In advance of Gary Edwards’ talk on 20th September about 17th century surgeons and their practices, this is a short scene-setter which I hope will whet your appetite to hear more.
In the 17th century, the journey from the cradle to the grave could often be a very short one as a browse through contemporary burial records reveals. In nine months during 1668-9, for instance, 47 of the 70 burials recorded at Poole St. James’ church, were of children. Childbirth, even if attended by an experienced midwife, was a dangerous time for infants and mothers because of poor sanitary conditions and lack of knowledge. Those who survived the trauma of birth were all too likely to succumb to one of the infectious diseases which regularly broke out, including measles, typhus, smallpox and plague. Outbreaks of the dreaded plague killed up to 150 people in Blandford and Bridport in 1626 and 500 in Salisbury in 1627. Woodbury Fair was cancelled for three years to avoid spreading the infection. In 1628, Shaftesbury suffered from an outbreak with only 20 fatalities but 10 years later, as many as 400 people may have died at Wimborne. In 1645 it was the turn of Poole when the plague struck in the middle of the Civil War and probably took about 118 lives (see the post ‘Epidemic!’ on this blog).
Those who survived into adulthood would rely mainly on folk remedies which every good housewife knew how to concoct. In the 17th century, some of these were collected and published in guides such as Gervase Markham’s ‘The English House-wife’, published in 1615. Many were based on common herbs like this cure for headache: For the Head-ach, you shall take of Rosewater, of the iuice of Camomile, of warme milke, of strong wine vinegar, of each two spoonful, mixe them together well upon a chafing dish of coals: then take a peece of drie rose cake and steepe it therein, and as soone as it hath drunke up the liquor and is thoroughly hot, take a couple of sound Nutmegs grated to a powder, and strew them upon the rose cake, then breaking it into two parts, bind it upon each side upon the temples of the head, so let the party lye down to rest, and the paine will in short space be taken from him.’ It was only in serious cases (and if they could afford it) that people turned to the apothecary, the physician or the surgeon.
At the beginning of the century, medicine was still based on the medieval theory of illness resulting from any imbalance in the four fluids or humours of the body, but some physicians began to challenge aspects of the theory, based on their observations. In 1628, William Harvey published a well-argued thesis proposing that blood circulates round the body, but it took many years for the idea to be generally accepted. Epidemics of infections diseases, including the plague, gave doctors the chance to study symptoms and the efficacy of remedies, and the Civil War provided many examples of trauma for surgeons to improve their techniques.
One of the most noted surgeons of the century was Richard Wiseman who became Sergeant Surgeon to King Charles II. As a young man, recently trained as a barber surgeon, he served on the Royalist side of the conflict and was present during the battle of Weymouth in 1644-5. In later life, he published several ‘Chirurgical Treatises’ dealing with many surgical procedures including some honed during the war. On treating gunshot wounds with fracture he advises ‘if the Wound be not large enough, make it so that you may the better pull out the extraneous bodies, whether Slug, Bullet, Rags, Splinters, or Shivers of Bones, so shall the Extension be made the easier and less subject to Inflammation . . . Whereas if the Wound be not so cleaned, these extraneous bodies, nay the smallest Shivers of Bone, will raise such disturbance as will render it incapable of Digestion . . . Make your Extension so soon as you may, and restore the Bones to their former place with what gentle dexterity and lenity you can.’
Also involved in the battle at Weymouth but on the Parliamentary side, was Thomas Sydenham, one of the Sydenham brothers of Wynford Eagle, Dorset. Although badly wounded, Thomas survived and went on to become a famous physician, his ‘Observationes Medicae’ being regarded as a standard text book. Among many other diseases, he wrote about the plague, basing his arguments on close observation of patients and treatment. He claimed that ‘an enquiry into the manner of curing diseases may proceed very successfully, tho’ we are ignorant of their causes, because the cure of most diseases is not effected by this kind of knowledge, but by a suitable and experienced method’. Today’s doctors would not agree with him but would probably approve his detailed observations as a basis for treatment.
For plague and pestilential fevers, he recommended moderate bleeding followed by the raising of a sweat in the patient for twenty four hours. Then he administered a sudorific (sweat inducing) bolus or pill: ‘Take of Venice treacle, half a dram; the electuary of the egg, a feruple; Gascoign’s powder, twelve grams; and the juice of the kermes enough to make the whole into a bolus; to be taken every six hours, drinking after it six spoonfuls of the following julep: take of the distill’d water of carduus benedictus, and compound scordium water, of each three ounces, treacle water, two ounces; syrop of cloves, an ounce: mix them together for a julep.’ Venice treacle was ‘theriac’, an ancient concoction regarded as a cure-all, an electuary was a medium to make medicine more palatable, Gascoign’s powder contained various powdered substances including pearls, and both cochineal and juice of kermes were red coloured dyes made from crushed insects. I haven’t managed to work out how much a feruple was! The refreshing julep was made of spiced and sweetened herbs, carduus benedictus (‘blessed thistle’) and scordium (water germander). After a further twenty four hours, the patient was given a purge made of an infusion of tamarinds, senna leaves, rhubarb, manna (from the manna ash) and syrup of roses. By this treatment, Sydenham claimed, ‘I recovered several persons who were seized with a pestilential fever . . . and did not lose a single patient after I began to use it.’
As a garrison town for the Parliament during the Civil War, Poole must have seen many injured soldiers requiring the attention of a surgeon. Although we know the names of several 17th century doctors practicing in Poole, there is very little information about their treatments and whether they would have been similar to those used by Wiseman and Sydenham. During the plague outbreak of 1645-6, the sick were isolated at Baiter in the town windmill and several purpose-built pest houses. Here they were attended by Dr. John Spence who was paid a salary of 30s (£1.50) a week by the town. From the accounts we know that he used pitch and tar to fumigate the houses and ordered a lot of vinegar, perhaps to wash the patients. He also obtained ‘cuill oyle’ and a box of drugs from Salisbury, but what they were and how they were used is not explained.
Those whose ailments were beyond the aid of medical treatment were advised to seek help from their faith. A letter of 1687 in the Poole archives from Dr. John Tillottson (Doctor of Divinity not Medicine) is an example. Having heard that his friend Mr. Nicholas Hunt of Canterbury was suffering from a fatal cancer, he wrote to console him and urge him to resign himself to God’s will: to renew your Repentance for all the Error and miscarriages of your Life and earnestly to beg God’s pardon & Forgiveness . . . to exercise Faith and Patience for a little while; and be of good Courage since you see Land; the Storm wch you are in will soon be over.’ In an age when religion was so central to people’s lives and disease would be seen as a punishment from God, faith could also be a consolation when science failed.