Working Papers

Working Paper No.1:  

Pelling_BarberSurgeonsOrds-2

`Barber-Surgeons’ Guilds and Ordinances in Early Modern British Towns – the Story So Far’ – Synopsis.

Margaret Pelling

This Working Paper consists of an introduction, transcriptions of original documents from Norwich and Newcastle, and an annotated bibliography with entries for more than 40 English, Scottish and Irish towns and cities. The intention is to provide a baseline on which other scholars can build. Town records are so rich that it is very possible that more material relating to barber-surgeons and their organisations remains to be discovered. It is worth looking not just at archival records but at the town histories and editions produced from the seventeenth century onwards. In some cases these include material which was subsequently lost. The records of town guilds and companies have proved very vulnerable to all kinds of casualties, yet they are often our best hope of recovering information on the bulk of regular medical practice in early modern towns. Hundreds of barber-surgeons are known to have lived and worked in these centres, and they were arguably the general practitioners of their day. It is also reasonable to claim that the companies, under the aegis of town councils, exercised the most widespread and effective form of medical training and regulation in early modern Britain. The importance of these functions has been submerged by subsequent accounts which focus on physicians on the one hand, and quacks on the other. This narrative has in many ways been encouraged by the profession itself, which, in establishing its claims to autonomy, has sought to downplay its connections with civic society and civic oversight. Company ordinances, regarded by many later medical antiquarians as quaint curiosities, make it clear not only that companies supervised the training of apprentices and the handling of serious cases, but also that the medical crafts were integrated into urban life and overlapped in many ways with other occupations. Such overlapping is embodied in the life histories of many practitioners, who diversified into other trades as opportunities arose. We need therefore not simply to cherry-pick the `medical’ clauses in ordinances and similar sources, but to consider their implications as a whole.

We very much hope that anyone who has additions or corrections to offer relating to the presence of barber-surgeons in towns will be prepared to send comments to be posted on the website.

Margaret.pelling@history.ox.ac.uk

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Working Paper No: 2

EMP_WP2_Barry_Houghton

‘John Houghton and Medical Practice in William Rose’s London’ – Synopsis.

By Professor Jonathan Barry.

Working paper no 2 (‘John Houghton and Medical Practice in William Rose’s London’) considers the evidence for medical practice in London c.1700 provided by the publications of the apothecary, journalist and Fellow of the Royal Society, John Houghton (1645-1705), particularly his A Collection for the Improvement of Husbandry and Trade, a one- or two-sheet periodical which ran (almost continuously) from March 1692 to September 1703. Surprisingly this source has never been used by medical historians, even though it contains several sections of particular interest.

Each issue contains an editorial by Houghton, offering in effect a serial natural history, considering in turn the mineral, vegetable and finally animal kingdoms, epitomising the publications of fellow members of the Royal Society (men such as Evelyn, Ray, Plot and Willis) giving readers the latest scholarship on the nature and uses of objects, and linking these to trade issues by considering the import data for each substance and discussing how far England could either produce the commodity better itself or make more profitable use of it. Houghton frequently discusses how products are used medicinally, offering us an apothecary’s perspective on a wide range of health issues, written largely for a lay audience. Occasionally he also considers more general issues, such as the necessary qualifications for a physician, or reports his own experiments and health experiences.

Houghton also needed to make his publication pay by taking in advertisements. Initially these took the form typical of other newspapers, namely the sale of books (many medical), patent medicines and other announcements by those with products or services to sell. But increasingly Houghton dropped these in favour of advertising his own services. The paper discusses the range of (largely medical) products he could himself supply, but he also offered an information service: ‘whoever will buy or hire, sell or let houses, lodgings or estate, want or will put out apprentices, want servants or will go to service; will take or go to board; will put to school or want scholars; or will have anything else enquired of, that is honourable for me to do, may be enter’d in my books for half a crown each; and its probable I may help them’. A substantial proportion of these advertisements were placed by medical practitioners, including physicians, surgeons and in particular (unsurprisingly) apothecaries, and they throw light on apprenticeships, the demand for medical practitioners in different communities (including provincial towns) and the desirable attributes of shops.

Through Houghton’s Collection we obtain an invaluable insight into the shared medical world of layman and practitioner, scientist and ordinary patient. His advertisements underline the potential mobility of practitioners (both geographically and across the tripartite division of medicine), their need (at least sometimes) to look beyond personal connections when developing their careers and businesses, and the factors that might underpin the investments that apothecaries, in particular, might make. His comments on medicine and medicinal substances reveal the impact of the new science and changing models of medical practice, but without the polemical or intra-professional debates that make it hard to trust many other writings. Overall, Houghton’s caution and empiricism make his work a reliable testimony to the normal pattern of medical practice in William Rose’s London.

Jonathan Barry

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Working Paper No:3

WhittyEMPHandlist 

‘British Books and Books Published in English Related to Medicine, 1475-1640: A Handlist of Identified Works’ – Synopsis.

The author of this paper, Christopher Whitty, is a physician and epidemiologist with an interest in tropical and infectious diseases. He is currently Professor of Public and International Health at the London School of Hygiene and Tropical Medicine and has roles as an advisor to government. The work for the paper was carried out in the mid-1990s while he was a medical student at Oxford University, as an option in the history of medicine under my supervision. The paper has already been used by a number of scholars, including D Phil/PhD students, and it seems a good idea to make it more generally available. Dr Whitty is strongly in favour of this and wishes to stress that he sees the paper very much as a work in progress to which he hopes other scholars will contribute. He also wishes to thank the Wellcome Trust who provided a travel grant to support the research for it.

During the early modern period medical publishing for highly literate practitioners and the learned was of course largely not in English but in Latin or other vernacular languages, and was led not by London but by the great continental publishing centres, mostly in Italy, France and the Holy Roman Empire. For the period up to 1600, the majority of such publishing can now be accessed via the Universal Short-Title Catalogue project based at the University of St Andrews, and searchable at http://ustc.ac.uk/index.php/search – the classification heading of medical texts includes just over 12,000 titles (of these about 550 were published in England, and 530 in English). Whitty’s handlist is concerned with the rise of English vernacular publishing and the emergence of a native trend in medical writing and communication.

Many of us working on English vernacular sources will be able to relate to what Whitty rightly calls the frustrations of trying to identify published works relating to medicine in the early modern period. Because of the seamless nature of early modern discourse, in which vocabulary and concepts we might see as ‘medical’ are freely used in other contexts, while medical practitioners are equally likely to use religious or literary terminology, it is often impossible to identify medical works accurately by titles alone. Moreover, the concept of a monograph was as yet relatively rare, and we need to recognise the variety of texts providing medical information or advice – plague tracts, herbals, midwifery manuals, pharmacopoeias, medical polemics, housewifery manuals, surgical textbooks, and regimens. The task is further complicated by the prevalence of whole or partial translations. Hence Whitty stresses the need to inspect many of the works in question, physically or on microfilm. He mentions other scholars (Russell, Larkey, Slack, Webster) who have either attempted to make checklists, or who have done so for their own use without publishing them. No such list existed at that time in print. Whitty saw the recent completion of the second edition of Pollard and Redgrave’s Short Title Catalogue (1976-1991), which covered the period 1475 to 1640, as creating an ideal opportunity to put together a reliable list based on the latest bibliographical findings.

We now live in a virtually different universe with respect to such projects. It is not often necessary these days to resort to microfilm. Early English Books Online (EEBO), for example, dates from the end of the 1990s. During the same decade the Short Title Catalogue was incorporated into the files of the Eighteenth-Century Short Title Catalogue, to create the English Short Title Catalogue. CDRom editions of the latter came out from the late 1990s onwards. It is now available online under the aegis of the British Library and is updated on a daily basis. Such resources will ultimately provide a whole new dimension in terms of comprehensiveness and searchability. The obvious project to mention in the context of these step-changes is ‘Vernacular Medical Books in Early Modern England’, which has grown out of the work of Mary Fissell of Johns Hopkins University. Working in co-operation with Elaine Leong of the Max Planck Institute for the History of Science, Fissell plans to document, and make searchable by author, title, and subject, all pre-1700 medical books published in English, paying particular attention to English translations of medical texts originally written in other European vernaculars and in Latin. Others involved in this project include Tillmann Taape, of the History and Philosophy of Science Department of Cambridge University, whose PhD is concerned with vernacular traditions of medicine and alchemy, with particular reference to the surgeon and apothecary Hieronymus Brunschwig; and Olivia Weisser, now of the University of Massachusetts Boston, whose book Ill Composed: Sickness, Gender and Belief in Early Modern England is due out shortly.

Fissell and her collaborators will obviously cover more chronological ground than Whitty’s handlist and will include the boom years of print in the mid-seventeenth century when censorship lapsed or was abolished. They may also include some types of literature, for example Bills of Mortality, or advertisements, which Whitty decided to exclude. Nonetheless, these and other scholars with access to it are still finding Whitty’s handlist valuable, and no equivalent list is as yet available in print or online. Moreover, Whitty’s list raises many of the problematic issues of definition, inclusion and exclusion which are constant whatever the search mechanisms involved.

Margaret Pelling

April 2015

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Working Paper No: 4

Eastanglianwitchtrialappendix2

In 1645, a series of witch trials began in East Anglia, which, within just two years, had claimed the lives of almost 200 victims. Chief responsibility for the trials has largely fallen on the obscure figure of the so-called witchfinder general Matthew Hopkins, whose exploits have long attracted the interest of both scholars and others, including filmmakers and writers. However, as I argue in my recent book on the subject (Witchcraft, Witch-Hunting and Politics in Early Modern England, Oxford, OUP, 2016), it is possible to view the trials in a different light, more specifically as an attempt by a puritan minority to purge the nation of a range of enemies (diehard supporters of Charles I and his Arminian Church, Catholics, witches and other moral deviants) as a prelude to the creation of a new, godly state. In many respects, East Anglia provided the most fertile ground for such a religious movement. Prior to the civil wars, it was at the heart of the conflict between the King and his political and religious advisors on the one hand, and their puritan opponents on the other. Much of that opposition was crushed or went underground, many dissidents removing to New England to avoid further persecution. After 1642, however, the boot was on the other foot. Religious and political purges ensued, followed by a brief period of official iconoclasm, under the watchful eye of a Suffolk man named William Dowsing. And then the witch accusations and trials. In this appendix – a kind of gazeteer of the Hopkins’ trials – I seek to describe the religious and political conditions of each of the individual communities that produced witches in this period. In the process, it should be self-evident that Hopkins was merely the catalyst for witch-hunting at this time rather than the chief instigator, and that the witch hunts themselves were the product of the unique set of circumstances prevailing in this region of England at this particular time.

Peter Elmer,

February 2016

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Working Paper No. 5: The Life and Times of Dr Richard Frewin (1681-1761): Medicine in Oxford in the Eighteenth Century. A.H.T. Robb-Smith (ed. Margaret Pelling).

(click the link below to access PDF of the paper)

Frewin

Richard Frewin lived a long and prosperous life as a physician in 18th-century Oxford. He was highly successful, but he made no discoveries, nor did he leave any publications. He had many important patients, but he does not feature largely in their surviving papers. One of his patients compared him to Hermann Boerhaave, but this must have been on the grounds of his clinical acumen, as he played no major role in medical education. He held posts in the university, but these were in rhetoric, chemistry, and even history, rather than in medicine.

Why then is Frewin of interest? It could easily be argued that physicians, especially university-trained physicians, have already received far more attention than any other type of practitioner and that they are disproportionately represented in most biographical sources. The author of this Working Paper, the late Alastair Robb-Smith, brought together every scrap of material relating to Frewin and some may find his attention to detail excessive. It is certainly the case that in today’s academic world no journal would accept such a contribution, nor would any publisher be likely to take on a monograph about Frewin. Robb-Smith gave the lecture on which his MS was based as long ago as 1972, and medical history, and the history of the long 18th century, have both come a very long way since then.

There are however good reasons for making Robb-Smith’s material available. (1) Although Frewin is his aim and object, the individual becomes in the end mainly a peg on which a great deal of contextual information is hung, involving a large number of other identities, medical and otherwise. (2) Robb-Smith points out that far less was known about provincial than about metropolitan medical practice, and this is still true today. An advantage of the case of Frewin is that we gain insight also into the interconnections between London, and a nearby university town and centre of influence. (3) Robb-Smith’s exhaustive approach helps to create a more rounded and realistic account of a physician’s life than is often the case. In this context it becomes a virtue that Frewin was not particularly distinguished. At the same time, we can recognise in Frewin an example of the type of medical practitioner, often but not always a physician, who decided that discretion was the better part of valour where many contemporary issues were concerned, especially in politics. This attitude did not preserve Frewin from becoming involved in various disputes, inside and outside the university. (4) Frewin’s connections with Oxford reveal a great deal about how business was done in the 18th-century university, the role of patronage and even corruption, the ceremonies and the gossip, the involvement of the university in national politics, the importance of personal and client relationships, the level of absenteeism, and the very limited extent to which the existence of a post in a subject implied attention to that subject within the university. We even learn something of how housing was provided for university post-holders, a rather too familiar problem in the present day. Robb-Smith was himself very much an Oxford man, but his assessments are critical, and often scathing. He does state his opposition to the view that medical education scarcely existed at Oxford, such that English physicians were obliged to qualify themselves overseas, but he goes on to demonstrate what more recent historiography has also established more comprehensively, which is that, in both English universities, interested parties conducted teaching and research effectively on a private basis, outside the formal curriculum. Similarly, he is rightly sceptical about how certain we can be that many MBs and MDs actually practised. (5) The incidentals of Frewin’s life and times demonstrate how physicians constructed a livelihood for themselves, which could involve marriage, sinecures, and enterprises such as private madhouses as much as medical practice. We can observe also how physicians bargained and fought among themselves for a practice, that is, the de facto right to dominate access to patients in a defined area. In the past, details of this type have tended to give medical historians the false impression that there could only be very few practitioners in any given location. Robb-Smith focuses on the world of physicians and does not deal with the full range of practitioners, but we do see something of the ways in which physicians and apothecaries worked (and sometimes colluded) together. We glimpse how close some apothecaries were to their patients, and how an ageing retired physician might keep an ‛old nurse’ to watch over him as he slept. We also see how little clarity there still was about what later became medical ethics, that is, the agreed principles governing relationships between practitioners. Also of interest is the evidence of ‛private’ apprenticeship, whereby an established physician effectively took on a pupil. (6) For historians hunting, often vainly, for case-records of practice, Frewin offers an explicit instance of what must often have happened to such records. Frewin’s were obviously extensive and detailed, but he made sure that they were all destroyed. (7) We can observe the importance of networks of communication, although it is also clear that these were often faulty – that is, the rumour mill got it wrong. Of particular interest are the reports of a well-placed person’s illness or impending death. This was valuable information in the early 18th century, as it was in the whole of the early modern period. Such reports, or rumours, were the signal for interested parties to mobilise their candidatures, their sources of influence, and even their stock of damaging gossip aimed at downing rivals for the position in question. Although direct evidence is usually fragmentary, medical practitioners clearly played an important role as transmitters of information about illness and death. A practitioner could curry favour with an important patient or patron by being the first to provide him (or her) with such news. (8) We gain a clear impression of the literary activities in which a university-trained physician might engage, ranging from the frivolous through the pretentious to the political. We can also note the readiness of ‛respectable’ physicians to resort to pamphleteering in order to defend or to attack. For all these reasons, in spite of its discursiveness and tendency to anecdotage, Robb-Smith’s account of Frewin still has a lot to offer.

The Working Paper is an edited version of the fifteenth Gideon de Laune lecture, given by Robb-Smith to the Worshipful Society of Apothecaries in London on 19 April 1972. Robb-Smith died in 2000, after a notable career in Oxford as a pathologist and expert on disease classification. He was also active and valued as a medical historian of the traditional type, publishing on the Oxford hospitals, anatomy in Oxford, and related subjects (see below). He was however not inclined to hagiography. At one point he became my supervisor and, although this arrangement was not successful, I retained a respect for his standards and commitment. Late in his life he passed the Frewin MS to me with the idea that it might be published in the Oxford Wellcome Unit’s Research Publication series. Unfortunately this series was terminated so that the MS never appeared. I am grateful therefore that the EMP project has provided an opportunity to make Robb-Smith’s work available. Because the text was essentially the typescript of a talk, I have done a fair amount of editing in order to clarify or make minor corrections and additions. The original talk was evidently illustrated with slides, but these were not supplied to me. I have left in references to them so that readers will be aware of what was available at the time. Regrettably, although he was able to expand and revise his lecture to some extent, Robb-Smith did not provide footnotes. It did not seem worthwhile to try to recreate these, partly because the nature of his sources is mostly evident from the text. The extensive quotations have not been checked, so that the reader is advised not to quote from these without reference to the originals. As far as possible I have checked the titles of the works mentioned, and I have appended to the text some further reading which I hope will be helpful. Finally, I should like to thank Dr John Ford of the Society of Apothecaries for clarifying the date of the lecture for me, Dr Dominic Keech and Dr Georgina Edwards for giving me access to the Shippen memorial in Brasenose College chapel, and Dr Peter Elmer for providing the Sloane MS reference. I am also grateful to Belinda Michaelides of the Oxford Wellcome Unit for her invaluable help with scanning and reformatting.

Select publications by A. H. T. Robb-Smith:

The Oxford Medical School and its Graduates, from the Presidential Address to the Oxford Medical Society, June 1958 (1958) [offprint from Oxford Medical Gazette].

The Radcliffe Chapel and the Combe Benefactions (Oxford, [1965]).

(with H. M. Sinclair) A Short History of Anatomical Teaching in Oxford (Oxford, 1950).

‛John Hunter’s private press’, Journal of the History of Medicine, 25 (1970), 262-9.

A Short History of the Radcliffe Infirmary (Oxford, 1970).

‛Cambridge medicine’, in A. G. Debus (ed.), Medicine in Seventeenth-Century England (London, 1974), pp. 327-70.

Some Notes on Oxford Medical History, XXIII International Congress of the History of Medicine, Oxford (1972).

‛Medical education’, in M. G. Brock and M. C. Curthoys (eds), The History of the University of Oxford. Vol. 6: Nineteenth-Century Oxford, Pt I (Oxford, 1997), pp. 563-82.

(with I. M. Moriyama and R. M. Loy) History of the Statistical Classification of Diseases and Causes of Death, rev’d by H. M. Rosenberg and D. L. Hoyert, National Center for Health Statistics (Hyattsville, MD, 2011).

Margaret Pelling

Senior Research Associate

Wellcome Unit for the History of Medicine

University of OxfordMargaret.pelling@history.ox.ac.uk