The age of purges

The age of purges

Sara Read offers some examples of how medical case notes can reveal a painful side to our ancestors’ lives, with treatments ranging from chicken soup for the soul to pigeon entrails for the body

Dr Sara Read, specialist in early modern culture and medicine

Dr Sara Read

specialist in early modern culture and medicine

In record offices up and down the country, the diaries, journals and case notes of many doctors through the centuries are often overlooked. These documents might contain valuable information on a family member, or the lives of their friends and neighbours. The sort of information these notes hold not only tell us a lot about medical attitudes throughout history but might also provide contextual information that will bring your relative, or their immediate contemporaries, to life in ways that birth and death records simply can’t.

Visiting the doctor in the 17th century was very much a last resort for ordinary people, as the fees were prohibitive. If someone in the family fell ill, the first treatment would be one of the many herbal cures that most housewives were skilled in making. For those living in the household or on the estate of landed gentry, the lady of the manor often acted in the role of physician as part of the pastoral care the estate provided. Lady Margaret Hoby and Lady Grace Mildmay are just two examples of early 17th century titled ladies who were recorded performing this role.

John Hall’s Select Observations
John Hall’s Select Observations contains many fascinating (and unpleasant) case histories

Lots of books, such as The Ladies Delight: Or, a Rich Closet of Choice Experiments & Curiosities (1672), by Hannah Woolley, were available, which combined household hints with recipes for cures for conditions from chesty coughs to backache and, perhaps more surprisingly, breast cancer. The remedy for a cough was given as a mixture of boiled honey infused with powdered colt’s foot mixed into a thick paste, to be taken as required. If homemade cures didn’t work, the family would call on the services of the local apothecary, with his jars full of exotic herbs and bottles of colourful liquids, the equivalent of consulting the pharmacist today. Only if all else failed and funds allowed would you call upon a physician, who would make a note of your visit in his casebook.

One of the most famous of these collections of case notes is available in a modern edition, so doesn’t even require a trip to the record office in the first instance. John Hall (1575-1635), who was married to William Shakespeare’s daughter Susanna, had an extensive medical practice in and around Stratford-upon-Avon in the early 1700s. It extended some 40 miles around his home, known as Hall’s Croft. His book Select Observations has 200 cases, some added by his editor, many of which refer to separate individuals.

The notes seem to have been selected for potential publication by the doctor himself, as his 17th century editor, fellow physician James Cook (1614-1688), claimed that the published cases were selected by Hall as being those he deemed “fittest for public view”. On the back of his handwritten notes is a table of contents in his own hand too, which further suggests he intended to publish them at some point. Cook bought two notebooks from Susanna Hall, and these formed the basis of a printed edition in 1657. One of the notebooks is extant in the British Library but the other is now lost. The published edition names patients and gives a frank account of their illnesses and treatment.

Hall’s original notes were in an abbreviated Latin code which would have afforded his patients some degree of confidentiality in his lifetime. After publication they would have none – although many would be dead by the time their consultations became public. For the genealogist this breach of confidentiality means that we can flesh out some invaluable details of the lives of Hall’s patients. The patients range from the very young, such as the countess of Salisbury’s infant son Talbot, who had a fever and worms, to the more elderly such as the 70 year old ‘Esquire Beaufou’, who became ill after eating too much cream with his supper. Other patients include “Mrs Hall of Stratford, my wife” and “Elizabeth Hall, my only daughter”, Shakespeare’s only grandchild in his lifetime. Also listed was poet Michael Drayton, a friend of Shakespeare, who had a tertian (three-day) fever.

Hall even discusses his own ailments such as the haemorrhoids he suffered, which were aggravated by visiting patients on horseback. Hall tried several treatments for this condition but when it developed into a fever another physician had to be consulted. He ordered a pigeon to be cut open while still alive and applied to Hall’s feet to attempt to draw out the fever.

 The apothecary’s shop
The apothecary’s shop was the forerunner of today’s pharmacy Alejandro Linares Garcia

A number of these cases refer to teenagers including John Emes who at 15 has a brief entry which noted that he had a problem with ‘pissing’ the bed. This term, now unacceptable, was in fact the normal polite, colloquial term for urination, and so normal to see in a patient’s medical record. Emes was cured with a medicine made from the windpipe of a cock powdered with crocus and mixed into a raw egg taken in the morning.

Fourteen-year-old Richard Wilmore of Norton Worcestershire, some sixteen miles from Hall’s home, has a longer entry, after he saw the doctor for a case of vomiting worms. The worms are described in detail as being black, an inch and half long with little red heads, and six feet, which crept about like earwigs. Wilmore was very ill when the doctor first visited him, “almost dead” in fact. The disease re-presented every new moon, Hall notes. Wilmore was cured with emetics made from rhubarb and senna. He gave the doctor his thanks, and when Hall bumped into him some two years later was happily able to report that the problem had not returned.

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A medieval depiction of bloodletting
A medieval depiction of bloodletting

Editha Staughton has two entries when she is 16 and 17. In the first entry the young woman was tormented by intestinal worms which Hall cured “perfectly and speedily” but more seriously by the next year Staughton had become seriously depressed, which Hall believed to be caused by her delayed adolescence. She believed that her parents were trying to kill her, and suffered from insomnia or “watching”. Other physicians had purged her but she was still unwell, so Hall prescribed a healing chicken and herb broth, and various medicines. This was followed by more purging, bloodletting and leeches to her haemorrhoids. After all these interventions “by the blessing of God she was delivered from her Distemper”.

A Mr Fortescue suffered from epilepsy, then known as ‘the falling-sickness’. He consulted Hall on 5 June 1623, and Hall determined that the condition emanated from the man’s stomach. Fortescue was treated with pills containing aloes, rhubarb, and senna to purge his system, he was also let blood, and given sneezing powder and opiates.

The English Physician
Nicholas Culpeper’s herbal handbook The English Physician (1652) was a major reference work for medical treatments, and remains in print today

Other entries perhaps highlight the difference between early-modern sensibilities and our own as Hall notes that Lady Harvey – whom he describes as a very religious woman – had been troubled with inordinate discharge and backache after giving birth but which Hall cured with a treatment of dates and honey. The treatment worked so well that Harvey notes that she was cured from her pain, and it “made her fat”. Similarly we know that Mrs Davis of ‘Quenton’, probably Quinton, a parish of Stratford, suffered from wind, and Mrs Sheldon who was very corpulent, but well coloured – a reference to her humours, or bodily fluids, being considered to be in a good balance (see box) – had repeated miscarriages in the second month of her pregnancies.

Hall’s published notes are only one example and there are other case notes in manuscript from doctors and apothecaries alike up and down the country. For instance, in Stafford Record Office is the small notebook of local physician Richard Wilkes which gives details of his patients over a two-year period. These include a Mrs Budworth who sadly delivered a stillborn baby in 1736. Similarly, John Westover, an apothecary and surgeon, from Wedmore in Somerset left notes covering his practice from 1685-1700. This book has been edited and made available online in PDF format by the Wedmore Genealogy Pages here. Dr Hall’s house in Stratford town centre is now part of the Shakespeare Birthplace Trust and is open to visitors to get a sense of both how Hall lived, where he consulted patients, and his garden where he grew many of the herbal cures he relied upon.

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