7 - Unruly Patients

Summary

Abstract: Chapter Seven reveals that genitourinary patients’ interactions with medical practitioners were often fraught. Medical writers regularly detailed patients’ inabilities to regulate their diet and sexual activity during treatment. Gourmandizing and debauchery were framed within blame narratives that shifted blame for poor health outcomes onto the patient. The chapter considers how far these actions were designed to reclaim control over the body. Expanding on scholarship that has explored the ways in which tensions and authority were negotiated, this chapter illustrates that an important weapon in a patient's arsenal was space and place, which was manipulated to gain control of the medical encounter. These actions framed them, in the eyes of medical writers, as obstinate and unruly patients.

Keywords: patient-practitioner relationships; diet; sexual activity; space; authority

‘Patients are like Children, still desiring such things which are offensive and hurtfull’, the surgical treatise of Felix Wurtz complained in 1658. This was not a unique sentiment and medical texts made clear that patients were aware that their behaviours did not always meet practitioners’ expectations. Daniel Turner declared of one venereal disease patient that ‘he said, he was very sorry he had not been governed by my former Advice; for he found my Predictions were come to pass, and he could only blame his own Obstinacy and Indiscretion’. Being a good patient required men to follow their prescriptions and to restrain their desires for food, drink, and sex. Gourmandizing, drinking, and licentious behaviour were all construed in certain circumstances as unmanly. Neglecting one's health through unregulated consumption suggested that neglect of social duties was probably not far behind. Restraint also demonstrated good manners which were increasingly bound to self-control of the body. Self-control was a key marker of patriarchal manhood. Objections about patient behaviour and observations of men's irregularity during treatment show that some men were unruly patients who jeopardized their own health. Discussions in printed literature and observations show that men attempted to manipulate and control the medical encounter, treatment, and cure by utilizing space and place.

Tensions existed between elite male patients and the physicians and surgeons with whom they consulted because these men were usually of a lower status than their patients. The establishment of the Royal College of Physicians in 1518 granted only a few elite practitioners elevated status.