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)

Finding Medical Practitioners in Early Modern Britain.

History has been likened to dropping a bucket over the side of a ship, attached to a long chain. What comes up is a microcosm of life deep below the waves. So it is with an historical source. It offers a tiny little glimpse – a snapshot in time – of one particular event, or one person. On its own, though, it doesn’t give us a full picture. It is a frustrating fact but many people, in fact the majority of people, left little or no trace in the historical record. Even when one or two documents survive, it is often difficult to get much more than bare facts. Does this mean, though, that we shouldn’t bother even trying to piece together the lives of people in the past?

Our project is a study of medical practitioners in the early modern period. In fact, it is the largest concentrated study of practitioners probably yet undertaken in Britain. The aim is to try and identify all those engaged in the practice of medicine in England, Wales, Ireland and (later) Scotland between roughly 1550 and 1715. It is a massive undertaking. Who, for example, will be included? The list is enormous. Physicians, apothecaries, surgeons, barbers, barber-surgeons, chirurgeons, chymists, druggists, surgeon-apothecaries, cunning folk, medical entrepreneurs and quacks…and all points in between. Dr Peter Elmer, formerly of the Open University and now a senior research fellow at Exeter has already collected over 12,000 names, many with individual biographies. I’ve been charged with finding Welsh practitioners and, after eight months, the list already stands at more than 600 – and this for a country that reputedly had very few doctors. You can keep up with progress on the project at our website here: http://practitioners.exeter.ac.uk/

How are these people being located? The majority of my work is done in archives and on online catalogues. At the moment it is the sheer number of practitioners coming to light that is most surprising. They were, quite literally, everywhere. The problem lies in the deficiency of records and their limitations in offering much more than a glimpse of an individual’s life. Parish registers, for example, are often the only record that someone ever existed. In some cases, they might contain occupational data, and this begins to give some context. The Montgomeryshire parish registers are a useful case in point, with around 60 references to medical practitioners between the dates noted above.

 

(Image of North Devon Parish registers: Copyright Devon County Council)

Amongst the Montgomeryshire names are men like Arthur Jones of Berriew, a barber who died in 1697, Richard Evans of Brithdir “Physition” who died in 1701 and John Humphreys of Llanfechain, “chirurgeon” who died in 1660. Given that occupational data in parish registers is relatively rare, it seems fair to assume that recorded occupations suggest that these were the primary occupations of the people concerned. In each case, however, these are the only references to each man that I can find. No further evidence of their practice, their social status or indeed their lives, can be firmly established. At the very least though, and when aggregated, even this bare data does begin to allow us to see something of the landscape of medical practice in a given area. In Montgomeryshire, for example, is a rare reference to the occupation of midwife – one Catherine Edward of Glynceiriog, who died and was buried in April 1688. Midwives seldom appear in the historical record in Wales, so even brief references are interesting.

In other cases, though, it is possible to build up a broader picture of an individual practitioner’s life. The baptisms of children give both an indication of family formation as well as placing a person within a given area for a fixed number of years. Richard Ellis, for example, was a barber in Newtown, now in Powys. No record can be found for his birth or death, but the baptisms of his children William, Sarah and George between 1732 and 1737, in each of which he was referred to as a barber, tell us that he was at least practising between those dates. Also, it might be inferred (although by no means certain) that this was at the earlier end of his career given that children tended to be associated with marriage and the establishment of a household. The Newtown apothecary Thomas Kitchen provides a similar example, with the baptisms of his children Edward, Eusebius and Margaret between 1733 and 1737. Whilst we can’t tell anything about his business from this, we can at least fix him both geographically and temporally.

Other types of sources can unwittingly provide testimony to the businesses and social networks of medical practitioners. Wills and probate inventories can certainly be revealing about shop contents but, by looking further at things like the names of benefactors and even the signatories to wills it is possible to discern networks. In early-modern Wrexham, for example, a cluster of seventeenth-century wills reveal close links between practitioners in the same town, suggested by debts but also by their acting as executors or appraisers for colleagues. In some cases, for example that of Godfrey Green of Llanbeblig, died 1699, his entire shop and business found its way into the possession of another apothecary, John Reynolds, where it was still described as being the shop goods formerly of Godfrey Green when Reynolds himself died in 1716.

(Image of Cardiff from the North West: Used under creative commons licence, Wikipedia)

The best evidence can often be found where a picture can be built up using a variety of different documents. I’m currently working on an article about medical practitioners in early-modern Cardiff and especially their role within the early modern urban environment. Town records are generally better than for rural areas, but it is interesting to note the depth to which medical practitioners were often involved in town business. One Edward Want of Cardiff, an “barber-chirurgeon”, appears variously in documents in the second half of the seventeenth century. From parish registers we have his dates of birth and death, as well as the fact that he took over his business from his father of the same name. From hearth tax records we can tell that he was based in the affluent West Street area of the town, while a 1666 town survey further reveals that he was charged 6d  half a burgage in that area – the small plot probably indicating a shop. At some point he had occupied a mansion house near the corn market, a fact attested to by a land lease document, further suggesting wealth and status. References in the wills of two other Cardiff traders indeed refer to him as an Alderman, and Cardiff borough records also list him as a juror. We can also tell that his son Sierra Want was apprenticed to a Bristol barber surgeon, a common practice for the sons of middling-sort South Walians. Whilst his will contains nothing  of his medical practice, the use of a variety of documents can help us build up a real picture of the commercial and personal life of Edward Want.

In pulling the bucket up from the depths it is often difficult to glean much more than the barest facts; we often need more to really start to close in on the lives of our early-modern forebears. With practice, a little ingenuity and a great deal of luck though, even the smallest of extra facts help us to piece together a picture not just of how many people were practising medicine in Britain, and perhaps especially in rural Britain where records are fewer, but also something of their lives, occupations and statuses within their communities.

Alun Withey

(This post has appeared in an altered form on DrAlun.wordpress.com – apologies for cross-posting.)

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.