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The quack will see you now

Medieval medicine and it’s practitioners get a rather bad press, Quackery neatly wrapping the whole issue into an understandable term. History, it is said is always written by the victors and the same can be applied to the history of medicine.

Looking back to Tudor and Elizabethan times there was a small thriving elite of medical men practicing in the City of London. It was something of a club where members guarded their own self interest vehemently. This band of well paid, well respected and wealthy men became known as The Royal College of Physicians following it’s establishment in 1518. It is true to say the many used the college to further the science of medicine as it was at the time, but also many used its power to protect their monopoly on heath care and so their opportunities to earn large amounts of money.

Thomas Linacre 1460-1524

A small group of distinguished physicians, led by the scholar, humanist and priest Thomas Linacre, petitioned Henry VIII to be incorporated into a College similar to those found in a number of other European countries. The main functions of the college, as set down in the founding Charter, were to grant licences to those qualified to practise and to punish unqualified practitioners and those engaging in malpractice. The part about punishing unqualified practitioners is where the whole knub of the term Quack probably stems from.

Not everyone wanted to be part of this newly formed body for many reasons. Cost, freedom to practice where they wished, practicing free of the medical thinking of the day and to offer health care to those who needed it most and could least afford it. These practitioners where looked upon by the college as “Anti Establishment” and any chance to besmirch their reputation and ruin their livelihoods was taken.

At the bottom of the pile of these renegades was the local Wise Woman, probably every village had one. Offering rudimentary health care usually through plant or herbal remedies. As professional started to take themselves seriously these women were probably an easy target and it says a lot that today we perceive these women as cackling mad old crones possibly witches or in league with the Devil. Could this have been disinformation by the college?

Nicholas Culpepper

A step up were the Herbalists. The most notable to fall foul of the main stream was Nicholas Culpepper. Culpepper was a notable Herbalist of the time who was tried for witchcraft and indicted of bewitching a widow named Sarah Lynge who had been one of his patients. Apparently Lynge made quite a credible witness and it has been speculated that either she had been less than happy with Culpepper’s treatments, or perhaps that he had not responded kindly to her amorous advances. However there is a very large pointer as to the motivation for the trial as the initial claim of witchcraft had been brought before the court by none other than the Worshipful Society of Apothecaries. Culpepper was something of a local hero to the under classes of Spitalfields, as in a lot of cases he treated he asked for no fee and stated quite openly, “no man deserved to starve to pay an insulting, insolent physician“. He seems to have riled the medical fraternity at every opportunity and caused outrage by his willingness to examine patients in person rather than simply examining their urine (in his view, “as much piss as the Thames might hold did not help in diagnosis“).

So as you can imagine the medical men of the time were probably looking for a way to rid themselves of this thorn in their side. His anti establishment views in all probability saved him from being found guilty. The trial took place in the early stages of the English Civil War and Culpeper had already committed himself to the Parliamentarian cause. The City of London was on the whole anti Royalist and it could have been that Culpepper was tried by a likeminded judge. The site of Culpeper’s surgery now sits under the hairdressers Toni & Guy at 92 Commercial Street, Spitalfields.

Dr Butler

At the top were probably the college’s most reviled competitor, those that practiced under the name Doctor, but didn’t conform to the guidelines laid down. I think its fair to say that most medical thinking and treatments were a little left field taken from today’s perspective. It seems that if you were on either side of the fence your remedies were at times lethal and at best ineffectual. The most prolific practitioner of his time was Doctor William Butler, born in Ipswich around 1535. He attended Peterhouse College Cambridge where he gained a BA, MA and eventually became a Fellow in 1561. In a publication of 1898 called Brief Lives, William Butler was described as the “the greatest physician of his time“. The piece also describes him as an eccentric and a drunkard. He is reported to have lived at his Apothecaries shop in Cambridge along with an old servant woman called Nell, who’s main job seems to have been fetching her master home from the local tavern.

He first came to public notice in 1603 when he revived a local clergyman from an opium induced coma by the unorthodox method of slaughtering a cow and placing the senseless parson inside the “cowes warme belly” (I shudder to think what the Tabloid headline would be, had they been around in the 16th century).

James I 1566-1625

This brought him to the attention of King James who was at the time two Kings, James VI of Scotland and James I of England. Poor James had a chronic back problem which left him in constant pain. Dr Butler was called for and concocted his own remedy, which had a miraculous effect on the King relieving his pain considerably. According to Butlers records of his cure it’s hardly surprising that the king felt no more pain, as the medicine was so high in alcoholic content that James could have been trampled by an elephant and would hardly of felt it.

Henry Frederick, Prince of Wales 1594-1612

Although probably off his face at the time James was delighted with Butlers work and appointed him Court Physician, despite Butler having no medical qualifications whatsoever. As the incumbent of this position he was well placed in 1612 to treat the eighteen year old Henry Prince of Wales for Typhoid Fever. Its unclear what Butler’s diagnosis and treatment were, but they failed spectacularly and the popular Prince died. It could be argued that if Butler had managed to save the Prince, then the course of English history could have well turned out very differently. Henry was succeeded as the Prince of Wales by his younger brother Charles, later to become Charles I. Henry was a popular and charismatic figure who was much mourned by the population, Charles however was aloof and a little boring. Would Henry have got into the conflict with Parliament that sparked Civil War in England? We’ll never know.

It is unclear if he remained as Court Physician after the death of the young Prince, but what is known is that he set up a medical practice in the City of London. Again some of his remedies were to say the least, alternative. Fever patients, especially those with Malaria were treated by dropping them on the end of a rope through a trapdoor in London Bridge into the polluted waters below. My favourite however, is the cure for patients with epilepsy. They would be placed upon a chair and silently a man with a musket would creep up behind them and discharge the firearm a few inches above their heads!


Old Doctor Butlers Head

One of his cures that did gain popularity was the concoction known as Dr Butlers Purging Ale. This was produced by taking a barrel of strong ale into which a canvas bag containing senna, agrimony, maidenhair fern and scurvy grass was placed and left to mature. This produced a very powerful laxative, which was popular with Londoners well into the reign of Charles II. The ale was available from Dr Butlers premises in what is now known as Masons Avenue, a small alley that runs towards the Guildhall. The location today is taken up appropriately enough by the “Old Doctor Butlers Head” Public House.

In an effort to strike a bit of balance, Dr Butler did hold views which went against medical thinking of the time and are held to be correct in the modern world. Butler is believed to have been an “empiric” physician who based his treatments not on any theory but purely on reasoning and experience. He campaigned strongly against the practice of bleeding a patient and the novel and fashionable use of dangerous chemical remedies. With regard to his sobriety and a legacy of eccentricity it’s worth remembering that the medical profession of the 17th century was a close knit affair. Anyone wanting to practice within the City of London had to be a member of the Royal College of Physicians. Although this rule was impossible to enforce, people who practiced outside this august body found themselves at the sharp end of a very rough PR campaign by the accredited physicians, who slandered and rubbished them at every opportunity. In a time where medicine would seem so strange to us now, its conceivable that Dr Butlers methods were not called into question by his patients and would be considered normal.

Sir Fulke Greville

This is not to say that the establishment had a monopoly on sound ideas. Take the case of Sir Fulke Greville an Elizabethan nobleman and favourite at court. He had a large mansion house in Holborn and during a visit had an altercation with a servant, Ralph Haywood, who believed that he had been cheated by being left out of his master’s will. Haywood then turned the knife on himself. Greville’s physicians treated his wounds by filling them with pig fat. Rather than disinfecting them, the pig fat turned rancid and infected the wounds, and he died in agony four weeks after the attack.

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