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Good Advice and Little Medicine: The Professional Authority of Early Modern English Physicians

Published online by Cambridge University Press:  10 January 2014

Harold J. Cook
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Extract

      Henry:
      Then you perceive the body of our kingdom, How foul it is;
      What rank diseases grow, and with what danger, near the heart of it.
      Warwick:
      It is but body, yet distempered, Which to his former
      Strength may be restored with good advise and little medicine.
      [Shakespeare, Henry IV]

Shakespeare's words remind us that in the learned traditions of Renaissance Europe, good advice remained more important than potent medicines for restoring both physical and political states to their previous strengths. As the lord advised the king, so a physician advised his patient, or lawyer his client, or minister his flock: preventing troubles was worth far more than cure, and the best remedy even when matters went wrong was good advice on how to return to a state of harmony. Still, plenty of quacks in politics and medicine, law and church, advocated strong measures, not helping people to live in accordance with their world but attempting to alter the conditions under which they lived. Bad advice and powerful remedies seemed to be everywhere, trampling good council and temperate behavior. The connections between learning and authority that lay behind claims to authority in general are especially well illuminated by the ways in which the physicians argued for possessing, maintaining, and extending their professional privileges.

Among all the number and variety of medical practitioners in early modern England, one small group self-consciously considered itself to be professional: the physicians. As one of the three learned professions surviving from the Middle Ages, the “medical profession” has been a crucial test case for various definitions of what a profession is or was.

Type
Research Article
Information
Journal of British Studies , Volume 33 , Issue 1 , January 1994 , pp. 1 - 31
Copyright
Copyright © North American Conference of British Studies 1994

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References

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14 “Concerning Phisicians,” 32 Hen. VIII, c. 40. The so-called Quacks Charter of 1542–43, concerning all men and women with a “knowledge of the nature kinde and operacion of certeyne herbs rotes and waters, and the using and mynistering of them to suche as been pained with customable diseases,” protected them not from the supervision of the physicians but only from the suits and “vexations” of the surgeons: “An Acte that persones being no commen Surgeons maie mynistre medicines owtwarde,” 34 & 35 Hen. VIII c. 8.

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31 In early modern English, “diet” still retained its Greek meaning of a regular way of life, just as a German or Japanese parliament is called a “diet” if it meets regularly. Our association of “diet” with eating, and more specifically with abstaining from food, is the last dim legacy of this more inclusive ancient notion of regulating one's life for health.

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39 Securis, sig. Biiiiv. This is consonant with Aristotle's notions of virtue as derived from practical reason, and with contemporary Anglican notions of conscience as habits of mind; see McAdoo; Wood; Sherman, Nancy, The Fabric of Character: Aristotle's Theory of Virtue (Oxford: Clarendon Press, 1989)Google Scholar. Paula Gottlieb points out that one of Aristotle's central “ethical” analogies is the equation between goods and healthy things; see Gottlieb, Paula, “Aristotle and Protagoras: The Good Human Being as a Measure of Goods,” Aperion 24 (1991): 25–45Google Scholar.

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45 Ibid., pp. 2–8.

46 Ibid., pp. 117–18.

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52 McAdoo (n. 34 above), p. 27; Wood (n. 34 above), p. 5.

53 For more on the rights and responsibilities entrusted to the College of Physicians by the early Stuarts, see Cook, Harold J., “Policing the Health of London: The College of Physicians and the Early Stuart Monarchy,” Social History of Medicine 2 (1989): 1–33CrossRefGoogle ScholarPubMed.

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57 Roy Porter has recently taken up this theme with gusto; see, e.g., his “The Language of Quackery in England, 1660–1800,” in The Social History of Language, ed. Burke, Peter and Porter, Roy (Cambridge: Cambridge University Press, 1987), pp. 73–103Google Scholar, “Before the Fringe: ‘Quackery’ and the Eighteenth-Century Medical Market,” in Studies in the History of Alternative Medicine, ed. Cooter, Roger (London: Macmillan, 1988), pp. 1–27CrossRefGoogle Scholar, Health for Sale (n. 8 above).

58 For a further elaboration, see Cook, , Decline of the Old Medical Regime (n. 8 above), pp. 28–69Google Scholar. Published advice became more that of hygiene (good for anyone who followed the rules) than of dietetics (appropriate only for a particular person). On the literature of public hygiene, see Smith, Ginnie, “Prescribing Rules of Health: Self-Help and Advice in the Late Eighteenth Century,” in Porter, , ed., Patients and Practitioners (n. 8 above), pp. 249–82Google Scholar; Hannaway, Caroline, “From Private Hygiene to Public Health: A Transformation in Western Medicine in the Eighteenth and Nineteenth Centuries,” in Public Health, ed. Ogawa, Teizo (Tokyo: Saikon, 1980), pp. 108–28Google Scholar.

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60 The alchemists made this so plain that C. G. Jung rooted a large body of his psychological theory in it. For a discussion of his views, see Dobbs, B. J. T., The Foundations of Newton's Alchemy; or, ‘The Hunting of the Greene Lyon’ (Cambridge: Cambridge University Press, 1975), pp. 26–35Google Scholar; for a Jungian perspective, see Jacobi, Jolande, ed., Paracelsus: Selected Writings, 2d ed., Bollingen Series no. 28 (Princeton, N.J.: Princeton University Press, 1958)Google Scholar.

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62 For instance, O'Dowde, Thomas (The Poor Man's Physician, Or the True Art of Medicine, 3d ed. [London, 1665]Google Scholar, sig. A4V): “I scorne … the Greatest Doctor, mounted on his Asse and Footcloth, jogging on the old Road, laden with ignorance in the diviner sorts of Medicines.”

63 For example, Culpeper, Nicholas (A Physicall Directory Or a Translation of the London Dispensatory Made by the Colledge of Physicians in London [London, 1649]Google Scholar, translator's preface): “I am confident there be those in this Nation that have wit enough to know that the Papists and the Colledg of Physitians wil not suffer Divinity and Physick to be printed in our mother tongue, both upon one and the same grounds, and both colour it over with the same excuses.”

64 Kocher, Paul H., “The Physician as Athiest in Elizabethan England,” Huntington Library Quarterly 10 (1947): 229–49CrossRefGoogle Scholar; Hunter, Michael, “The Problem of ‘Atheism’ in Early Modern England,” Transactions of the Royal Historical Society, 5th ser., 35 (1985): 135–57Google Scholar; Wootton, David, “Unbelief in Early Modern Europe,” History Workshop, no. 20 (1985), pp. 82–100Google Scholar.

65 See esp. Shapiro, Barbara J., Probability and Certainty in Seventeenth-Century England: A Study of the Relationships between Natural Science, Religion, History, Law, and Literature (Princeton, N.J.: Princeton University Press, 1983)Google Scholar.

66 Shapin, Steven and Schaffer, Simon, Leviathan and the Air Pump: Hobbes, Boyle, and the Experimental Life (Princeton, N.J.: Princeton University Press, 1986)Google Scholar; Shapin, Steven, “The House of Experiment in Seventeenth-Century England,” Isis 79 (1988): 373–404CrossRefGoogle Scholar, “Who Was Robert Hooke?” in Robert Hooke: New Studies, ed. Hunter, Michael and Schaffer, Simon (Woodbridge, Suffolk: Boydell Press, 1989), pp. 253–85Google Scholar; Hunter, “Alchemy, Magic and Moralism” (n. 34 above); Golinski, J. V., “A Noble Spectacle: Phosphorus and the Public Cultures of Science in the Early Royal Society,” Isis 80 (1989): 11–39CrossRefGoogle Scholar; Southgate, B. C., “‘Forgotten and Lost’: Some Reactions to Autonomous Science in the Seventeenth Century,” Journal of the History of Ideas 50 (1989): 249–68CrossRefGoogle Scholar, esp. 266–67; Daston, Lorraine, “Nationalism and Scientific Neutrality under Napoleon,” in Solomon's House Revisited: The Organization and Institutionalization of Science, ed. Främgsmyr, Tore, Nobel Symposium no. 75 (New York: Science History Publications, 1990), pp. 95–119Google Scholar; and Pumfrey, Stephen, “Ideas above His Station: A Social Study of Hooke's Curatorship of Experiments,” History of Science 29 (1991): 1–44CrossRefGoogle Scholar.

67 Cook, Harold J., “The Society of Chemical Physicians, the New Philosophy, and the Restoration Court,” Bulletin of the History of Medicine 61 (1987): 61–77Google ScholarPubMed, “Physicians and the New Philosophy: Henry Stubbe and the Virtuosi-Physicians,” in Medical Revolution in the 17th Century, ed. French, Roger and Wear, Andrew (Cambridge: Cambridge University Press, 1989), pp. 246–71CrossRefGoogle Scholar, “The New Philosophy and Medicine in Seventeenth-Century England,” in Reappraisals of the Scientific Revolution, ed. Lindberg, David C. and Westman, Robert S. (Cambridge: Cambridge University Press, 1990), pp. 397–436Google Scholar, and Decline of the Old Medical Regime, pp. 133–182.

68 Cook, Harold J., “Practical Medicine and the British Armed Forces after the ‘Glorious Revolution,’” Medical History 34 (1990): 1–26CrossRefGoogle ScholarPubMed.

69 “An Act for exempting Apothecaries from serving the Offices of Constable, Scavanger and other Parish and Ward Offices, and from serving upon Juries,” printed in Raithby, John, ed., The Statutes at Large, of England and of Great Britain (London, 1811), 3:367–68Google Scholar. At the same time, in Edinburgh, the surgeons began to pay taxes at the rate of professional men in 1695; see Dingwall, Helen M., “Seventeenth Century Edinburgh Surgeons: Trade or Profession?” Proceedings of the Royal College of Physicians, Edinburgh 22 (1992): 81Google ScholarPubMed.

70 Quoted from the law report of the case in 6 Modern (Mod.), 44, printed in English Reports, vol. 87. In the report of the case in 3 Salkeld, 18, English Reports, vol. 91, the jury could not decide “whether [Rose's behavior] was practising as a physician.” According to The Case of the College of Physicians London, Wherein they are Defendants (London, 1704)Google Scholar, the question was “whether the said Mr. Rose did practise Physick within the Intent of the Letters Patents and Act of Parliament.”

71 6 Modern, 44. According to the Case of the College of Physicians, the special verdict was “argued three several times.”

72 6 Modern, 44. The words of 3 Salkeld, 17, are “let the distemper be what it will, the prescribing and advising what is fit for it, is the business of a physician, though without a fee, but that rarely happens.”

73 The Manuscripts of the House of Lords, Vol. 5: 1702–1704 (London: H.M. Stationery Office, 1910), p. 549Google Scholar; Journals of the House of Lords (February 18, 1703/1704), 17:441Google Scholar.

74 Dodd's, plea is summarized in Observations upon the Case of William Rose an Apothecary, As represented by him To the Most Honourable House of Lords (London [printed for the College], 1704), pp. 3–6Google Scholar.

75 Manuscripts of the House of Lords, p. 549. David Sacks has pointed out to me that another difference between Bonham's case and Rose's is that the legal issue centers on an exegesis of statutory language; that is, statute was not being measured against eternal norms, but was sovereign, needing interpretation of its words alone.

76 Manuscripts of the House of Lords, p. 549.

77 Observations upon the Case of William Rose, p. 24.

78 Porter, ed., Patients and Practitioners (n. 8 above).

79 Conflating the question about physic with the issue of supplying medical care to the poor, R. S. Roberts concluded that “the House of Lords gave the verdict to the apothecary, because it could no longer be denied that the Physicians' concept of what constituted medical practice did not serve the needs of the mass of the people” (Roberts, R. S., “The Personnel and Practice of Medicine in Tudor and Stuart England: Part II: London,” Medical History 8 [1964]: 229CrossRefGoogle Scholar). For more details on the Rose case, see Cook, Harold J., “The Rose Case Reconsidered: Physic and the Law in Augustan England,” Journal of the History of Medicine 45 (1990): 527–55Google Scholar.

80 Rosenberg, Albert, “The London Dispensary for the Sick-Poor,” Journal of the History of Medicine 14 (1959): 41–56Google ScholarPubMed; Ellis, Frank H., “The Background to the London Dispensary,” Journal of the History of Medicine 20 (1965): 197–212Google ScholarPubMed.

81 McKeon, Michael, The Origins of the English Novel, 1600–1740 (Baltimore: Johns Hopkins University, 1987)Google Scholar; Watt, Ian, The Rise of the Novel: Studies in Defoe, Richardson, and Fielding (Berkeley: University of California Press, 1964)Google Scholar; Morgan, Charlotte E., The Rise of the Novel of Manners: A Study of English Prose Fiction between 1600 and 1740 (1911; reprint, New York: Russell & Russell, 1963)Google Scholar; Reedy, Gerard, The Bible and Reason: Anglicans and Scripture in Late Seventeenth-Century England (Philadelphia: University of Pennsylvania Press, 1985), p. 143CrossRefGoogle Scholar.

82 For two different examples of such physicians, see Levine, Joseph M., Doctor Woodward's Shield: History, Science and Satire in Augustan England (Berkeley: University of California Press, 1977)Google Scholar; and Hone, Campbell R., The Life of Dr. John Radcliffe, 1652–1714 (London: Faber & Faber, 1950)Google Scholar.

83 Cook, Richard I., Sir Samuel Garth (Boston: Twayne, 1980)Google Scholar; Sena, John F., The Best-natured Man: Sir Samuel Garth, Physician and Poet (New York: AMS Press, 1986)Google Scholar; Booth, C. C., “Sir Samuel Garth, F. R. S.: The Dispensary Poet,” Notes and Records of the Royal Society 40 (1986): 125–45CrossRefGoogle Scholar; Krapp, Robert M., “Class Analysis of a Literary Controversy: Wit and Sense in Seventeenth Century English Literature,” Science and Society 10 (1946): 80–92Google Scholar; Boys, Richard C., Sir Richard Blackmore and the Wits: A Study of ‘Commendatory Verses on the Author of the Two Arthurs’ and the ‘Satyre against Wit’ (1700), University of Michigan Contributions in Modern Philology no. 13 (Ann Arbor: University of Michigan Press, 1949)Google Scholar; Rosenberg, Albert, Sir Richard Blackmore: A Poet and Physician of the Augustan Age (Lincoln: University of Nebraska Press, 1953)Google Scholar; Solomon, Harry M., Sir Richard Blackmore (Boston: Twayne, 1980)Google Scholar.

84 Such distinctions are never sharp or entirely clear, but see Chartier, Roger, Cultural History: Between Practices and Representations, trans. Cochrane, Lydia G. (Oxford: Polity, 1988)Google Scholar, and esp. “From Texts to Manners, A Concept and Its Books: Civilité between Artistocratic Distinction and Popular Appropriation,” in his The Cultural Uses of Print in Early Modern France, trans. Cochrane, Lydia G. (Princeton, N.J.: Princeton University Press, 1987), pp. 71–109Google Scholar. Older notions of civic virtue versus the newer virtues of commerce and manners are at the heart of Pocock's Virtue, Commerce, and History (n. 54 above). The forthcoming work of Lawrence Klein on civility in the early eighteenth century will also speak to these issues.

85 As Michael MacDonald notes, Napier “was distinctly hostile toward the Puritans' effort to transform the minister's duty to provide spiritual consolation into an obligation to convert suffering men and women to a more rigorous and saintly way of life” (Mystical Bedlam [n. 34 above], p. 223).