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

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/

New book by Professor Jonathan Barry, and additional source material.

The project is pleased to announce the publication of Raising Spirits: How a Conjuror’s Story was Transmitted across the Enlightenment (Palgrave: 2013) –http://us.macmillan.com/raisingspirits/JonathanBarry

To accompany the publication, Professor Barry has compiled a transcript of all Perks’ letters used within the book, together with commentary and alternative versions and comparisons. It is hoped that this provides a useful companion to the volume for scholars.

Perkseditions

Congratulations to Professor Barry on publication.

Finding a Good Home for Practitioners: the Final Fate of the Oxford Biographical Index

 I am very pleased to be involved in the Exeter project. As retirement approached, I was faced with the problem of what to do with over 22,000 cards of biographical information on medical practitioners of all sorts which I have been accumulating since the 1970s (aka the Biographical Index). I very much wanted this information to be generally available, but it seemed most likely that the cards would end up on a skip. Cards, 6 inches by 4 inches, are of course an antique technology and the chances of being able to convert them into an online resource seemed remote.

The Exeter project has changed all that. Work has already begun, with the help of Dr Frances White, on entering biographical data extracted years ago from the records of the Barber-Surgeons’ Company of London. This will be followed by the more varied data collected for London and East Anglia, especially Norfolk, Suffolk, and Cambridgeshire, but including parts of Yorkshire, Essex and Lincolnshire. Over the years I also collected stray practitioners from other locations for the Biographical Index if I found the information relating to them particularly interesting. Generally speaking, these individuals were obscure rather than represented in such sources as the Oxford Dictionary of National Biography.

The Biographical Index began under the supervision of Dr Charles Webster, then of the Wellcome Unit for the History of Medicine in Oxford, building on the pioneering surveys by Wickersheimer, Talbot and Hammond, Raach, R. S. Roberts, Whittet, and others. We adopted an inclusive methodology which, rather than judging by modern standards, instead accepted the choices made by early modern people as to the usefulness of a given practitioner. We were more interested in the lower orders of practitioner – barber-surgeons, barbers, midwives, bonesetters, oculists, as well as more peripheral occupations such as distillers and druggists – than in the physicians and elite surgeons who have tended to leave the most extensive written records and who have attracted most attention from historians. We also adopted ‘medical practitioner’ as being the least misleading, the most inclusive, and the least judgemental term to apply to medical personnel of all kinds, and gave preference to ‘occupation’ rather than ‘profession’ in describing medical pursuits.

This approach involved piecing together scraps of information, each of them often frustratingly small, and it also entailed using a wide range of sources, most of them not obviously medical. It became evident that practitioners could crop up in almost any form of record – the problem was that of judging when the law of diminishing returns had set in. Other dilemmas emerged: for example, it became clear that our modern idea of the full-time, uniformly qualified professional was inapplicable, and that early modern practitioners were likely to occupy a range of trades as well as medicine, or to diversify into other means of making a living, or to engage in more than one part of medicine over a given lifetime. Knowing this increased the complications – and temptations – of identifying one individual with another of the same name. Additionally it  reinforced the suspicion that a person identified as a practitioner might well not have practised for the whole of his or her working life. Other lessons had to be learned, for example that ‘nurses’ in parish records had to be assumed to be wet-nurses rather than sick-nurses unless further evidence suggested otherwise; and that the term ‘doctor’ could be a snare and a delusion, leading to mare’s nests full of doctors of theology, doctors of canon or civil law, and practitioners who were not academically qualified as ‘doctors of physic’ but who had been granted the title of doctor by themselves or by their patients. There was also, usually, a distinction between ‘physician’ and ‘practitioner of physic’. By contrast, there seemed to be little difference between ‘surgeon’ and the now obsolete form ‘chirurgeon’. Allowance also had to be made for the fact that women, in particular, tended not to be accorded occupational labels and were known by what they did, not by what they were. Nonetheless, in spite of problems of definition it became possible to conclude that there was a surprisingly high ratio of practitioners per head of population, and that this almost infinite variety was in part created by the high level of demand among early modern people for medical care of all kinds.

 We focused on London and East Anglia because these were the most populated and best developed parts of the country in the early modern period, and tended to have the best levels of record survival. I found the Norwich records especially rewarding, and Norwich’s practitioners are perhaps the most thoroughly represented in the Biographical Index. By the same token, we concentrated on towns, small and large, although wills, licences, and other sources covering the countryside showed that practitioners, especially barbers, could be found even in very small villages. Provisional numbers of practitioners could be mapped for most places in Norfolk and Suffolk. It was also evident that Norwich practitioners went out into rural areas, especially to larger households, and that people were drawn to Norwich for medical care, including that provided by the poor law. Not all medical care was voluntary: Norwich employed a wide range of practitioners to treat the poor, partly as a public health measure, and this treatment could be compulsory.

The focus of my own research subsequently shifted from Norwich to London, and in particular the 700 or so ‘irregulars’ whom the London College of Physicians tried to suppress between 1550 and 1640. These were of all kinds, ranging from doctors of physic as well qualified as the Fellows of the College themselves, to apothecaries, barber-surgeons, ‘old women’, and alleged empirics or quacks. With the essential assistance of Dr White, the information from the College’s ‘Annals’ (or minutes) and other sources was lifted from the Biographical Index cards and transformed into a database, constructed according to the (relatively limited) software available in the 1990s. This, the ‘CPL Database’, is currently available via a link on the website of British History Online. The information it contains will ultimately be absorbed into the Exeter project.

Although the Biographical Index has proved to be an invaluable resource for my own research, it now looks technologically very primitive compared with what will be achieved by my Exeter colleagues. Maps and tables, which used to be either hand-drawn or laboriously reproduced from another source, can now be produced in an instant in a variety of colours and formats, and constantly updated. Searches are of course infinitely easier. The publications of local record societies, which are an essential basis for any research of this kind, can now be downloaded and rapidly assimilated. All these advances have made possible the wide scope of the Exeter project. To me it is especially welcome that Ireland and Wales will be covered, as both have been neglected in the past, partly because of the difficulties inherent in their surviving records. Perhaps best of all, everything will be available online to anyone who is interested. So great are the improvements in scale and technique that it is something of a relief to find that many of the issues of definition and interpretation do, in fact, remain the same.

Dr Margaret Pelling, Oxford

(For the Database of Physicians and Irregular Practitioners in London 1550-1640, assembled by Margaret Pelling and Frances White see: – http://www.british-history.ac.uk/source.aspx?pubid=107)

 For more information on, and uses of, the Biographical Index, see:

 (with C. Webster) ‘Medical Practitioners’, in Health, Medicine and Mortality in the Sixteenth Century, ed. C. Webster (Cambridge University Press, Cambridge, 1979), pp. 165‑235

‘A Survey of East Anglian Medical Practitioners 1500-1640’, Local Population Studies, 25 (1980), 54-5

 ‘The Patient’s Choice: Identifying Medical Practitioners’, in P.L. Dickinson and S. Colwell (eds.), English Genealogical Congress. Selected Papers…1978 and 1984 (Society of Genealogists, London, 1986), pp. 137‑49

 The Common Lot: Sickness, Medical Occupations and the Urban  Poor in Early Modern England (Longman, London, 1998)

 Medical Conflicts in Early Modern London: Patronage, Physicians and Irregular Practitioners 1550-1640 (OxfordUniversity Press, Oxford, 2003)

Database now operating!

Let battle commence! After months of hard work by Dr Justin Colson and colleagues at the IHR in London, our project database is now up and running and ready to start accepting the legions of early-modern practitioners that we expect to find.

Archival work is well underway and all members of the team are busy collating source material to construct what will be a huge resource. The numbers of practitioners already located in early-modern Wales, for example, a country traditionally thought of as extremely deficient in terms of medical practice, already stands at over 600, with the vast majority of Welsh archives still to be consulted.

With the database in place, each member of the team will now be better able not only to collect source material ‘in the field’ but to analyse and compare the data in various new and exciting ways.

 

 

Questions of Practice…and Practical Questions by Dr Peter Elmer

During the course of the next few years, we hope that our project will shed light on a whole host of issues and problems related to the role of medicine and medical practitioners in early modern society and culture.  Members of the project team share a range of interests. For some, the statistical data relating to a whole panoply of issues will provide fascinating evidence for the nature and diversity of practice across the British Isles. The inclusion of Wales and Ireland, in particular, offers a fascinating opportunity to explore the medical worlds of two nations that have previously been largely ignored by historians of medicine. It also provides the chance to investigate the degree to which interaction occurred across national and geographical boundaries, as well as between the regions and the centre in England.

 At the current time, my own area of special interest has focused on the religious and political dimensions of medicine in the early modern period. In particular, I believe that the vast amount of new and detailed information that has already been gathered makes it possible to reassess the on-going debate over the ideological roots of medical change in early modern Britain. The consensus remains, founded largely on the pioneering work of Charles Webster and Harold Cook, that medical innovation in Britain, be it in relation to medical thinking or medical practice, was largely inspired by puritanism. More recently, Margaret Pelling has argued that the nascent medical ‘profession’ was, if anything, largely apolitical, members preferring to avoid office-holding at all levels. On the basis of evidence gleaned from the project, I believe that it is now possible to re-assess some of these claims and to propose a different account of the way in which religion and politics helped to shape medicine and medical change in the sixteenth and seventeenth centuries.

 Generally speaking, I have found little evidence to suggest that medical change was the monopoly of any one religious or political body. The situation, of course, is further complicated by the on-going debate over nomenclature (in particular that relating to definitions of such a slippery term as ‘puritanism’, and how it changed over time). Nevertheless, new evidence suggests that those of a distinctly anti-puritan stance were just as likely to promote new ideas in medical thinking, and new attitudes to the organization of medicine, in the key period after 1640. Many Anglican royalists, who opted to study medicine rather than pursue a clerical career in the 1650s, would appear to have been receptive to the chemical medicines and philosophy of iconoclasts such as Paracelsus and van Helmont. After the Restoration, when many returned to the Church, they continued to study and promote such ideas. Renewed focus on the period after 1660, in particular the role of the restored king, Charles II, and leading figures in the church such as archbishop Sheldon, also suggests a great enthusiasm in royalist-Anglican circles for the medicine of van Helmont and a willingness to promote institutional change. The failure of the Society of Chemical Physicians in 1665 to usurp the authority of the London College of Physicians – a body that was seen by some as puritanically inclined after 1660 – did not prefigure an end to official encouragement for change. Charles II’s court was dominated by chemical physicians, and new attempts to overthrow the monopolistic authority of the College of Physicians resurfaced in the 1670s.

 While puritanism then does not seem to have acted as the chief catalyst for medical reform in the 17th century, the evidence from the database strongly points to the period from 1640 to 1660 as a key moment in the creation of a new atmosphere in society receptive to medical innovation and speculation. While no one group monopolized such attitudes, the period did witness one further important development. From 1640 onwards, there is a mass of evidence to suggest that the medical ‘profession’ was becoming increasingly politicized, and that this politicization took numerous forms. One of the most interesting concerns office-holding, at both local and national level. Whereas prior to 1640, as Maggie Pelling has shown, physicians rarely took on political office, thereafter they were to do so in considerable numbers, a process that was further accelerated in the years after 1660. By 1700, it was quite common for medics to sit as aldermen in their local corporations, and to assume the office of mayor. Medical men, then, were no more immune from the political events of the period after 1640, and they played their part in such developments in a variety of ways, which I hope to explore in future publications and talks*. At the same time, the politicization of the medical ‘profession’ impacted, in subtle ways, on medicine itself. While, I suggest, it is no longer possible to argue for a straightforward correlation between medical progress on the one hand, and a single religious or political group on the other, there are grounds to suggest that medical thinking was shaped by the wider political and religious currents of the age.

*  upcoming: Peter Elmer, ‘Medicine, Religion and the Politics of Healing in Early Modern England’, King’s College, London, Strand campus, Wednesday 6 February 2013, at 6.00pm.

Welcome to the Project: Building the database

Welcome to the first blog post for our major new project “The Medical World of Early Modern England, Wales and Ireland, c. 1500-c.1799”, based here at Exeter. The blog will be used to share project news, report on findings and also to share interesting snippets of information as they arise. We are also hoping to attract guest contributors to provide insights on various aspects of early modern medicine.

What, firstly, are the aims of this project? The main objective is relatively straightforward; to assemble a database containing information relating to as many early modern medical practitioners as it is possible within its five-year span. This database will allow an exciting new prosoprographical study to be made of practice across early modern Britain. It will, for example, give a broad picture of the geographical and temporal spread of practitioners. Did their numbers increase? Are there ‘pockets’ of practice, or were they spread evenly across the country. Likewise, under what titles can they be found – e.g. physicians, doctors, apothecaries, surgeons, and so on? What might this reveal about patterns of medical nomenclature and self-fashioning?

But also central is the construction of individual biographies of practitioners. Aside from their medical activities, what can we learn about their roles and positions within their communities? Did medical practitioners form networks, correspond or work together, whether in medicine or in other ways. On occasion, for example, doctors or apothecaries actedas signatories for the will of a colleague, or might carry out an inventory of their premises. Apprenticeship records can yield much information about where medical training took place, where masters found their apprentices and so on. In many ways there is a world of medical practice yet to discover. By building up and charting these links, we hope to create a much more detailed map of medical practice than has previously been possible, with the eventual aim of a major new monograph exploring early modern medical provision.

The project is based on an existing database/calendar of medical practitioners collected over several years by Dr Peter Elmer, and involving exhaustive searches of a wide range of archives from official sources, institutions and county archives. This impressive document already contains between 15000 and 18000 names.

After the achievement of a major grant from the Wellcome Trust, the project formally commenced in September 2012 and the first stage has been the conceptualisation, and building of a database, capable of accepting both the size of the data already collected, and a different format. This work is now underway and, it is hoped, a working model should be up and running by the end of this year. Archival work has already commenced and this is already throwing up interesting results. For Wales, for example, taking into account Peter Elmer’s and Alun Withey’s exisiting data and adding finds from the first two months of searching, the list of Welsh practitioners has grown from 27 pages to 68 pages…and this for a country which is generally regarded as having few doctors!

In many ways this project is timely. Over the years much historical attention has focused on practitioners, often in the form of either single biographies of individuals, studies of groups within institutions or, more recently, local quantitative studies. This project, however, aims to raise new questions about the shape of medical practice in early modern Britain by undertaking a much broader quantititive study than has hirtherto been attempted. Its approach is multi-regional, taking into account the various constituent parts of the British Isles, with research fellows working on individual areas to maximise the concentration upon collections of archival sources in, say, Wales or Ireland, as well as across England.

There are important questions to raise and perceptions to challenge, perhaps most notably the enduring belief in the relative lack of practitioners in this period. In fact, as the more than 15000 names already collected is beginning to suggest, early modern Britain was in fact replete with practitioners, from Physicians to doctors, apothecaries to chemists, barbers to surgeons and quacks to empiricks. It might one day be possible to argue that seventeenth-century Britain contained as many people practising medicine as today. At the very least, it already seems that a reappraisal of the map of medical practice is needed.

Please visit our site and blog regularly, and let us know if there is anything you would like to see included, or if you would like to find out more about what we do.