If you were ill in Tudor times (and could afford it) you could visit one of three types of doctor – an apothecary, a physician or a barber surgeon. However visiting one of the medical professionals in Tudor times was very expensive, so many people preferred to trust “quacks”.
Quacks and Quackery in the Middle Ages and Renaissance
The quacks were travelling salesmen who followed fairs and markets around the countryside, offering magical pills, potions and salves to sick people and then moving on quickly before their cures could be seen to be ineffective. There was a certain element of danger in what they did – if too many of their patients died, especially if they were rich or powerful, the quacks could be accused of witchcraft, tried and put to death.
They would combine a certain amount of theatricality and performance with dispensing medicine, re-enforcing the image of medicine as something mystical, inexact and unscientific. This “smoke and mirrors” approach to treating health problems was still preferable to many people because of the expense of visiting a qualified doctor and the brutality of treatments at that time.
The word “quack” comes from an old Dutch word, “quacksalver” which means “a boaster who applies salve”. “Quack” was a medieval word for shouting. The word “quack” is still in common use today and is generally applied to unproven or unconventional medical practitioners and practises.
Apothecaries: The Theory of the Four Humours
Apothecaries were rather like modern chemists, in theory if not in fact. They would dispense cures based on herbs, astrology and folk lore, using theories based on the four bodily humours. These were:
- Sanguine (warm and cheerful)
- Phlegmatic (cool and sluggish)
- Melancholic (gloomy and sad)
- Bilious (ill-natured and quick tempered)
Having too much of any one humour was thought to unbalance the metabolism and cause illnesses, both physical and mental. The humours could be balanced by following a range of special diets prescribed by the doctor.
An apothecary’s shop would be full of jars and bottles of all sorts of mysterious substances, including herbs, spices, infusions and more sinister items such as dried mouse ears, woodlice and various preserved parts of animals such as frogs, hares and foxes. Spiders and cobwebs were also believed to have excellent therapeutic properties, and modern research has shown that cobwebs actually contain a powerful antiseptic.
Some of the apothecary’s herbal remedies were based on long established histories of successful use, and even today, herb and plant extracts are used as a basis for numerous modern medicines.
Physicians in Medieval and Renaissance Times
Physicians were the hierarchy of medicine in the Middle Ages and Renaissance period. Henry VIII granted a charter to the Royal College of Physicians in 1518 in recognition of the superior knowledge of physicians at that time. Physicians, generally speaking, would have studied the writings of ancient Greek and Arab scholars at university, including the writings of Galen, Hippocrates and the Arab scholar Ibn Sina (Avicenna).
The medicine they would have practiced was a combination of philosophy, astrology and herbalism, but did not have much basis in scientific research and consequently had a fairly low success rate.
If you visited a Tudor doctor, you were very likely to have had leeches attached to your skin to suck out bad blood. Different complaints were treated by bleeding from different parts of the body – for example, bleeding from the feet was carried out in the belief that this drew the blood containing “bad humours” downwards, away from the brain and the heart.
Barber Surgeons and Historical Hygiene
The first surgeons were also barbers, who performed operations and removed teeth as well as cutting hair. The first barber surgeons used to attend soldiers on the battlefield and amputate limbs when necessary, as well as dressing wounds.
Barber surgeons were regarded with contempt by physicians, because their rough and ready methods were not backed up by years of study. The Company of Barber Surgeons was not granted a Royal Charter until 1540, more than twenty years after the Royal College of Physicians was granted their charter.
The Tudor surgeon’s medicine chest would have contained an awesome selection of saws, knives, clamps, hooks, scalpels and probes, all in a disgustingly unhygienic state. The surgeon would work in his everyday clothes (usually bloodstained from work on previous patients) and would leave surgical instruments lying about on the floor, still stained with the detritus of his day’s work.
Unsurprisingly, the mortality rate from surgery was very high. Patients would die from loss of blood or infection from the unhygienic working practises. Asepsis was an unknown concept in these historical times, and barber surgeons would wear their bloodstained clothes as a mark of pride to show how busy they had been.
Asepsis remained an alien concept in medicine until well into the nineteenth century and hence, mortality rates from any sort of invasive medical procedure also remained frighteningly high.