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The Worst Medicine

By George Scialabba,
a frequent contributor to Book World, the Boston Globe and other journals
Tuesday, November 30, 2004; Page C05

HEAL THYSELF
Nicholas Culpeper and the Seventeenth-Century Struggle to Bring Medicine to the People
By Benjamin Woolley
HarperCollins. 402 pp. $24.95

When King Charles II awoke feeling ill on Feb. 2, 1685, he received the best medical care the age could provide. The royal barber, who had come to shave him, hastily bled him instead, drawing a pint from a vein in the king's arm. When the royal physicians arrived, the surgeons "scarified" Charles (made deep scratches), afterward drawing another half-pint of blood with heated cups. Then it was time to purge His Majesty, using an emetic of antimony to coax out impurities from one end of the royal person, followed by a series of enemas to expel more from the other. The king's hair was cut off and a blistering agent applied to the scalp; elsewhere on his body, a red-hot cauterizing tool was used. To attract harmful humors down from the head, "noxious plasters" were applied to the soles of his feet. Naturally, the royal internists could not be left out. The king was prescribed a rare and expensive medicine, "the skull of a man that was never buried, being beaten to a powder and given inwardly," along with a tried-and-true remedy, crushed stones "from the intestines of the wild Persian bezoar goat." Notwithstanding (or, perhaps, not withstanding) these state-of-the-art ministrations, Charles died on Feb. 6.

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Of course not all the king's subjects could afford such expert professional attention. The average Englishman frequently had recourse to the apothecary and the barber to dose and bleed him, without benefit of a degreed practitioner who had read Galen and could prescribe in Latin. In 17th-century England, as in 21st-century America, many people went without medical care for lack of money. In those days, however, they may have been better off for it.

Nevertheless, there was considerable popular resentment over the privilege of doctors, who were trying to bring the practice of medicine under tighter control. Throughout the 1630s, the College of Physicians petitioned the king to issue directives to the Society of Apothecaries: no medicine to be made without a doctor's order; only medicines from the college's approved list (the pharmacopoeia); all candidates for the society to be vetted by the college; college "censors" to visit and inspect apothecaries' stores without warning. The doctors charged the apothecaries with unprofessional behavior: carelessness, incompetence, even fraud. The apothecaries replied that they knew more about medications, and often about medicine, than the doctors, whose qualifications mainly consisted of having attended a university and memorized a few ancient texts, and who in any case cared little about the common people, whom only the apothecaries served.

Benjamin Woolley's "Heal Thyself" moves back and forth between this turf war and the large social conflicts it exemplified: Parliament against the king; London against the court; the middle and lower classes against the nobles and the rich; the new dissenting sects against the established church and the hated Catholics or "papists." The physicians represented tradition and had many connections to the court, as well as the patronage of the king. The apothecaries found more sympathy among the people and Parliament. Woolley lays out this context in great detail, together with, it sometimes seems, at least a few details about nearly everything else in 17th-century England. A characteristic English antiquarian verve animates his innumerable asides: about the exotic fruits hanging in apothecaries' windows, the ceremony of the Royal Touch to cure scrofula, the ingredients in the Ointment of Red Lead applied to the breast cancer of Mary Culpeper.

Her son and our hero, Nicholas Culpeper, author of the never-out-of-print "English Physitian," better known as "Culpeper's Herbal," seems to have been a merry, saucy rogue. He sported "cascading tresses of dark hair, complemented by a jaunty moustache" and had "small dark eyes, full of spirit." His friends testified to his "knack of jesting," his "consumption of the purse" (free-spending ways) and "outbursts of 'choler.' " Choler was one of the four humors postulated by Galen; it made one "quick-witted, bold, no way shame-fac'd, furious, hasty, quarrelsome, fraudulent, eloquent, courageous, stout-hearted." This is unmistakably the profile of an anti-authoritarian, and Nicholas heartily joined in the apothecaries' struggle against the dead hand of medical tradition. In those days, merely translating the classics (or, as William Tyndale found, the Bible) into the vernacular was considered subversive. In addition, Culpeper's translation of the official pharmacopoeia was laced with savage polemics against the doctors' greed and obscurantism.

More important, all Culpeper's writings, in both Latin and English, were crammed with information ordinary people could use: about the medicinal properties of plants, methods of preparation and administration, the varieties of disease. (Also, it must be said, with much useless astrological speculation.) Movingly, in stately yet earthy 17th-century prose, he explained his purpose:

"I saw Ancient people coming to me, sick, and coughing, and crying out for the Lord's sake help us. I saw young Children . . . desiring me to give them the grounds of Physis in their Mother Tongue. . . . The Works of God are given freely to Man, his Medicins are common and cheap, and easie to by found: 'tis the Medicines of the Colledg of Physitians that are so dear and scarce to find." The people responded. Culpeper's books were runaway bestsellers, as important in their way to the history of freedom in the English-speaking world as to the history of medicine.

Pleasingly, "Heal Thyself" also gives the old order its due, in the form of a contrapuntal narrative thread about William Harvey, the king's physician and chief ornament of the College of Physicians. Though politically and personally conservative, Harvey was a great scientific innovator, and Woolley does his achievements full justice. It's as though our author is saying that it takes all four of the humors to keep our world lurching unsteadily toward the light.


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