Category: Patients

Hans Sloane’s New York Connections

Posted on February 10, 2013 by - Americas, Early Modern History, Hans Sloane, History of Medicine, Letter-writing, Networks, Patients, Royal Society

I was just in New York at a rather fun Cookbook Conference, speaking on medicinal remedies in manuscript recipe books. As I was preparing for my first trip to New York, I idly searched the Sloane database, wondering whether Sloane had any New York connections. I found two letters that refer to New York.

Central Park, New York, February 2013. Photo Credit and Copyright: Mark Gudgeon. Used with permission.

The first is from Patrick Gordon, a naval chaplain, who wrote to Sloane in late April 1702. Gordon apologised for missing the last Royal Society meeting and recent Philosophical Transactions. He asked if there were any commands from the Royal Society for his upcoming residence in New York. Gordon noted that he would be residing in New York for several years. The Royal Society (and Sloane) relied on the reports of men deemed reliable (such as Gordon) for information about medical and scientific matters from across the world.

At present, no subsequent letters from Gordon are in the database, but letters from other men in North America suggest how this relationship might have functioned. Col. William Byrd, for example, wrote a few letters from North America between 1706 and 1710. He clearly referred to Royal Society directives in the information he gathered. Byrd even sent samples, such as roots to cure snakebites.

Sometimes requests for assistance came to Sloane from the other side of the world. On 30 October 1716, William Vesey of New York wrote to Sloane to thank him for medical advice.

The spires of the third Trinity Church (c. 1846) against the backdrop of 1 World Trade Center. Credit and copyright: Lisa Smith.

Vesey had been receiving Sloane’s advice for smallpox and was now recovering from it. Vesey, who was one of the early rectors of Trinity Church in Manhattan, had visited England in 1714-15.(1) As payment, Vesey enclosed five guineas. This was the equivalent of about £444 in 2005 and would have bought one cow in 1720.(2)

Sloane’s reputation as a physician was indeed international! That said, most of his patients from outside Britain and Ireland came from Jamaica, France and the Netherlands. Many were people who had travelled abroad (such as Isabella Pierrepont, the Duchess of Kingston) or, like Vesey, had heard of Sloane while in London (such as the Swedish ambassador, Count Carl Gyllenborg).

Although Sloane’s New York connections are not in themselves particularly impressive, they were a small part of a much wider global network of travellers and shared ideas.

(1) This I discovered on an amble about Lower Manhattan after writing this post. Vesey has a street named after him and is mentioned on the sign outside Trinity Church. See also the Wikipedia entry for William Vesey.

(2) This was calculated using the National Archives historical currency converter. 

Note: this entry was updated on February 13, 2012 with the information about Vesey’s occupation and travels.

 

An Eighteenth-Century Case of Hair Voided by Urine

Posted on December 17, 2012 by - Collecting, Early Modern History, History of Medicine, Patients, Philosophical Transactions, Remedies, Royal Society

“Honourable Sir!” wrote Thomas Knight to Sloane in February 1737 (British Library, Sloane MS 4034, ff. 34-5). He wished Sloane’s advice on an “uncommon Case”—the discovery of hairs discharged by a man who suffered from a burning pain during urinating. Knight thoughtfully enclosed the matter in a pill box for Sloane’s examination.

The patient must have been in great pain as all the adjacent parts, internal and external, were swollen and irritated. He had tried bleeding, clysters, emulsions, and opiates, all to no avail; he was only relieved when he finally passed the “hairy Substance with the gritty Matter that adheres to it”. Importantly, the patient had “kept a strict Regimen” for many years because of gout and “incontinency of urine”. As part of his regimen, he regularly drank cow’s milk.

L. Beale, Kidney diseases, uinary deposits, 1869.
Credit: Wellcome Library, London.

Knight theorized that the fine hairs had come from the skin of some animal that had gotten into the patient’s body and then circulated through the body until reaching the renal glands. “It is more possible”, he thought, “that they were extraneous, than that they were generated in the Urinary Passages”. He recognised that the veins in the body were indeed very small, but damp hairs “become very flexible, pliable and susceptible of being contorted and of assuming any Figure”. Perhaps “some of the downy-hair about the [cow’s] Udder might got along with the Milk”.

The oddity of the story is itself intriguing, but so too is the afterlife of the letter and sample. The details noted on the back of the letter by Sloane (or on his behalf) suggest the process of cataloguing in his collections.

Apr 27 1738

Ent’d in L.B.

Knight of Hair voided by Urine.

 

Ph. Tr. No. 460

VIII IX A letter from Mr T Knight to Sir Hans Sloane

pr. R. S. &c concerning Hair voided by Urine.

The letter and/or the sample were kept and entered into one of the collections in 1738. The letter was also passed on to the Royal Society and it was published in Philosophical Transactions no. 460.

So, what did the Royal Society make of Knight’s report? The Phil. Trans. editor in 1739, Cromwell Mortimer, remarked after the letter: “I doubt of these Substances being real Hairs; I imagine they are rather grumous Concretions, formed only in the Kidneys by being squeezed out of the excretory Ducts into the Pelvis”.

Painful enough, in any case, but at least no need to fear drinking milk!

Bed-wetting in the Eighteenth Century

Posted on November 28, 2012 by - Early Modern History, Gender History, History of Medicine, Patients

Sometimes the embarrassment and frustration of eighteenth-century sufferers seems to seep from their letters. One such case is that of a young boy, John Plowden. A Mr John Manley of Winchester wrote seven letters to Sloane in 1723-4, asking advice about the child’s lack of bladder control. The relationship between Manley and John is never made clear in the letters. The boy did not seem to be an apprentice and his father was still alive. His age was also not given, though it seems likely that he was at least the age of reason (seven)–but perhaps not much more. John’s own letter was composed in grammatical sentences, but he retained a childish script.

A man carrying a child’s commode. The child has just had an accident, according to the picture’s text. (1769) Credit: Wellcome Library, London.

In October 1723, Manley complained that John “has several times bepiss’d his Bed, & when ever that happens, it is always but midnight. He has also bepiss’t his Breeches about six times a day.” A month later, John and his nurse insisted that she had been “very careful & vigilant in complying” with providing John with his remedies. The real problem, though–as Manley claimed–was that John “is so negligent that he has sometimes bepiss’t his Breeches in the day time. I say tis his own negligence, for he is never deny’d leave to do down whenever he askes it”. A strong statement.

John reported in January 1724 that his control had improved. He was now able to wake himself up in the night when he needed to urinate and “don’t do it in my Sleep so often as I us’d to do”.  Manley noted that John had occasional mishaps in bed the previous month, but the nurse had spotted a pattern: the “mischances happen chiefly on those nights [when] at going to bed he makes but a small quantity of urine.” With the cause identified, it became possible to change John’s behaviour. Having John write his own letter to Sloane may also have been an attempt to make him take responsibility for his problem.

Setting aside the fact that toilet training is obviously a desirable goal, this case highlights the importance of bodily control from an early age in the eighteenth century. John’s guardian must have been deeply concerned about the “mischances” if he was consulting one of England’s leading physicians: few people wrote to Sloane about children and consulting Sloane was expensive (a guinea per letter). Manley saw this as a troubling matter.

In John’s case, his physical symptoms suggested a potentially worse problem–an underlying lack of self-control. By the early eighteenth century, there was a growing emphasis on masculine self-management in terms of mind, body and behaviour. Young boys were particularly vulnerable to learning bad habits that could have long-term effects. Manley’s letters reveal a tone of increased impatience with the boy’s repeated “negligence”, while John himself recognised a need to regain control of his own body. And this mastery needed to be as much mental as physical, including even the ability to wake himself when asleep. Much was at stake for young John Plowden.

I also discussed this case in “The Body Embarrassed? Rethinking the Leaky Male Body in Eighteenth-Century England and France”, Gender and History 23, 1 (2011): 26-46.

Update October 24, 2013: Hannah Newton has an excellent post up at earlymodernmedicine on remedies and explanations for bed-wetting (“Wet Beds & Hedgehogs”).

Gender, Bowel Movements and Data

Posted on November 20, 2012 by - Databases, Gender History, History of Medicine, Patients, Research and Writing

A diverting weekend on Twitter, at least if you’re a medical historian. It all started when John Gallagher (@earlymodernjohn) wondered:

On #earlymodern diaries: do #twitterstorians worry that our information about individuals is heavily weighted towards their bowel movements?

A fine question, which several Twitterstorians pondered. Elaine Chalus (@EHChalus) suggested that this was a gendered concern, since:

Bowels have never featured much in the women’s letters/corresp I’ve read over the years. ‘Face ache’ though does.

I had never paid much attention to the bowel movements of the patients I study, but had a memory that women discussed bowels frequently in a medical context. But what might my Sir Hans Sloane’s Correspondence Online have to offer by way of insight?

First, that I do not have a category for tracing patients’ discussions about their excretion. That said, “bowels”, “stomach”, “diarrhoea”, “constipation”, “stool”, “urination” and “urine” all appear as key terms.

Second, after a quick search for “bowels”, “stool” and “diarrhoea” (sixty-eight out of 713 medical letters), I found that men were indeed much more interested in bowel movements overall. Twenty-six of these letters involved women: most were written by medical practitioners (15) or by male relatives (6). The remainder involved women writing on behalf of other females (2) or male relatives (3). No women wrote about their own bowel movements. In contrast, sixteen men wrote about their own and eighteen wrote about other sufferers’ (eleven males and six females). Medical practitioners wrote for an equal number of male and female patients.

What surprised me most is how few letters discuss this issue. Perhaps there might be more references in the 164 letters mentioning “stomach”. However, it could also reflect the categories chosen for the database and a further choice on the part of individual researchers not to input this data because it is so common. As with any database, decisions must always be made.

Only, I’m left with a lingering question… Would it be meaningful to be able to trace the number of references to bowel movements in the eighteenth century?

Eighteenth-Century Ear Worms

Posted on November 5, 2012 by - Animal History, Early Modern History, History of Science, Patients, Remedies

In 1702, Mr. Hare, the Vicar of Cardington in Bedfordshire, wrote to Sloane with a “matter of fact”: a case of ear worms. Gory it may be, but this tale tells us much about domestic medical practices and popular scientific interests!

Hare reported that a young man—who lodged in the same house as him—had been suffering from some running humour and pain in his right ear, which he’d tried to treat with clean wool and honey. After several days, a maid in the house examined the lodger’s ear when she noticed it was bleeding. She “saw something working in his Ear like maggots” and promptly sent for a neighbouring woman to help. The neighbour’s remedy: an application of the steam of warm milk.

Hare took a look at the ear later that day, describing the worms inside as “large maggots in shape & Colour like those that commonly breed in putrefied flesh.” He began to pick out “a great number of Insects”, counting twenty-four. Although there were more worms in the ear, Hare could not extract them; they had burrowed in too deep during the operation. Instead, he left the patient “for about an hour in which time he was very uneasy & full of pain”, with a “thick bloody matter” in the ear. Fortunately, the remaining worms had started to work their way out and Hare “pickd out nine more” during a second attempt. The patient “found himself more at ease upon which we concluded that there were no more.” By the following day the young man had entirely recovered.

Illustrations from the English translation of Nicolas Andry’s An Account of the Breeding of Worms in Human Bodies, London, 1701 (Source: Wikimedia Commons)

Hare provided several details about domestic medical practices. The young man started off with self-treatment. A maid in the house examined his ear. A neighbouring woman and a clergyman (Hare) administered further treatments. This was typical of the process of seeking medical advice. Physicians and surgeons were seldom the first point of medical assistance—and some problems might be sorted out before their help was even necessary.

We also have some clues as to what sorts of treatments they tried. The honey and cotton wool would have been readily available and were the sort of basic application that one might try to treat an ear problem. According to the Countess of Kent’s A Choice Manual (1687), various types of simple applications for inflammations or injuries included honey. The milk steam also makes sense. In popular thought, milk was thought to draw worms out. But there were various ways this might be administered. In An Account of the Breeding of Worms in Human Bodies (1701), for example, Nicolas Andry referred to injecting warm women’s milk into the ear.

The timing of the letter suggests that the observation was offered in response to Nicolas Andry’s treatise, which had been published in English only the year before. Andry identified the different types of bodily worms, which he attributed to eggs hatching inside the body. In the human head, for example, worms might occur in the brain, nose, eyes, teeth, or ears. An Account detailed Andry’s experiments with a microscope as he explored the inner world of the human body and its many worms—including spermatozoa. Hare called his letter as a “matter of fact” (eyewitness testimony about an observation), but it was of limited scientific value and never appeared in the Philosophical Transactions. His keenness to share his account about a timely subject, however, suggests a man who was deeply interested in science and medicine.

And the account itself reveals a man who had a very steady hand…

An Old Sick Gentleman and a Family Scandal

Posted on October 22, 2012 by - Conferences, Early Modern History, Family, Patients

I first discovered the Newdigate family when I was a Ph.D. student. Elizabeth Newdigate’s medical letters to Sloane read like a soap opera, filled with heartache and family disapproval. But it wasn’t until several years later that I realised just how dysfunctional the family was.

This week, I’m giving a paper on her father, Sir Richard Newdigate, who wrote a curious pamphlet that gives a fuller picture of the family’s problems: The Case of an Old Gentleman, persecuted by his Own Son (1707). For several years, he had been embroiled in legal difficulties with his children, including financial disputes, an attempt by two of his sons to have him declared a lunatic, and a complaint by four of his daughters in the House of Lords about his “cruel Severities and unreasonable Usage and Practices”. Newdigate hoped to defend his tarnished reputation.

Throughout his account, Newdigate referred to himself as an “Old Sick Gentlemen” – which indeed he was. When the troubles started in 1701, Newdigate was in fine health. He had just undertaken a lengthy tour of France with no ill effects. But his health steadily deteriorated at pace with the arguments, leaving him a broken old man before he died in 1709. Although Newdigate did not mention the physical pains of ageing, he repeatedly identified himself as “old” and used terms of emotional suffering (“persecuted”, “afflicted”, “lacerated”). What seemed to wound him most was the attempt to have him declared a lunatic. This would have removed all his legal authority over his estates and person.

Sir Richard emerges as a sympathetic character in his account, an old man who was being bullied by his children. The story evokes images of King Lear, although Newdigate specifically referred to the Bible (Genesis 9: 18-29): Ham’s shaming of Noah by refusing to cover his father’s nakedness. In pursuing their demands, the Newdigate children had allowed their father to be roughly assaulted by ruffians, chipped away at his paternal authority, accused him falsely, and stopped providing care. Fear and social isolation exacerbate physical pain and cause emotional suffering. Newdigate’s accounts centered on two main anxieties associated with old age: the steady decline of authority and the absence of caring children.

Biographers of Newdigate, such as Eileen Gooder (The Squire of Arbury: Sir Richard Newdigate, Second Baronet and His Family, 1644-1710) roundly condemn Newdigate’s children, providing evidence of what a good father he had been – of course basing their interpretation on Newdigate’s accounts of himself as a poor old man. But the story may not be so simple. Two adult children had also been committed, hinting at a real strain of mental illness in the family. And the suggestions in medical records that the daughters’ darker allegation of “unreasonable Usage and Practices” might have been true. Tracing the truth of the story through the Newdigate family records is part of my ongoing research.

Sir Richard Newdigate’s success in fashioning himself as an elderly victim reveals much about the wider cultural anxieties about aging. The real suffering that came with old age was not mere physical discomfort, but the fear of being abandoned or preyed upon by one’s family. Newdigate drew on these concerns to elicit sympathy from his readers and to re-establish his reputation: who could blame an “Old Sick Gentleman” who had been vulnerable to his demanding children?

 

On Sloane’s assistance to Elizabeth Newdigate, see my article, “Reassessing the Role of the Family: Women’s Medical Care in Eighteenth-Century England”, Social History of Medicine 16, 3 (2003): 327-342.

Making Friends in Early Modern England: Sloane and the Willughbys

Posted on September 24, 2012 by - Early Modern History, Hans Sloane, History of Science, Networks, Patients, Royal Society

The narrative usually associated with Sloane’s early career is one of luck, key patrons, and opportunities. It goes something like this… In 1685, aged 25, Sloane finished his medical degree at the University of Orange and moved back to London. Robert Boyle, his friend, helped Sloane to obtain an apprenticeship with the famous Thomas Sydenham. Two years later, Sloane had another wonderful opportunity when he became personal physician to the Duke of Albemarle, the new Governor of Jamaica. He returned to London in 1689, after the Duke died, but had during his stay in Jamaica found a wealthy wife and started an extensive exotic botanical collection. From this point, his career was set.

But Sloane’s correspondence suggests that Sloane worked hard to build up his own social and patronage networks. What often gets left out of the grand narrative of immediate success is that Sloane remained a household physician for four years to the widowed Duchess of Albemarle (who remarried, becoming Duchess of Montagu). A comfortable position, perhaps, but one of dependence. It wasn’t until 1693 that Sloane became an independent man. He began his private medical practice and became second secretary for the Royal Society. He also started a friendship with the Willughby family. In early modern Europe, patronage and friendship were closely related—the word ‘friend’ could refer to either, or both. Sloane’s relationship with the Willughbys reveals his care in cultivating friendships.

The Willughbys were a gentry family known for their naturalist interests. Francis Willughby (d. 1672) had been an active Royal Society member and his children Thomas and Cassandra also took an interest in natural history. Miss Willughby oversaw her brother’s gardens and catalogued her father’s library. They also had a connection with a close friend of Sloane’s, John Ray. Francis Willughby was Ray’s patron, giving him employment as household chaplain and tutor to the children and leaving him a generous annuity to continue his scholarship full time. Making friends with such a family could only help Sloane’s career.

Cassandra Willughby married widower James Brydges, Duke of Chandos in 1713. Sloane advised the Duke, who was involved in the Royal African Company, on botanical matters and slave inoculation. (Chandos family portrait by Kneller, 1713. Source: National Gallery of Canada, Wikimedia Commons. )

Sloane wrote the first letter to Miss Willughby on behalf of the Duke of Montagu in November. Lord Montagu enquired after the family’s health, remembering their ‘greate favours to his sonne the last summer’ (BL Sl. MS 4066, f. 164). In a second letter, this time on his own behalf, Sloane presented two favours (BL Sl. MS 4068, ff. 13-14). He shared the news that he had successfully proposed Thomas Willughby for fellow of the Royal Society and enclosed a recipe for cashew sugar enjoyed by Miss Willughby at Montagu House.

These were offerings to potential friends, but also emphasised Sloane’s scientific connections and sociability. The Royal Society nomination was Sloane’s initiative, ‘Mr Thomas Willughby giving me leave to propose him’. Sloane promised that when Willughby came to London, ‘I will wait on him & carry him thither’, something that further marked Sloane out as a well-connected member of the Royal Society.  Introducing the new Fellow was not just a courtesy, but gave Sloane a chance to show his own extensive network.

The recipe for Miss Willughby was particularly meaningful, suggesting at its most basic that he had attentively noticed her food preferences. Recipe exchange was also a form of social currency. Bonds were strengthened through sharing secret knowledge and assuming future reciprocity. The recipe also featured cashews, an imported, high-status food that casually referenced Sloane’s and Miss Willughby’s shared interest in botany. Sloane would later provide the Willughbys with other favours; his early offer of service to the family established a long-lasting relationship.

Willughby’s family home, Wollaton Hall (Samuel Hieronymous Grimm, 1773). Source: British Library, Wikimedia Commons.

In return, the Willughbys often consulted Sloane on medical matters. The correspondence does not specify other ways in which the Willughbys reciprocated, but there are hints. When Willughby thanked Sloane for his help in finding a house to rent, Willughby complained that he had not been able to come to London and instead hoped that he ‘could tempt [Sloane]’ to visit him in Nottinghamshire soon BL Sl. MS 4062, f. 13). The invitation was a return of Sloane’s help and indicated a genuine interest in seeing a friend.

Sloane also used his position with the family to request favours on behalf of John Ray’s family.  At Ray’s death in 1705, for example, his widow Margaret told Sloane that the family had been left with £40 annually. She appealed to Sloane to ask Willughby for half a year’s salary that would cover the costs from Ray’s illness and funeral. Willughby was indeed ‘very sorry Mr Ray has left his family in so ill a condition’ and given Ray’s reputation and service, was ‘willing to doe what you ask of me if there is reasonable occasion in charity to the widow to doe it’ (BL Sl. MS 4062, f. 24). Willughby provided other support to the family, sending £20 to Sloane for them and discussing a Ray monument (BL Sl. MS 4062, f. 22).

Sloane’s assistance must have been effective. Margaret Ray thanked Sloane in 1706, sending her gratitude to Willughby. In this case, Sloane tapped into his other friendships to help the Rays.  The Willughbys were Ray’s patrons, with Thomas Willughby paying £12 more annually than his father’s will specified (BL Sl. MS 4062, f. 24), but Mrs Ray did not feel able to approach them directly.  Sloane, however, was in a good position to help, being Willughby’s friend and social equal.

When Sloane met the Willughbys, he was at a transitional point in his career. He was starting to be able to use his newfound status to expand his circle of friends and potential sources of patronage. By the early eighteenth century, Sloane had developed extensive scientific, medical and collecting networks through which he could obtain, give and negotiate favours. Sloane’s success was not just a matter of luck and important patrons, but was closely tied to his efforts in building relationships and exchanging favours, just as he’d done with the Willughbys. The idea of winning friends and influencing people as a career strategy is not just a twentieth-century concept…

And Sloane was very, very good at it.

A longer version of this case is discussed in my soon-to-be-out chapter, “Friend and Physician to the Family” in From Books to Bezoars: Sir Hans Sloane and His Collections, eds. M. Hunter, A. Walker and A. MacDonald (University of Chicago Press, 2012).