What was the position of the practicing doctor within the seventeenth-century community?
How did people regard both them and the services they provided? It has often been said that doctors were unpopular. It was, after all, the local doctor’s prescriptions that commonly made you either violently sick, gave you diarrhoea or otherwise left you similarly disadvantaged or distressed.
‘Damn the Doctor’ ran the title of one seventeenth-century satire. Advice given to Lord Herbert about his health in 1681 suggested that he “never see a damn’d doctor again as long as ye shall live”. According to the poet Bernard Mandeville, “Physicians value fame and wealth/above the drooping patient’s health.”
Were doctors really disliked that much?
In fact, there is much evidence to show that people appreciated the services of their local practitioners. This was, remember, a world of sickness. Danger lurked in bad airs, unwholesome environments, noisome streets, unwashed bodies and verminous bedding. It has even been argued that most people felt ill in some way for most of the time. The local doctor was by no means the answer to all of this; but, (s)he was one weapon in the continuing war waged upon sickness and disease.
It is difficult to access ‘ordinary’ people’s views about practitioners. One way we can do this is through their testimonies in prosecutions, giving a rare chance to hear the actual voices of patients. But, obviously, these only tell us of cases that had gone wrong. Finding testimonies to practitioners who had obviously done well is more challenging. One possible way to do this, though, is through the surviving records of community testimonials to the skills of their local practitioner.
For some doctors, to achieve some level of legitimacy (perhaps more for themselves than their patients) meant obtaining a licence to practice from either the Royal Colleges, the Archbishop of Canterbury or one of the various diocesan bishops. In theory, and indeed in law, all physicians should have obtained a licence, but this was neither practical nor easy to enforce beyond London and its surroundings. Nevertheless, one aspect of applying for a licence was providing some sort of proof of good, charitable or successful practice in a particular neighbourhood.
When David Davies of Llangurig applied for a licence to practice from the Bishop of Bangor in 1749, no less than three local vicars testified that the “said David Davies is a very usefull person in his neighbourhood, has performed several cures in surgery, and (as far as we are judges) we think him a person worthy to be licens’d”. (National Library of Wales MS Bangor Episcopal B-SM-2). The supporters of Richard Davies of Llanynys stressed that he was a “person of good character” and “hath performed several cures in surgery”. (NLW MS Bangor Episcopal B-SM-3). When Benjamin Powell of Brecon applied for a licence in 1708, a list of local parishioners supported his application, stating that he was “a p(er)son who is commendably instructed both in the art of Phisick and Chirurgery and is very much Experienced in both the sayd arts, as being one who hath undergone and p(er)formed severall great and desperate cures”. (NLW, Church in Wales Diocese of Llandaff episcopal 1, MS 1194).
It is worth mentioning too that it was not only men, nor ‘orthodox’ practitioners who could rely upon the support of their communities. In fact, where an unlicensed practitioner faced prosecution, the people of Ledbury in Herefordshire intervened and petitioned the Bishop of Hereford to try and save her from prosecution:
The bearer is an honest poor woman of ye parish of Ledbury, who is as far as we are informed, cited into your court for practising surgery. She sometime ago cured a pauper of our parish who had at that time seven small children of a sore breast, without any prospect of reward; and ye parish, hearing of ye service she had done them, ordered ye overseers of ye poor to give her five shill: wch is ye only act of this nature of we can hear she ever did. This matter being so very malitious, we request the favour she may be discharged. She is very poor therefore we hope it may be with as little expence as possible…” (NLW Bodewryd (2), MS 380)
In terms of financial gain, not all doctors were out to fleece their patients. It was not uncommon for practitioners to tailor their bills towards the financial means of their patients. A poor patient might even be treated free, or for a few pennies; a wealthy yeoman might have to spend a few shillings. Also, the local parish authorities could intervene to either bring a practitioner to attend to a sick parishioner or, alternatively, send a parishioner to a large town to secure the services of a well-known or well-respected doctor.
Also worth mentioning is that early-modern people had perhaps a different level of expectation with regard to what the doctor could do. Today, we go to the doctor and expect to be diagnosed – instantly – and sent on our way with a prescription for a ‘cure’. This worked slightly differently in the seventeenth century.
When people went to the doctor, they engaged in a two-way dialogue to agree diagnosis and secure a receipt or preparation. Once this was obtained it is questionable whether the early-modern patient expected to be cured. Rather, they hoped to be cured but, if this didn’t work, there were plenty of other doctors and receipts to try – often gleaned from friends and neighbours. If they did recover, naturally they might attribute that recovery to the doctor and his preparation. This would then be retained for future use as a ‘probatum’ (proven) remedy. In this sense, the doctor might easily escape sanction if his cures failed, as the patient was only using his services as one of a range of options in any case.
Before we write off early-modern practitioners as figures of distrust, dislike or ridicule, it’s worth remembering that they were often valued members of a community whose efforts to help their fellow parishioners were appreciated. Often treating the poor for free, and providing an important source of medical knowledge and goods, they offered some degree of comfort in a world where sickness was ubiquitous.
This article was originally published on Dr. Alun Withey’s Blog.
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