupational structure as an aspect of the general structure of agricultural and industrial production, researchers are increasingly focusing upon the question of economic activity from the perspective of the individual. It is increasingly recognized that occupational identity was neither definite, nor fixed. How did households combine economic strategies in response to opportunities, challenges, and natural cycles? How did economic and occupational identity change throughout an individual’s lifecycle? Indeed, how did occupational identity actually reflect economic activity?

This two day workshop brings together sixteen research papers by scholars from across the UK and western Europe, addressing the theme of occupation and identity from a range of angles ranging from demographic quantification to detailed biography. Central to all is the question of how work was defined, and how it in turn affected the lives of individuals in pre-modern Europe.

Plenary speaker: Dr Margaret Pelling, University of Oxford.

Registration is now open for delegates until 1st March, at a rate of £70 or £35 for registered postgraduates, including refreshments (day rates also available). Accommodation and an evening meal are also available for delegates.

Registration form available here:

Registration Form

Flyer available here:

Flyer

http://humanities.exeter.ac.uk/history/research/centres/medicalhistory/newsandevents/events/landscapeofoccupations/