by Richard Sugg
For adults, there were riding accidents. Robert Boyle recalled a man of around twenty-four who, after falling from his horse, ‘had his skull broken in several places’. Although the man was rich enough to have a number of surgeons attend to him (‘during which he was divers times trepanned, and had several pieces of his skull taken off’) he did not recover easily. About three days after the fall he suffered a loss of sense in his right side, while his arm and head became completely paralysed. Having endured this state for almost six months, he was saved by just one of the surgeons, who refused to let the others close up the skull. With the patient’s agreement ‘his head was further laid open; and at length, under a piece of proud flesh, they found, with much ado, a splinter, or rather flake, of a bone’. This, Boyle adds ‘was not pulled out without a great haemorrhage, and such a stretch of the parts, as made the patient think his brain itself was tearing out’. Despite living on without an entire skull, the man went on to become ‘strong [and] healthy’, saving that he was ‘a little obnoxious to take cold in his head’.62
If you survived your childhood, kept out of wars, deferred obsequiously to every man who bandied words with you, and were not thrashed by your employers, you still had a fair chance of being cut open at some point in your life. Men of all ages seem to have been frequently afflicted with urinary stones of sometimes startling size. After his death in 1622, the Puritan minister Nicholas Byfield underwent an autopsy which yielded a bladder stone of thirty-three ounces in weight (compare a good-sized red cabbage).63 In February 1602 the lawyer John Manningham pictures lithotomy as a kind of surgical Russian roulette. After cutting open the scrotum, the surgeons would ‘grope for the stone with … a tool which they call a duck’s bill’; but, ‘if the stone be greater than may be drawn forth at the hole made by the seam, the party dies for it’. This fate had indeed recently befallen one ‘Burneham of London’, Manningham tells us, after he resorted to the procedure out of desperation.64
Samuel Pepys was cut for the stone on 26 March 1658. In May 1669 John Evelyn’s brother seems to have been suffering from a bladder stone for some time. Because he was resistant to the idea of an operation, Evelyn took Pepys along in an effort to persuade him. Although we are not told precisely what Pepys said, we know that he was brandishing a proud trophy on his visit: his own bladder stone, which, Evelyn states, was ‘as big as a tennis ball’.65 Evelyn himself must have had a good idea of what was in store for his brother. Back in May 1650, during his French visit, he had seen five different patients undergo lithotomies in a Paris hospital:
there was one person of forty years old had a stone taken out of him, bigger than a turkey’s egg: the manner thus: the sick creature was stripped to his shirt, and bound arms and thighs to an high chair, two men holding his shoulders fast down: then the surgeon with a crooked instrument probed til he hit on the stone … he made incision through the scrotum about an inch in length, then he put in his forefingers to get the stone as near the orifice of the wound as he could, then with another instrument like a crane’s neck he pulled it out with incredible torture to the patient …
Adding laconically that ‘the effusion of blood is great’, Evelyn further notes that there is a common danger of fever or gangrene, and that some wounds will never close. We can only hope that the next victim Evelyn saw was happily oblivious of these dangers. He certainly seems to have been surprisingly little perturbed at his ordeal – showing ‘much cheerfulness’ and ‘going through the operation with extraordinary patience, and expressing great joy, when he saw the stone was drawn’. All this is impressive in its own right – but still more so when we learn that the subject was a child, just eight or nine years old.66
We have seen that those undergoing surgery would rarely be in any state to quibble about cannibalistic medicines. And we can also assume that most would have taken such treatments as an alternative to surgery if they could. The list of ingredients cited at the start of this chapter includes a ‘stone taken out of a man’s bladder’. Perhaps shrewd patients sold these after their own lithotomies. At any rate, they were commonly held to cure the stone, being recommended as late as 1739 by an Irish clergyman. For ruptures Barbette advised pills made of mummy, myrrh, filings of steel, dried hare’s dung and powdered earthworms.67 The royal surgeon John Browne proposes that scrofulous tumours be ‘softened and dissipated’ with ‘resolving and discussive medicines’ such as ‘hen’s fat, man’s fat, oil of sweet almonds’ and so on; whilst Banister holds that a wound drink of herbs and mummy is better for bones fractured by gunshot ‘than all those splints wherewith some are sore tormented’.68 As we saw in chapter three, the case of Lorenz Seitz, the ‘journeyman brewer in Nuremberg … rescued from knife-happy barber-surgeons by … Johann Michael Schmidt, the local executioner’ offers a particularly sharp contrast between the horrors of amputation and the simple use of bandages – these latter almost certainly being steeped in human fat.69
Some degree of anaesthetic relief was in fact available in the early modern period. In October 1602 John Manningham writes of ‘a certain kind of compound called laudanum’. Available ‘at Dr Turner’s, apothecary, in Bishopgate St’, this was ‘very sovereign to mitigate any pain’ and ‘will for a time lay a man in a sweet trance’. But laudanum, or opium, was clearly novel at that point; and even later on seems to have been used far less than we might expect. Unlike the numerous genteel opium addicts of the nineteenth century, good Christians of Milton’s time suffered their pain stoically.70 Indeed, in the sixteenth century the Puritan City Fathers of Zurich had banned even the primitive anaesthesia of the day, insisting that ‘“pain is a natural and intended curse of the primal sin”’, and that ‘“any attempt to do away with it must be wrong”’.71 Although Mayerne noted the use of opium (and human fat) as painkillers in his treatise on gout, Barbette stated, tellingly, that pain ‘must of necessity be eased, because it creates watchings, and dejects the spirits, and is cause of the flux of humours to the party affected’ – that is, only because it makes the patient yet more sick.72
Illness
If much of the above is all too vivid, it is perhaps also (at this distance) a little impersonal. Let us therefore focus our attention for a moment by returning to that pious devotee of skull-moss, the clergyman and popular religious author Richard Baxter (b.1615). ‘Poor health was a permanent feature of Baxter’s life’, according to his biographer, N.H. Keeble: ‘as a child he suffered from catarrh, colds, and a prolonged cough. In the early 1630s he was’, by his own admission, ‘“in expectation of death, by a violent cough, with spitting of blood, etc, of two years continuance”’. ‘“From the age of twenty one till near twenty three”’, Baxter adds, ‘“my weakness was so great, that I expected not to live above a year”’. When Baxter’s book The Saints’ Everlasting Rest appeared in 1650, it was, Keeble tells us, ‘addressed to its reader as the legacy of a dying man’. Perhaps to his own disappointment, Baxter in fact limped on through a quite long but incessantly painful life (dying only in 1691). He ‘suffered chronically’
from flatulency and gastric problems, ‘incredible inflammations of stomach, bowels, back, sides, head, thighs, as if I had been daily filled with wind’; from scurvy and from repeated haemorrhaging from ‘eyes, and teeth, and jaws, and joints, so that I had scarce rest night or day’; he was prone to catch colds and chills, and he suffered regularly from headaches, from ‘terrible toothache’, and from gallstones, in later life the severity of the pain leaving ‘scarce any part or hour … free’.73
The impressive volume of Baxter’s writings looks little short of miraculous in view of this extraordinary suffering. As Keeble concludes, ‘physical indisposition at best, pain at worst, were his constant experience’.
Keeble also notes that ‘the thirty or more different physicians Baxter was to consult during his life were unable to prescribe any sustained relief. Little wonder, then, that Baxter would gladly insert the moss of a dead man’s skull into his nostrils (although nosebleeds may have bee
n a mild complaint by comparison with haemorrhages from the eyes and joints). Baxter’s case seems to have been an extreme one. He himself described his symptoms as those usually experienced only by men ‘about fourscore years of age’.74 Nowadays, anyone under sixty who suffered even a fifth of this pain and discomfort would consider themselves immensely unlucky – especially if medical science offered them almost no help whatsoever.
Baxter himself undoubtedly took a very Christian attitude toward his sufferings. As an intensely fervent Protestant, he not only often believed that he was about to die, but very possibly wanted to. Few people so vividly exemplify that porous boundary between heaven and earth, or life and death, which we noted above. Baxter was, for example, an avid believer in ghosts, poltergeists and demonic possession.75 And Baxter’s experience suggests another distinctive feature of early modern illness. Whether passionately religious or not, many people must have endured frequent pain or severe discomfort as a more or less normal feature of their lives. Did they really always consider themselves to be ‘ill’? For most of us, the psychology of occasional illness is relative to long periods of being well. But such psychology must be very different if you are almost never fully healthy in the first place. Even if they were not especially tough or stoical, most men and women would probably have minimised their response to degrees of sickness or pain just because it was so familiar. Thus, in the time of Charles I and Cromwell, the gentleman Walter Powell of Llantilio is brisk and seemingly stoical when he records in his diary, ‘I fell sick of the small pocks for six days’, ‘my gout began in ye joint of my great toe’, ‘I fell on my stairs and break my rib’ – and even when ‘my right eye began to fail and I fell sick shortly and was like to die at Christmas’.76 (This seemed to hold for the deaths of others, with Powell noting sparely on 7 and 13 January 1654, ‘John Rawlins died drowned’, and ‘my son Charles his messenger came to tell us that my son Richard was like to die’.77)
Teeth
In the case of his toothache, wretched Baxter was at least far from alone. It has often been claimed that this was an especially pervasive problem of the pre-modern world. Although most people could not possibly have consumed a fraction of the extrinsic sugar easily available to European children nowadays, they also seem to have had very rudimentary methods of tooth care.78 As Honan notes, in Shakespeare’s boyhood reasonably affluent children usually cleaned their teeth ‘with a cloth and a sweetish paste’.79 This may have been more effective than the plain ‘cold water’ recommended by a writer of 1547 – but probably not much.80 To ‘go to the dentist’ meant simply to have your rotten tooth yanked from your head by a surgeon – an experience which could hardly have been much more pleasant than being cut for the stone.81 By the time she was sixty-five, Elizabeth I was supposed to have black teeth, and she would go on to lose even these some time before she died in 1603.
If surviving records offered us not one direct complaint about toothache, we could still infer the seriousness of this problem from the number and range of medical remedies directed against it. A relatively palatable option was burnt deer horn. If you were a dog, meanwhile, you were likely to have your own peculiar dental problems. In addition to not brushing your teeth, you might find that people were trying to get them off you, healthy or not, as another popular cure was a powder made from canine molars.82 Cavities, we are told, ‘may be filled with the brain of a partridge or crow’s dung’. And the terrors of surgical tooth extraction are obliquely visible to us in the belief that, alternatively, ‘a tooth may be easily extracted by touching it with dog’s milk’ (although you should avoid touching healthy teeth, as these would fall out also if you did83). It is certainly no small matter trying to find a National Health Service dentist amidst the wreckage left by the legacy of Margaret Thatcher and her monstrous offspring, Mr Blair. But even now, that may just be slightly easier than trying to milk a dog. Small wonder, then, that you might resort to a form of corpse medicine to avoid losing teeth if you could help it. You could, it was thought, cure an ailing tooth by touching it with one taken from a dead body.84
Food for Worms
Most of us could happily forget the frequent or continual tooth pain experienced by men and women through the ages of Marlowe, Pepys and Boswell. But there is one other ailment of the period of which we are still more thoroughly (and mercifully) oblivious. As Piero Camporesi in particular has emphasised, when Christians of the sixteenth and seventeenth centuries insisted on the fundamental vileness, putrescence and corruption of human flesh, they had far better cause than we might ever guess. Why? Close your eyes a moment, and imagine that you have acquired the doubtful gift of X-ray vision. You are looking at the contents of a live intestine: large amounts of half-digested meat and fish are patiently dissolving in a mist of stomach acid and ale fumes. But in the midst of this peaceful scene, things are moving. Long, hairy, squirming and densely entangled as they coil in a writhing greedy maze around one another, intestinal worms are busily finishing off the meal that this well-fed Elizabethan has not yet digested. For yes, this is not an animal, but a human stomach.
For reasons which are not entirely clear, numerous people seem to have been horribly afflicted by intestinal worms in this period. Camporesi tells of various cases, from those causing emaciation, to others marked by horrible convulsions and torments, and a handful considered life-threatening. There was, for example, ‘“a five-year-old child in whom worms had gnawed through the belly and come out of the navel”’; while another sufferer recovered after he had ‘“thrown up a worm, four inches in length”’ with ‘“a small, round head”’.85 In summer 1655 a London innkeeper, Mr Parry, fell ill. On the thirtieth of July, when ‘going to stool’ he voided a total of twelve ‘serpents’ – one having a head like a horse, another ‘headed like a toad’, and a third ‘like a greyhound’. Admittedly, the apocalyptic overtones of the pamphlet (‘before the destruction of Sodom and Gomorrah, sundry strange prodigies … were seen’) were in this case probably inspired by the recent civil war, and the execution of Charles I, six years previous.86
But more sober observers were still finding broadly similar creatures come the Restoration. Writing in 1668, the physician William Ramsey laments the ‘several species of worms macerating and direfully cruciating every part of the bodies of mankind’, asserting that they had indeed killed ‘more than either sword or plague’.87 Infants less than a year old could, Ramsey claims, be ‘molested with worms’; one child at Delph, for example, having been ‘miserably macerated’ by them. In Montpellier a man voided a flatworm seven foot long. Innumerable other victims expelled creatures of remarkable lengths and shapes through their mouths, anuses or ears, as well as in urine. More dramatically, one forty-year-old man had a swelling in his groin which finally split to release three huge worms.88
And these patients of course had to think themselves lucky that they had managed to eject the worms, however painfully. ‘Infinite numbers of people’, Ramsey insists, ‘die by these vermin under the notion of other maladies’, with both patient and doctor remaining oblivious.89 Ramsey’s explanation of these creatures looks to us partly religious and partly scientific. One cause was gluttony, and another simply the wrong kinds of meat. We can only guess at what it felt like to be inhabited by this teeming voracity of serpentine life forms. Anyone still doubtful about their existence might want to inspect the breathtaking variety of worms which Ramsey has had drawn in his book – some twenty-five assorted creatures which are, he adds, just a few specimens found ‘among millions of others’ in the dank cellars of the guts.90 Anyone looking at these drawings would be inclined to imagine the human digestive tracts not as quiet, private regions of gustatory pleasure, but as busy entomological landscapes in their own right – the material, indeed, of a whole televised nature programme, had anyone been able to insert a modern surgical camera into these penumbrous bristling depths.
Eaten Alive
For many of the early modern poor, it was clearly hard enough getting food into
your body in the first place. But even once you had, it seems that someone (or something) was still likely to steal it. Anyone who has found this especially difficult to stomach may now want to skip to the following section. For matters are about to deteriorate. In this case, you need only imagine that you are looking at the outside of your body. You will need, however, to picture a small boil on (say) your upper arm. Then imagine that it is itching. On inspecting it curiously, you can further discern that it is – albeit very faintly – moving. Finally galvanised by mingled discomfort, fear and curiosity, you allow a surgeon to thrust a lancet into this alien entity. The pain is mild by comparison with what follows. The boil proves to be oddly dry, with little or no pus secreted beneath the skin. Instead, a closely packed swarm of innumerable minute insects comes bursting forth.