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Working Paper Number 3 now uploaded.

Posted on 27th May 2015 by Alun Withey

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

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

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)

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/

Finding Medical Practitioners in Early Modern Britain.

Posted on 29th May 2013 by Alun Withey

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.)