This book provides a complete reappraisal of Welsh medical history in the early modern period. It investigates some of the factors affecting the types and spread of disease in Wales. Studies of disease and the body in popular cultural sources, such as poetry and vernacular verse, contribute to a wider assessment of a 'Welsh' bodily concept. The book explores the importance of geography and regional variation in affecting the sickness experience. It then examines the pathways through which medical information travelled in Wales, through detailed analyses of both oral and literate cultures in early modern Wales. The book also investigates medical material culture within the home in early modern Wales. It further analyses the 'sick role' and the ways in which sufferers both experienced and described their symptoms, foregrounding the growing impact of literacy and letters in sickness self-fashioning. The book looks at the availability of medical care in the early modern community, arguing that sickness served to create a temporary medical family, who provided a comprehensive structure of support from visiting to the provision of physical care. Finally, it argues that Welsh practitioner's desire to adopt English medical nomenclature points to a growing wish to be seen as 'legitimate' practitioners, a view backed up by the increasing numbers of medical licences granted to Welsh physicians.
This introduction presents an overview of key concepts discussed in the subsequent chapters of this book. The book investigates some of the factors affecting the types and spread of disease in Wales. The chapter explores something of the importance of geography and regional variation in affecting the sickness experience. It also explores the ways in which Welsh people conceptualised their bodies and how this information was assimilated and disseminated. The book examines the pathways through which medical information travelled in Wales, through detailed analyses of both oral and literate cultures in early modern Wales. It utilises a comprehensive study of over 3000 probate inventories to investigate medical material culture within the home in early modern Wales. The book analyses the 'sick role' and the ways in which sufferers both experienced and described their symptoms, foregrounding the growing impact of literacy and letters in sickness self-fashioning.
The presence of large groups of people in close proximity proved a fertile breeding ground for all manner of epidemic and endemic diseases throughout the early modern period. Water supplies were often contaminated as people empted their waste into the nearest available stream or river. Plague was certainly present during the sixteenth and early seventeenth centuries in Welsh towns, although it appears to have made less impact here than in some parts of England. Smallpox too was an endemic disease which often became epidemic, and was certainly notorious throughout Wales during this period, killing around a quarter of those who contracted it. Urban areas tended to follow different patterns of mortality to those in the countryside. Diet was another strong factor affecting susceptibility to disease. Malnutrition lowered immunity to disease, especially during harvest failures and poor weather when staple crops were in short supply.
Individual concepts of illness and the body in Wales involved a range of dynamic and overlapping spheres, including lay referral networks, religious beliefs and affiliation, literacy, language, popular illness narratives and so on. Italian, French and eventually English universities began to offer formal medical training and by 1500 a structure of medical practitioners was well developed. During the sixteenth century, literate Welshmen were beginning to translate English medical texts into vernacular Welsh. For the majority of people in Wales, oral culture was the main means of reception and transmission of ideas. One of the strongest contributory factors in concepts of health and sickness in Wales was religion. Christianity provided an explanatory framework for the body, and stressed the duty of each individual to look after their bodies as the vehicle for their immortal souls.
In England, between 1641 and 1800, Mary Fissell has identified over 2,700 editions of vernacular medical texts, or books containing medical information, intended for self-help and lay use. A brief glance at the publishing situation in Wales, however, reveals why medical books have been largely overlooked as potential sources. Four-fifths of people in Wales were illiterate, and there was no printing press located in Wales until 1718. The first printed translations of popular self-help books into Welsh did not occur until the nineteenth century. Nicholas Culpeper's British Herbal was not published in Welsh until 1816. The book trade in Wales grew steadily during the early modern period, and there were a number of means through which English books could be obtained. Throughout the early modern period, Welsh medical language underwent some profound changes, most importantly through the influx and assimilation of English medical terminology.
Social networks and the spread of medical information
Medical knowledge was ubiquitous within early modern society, but this information did not exist in isolation. A medico-social network could involve family, friends, employers and employees, but also even bring together people of such disparate social classes as would normally preclude communications between them. Such networks crossed social and geographical boundaries and question previous depictions of Wales as being insular and remote. This chapter explores these networks and highlights the variety of means by which medical knowledge could spread. Medical information in Wales, as elsewhere, fell within the wider context of knowledge exchange through both oral and literate means since people derived their medical remedies from family and friends, neighbours, wider kin and medical practitioners. Consultations with practitioners provided another strong source of medical remedies and such remedies are much in evidence in Welsh collections.
The role of the early modern home as both a storehouse of medical knowledge and physical space of healing has long been stressed. Many seventeenth- and eighteenth-century self-help books extolled the virtues of a well-equipped kitchen. Home-brewing was an important part of the domestic routine, and especially in larger houses. Honey, too, was a common medicinal ingredient, useful for a range of purposes from burns to colds. Aside from individual ingredients, there are other items which may also point to the production or storage of medicines within the home. Turning to the shop inventory of one John Thomas of Llandaff, direct evidence of the presence of medicines for sale can be seen. Apothecary shops were widespread across many areas of Wales. Richard Philpots, a Swansea apothecary, may have been responsible for mixing and preparing many of the remedies for sale in his shop.
Sickness and the 'sick role' were far from being a uniform experience. There are actually few works which explore sickness experience in any great detail, and those that do tend to be too reliant on the Parsonian model. One common criticism of the Parsonian sick role is that it is not gender-specific and even privileges men inasmuch as it was they who most easily fitted the model of physical withdrawal from the workplace. As Ralph Houlbrooke has convincingly shown, the comportment and speech of the sick could be incredibly important to family and friends. Speech was a self-conscious representation of sickness, a verbal manifestation of inward suffering certainly, but importantly also one delivered with others in mind. Welsh people understood and perpetuated sickness through their own language even though this was subject to outside influences.
This chapter explores the issue of domestic care for the sick, with particular emphasis on gender healing roles within the family unit. It highlights the important medical relationships between parents and children, such as that of father and daughter, and foreground the important role of men in collating and recording household medical knowledge. There were few formal places of medical care available in Wales beyond the home until the nineteenth century. In the early modern period, physicking the family was, at least culturally, part of the domestic duties of women, and they were expected to have a basic knowledge of herbs and medical preparations. There are clear signs that Welsh practitioners desired 'legitimacy' and aspired to be viewed as orthodox, and their numbers and spread should raise questions about the almost total dominance of magical and lay practice in Wales.
Early modern society was strongly based around concepts of inclusion and neighbourliness, with strong social expectations of good conduct. The Welsh lexicographer Sir Thomas Wiliems of Trefriw was also a renowned physician and proponent of the art of uroscopy, offering his diagnoses without necessarily needing to see the patient. Medical care, especially of the poor, fell under the auspices of the parish, although this was by no means the only structure. Legally, the parish was bound to make provision for the sick poor, but other systems of relief, such as those of Dissenters, existed alongside. In England, the poor were often paid to undertake 'tending' roles, providing general medical care from domestic work to attending to the physical needs of the sufferer. Specific payments for treatment of individuals in fact formed a strong part of community intervention, and the parish could pay for the services of a range of healers.