Early Modern Ireland and the world of medicine: Practitioners, collectors and contexts 9781526145147

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Early Modern Ireland and the world of medicine

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SOCIAL HISTORIES OF MEDICINE

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Series editors: David Cantor and Keir Waddington Social Histories of Medicine is concerned with all aspects of health, illness and medicine, from prehistory to the present, in every part of the world. The series covers the circumstances that promote health or illness, the ways in which people experience and explain such conditions, and what, practically, they do about them. Practitioners of all approaches to health and healing come within its scope, as do their ideas, beliefs and practices, and the social, economic and cultural contexts in which they operate. Methodologically, the series welcomes relevant studies in social, economic, cultural and intellectual history, as well as approaches derived from other disciplines in the arts, sciences, social sciences and humanities. The series is a collaboration between Manchester University Press and the Society for the Social History of Medicine. Previously published The metamorphosis of autism: A history of child development in Britain Bonnie Evans Payment and philanthropy in British healthcare, 1918–​48 George Campbell Gosling The politics of vaccination: A global history Edited by Christine Holmberg, Stuart Blume and Paul Greenough Leprosy and colonialism: Suriname under Dutch rule, 1750–​1950 Stephen Snelders Medical misadventure in an age of professionalization, 1780–​1890 Alannah Tomkins Conserving health in early modern culture: Bodies and environments in Italy and England Edited by Sandra Cavallo and Tessa Storey Migrant architects of the NHS: South Asian doctors and the reinvention of British general practice (1940s–​1980s) Julian M. Simpson Mediterranean quarantines, 1750–​1914: Space, identity and power Edited by John Chircop and Francisco Javier Martínez Sickness, medical welfare and the English poor, 1750–​1834 Steven King Medical societies and scientific culture in nineteenth-​century Belgium Joris Vandendriessche Managing diabetes, managing medicine: Chronic disease and clinical bureaucracy in post-​war Britain Martin D. Moore Vaccinating Britain: Mass vaccination and the public since the Second World War Gareth Millward Madness on trial: A transatlantic history of English civil law and lunacy James E. Moran

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Early Modern Ireland and the world of medicine Practitioners, collectors and contexts

Edited by John Cunningham

Manchester University Press

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Copyright © Manchester University Press 2019 While copyright in the volume as a whole is vested in Manchester University Press, copyright in individual chapters belongs to their respective authors. Published by Manchester University Press Altrincham Street, Manchester M1 7JA

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www.manchesteruniversitypress.co.uk British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Electronic versions of chapters 3, 4 and 7 are also available under a Creative Commons (CC-BY-NC-ND) licence, thanks to the support of the Wellcome Trust and the AHRC, which permits non-commercial use, distribution and reproduction provided the editor(s), chapter author(s) and Manchester University Press are fully cited and no modifications or adaptations are made. Details of the licence can be viewed at https://creativecommons.org/licenses/by-nc-nd/3.0/ ISBN 978 1 5261 3815 6 hardback First published 2019 The publisher has no responsibility for the persistence or accuracy of URLs for any external or third-party internet websites referred to in this book, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

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Contents

List of tables  List of contributors  Acknowledgements  List of abbreviations  Introduction  John Cunningham

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1 Locating the Gaelic medical families in Elizabethan Ireland  20 Áine Sheehan 2 Early Modern medical practitioners and military hospitals in Flanders and the south-​west of Ireland  Benjamin Hazard

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3 Sickness, disease and medical practitioners in 1640s Ireland  61 John Cunningham 4 Promoting medical change in Restoration Ireland: the chemical revolution and the patronage of James Butler, duke of Ormond (1610–​88)  Peter Elmer 5 The episcopal and institutional regulation of midwifery in Ireland c. 1615–​1828  Philomena Gorey

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6 Causes of death and cultures of care in County Cork, 1660–​1720: the evidence of the Youghal parish registers  123 Clodagh Tait

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Contents

7 Medical practitioners as collectors and communicators of natural history in Ireland, 1680–​1750  Alice Marples

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8 Collecting medicine in early eighteenth-​century Dublin: the library of Edward Worth  Elizabethanne Boran

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9 The multiple meanings of an eighteenth-​century account of a Caesarean operation  Lisa Wynne Smith

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10 Transforming tradition in the British Atlantic: Patrick Browne (c. 1720–​90), an Irish botanist and physician in the West Indies  Marc Caball

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11 The evolution of the medical professions in eighteenth-​century Dublin  Susan Mullaney

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Index 

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Tables

6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 8.1 8.2 8.3

Burials by month, 1666–​73  131 Child and adult deaths in 1683  132 Child and adult deaths in 1684  133 Numbers of recorded deaths, 1695–​97  133 Deaths in 1695–​97 according to attributed cause  134 Burials by month, 1703–​19  135 Ages at death as recorded in the burial registers of 1695–​97  137 The children of Samuel and Elizabeth Hayman, 140 showing intervals elapsing between their births  Subject divisions of Worth’s entire medical corpus  169 Places of printing of texts on anatomy, surgery and 177 physiology in the library of Edward Worth  Places of printing of texts on anatomy, surgery and physiology in the 1731 library of the ‘eminent physician’  179

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Contributors

Elizabethanne Boran is Librarian at the Edward Worth Library (1733), Dublin. Marc Caball is Senior Lecturer in History at the School of History and Archives, University College Dublin. John Cunningham is Lecturer in Early Modern Irish and British History at Queen’s University, Belfast. Peter Elmer is Senior Research Fellow on the Early Modern Practitioners Project at the University of Exeter. Philomena Gorey is an independent scholar and Tutor at the School of History and Archives, University College Dublin. Benjamin Hazard is Tutor and Assistant Examiner at the School of History and Archives, University College Dublin. Alice Marples is a Research Associate at the John Rylands Research Institute, University of Manchester. Susan Mullaney works as an ophthalmologist and, having completed a masters and a doctorate in the history of medicine, currently teaches the history of medicine in the School of Medicine at Trinity College Dublin. Áine Sheehan holds a PhD in History from University College Cork. She is an independent scholar and works at the Cork Butter Museum.

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Contributors

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Lisa Wynne Smith is Lecturer in Digital History at the University of Essex.

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Clodagh Tait is Senior Lecturer in History at Mary Immaculate College, Limerick.

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Acknowledgements

This collection of chapters stems from a conference on ‘The Medical World of Early Modern Ireland, 1500–1750’, held at The Long Room Hub, Trinity College Dublin (TCD), in September 2015. I am grateful for the assistance offered at TCD by Ms Sarah Barry, Dr Joseph Clarke, Dr David Ditchburn and Professor Jane Ohlmeyer. The conference took place as part of a Wellcome Trust-funded project (Ref. No. 097782/Z/11/Z) at the University of Exeter:  ‘The Medical World of Early Modern England, Wales and Ireland, c.1500– 1715’. The chapters in this volume by John Cunningham and Peter Elmer were supported by this grant and the chapter by Alice Marples was supported by an AHRC-funded studentship under grant AH/J00989X/1. Considerable thanks are due to the project team at Exeter and those associated with its work, especially Professor Jonathan Barry, Dr Justin Colson, Dr Peter Elmer, Mrs Claire Keyte, Dr Hannah Murphy, Dr Margaret Pelling, Dr Ismini Pells, Dr Patrick Wallis and Dr Alun Withey. My colleagues at the School of HAPP, Queen’s University, Belfast, foster a scholarly environment that has helped me considerably in the tasks of writing and editing. Alan R. Hayden very kindly provided the image that appears on the book cover. Dr David Cantor has been a most supportive series editor, for which I am grateful. Thanks also to the staff at Manchester University Press, as well as to the two readers who offered many helpful suggestions for improvements to the text. Finally, I wish to thank all of the contributors to this volume for their patience and diligence in preparing their work for publication.

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Abbreviations

BHoM BL Bodl. Lib. CSPD CSPI DJMCS ECI HMC IHS JHCI JHMAS KQCPI NLI NLS ODNB PRIA PROI RCPI RCSI RIA RSLA TCD TNA

Bulletin of the History of Medicine British Library, London Bodleian Library, Oxford Calendar of State Papers Domestic Calendar of State Papers Ireland Dublin Journal of Medical and Chemical Science Eighteenth-​Century Ireland: Iris An Dá Chultur Historical Manuscripts Commission Irish Historical Studies Journals of the House of Commons of the Kingdom of Ireland (4th edn, 21 vols, Dublin, 1796–​1801) Journal of the History of Medicine and Allied Sciences King and Queen’s College of Physicians of Ireland National Library of Ireland, Dublin National Library of Scotland, Edinburgh Oxford Dictionary of National Biography Proceedings of the Royal Irish Academy Public Record Office of Ireland Royal College of Physicians of Ireland, Dublin Royal College of Surgeons in Ireland, Dublin Royal Irish Academy, Dublin Royal Society Library and Archives, London Trinity College Dublin The National Archives, Kew

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Introduction Downloaded from manchesterhive © Copyright protected It is illegal to copy or distribute this document

John Cunningham

The history of medicine in Ireland has attracted varying degrees of scholarly attention for centuries. As early as 1765, the Limerick-​based surgeon and antiquarian Sylvester O’Halloran sounded an optimistic note on the state of the field. Writing to a friend, he announced that ‘Enough has already been collected, to demonstrate, that Physic, and Surgery have been here, in a very respectable state, even before the birth of Christ’.1 A similarly patriotic outlook was offered half a century later by Edward O’Reilly, an apothecary and lexicographer. In the preface to his Irish-​English Dictionary, he wrote that ‘In our medical books it will be found that our physicians had as much knowledge of the human frame, and as much skill in the treatment of disease, as the physicians of any other nation at the same period’.2 As the nineteenth century progressed, such high praise for early Irish medicine continued to be voiced in various spheres, not least in collections of folklore.3 Snippets of this distant past were also selectively incorporated into the Irish beginnings of the sort of ‘traditional medical history’ that was also prominent in other countries:  work written by male physicians who sought to commemorate and celebrate prominent predecessors, to inspire their contemporaries, and to trace the histories of important institutions and organisations. Key vehicles for this type of writing were the newly founded medical journals, for example the Dublin Journal of Medical and Chemical Science (DJMCS) published from 1832 onwards. The DJMCS carried both general surveys, such as Philip Crampton’s ‘Outline of the history of medicine from the earliest period to the present time’, and pieces focused more directly on Ireland.4 A good example of the latter is Dr Aquilla Smith’s ‘Some account of the origin and early history of the College of Physicians in Ireland’, which appeared in 1841.5 Articles such as Smith’s helped to set the tone for much of the

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scholarship published over the following 150 years. These publications were usually written by male doctors and were marked by a pronounced focus on ‘great men’, individual hospitals and other institutions. For much of the twentieth century, histories of hospitals proved especially popular. The Royal Victoria in Belfast was, for example, the subject of seven books in forty-​four years, between 1953 and 1997.6 In assessing the merits of such scholarship in the Irish context, it is important to keep in mind the caution voiced by Huisman and Warner against retrospectively reducing traditional medical history to ‘flat caricature’.7 Many earlier publications remain the first stop for anyone studying this period. They are important and useful for a variety of reasons, not least due to the frequently high standards of scholarship employed and sometimes the subsequent loss of the primary sources utilised.8 One essay collection that stands out dates from 1952: What’s Past is Prologue:  A Retrospect on Irish Medicine.9 This volume was produced to mark a joint meeting of the British and Irish Medical Associations in Dublin in July of that year. It was certainly aimed at doctors, with almost one-​third of its ninety-​seven pages being taken up with advertisements for Irish whiskey and stout, cigarettes, cars, hotels, airlines and the odd medical device. It also contained a rarity for Irish medical history at the time: an essay by a woman, the prominent physician Margaret ‘Pearl’ Dunlevy.10 It may have been a desire to impress the British visitors that led to the commissioning of essays by an expert on ancient Irish law, Daniel A. Binchy, and another by a Jesuit priest with expertise in medieval Irish manuscripts and the medical curriculum at the southern European universities. At the same time, Binchy’s self-​deprecation as ‘a layman writing for experts’ hinted at the enduring assumption that the history of medicine was more properly written both for and by medics.11 This assumption was one of the factors that ensured that the emergence of the social history of medicine in England and elsewhere had little immediate impact on Ireland. This is indicated by, among other writings, Dr John B.  Lyons’s essay entitled ‘Irish medical historiography’, published in 1978.12 Lyons’s piece was merely a celebration of a selection of medical men who had written histories of various types over the preceding centuries. The years since the turn of the century have, however, witnessed the appearance of a large number of publications that can be seen as more in tune with wider trends in the history of medicine, in terms both of methodology and subject matter. The appearance of several nuanced and outward-​looking summations

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Introduction

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of the historiography allow this recent scholarship to be navigated more easily. Most influential has been the brief ‘anatomy of Irish medical history’ published in 1999 by Greta Jones and Elizabeth Malcolm as their introduction to a collection of innovative essays. Jones and Malcolm stressed the many perceived shortcomings of what had been written up to that point and sounded a clarion call for a social history of Irish medicine. While lamenting the underdeveloped state of their subject, ‘a vast sea of darkness’, they also sounded a note of cautious optimism about the task of bringing ‘Irish medical history fully up to date’.13 Malcolm and Jones’s essay certainly fitted with the approach traced by Huisman and Warner elsewhere, a polemical manoeuvre designed to propel Irish historians away, belatedly, from ‘traditional medical history’.14 While Malcolm and Jones acknowledged some earlier work to be of value and importance, they decried a situation where the wrong type of publication, ‘limited in scope and antiquarian in approach’, was ‘perhaps too plentiful’.15 The extent to which a variety of scholars have since responded to such criticisms and worked to transform the character of the history of medicine in Ireland is summed up well in an article published by Catherine Cox in 2013. She outlined how scholars had, with some success, gone about addressing certain of the issues signposted by Jones and Malcolm, for example the history of psychiatry. Significant in this context was the establishment in 2006 of the Centre for the History of Medicine in Ireland at University College Dublin and Ulster University. Yet despite the increased range and intensity of research, Cox rightly acknowledged that ‘there remain some very basic lacunae in our knowledge, especially in relation to periods before 1800’.16 The following collection of chapters addresses some of these lacunae. One substantial effort to explore aspects of the history of medicine in Early Modern Ireland was the collection of essays edited by James Kelly and Fiona Clark and published in 2010: Ireland and Medicine in the Seventeenth and Eighteenth Centuries.17 The appearance of that volume reflected both a growing interest in the field and a perceived need to redress the pronounced temporal imbalance that was also subsequently noted by Cox: in the rapidly developing historiography of Irish medicine, ‘the modern period overwhelms the early modern’.18 Kelly and Clark sought to open up fresh lines of enquiry and to ‘broaden the interpretative context’ of their subject.19 The authors of the essays in that volume achieved those aims while ranging across matters including professionalisation, social mobility, parliamentary legislation, cultural

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Early Modern Ireland and the world of medicine

contexts and gendered medical advice. This major contribution to the historiography is buttressed by a range of other essays and articles that have appeared in various other volumes and in journals in recent decades, of which the most impressive cohort has come from the pen of James Kelly.20 Kelly and Clark stressed ‘diversity’ as emblematical of Early Modern Irish medicine and pointed out that a great deal of further research is needed before any ‘balanced new synthesis’ of the subject can be attempted.21 In this context, the collective effort encapsulated in the present volume comprises a fresh and important contribution to a continuing enterprise. This enterprise is, for several reasons, necessarily collaborative. Most academic historians of medicine in Early Modern Ireland pursue this interest as one of several strands within a broader individual research agenda. The extensive expertise and the very considerable linguistic skills needed to pursue enquiry across the spectrum of medicine in Ireland in the period are very real obstacles to individual endeavour beyond specialised areas of interest. Furthermore, a historian who insisted on the plausibility of research-​led teaching largely focused on the subject under discussion here may, should they manage to secure an academic post, experience some difficulty in identifying sufficient secondary material to populate a module reading list. Multi-​authored essay collections encapsulating at least some of the variety that made up Early Modern Irish medicine thus have an important part to play in fostering the critical mass of ongoing publications needed to underpin and to help define a clear and confident identity for the subject.22 This is key to stimulating further student interest and to preventing, or at least minimising any negative effects of, the continued historiographical overwhelming of the Early Modern by the modern. As Cox and Luddy have insisted, scholars of the history of medicine in Ireland aim to do more than ‘simply “filling-​in” the Irish case’.23 It is necessary and important to pay attention to wider contexts and to pursue meaningful comparative perspectives. This is not merely a question of conforming to academic fashion or of the need to meet the expectations of key funding bodies. An insular an approach to medicine in Early Modern Ireland does not make sense because it cannot make proper sense of the subject. As the chapters in this volume remind us, Ireland was a space that people moved in and out of continuously. For medical practitioners, education, patronage and employment were push and pull factors that could propel a person halfway across the world, and sometimes back again.24 Knowledge and ideas likewise crossed

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Introduction

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borders and seas; for example, the medical manuscripts surviving from late medieval Ireland demonstrate the widespread reception of theories and practices then in vogue elsewhere in western Europe.25 Outbreaks of disease could also, of course, have a transnational history. One of the more devastating cases was the plague that arrived in Galway in July 1649, allegedly courtesy of a Spanish ship. It is to such large contexts that the title of this collection, Early Modern Ireland and the world of medicine, beckons. The point is not to advance exaggerated claims for the importance or exceptionalism, in medical terms, of a small island in the Atlantic Ocean. Rather it is to situate Early Modern Ireland as one site through which the history of medicine more broadly can be explored. Just as some of the contributions to this volume demonstrate a particular willingness to look outwards from Ireland, it is hoped these chapters may also encourage those working elsewhere more readily to look in. What would they see? It is worth remarking that by the time that Jones and Malcolm issued their plea for an Irish social history of medicine in 1999, that sub-​discipline was already seen to be in ill-​health by some, by others dead.26 Yet the vibrancy evident in research on Ireland since 2000 seems to dispel any notion of simply playing catch-​up with a corpse. The 1990s had also witnessed other competing claims on the general state of the history of medicine: either that it had ‘come of age’ or that it was ‘still in its infancy’.27 Both of these verdicts can be seen as applicable to the Irish case at present, with scholarship on the period after 1800 obviously attaining a greater intensity and maturity. Within the framework supplied by lively international debate on approaches to the history of medicine, the diversity seen to characterise medicine in Ireland before 1800 clearly allows for a wide variety of scholarly lines of enquiry. As this volume demonstrates, Thomas Rütten’s recent call for ‘many more individual case studies employing thick description and broad contextualization’ is one that scholars of Early Modern Ireland are well placed to respond to.28 The relatively underdeveloped historiography is in some ways as much an opportunity as a problem. At the same time, it is necessary to highlight a key limitation that exists with regard the scope for new research, especially by comparison with what Mary Lindemann has referred to as ‘paradigmatic England’.29 For a number of reasons, the source base available to historians of Early Modern Ireland is not as rich as might be expected.30 This can be looked at in two ways. First, there are sources for Early Modern English history that never existed in the Irish context. An obvious case is the material

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generated by the administration of the Poor Law, a system which was not introduced into Ireland until as late as 1839. At the level of elite physicians, the Dublin College of Physicians was not established until 1667, 150 years after its London counterpart, and very little relevant archival material has survived for the period before 1692.31 Ireland’s only university, Trinity College Dublin (TCD), produced few medical graduates in the century following its foundation in 1592.32 The records of the Established Church of Ireland –​parish registers, church courts, ecclesiastical licences, and so on –​were also limited in scope because the majority of the population was Catholic; what records the technically illegal Catholic Church may have generated were less likely to survive.33 The second factor of relevance here is that even where records were generated, they were very often destroyed later, on one occasion in particular. Following the establishment of the Public Record Office of Ireland (PROI) in 1867, enormous quantities of material were brought up to Dublin from all corners of the island. The manuscripts were carefully cleaned, rebound and catalogued, before unfortunately being blown up during the Irish Civil War in June 1922. An ongoing project at TCD aims to recreate a virtual PROI to mark the centenary of this disaster, an undertaking that historians of Ireland will follow with interest.34 The catastrophe of 1922 is the reason why, for example, hardly any wills survive from Early Modern Ireland. Surviving indexes of the prerogative and diocesan wills give a sense of the scale of what was lost, but unfortunately these indexes very often lack occupational data. Such gaps in the surviving sources necessarily complicate any effort to locate medical practitioners, to quantify them, or to reconstruct their social networks. Numerous court, corporation and guild records had also been housed in the PROI. It is simply the case that many of the types of sources that can be used to study and to reconstruct thick details of Early Modern society, especially below the elite level, were either never created in Ireland or were subsequently lost. This has obvious implications for the sort of medical history that can be written. The chapters that follow thus carry added value as examples of the types of enquiry that are feasible within the limitations associated with a difficult and deficient archival background.35 This volume contains the findings of new research by early career and established scholars located across Ireland and Britain. It explores some of the many contexts in which Early Modern Ireland intersected

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Introduction

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with the world of medicine. The individual historians working in this heterogeneous space cannot be seen as collectively pursuing any single clearly defined research agenda. Moreover, both ‘Early Modern Ireland’ and the ‘world of medicine’ appear to be increasingly broad categories of historical analysis. The volume thus encompasses a variety of different approaches and emphases, focused at different points across a period of more than two centuries. The state of the field, both in terms of the existing historiography surveyed above and with regard to the relatively small number of historians with diverse interests active in it, means that collections neatly focused around a central question or issue are not the norm. This volume instead enables important new insights into several key areas that are, for a variety of reasons, currently the focus of scholarly attention. It will undoubtedly provide stimulus for further research in these and other related areas, while also helping to deepen our understanding of the history of medicine in Ireland. Of particular note in the chapters that follow is the extent to which attention is concentrated on the seventeenth century. This allows important new insights into a key phase in the gradual and prolonged transformation of medical practice that took place in the Early Modern period, both in Ireland and elsewhere. One thread that runs through the collection is a focus on medical practitioners of various kinds. As might be expected, most of the individuals dealt with fall within the traditional tripartite division of regular medical practice: physicians; surgeons; and apothecaries. Among the surviving sources, the physicians are by far the most visible class of practitioner. The study of surgeons and apothecaries, both individually and collectively, becomes more feasible post-​1700 due to the richer body of sources that is available. Overall, researching regular male practitioners poses fewer challenges than any attempt to shed light on females and/​or so-​called irregulars.36 While unorthodox practitioners such as quacks or magical healers receive an occasional mention below, for the most part little detail can be recovered beyond the cases of a few individuals who enjoyed a high profile. Among the themes that can be traced in the chapters following is the change that took place in the character and organisation of medical practice in Ireland between the sixteenth and eighteenth centuries. The transformation of Irish society and culture more broadly in this period due to conquest, colonisation, Anglicisation and other factors is a prominent organising principle of both the older and more recent historiographies of Early Modern Ireland. The extent to which

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medicine was impacted by these processes of change is a question that merits close attention. Áine Sheehan’s chapter on ‘Locating the Gaelic medical families in Elizabethan Ireland’ is of importance in this context because it offers an overview of a substantial cohort of the medical practitioners active in late sixteenth-​century Ireland: the hereditary Gaelic physicians and surgeons. Some of the medical manuscripts created and preserved by these medical families have recently begun to attract more sustained scholarly attention.37 As a result, the extent to which learned Gaelic medicine was au fait with key Greek and Arabic texts and open to continental influences is now more fully appreciated. This undermines the simplistic assumption evident in some older romantic nationalist accounts of a close correlation between Gaelic medicine on the one hand and folk cures on the other.38 Sheehan’s chapter puts some flesh on the bones of this new understanding by paying attention to the numbers, locations and family backgrounds of the Gaelic medics in question, thus helping to bring at least some of them out of the shadows. By paying attention to geography, mobility and patronage networks, she conveys a clear sense of how Gaelic medicine was actually practised in the late sixteenth century. This contribution is all the more significant as it addresses a period when other key hereditary learned pursuits in Gaelic society, such as law and poetry, were facing a battle for survival alongside the institution of Gaelic lordship itself. Sheehan’s chapter provides a good basis for further exploration of how Gaelic medical practitioners reacted to the collapse of the old order and the ways in which they adapted to the new. By the eighteenth century, the transformation already underway in Elizabethan Ireland was largely complete. Ireland’s relationship to England was now firmly established and landed society, the Irish parliament and urban corporations were dominated by Protestants, many of whom were descended from seventeenth-​century English settlers. To readers with knowledge of the history of medicine in England, the picture traced in Susan Mullaney’s chapter on ‘The evolution of the medical professions in eighteenth-​century Dublin’ should accordingly seem much more familiar than the milieu explored by Sheehan. This was a world of guilds and colleges, where MPs concerned themselves with the provision of healthcare and practitioners engaged in pamphlet wars.39 New towns had been founded in the seventeenth century and old population centres such as Dublin had grown rapidly. This development greatly expanded the opportunities that existed to practise medicine in an urban setting. The limitations of the available

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Introduction

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sources for the Early Modern period mean that it is not possible to track with any accuracy broad trends in the growth or decline of the numbers of urban and rural-​based medics across the island.40 But the evidence concerning the city of Dublin is generally more detailed and useful. Mullaney’s chapter constitutes a significant reconstruction of key aspects of the medical world of eighteenth-​century Dublin. She explores the exponential growth in the numbers of the main categories of practitioners; physicians, apothecaries and surgeons. The shifts in relative status between these groups across the period, and the institutional and other factors underpinning such change, are also carefully addressed. Mullaney pays due attention to wider contexts in a way that brings out the potential that exists for more in-​depth comparative study of the place and practice of medicine in Dublin and cities elsewhere in the eighteenth century. The other chapters that follow here each offer some insight, from the perspective of health and medicine, into the reshaping of Irish society that occurred between the Elizabethan period and the eighteenth century. Military conflict and violence undoubtedly played a key role in that wider process. Just as in Ireland, warfare elsewhere in Europe also posed numerous threats and offered considerable opportunities to medical practitioners.41 Benjamin Hazard’s chapter expertly reconstructs a picture of military and medical migration between Ireland and the territories of Spain.42 He examines the origins and careers of a number of practitioners identifiable in a range of Spanish sources. In doing so he enables an improved understanding of the identities of Irish medical men abroad, and of the circumstances in which they found themselves. Hazard’s chapter suggests that further transnational study of the movement and practice of Irish medics in wartime would certainly be worthwhile. The same is true for his analysis of ‘military hospital systems’, where he focuses on Mechelen in Flanders and a Spanish field hospital established at Castlehaven on the south coast of Ireland in 1601. Careful attention to the surviving sources for these institutions has allowed Hazard to recover remarkable details of how they functioned, from the organisation of staff to the treatment of wounds and burns. This makes clear the extent to which the Spanish authorities viewed medical provision as central to underpinning their war effort, both on the continent and further afield. Hazard also argues for the importance of studying medicine on the battlefields, because they stood alongside the universities as key sites of learning and transmission of medical knowledge.43

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Hazard’s chapter reveals much about the efforts of a large and powerful Early Modern state to use medicine to manage and minimise war casualties among its armies. John Cunningham’s chapter, by contrast, deals with the medical context of a very different type of conflict, one where the order and careful organisation of a Mechelen was very much absent. The 1641 rebellion began in Ulster and quickly spread countrywide, unleashing chaotic communal violence between Catholics and Protestants.44 The survival of a large number of testimonies collected from witnesses and survivors of the rebellion allows diverse aspects of that infamous episode to be explored in considerable detail.45 These documents, known as the 1641 depositions, help to compensate in some respects for the subsequent loss of so much other source material from this period. Cunningham’s chapter draws upon the 1641 depositions to explore experiences of sickness, disease and wounds at the individual level, encompassing both male and female, and persons of varying social status. The depositions allow unique insight into how people in 1640s Ireland understood and reported their various ailments. This source also offers a snapshot of the locations and identities of a broad range of medical practitioners, many of whom are otherwise untraceable. Cunningham uses the depositions to trace the wartime experiences of a miscellany of medics, as practitioners, as local leaders, as victims and as survivors. This constitutes both a helpful case study of how the depositions can be employed to study a particular grouping and a worthwhile exploration of how the rebellion impacted on medical practitioners. The 1641 rebellion is rightly seen as a major point of rupture in Irish history. It was followed by a period of sustained warfare and conquest up to 1652, which paved the way for the far-​reaching Cromwellian settlement. The latter process cemented English and Protestant control of land and power in Ireland.46 The mid-​century upheaval also had some significant consequences for medicine. The war and subsequent settlement saw an influx of practitioners, mostly from England, some of whom would enjoy a high profile in various spheres over the decades following. The best known of these is the virtuoso William Petty, who played a central role in enabling the Cromwellian land settlement.47 Like Petty, Dr Abraham Yarner had strong government and army connections, while at TCD the Irish-​born Protestant John Stearne was also well-​placed to promote the study of medicine. The presence of such men lent a new visibility to Irish medicine, most obviously at the level of university-​educated physicians. This was at least partly a result of the

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ability and willingness of men such as Petty and Stearne to engage with the Dublin–​London governmental axis along which so much power and patronage flowed back and forth. The mid-​seventeenth century thus witnessed a strengthening of ties between the state and medicine in Ireland. It also saw a closer engagement, and overlap of personnel, between the worlds of English and Irish medicine more generally. This engagement was not merely due to the migration to Ireland of English Protestant doctors. For example, the Catholic Dr Edmund Meara left Ireland in the 1650s and set up at Bristol. In 1664 he was elected an honorary fellow of the London College of Physicians. A year later the London publication of his critique of Thomas Willis’s work raised his profile still further.48 Meara’s firmly Galenic retort to Willis’s writing on fevers was backed up by another doctor of Gaelic origins, Conly Cashin, who published a book on the subject in Dublin in 1667.49 In spanning both the confessional divide and the Irish Sea, this controversy in print reflected well the medical setting of Restoration Ireland. Some of the key developments that emerged within this environment are explored in the chapter by Peter Elmer. John Stearne’s gathering of a Fraternity of Physicians in Dublin 1654 has been seen as an important precursor to the eventual establishment of the Dublin College of Physicians in 1667.50 In 1664 Stearne intensified his efforts to secure the required royal support. By then the London College of Physicians was also engaged in a parallel political struggle over its new charter.51 The London College faced opposition too from a new grouping of chemical physicians, in which the Irish courtier and medic Thomas O’Dowde played a leading role. Peter Elmer’s contribution to this volume carefully traces the connections that existed between proponents of the ‘chemical revolution’ and James Butler, duke of Ormond. This approach throws new light on the considerable medical patronage dispensed by Ormond, the most powerful man in Restoration Ireland and a significant figure at the court of Charles II. In assessing the significance of Irish-​based medics within the wider movement for medical reform, Elmer also pays close attention to the 1650s background and to the roles played by members and correspondents of the Hartlib circle. The latter is a subject that ought to repay further investigation. Along with revealing more of the close ties that existed between English and Irish medicine in the mid-​seventeenth century, he also draws welcome attention to the presence in Ireland of medics with a continental background, most notably the chemist Pierre Belon.52 Elmer observes that Belon’s efforts

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to promote a spa at Chapelizod near Dublin can be related to medical developments elsewhere in Europe at the same time. This point reflects the fact that by the 1670s Irish medicine had seemingly begun to enjoy greater connectivity to the continent. This key development was due partly to increased outward migration for educational purposes.53 Also of significance here was the trend highlighted by Elmer whereby French Huguenot medics and other foreign practitioners were drawn to Ireland in greater numbers. While a variety of medics become easier to trace in the post-​1660 context discussed by Elmer, it unfortunately remains difficult to recover much information concerning one particular category of practitioners:  the midwives. Archival references to female midwives tend to be brief and passing, and quite often do not include the name of the woman being referred to. This relative paucity of source material mitigates against the pursuit of detailed case studies focused on particular places or within short timeframes.54 Philomena Gorey’s chapter thus necessarily spans much of the Early Modern period, and is all the more valuable for providing insight into the obscure world of Irish midwives. Gorey deftly situates the midwife’s practice in the contested space between the Church of Ireland and the Catholic Church, thus providing a useful insight into the interconnectedness of medicine and religion in Ireland. She sets out the limited evidence that exists for ecclesiastical licensing and explores the Dublin College of Physicians’s tentative early engagement with the regulation of midwifery. With the emergence of the man-​midwife in eighteenth-​century Dublin the practice assumed a higher profile, and Gorey also assesses the significance of this key development. Scholars of midwifery and many other aspects of medicine and society in Early Modern Ireland are keenly aware of the source limitations that impact on their work. Against that background, Clodagh Tait’s chapter demonstrates the exciting research possibilities that exist in certain cases where clusters of detailed archival material have in fact survived. Her chapter provides a fascinating insight into everyday life and death in the town of Youghal, Co. Cork, in the decades after 1660.55 Parish registers from seventeenth-​century Ireland are relatively few in number, but Tait makes a compelling case for meticulous analysis of what has survived. While recognising the limitations of the available sources, Tait rightly insists that ‘even an impressionistic picture is better than nothing at all’.56 Apart from briefly outlining some details of medical practice in seventeenth-​century Youghal, this ground-​ breaking chapter reveals much of interest relating to mortality trends in

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an Irish port town. The frequent traffic that existed between Youghal and other ports underpins Tait’s effort to relate deaths in Ireland to contemporaneous outbreaks of disease in England and further afield. This compensates to some extent for the fact that Irish sources for epidemics are less plentiful. Finally, Tait’s short case study of the Hayman family, exploring births and deaths among the sixteen children of that household, reinforces her call for the greater use of parish registers by Irish historians, not least as a means for detailed investigation of aspects of health and medicine. The content of the chapters that follow Tait’s valuable study of Youghal reflect the further opening up of Ireland to the wider world of medicine and learning after 1660. They offer an exciting range of local, national and global perspectives, with a particular emphasis on networks of communication and collecting among medical practitioners and their associates. Alice Marples demonstrates how the participation in such networks helped to offset some of the disadvantages felt by those practitioners in Ireland who were located at a distance from scholarly resources and communities. Indeed, their relative isolation had the potential to render their input all the more distinct and valuable. In this context, the Irish-​born physician Sir Hans Sloane, based in London, played a vital role as a point of contact. The survival of Sloane’s extensive archive allows historians a significant route into this world of corresponding and information sharing, including its Irish dimension.57 Marples argues that such networks helped doctors to negotiate their way through and make sense of a crowded marketplace, one where successful individuals such as Sloane were well placed to collate and assess the merits of diverse findings relating to medicine and natural history. Her exploration of the manner in which Irish physicians contributed to wider efforts to systematise knowledge in the decades either side of 1700 deepens our understanding of the place of Ireland in an increasingly densely networked world of medicine.58 Elizabethanne Boran’s chapter on Edward Worth expertly reconstructs another Irish aspect of this well-​connected world, namely medical book collecting. As with Sloane’s enormous collections, the fortunate survival of Worth’s library and fifty-​seven related book sale catalogues offers scholars a rich resource for new research.59 The Edward Worth Library is the most important medical collection extant from Early Modern Ireland, and Boran is the leading expert on its contents and history. Her chapter provides a detailed breakdown of the 1,012 items that made up Worth’s medical collection. It enables a clear

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and concise picture of the types of books collected by a physician who enjoyed prominence in Dublin medical circles from the 1710s up to his death in 1733. Boran draws attention to and seeks to explain some key trends evident in the library, for example the prominence of works that drew on Newtonian concepts, and the emphasis on plague literature. In connection with the latter, Boran argues that the outbreak at Marseilles in 1720 piqued Worth’s curiosity. The comparisons that she draws out between the makeup of Worth’s library on the one hand and that of an anonymous ‘eminient physician’ on the other adds a further layer of interest, offering as it does a wider perspective on medical book ownership in eighteenth-​century Ireland. Boran’s chapter serves to open up Worth’s library to a wider scholarly audience, while also pointing to some of the important ways in which that valuable collection might be profitably subjected to further detailed study. Lisa Wynne Smith’s contribution ties this transnational medical collecting milieu to the unlikely setting of rural Co. Tyrone in the 1720s and 1730s. Hans Sloane again features, as the recipient of letters that shed some light on the curious case of Mrs McKinna and her stone baby. Smith draws upon a blend of scholarly approaches to pursue an innovative microhistorical investigation of McKinna’s case and its contemporary meanings. The transmission of medical knowledge and the practices of individual medics could often successfully bridge the cleavages of a divided society, as was the case in Early Modern Ireland.60 Yet Smith brings out the ways in which different observers could at the same time attach widely disparate meanings to the same events. Alongside the outsider’s perspective offered by the Protestant clergyman John Copping, she seeks to recreate possible local Catholic understandings, informed by religious tradition, folklore and the experience of famine and poverty. While Smith’s criss-​crossing of the ‘permeable border between history and imagination’ may not appeal to all readers, it does suggest one possible strategy that historians of Early Modern Ireland could employ in meeting the frustrating challenges posed by an archival base that is often all too shallow. More pointedly, Smith’s chapter makes a strong case for creative engagement with the obscure and incomplete stories that can be recovered relating to groups and individuals whose voices and experiences are poorly represented in the written archive.61 In general, male physicians are the practitioners best represented and most visible in the archive. In the Irish context, those men who moved beyond the island and also made an impact beyond medical practice often achieved the greatest contemporary prominence, with

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Hans Sloane serving as a very good example. Marc Caball’s chapter assesses the career of a man who in some respects followed in Sloane’s footsteps. In 1756, three decades after the appearance of Sloane’s account of several Caribbean islands, Patrick Browne published his own Civil and Natural History of Jamaica.62 Browne was a Catholic, born in Co. Mayo around 1720. Caball assesses Browne’s significance as a botanist and seeks to situate him within the overlapping medical and scientific worlds of England, France, Irish-​speaking Connacht and the West Indies. This is a timely reminder of the need to look west as well as east when exploring Irish connections to Early Modern medicine. While Browne’s education in France, and his MD from Reims, reflects a common trend among Irish Catholic medical students of the era, his wider career suggests possibilities for further research into transatlantic networks of Irish medicine. In some respects, Caball’s chapter on Browne brings us full circle, back to the Gaelic medics discussed by Áine Sheehan. The common thread here is Gaelic manuscript publication, and Caball stresses that this insular tradition had a severely limiting effect on the reach and wider impact of Gaelic intellectual life. Sheehan and Caball both make significant contributions to the ongoing scholarly recovery of key aspects of this Gaelic culture. Overall the chapters that follow offer a range of important insights into a complex and diverse Irish medical world that extended from the butcher in the peasant household to the royal physician in the palace, encompassing Mrs McKinna, Sir Hans Sloane and a great deal in between. Notes 1 Quoted in J. Lyons, ‘Irish medical historiography’, in E. O’Brien (ed.), Essays in Honour of J. D. H. Widdess (Dublin, 1978), p. 90. 2 E. O’Reilly, Sanas Gaoidhilge-​ Sagsbhearla:  An Irish-​ English Dictionary (Dublin, 1817), preface. O’Reilly was referring to late medieval and Early Modern medical manuscripts written in the Irish language, of which many survive. See ­chapter 1 by Sheehan in this volume. 3 J. Wilde, Ancient Cures, Charms and Usages of Ireland (London, 1890), pp.  4–​9. 4 P. Crampton, ‘An outline of the history of medicine from the earliest period to the present time’, DJMCS, 14 (1839), pp. 504–​33. 5 A. Smith ‘Some account of the origin and early history of the College of Physicians in Ireland’, DJMCS, 19 (Mar. 1841), pp. 81–​96; E. Kennedy, ‘Introductory address, delivered at the first meeting [of the Dublin Obstetrical Society] in the Rotunda, Nov. 14 1838’, DJMCS, 15 (1839), pp. 160–​77.

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6 G. Jones and E. Malcolm, ‘Introduction: an anatomy of Irish medical history’, in G. Jones and E. Malcolm (eds), Medicine, Disease and the State in Ireland, 1650–​1940 (Cork, 1999), pp. 1–​17. 7 F. Huisman and J. H. Warner, ‘Medical histories’, in F. Huisman and J. H. Warner (eds), Locating Medical History:  The Stories and their Meanings (Baltimore, MD, 2004), p. 2. 8 For example, the books published by T. P. C. Kirkpatrick in the early twentieth century, including his History of Doctor Steevens’ Hospital, 1720–​1920 (Dublin, 1924). 9 O. Fitzgerald and W. Doolin (eds), What’s Past is Prologue: A Retrospect on Irish Medicine (Dublin, 1952). 10 M. Dunlevy, ‘Medical families in medieval Ireland’, in Fitzgerald and Doolin (eds), What’s Past is Prologue, pp. 15–​22. 11 D. Binchy, ‘The leech in ancient Ireland’, in Fitzgerald and Doolin (eds), What’s Past is Prologue, pp. 5–​9. 12 Lyons, ‘Irish medical historiography’, pp. 89–​111. 13 Jones and Malcolm, ‘Introduction’, pp. 1–​17. 14 Huisman and Warner, ‘Medical histories’, pp. 3–​5. 15 Jones and Malcolm, ‘Introduction’, p. 6. 16 C. Cox, ‘Discursive essay:  a better known territory? Medical history in Ireland’, Proceedings of the Royal Irish Academy (hereafter PRIA), 113C (2013), pp. 341–​62. 17 J. Kelly and F.  Clark (eds), Ireland and Medicine in the Seventeenth and Eighteenth Centuries (Farnham, 2010). 18 J. Kelly and F. Clark, ‘Introduction’, in ibid., p. 3. 19 Ibid., p. 6. 20 For example, J. Kelly, ‘The emergence of scientific and institutional medical practice in Ireland, 1650–​1800’, in Jones and Malcolm (eds), Medicine, Disease and the State, pp. 21–​39; J. Kelly, ‘Health for sale: mountebanks, doctors, printers and the supply of medication in eighteenth-​century Ireland’, PRIA, 108C (2008), pp. 75–​113; A. Sneddon, ‘Medicine, belief, witchcraft and demonic possession in late seventeenth-​century Ulster’, Medical Humanities, 42 (2016), pp. 81–​6; M. Lyons, ‘The limits of Old English liberty: the case of Thomas Arthur, MD (1593–​1674) in Dublin and Limerick’, in S. Ryan and C. Tait (eds), Religion and Politics in Urban Ireland, c.1500–​c.1750: Essays in Honour of Colm Lennon (Dublin, 2016), pp. 70–​88. See also, R. Whan, The Presbyterians of Ulster, 1680–​1730 (Woodbridge, 2013), pp. 138–​55. 21 Kelly and Clark, ‘Introduction’, p. 4. 22 On this latter point see L. Jordanova ‘Has the social history of medicine come of age?’, Historical Journal, 36 (1993), pp. 437–​49. 23 C. Cox and M. Luddy, ‘Introduction’, in C. Cox and M. Luddy (eds), Cultures of Care in Irish Medical History, 1750–​1970 (Basingstoke, 2010), pp.  1–​12.

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24 See, for example, ­chapter 10 by Caball in this volume. 25 A. Nic Dhonnachadha, ‘The “Book of the O’Lees” and other medical manuscripts and astronomical tracts’, in B. Cunningham and S. Fitzpatrick (eds), Treasures of the Royal Irish Academy Library (Dublin, 2009), pp. 81–​91. 26 R. Cooter, ‘ “Framing” the end of the social history of medicine’, in Huisman and Warner (eds), Locating Medical History, pp. 309–​37. 27 A. Wear, ‘Introduction’, in A. Wear (ed.), Medicine in Society:  Historical Essays (Cambridge, 1992), p. 1; Jordanova ‘Has the social history of medicine come of age?’, pp. 437–​49. 28 T. Rütten, ‘Early modern medicine’, in M. Jackson (ed.), The Oxford Handbook of the History of Medicine (Oxford, 2011), p. 71. 29 M. Lindemann, Medicine and Society in Early Modern Europe (Cambridge, 1999), p.  6. Aside from the substantial quantity of books and articles published in recent decades on Early Modern England, medicine in Scotland and Wales has also begun to attract greater attention. See, for example, H. Dingwall, Physicians, Surgeons and Apothecaries:  Medicine in Seventeenth-​Century Edinburgh (East Linton, 1995) and A. Withey, Physick and the Family:  Health, Medicine and Care in Wales, 1600–​1750 (Manchester, 2013). 30 The survival rate for source material post-​1700 is generally much better than for the earlier period. 31 There are several histories of the College, most recently A. McCreary, Healing Touch: An Illustrated History of the Royal College of Physicians of Ireland (Dublin, 2015). 32 D. Coakley, Medicine in Trinity College Dublin:  An Illustrated History (Dublin, 2014). 33 R. Refaussé, Church of Ireland Records (Dublin, 2006). 34 ‘Beyond 2022: Ireland’s national memory’, https://​histories-​humanities. tcd.ie/​research/​Beyond-​2022 (accessed 24 Oct. 2017). 35 See, for example, ­chapter 6 by Tait in this volume. 36 For midwives, an important class of female practitioners, see below and also ­chapter 5 by Gorey in this volume. 37 See, for example, the essays by recently published under the auspices of the Irish Texts Society in L. Ó Murchú (ed.), Rosa Anglica: Reassessments (London, 2016). 38 Wilde, Ancient Cures, pp. 4–​9. 39 A. Sneddon, ‘Institutional medicine and state intervention in eighteenth-​ century Ireland’, in Kelly and Clark (eds), Ireland and Medicine, pp. 137–​62. 40 One book offering a good example of the much more detailed research that is possible for England is I. Mortimer, The Dying and the Doctors: The Medical Revolution in Seventeenth-​Century England (Woodbridge, 2009). See also P. Wallis and T. Pirohakul, ‘Medical revolutions? The growth of medicine in England, 1660–​1800’, Journal of Social History, 49 (2016), pp. 510–​31.

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41 Early Modern military medicine has been attracting some more attention of late. See, for example, S. Pranghofer, ‘The early modern medical-​ military complex: the wider context of the relationship between military, medicine, and the state’, Canadian Journal of History, 51 (2016), pp. 451–​ 72, and also the several other relevant articles in that issue. 42 Hazard’s essay can be situated within the growing scholarly engagement with the subject of the Irish in Europe. Substantial outputs include the essays collected in T. O’Connor (ed.), The Irish in Europe, 1580–​1815 (Dublin, 2001). 43 For insight into a later period, focused on naval medicine, see C. Convertito, ‘Mending the sick and wounded:  the development of naval hospitals in the West Indies’, Canadian Journal of History, 51 (2016), pp. 500–​33. On military hospitals in late seventeenth-​century Ireland, see E. G. von Arni, Hospital Care and the British Standing Army, 1660–​1714 (Aldershot, 2006), ­chapter 3. 44 N. Canny, Making Ireland British, 1580–​ 1650 (Oxford, 2001), pp. 461–​550. 45 The 1641 Depositions have been digitised and are freely available to consult at www.1641.tcd.ie (accessed 22 Aug. 2017). 46 J. Cunningham, Conquest and Land in Ireland:  The Transplantation to Connacht, 1649–​1680 (Woodbridge, 2011). 47 T. McCormick, William Petty and the Ambitions of Political Arithmetic (Oxford, 2009). 48 P. Logan, ‘Dermot and Edmund O’Meara, father and son’, Journal of the Irish Medical Association, 43 (1958), pp. 312–​17; Edmund O’Meara, Examen Diatribae Thomae Willisii … de Febribus (London, 1665). 49 Conly Cashin, Willisius Male Vindicatus sive Medicus Oxoniensis Mendacitatis et Inscitae Detectus (Dublin, 1667). 50 Kelly, ‘The emergence of scientific and institutional medical practice’, pp. 23–​4. 51 H. Cook, ‘Physicians and the new philosophy’, in R. French and A. Wear (eds), The Medical Revolution of the Seventeenth Century (Cambridge, 1989), p. 259. 52 On Belon, see also J. Kelly, ‘ “Drinking the waters”:  balneotherapeutic medicine in Ireland, 1660–​1850’, Studia Hibernica, 35 (2008–​9), pp. 99–​146. 53 L. Brockliss, ‘Medicine, religion and social mobility in eighteenth-​and early nineteenth-​century Ireland’, in Kelly and Clark (eds), Ireland and Medicine, pp. 73–​108. 54 One institution that has inspired numerous publications and some important work on midwifery is the Dublin Lying-​ In Hospital, or Rotunda, founded in 1745. See, for example, I. Campbell Ross (ed.), Public Virtue, Public Love: The Early Years of the Dublin Lying-​In Hospital, the Rotunda (Dublin, 1986).

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55 Tait’s essay is an example of the results of a growing interest in Irish urban history, for which see Ryan and Tait (eds), Religion and Politics in Urban Ireland. 56 For the much richer possibilities that exist for research in England, see the work of the Cambridge Group for the History of Population and Social Structure. A helpful overview is available at www.campop.geog.cam.ac.uk (accessed 24 Oct. 2017). 57 The Sloane Manuscripts are held at the British Library. Sloane’s archive is gradually being made more accessible thanks to the Sloane Letters Project. See www.sloaneletters.com (accessed 24 Oct. 2017). 58 An important earlier study is K. T. Hoppen, The Common Scientist in the Seventeenth Century: A Study of the Dublin Philosophical Society, 1683–​1708 (London, 1970). 59 See http://​edwardworthlibrary.ie/​our-​catalogue (accessed 24 Oct. 2017). 60 Lyons, ‘The limits of Old English liberty’, pp. 70–​88. 61 For the reconstruction of another interesting case from Early Modern Ulster, see Sneddon, ‘Medicine, belief, witchcraft and demonic possession’, pp. 81–​6. 62 Sloane’s account was published as A Voyage to the Islands Madera, Barbados, Nieves, St. Christophers, and Jamaica, with the Natural History of the Herbs and Trees, Four-​Footed Beasts, Fishes, Birds, Insects, Reptiles of the Last of those Islands (2 vols, London, 1707–​25).

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Locating the Gaelic medical families in Elizabethan Ireland Áine Sheehan The study of the history of medicine in medieval Ireland has been dominated by the translation and interpretation of the medical manuscripts produced by a small group of hereditary medical families in Gaelic Ireland between the late fourteenth and early seventeenth centuries. The aim of this chapter is to broaden the discussion of the experiences of these families by placing them in the social and political context of sixteenth-​and early seventeenth-​century Ireland. To that end this chapter will look at three key features of the lives of the medical professionals in Elizabethan Ireland. First it will explore their prevalence and national distribution. It will then address the issue of who patronised these medical families and discuss the evidence that exists concerning relationships between patron and physician. Finally, the wider role that the families in question played in the warfare of the period and their place in rural Ireland will be assessed. A focus on medicine and medical practitioners is one means of investigating the interactions between Gaelic and English cultures during the long and bloody sixteenth century. The surgeons and physicians were members of an elite class of literate professionals in Gaelic society who were free to travel between the sometimes-​warring lordly territories in the politically fragmented landscape of sixteenth-​century Ireland.1 The later positive reputation of the Gaelic medical families, at least in some quarters, was summed up by the seventeenth-​century Dutch chemist and physician Jan Baptist van Helmont: The Irish Nobility had in every family a domestic physician, whose recommendation was not that he came loaded from the college with learning, but that he was able to cure disorders, which knowledge they have from their ancestors by means of a book belonging to particular families that contains the marks of the several diseases, with

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the remedies attached; which remedies were vernacula, the production of their own country –​for this reason, the Irish are better managed in sickness than the Italians who have a physician in every Village.2 Van Helmont of course had his reasons for praising vernacular remedies and the wisdom of non-​university-​educated physicians. His description of the Gaelic medical practitioners and their books reflects an image that has come to dominate our perception of these doctors. Van Helmont was correct to identify the hereditary nature of medical practice in Ireland and the importance of the medical manuscripts maintained by these families. However, these manuscripts do not contain details of native cures.3 Instead they are evidence of the close intellectual links that existed between Ireland and Europe in the Middle Ages. They reflect European medical knowledge of medieval writers such as Bernard of Gordon and John of Gaddesden. Aoibheann Nic Dhonnchadha has convincingly demonstrated that the creation of these medical manuscripts was not simply an act of copying and translating Latin texts into Irish but rather a process of editing and of curating a collection of texts. Her close analysis of the manuscripts produced by the O’Connor/​Ó Conchubhair doctors of Aghmacart, Co. Laois, has shone a light on the intellectual world of the Gaelic medical schools.4 The O’Connor medical manuscript Royal Irish Academy (RIA) MS 439 (3 C 19) is a prime example of the process of copying and editing undertaken at the medical schools. The scribe, Risteard Ó Conchubhair, did not simply copy the Latin manuscripts wholesale but rather worked at editing and compiling various texts to produce a learned edition. In the case of RIA MS 439, the manuscript is an amalgamation of four distinct medical tracts: three translations of Bernard of Gordon’s works,5 and a tract on sahaphati by Valescus de Taranta.6 The tract on sahaphati is interesting, not only for its uniqueness, but also because Risteard Ó Conchubhair provides a commentary on where his patron Donnchadh Óg Ó Conchubhair wanted the extract to be inserted in the manuscript. Donnchadh Óg originally ordered Risteard Ó Conchubhair to insert the extract after Book 3.24 of the Lilium Medicinae (following the chapter ‘De Lentiginibus Faciei’).7 The introduction of an extract on sahaphati, a skin disease characterised by the appearance of pustules about the nose with a general red complexion, following a chapter regarding facial freckles, points to Donnchadh Óg’s motives behind the compilation of the manuscript. He wanted to include a skin condition,

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not recognised in Bernard of Gordon’s work, to create a more complete and useful medical compendium. The disappointment of some scholars8 that such manuscripts do not contain evidence of native cures must therefore be leavened with the understanding that the Gaelic medical families were part of a broader intellectual world that stretched beyond the shores of Ireland and connected small schools such as the one at Aghmacart in Co. Laois with schools in Scotland, and further afield to the great European universities. Van Helmont’s identification of Gaelic medics as hereditary practitioners who were not ‘loaded from the college with learning, but … [were] able to cure disorders’ highlights his own scepticism regarding the university curriculum and the belief that Ireland on the fringes of Europe remained untouched by such concerns. It is true that medicine in rural Ireland in the late medieval and Early Modern period was dominated by a group of hereditary medical families. There were at least twenty families active in the sixteenth century. These can be grouped based on the province in which they practised.9 The families of O’Callanan/​Ó Callanáin, O’Hickey/​Ó hÍcidhe, Lane/​Ó Leighin, Troy/​Ó Troighthigh and Nealon/​ Ó Nialláin were found in Munster. The MacCashin/​MacCaisín, Bolger/​ Ó Bolgaidhe, O’Connor/​Ó Conchubhair, Cullen/​Ó Cuileamhain and O’Shiel/​Ó Siaidhail were active in Leinster. For Connacht, the relevant surnames were MacKinley/​Mac an Leagha, MacVeigh/​Mac an Beatha, Canavan/​O Ceandubháin, Kearney/​Ó Cearnaigh, Fergus/​Ó Feargusa and Tully/​Ó Maoil Tuile. Those associated with Ulster were Dunleavy/​Ó or Mac Duinnshléibhe10 and O’Cassidy/​Ó Caiside. This regional classification does not, however, take into account the movement of members of these families to other lordships. For example, the O’Shiel family were from King’s County (now Co. Offaly). Yet they are recorded as serving further north as physicians to the MacMahons of Oriel in Co. Monaghan. Certain other families, for example the O’Fennells/​Ó Fionnghaill and the O’Mearas/​Ó Meadhra who served the earls of Ormond, had their origins in Co. Tipperary.11 Locating Gaelic medics

In 1575 there was an outbreak of plague in the city of Dublin. In the aftermath and in response to the high mortality, the corporation of Dublin granted citizenship to several doctors who had stayed in the city to tend the sick during the crisis. Included in this group was one ‘Nicholas Hicky, doctor of physic’. He was made a freeman of the city:

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in consideration that he shall henceforward dwell and make his abode in Dublin, shall have and be payed by the hands of the thresorer of this cittie out of the thresorie and revenewe of the said cittie yearlie ten pounds, lawfull monie of Irland, beginning from Maie next [1580], during his good behavior and usadge, and shall observe the orders and dyrections following, that is to saie, taking for the vewe and loking of eche passientes uryn without visitacion, sixe pence sterling; every visitacion of such passient and vewe of his water, twelve pence sterling; item for eche visitacion without viewe of his water, twelve pence sterling, over and besyds consideracion that if he undertake to cure eny man for a certayne som of mony, then he to be at libertie to agre with the saide partie; also, that upon lysence of Mr. Mayor of this cittie for the tyme being, he may goo threskore [60] myles out of this cittie, so as he return agayne within XII daies after, and that without lysence he may goo no further then that he may return within XXIIII howres after; and if the Mayor for the tyme being shall send for hym at any tyme he shall com to the said Mr Mayor presently, upon payne of losing halfe a yeares stipend.12 Nicholas Hicky was descended from the famous Gaelic medical family, the Ó hÍcidhe, who from their home territory in Thomond (now Co. Clare) had spread throughout the south and midlands of Ireland during the late medieval period. They were a highly regarded medical family among the Gaelic and Anglo-​Irish communities. This status may have derived not only from the ancient connection this family had with the practice of medicine but also from their involvement in the introduction of European medical ideas to Ireland in the Middle Ages. The earliest extant translation into Irish of European medical knowledge are the ‘Aphorisms of Hippocrates’, translated by two Munster doctors, Aonghus Ó Callanáin (O’Callanan) and Nicol Ó hÍceadha (O’Hickey) in 1403.13 This text was widely disseminated throughout the Gaelic medical schools. The Ó hÍcidhe family manuscript containing the translation of the Aphorisms of Hippocrates was bought in 1500 by Gerald Fitzgerald, earl of Kildare for ‘a score of kine’. This manuscript consisted of ‘two and twenty quarternions’14 and it remained in the earl’s library for a period before being returned to the Ó hÍcidhe family. The earl’s interest in their medical knowledge may have drawn some members of the family to Co. Kildare and from thence to practice in the

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English-​controlled Pale around Dublin. The Fiants of Elizabeth I record members of the family living on the bounds of the Pale in the late sixteenth century.15 Coupled with Nicholas Hicky’s presence in Dublin, it would seem that the family moved easily between Gaelic, Anglo-​Irish and English territories in Ireland.16 The careers of Gaelic physicians and surgeons such as Nicholas Hicky reflect the high regard in which they were held by the urban as well as rural elites, and the ease with which they could travel between at times hostile territories. The history of medicine can therefore provide an alternative perspective to that offered by the many studies concerned with political and military contexts, and with the social and cultural divisions that existed between Gaelic and English Ireland respectively. Locating the Gaelic medical families in Elizabethan Ireland is no small task. This is so not only because are they widely distributed throughout the country, but also because they form one of the largest groupings of professionals in Gaelic society. On a purely practical level, researching any Gaelic family through the surviving English governmental sources can be fraught with pitfalls. It should be remembered that the government sources record the interaction of two distinct cultures and societies; there is rarely any consistency of spelling of personal names or locations. The English governmental records provide a snapshot of the progress of the English conquest throughout the sixteenth century. As such the areas under Gaelic control that resisted the longest appear later in the English sources. Therefore, counties Donegal, Tyrone and Fermanagh are largely absent from English administrative sources until the early seventeenth century. Consequently, some professional families of Ulster, for example the Mac Giolla Senáin (Mc Gilsenan) and Mac Birrthagra (Berkery) brehons,17 or the Ó hEoghusa (Hussy) poets are totally absent from government records. The MacDuinnshléibhe medics, meanwhile, appear under a very different name, as Ultagh/​Owltagh. Finally, the nature of families in Gaelic Ireland, specifically the large geographic spread of some families such as the Ó Conchubhair18 and Ó Cearnaigh families, requires the researcher carefully to tease out the evidence for individuals linked to a given profession. Such detailed investigations help to separate the medical families from the background noise created by the clash of Gaelic and English cultures. There are indications that some of the locations associated with the medical families were strategically chosen to take advantage of the road

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and riverine communication networks.19 For example, Ballyowen, Co. Offaly, linked to the surgeon Patrick Cassadie,20 is located on the Slighe Mhór. The latter was one of the oldest routeways in Ireland, cutting through the midlands and connecting the east coast with Galway in the west. Other surgeons are identified as living within easy distance of the other great routeway, the River Shannon. The surgeons Laughlen McEnlay21 and Murtagh McMulltully22 are recorded as having lived at Curraghboy, Co. Roscommon and Moydrum, Co. Westmeath, respectively. Both locations are situated slightly to the north of the Slighe Mhór and on either side of Lough Ree on the River Shannon. This intersection of riverine and land routes offered the medical families access to patrons/​patients beyond their immediate locality. Travel on these routes could be hazardous, as they passed through multiple lordships. A  traveller would have to obtain safe passage by applying to the local chieftain; otherwise they would be exposed to attack and raids by brigands, as well as from members of the chief ’s own military entourage. There is evidence from the mid-​fifteenth century of Gaelic chiefs receiving pensions in consideration of their protection to merchant travellers. For example, Ó Néill of the Fews received a pension from the archbishop of Armagh, John Bole, to protect any merchants among the archbishop’s followers journeying to Armagh.23 The Gaelic professional elite, including the physicians and surgeons, was somewhat protected from attack because of their high ‘honour-​ price’ under the brehon laws.24 The documentary evidence points clearly to the ability of members of the Gaelic professional classes to travel freely between otherwise hostile lordships. This freedom of movement to travel between hostile lordships, and farther afield to Scotland and Europe, allowed many of the Gaelic medical families to expand their patronage networks, to gain a broader clinical experience and to pursue further medical education. The Gaelic medical families were part of a broader intellectual network with Gaelic physicians travelling to Scotland in search of patronage and vice versa. At the Ó Conchubhair school at Aghmacart, Co. Laois there is evidence of the presence Scottish medical students as well as students from various parts of Ireland. Examples include Cathal Ó Duinnshléibhe of the Donegal medical family and Donnchadh Albannach Ó Conchubhair, one of the O’Connor physicians of Lorn in Scotland.25 They collaborated in the copying and compilation of what is now National Library of Scotland (NLS) MS 73.1.22 (Gaelic MS CXVII). This manuscript consists of Cormac Mac Duinnshléibhe’s translations

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of Bernard of Gordon’s Lilium Medicinae and Liber Pronosticorum as well as an anonymous translation of Petrus de Argellata’s (Pietro d’Argelata) Chirurgia.26 In one of the colophons accompanying this manuscript, Cathal Ó Duinnshléibhe comments that two other doctors, Iollann Máig Bheatha and Feargach Ó Ferghusa, were also at the school during the composition of the manuscript.27 It is probably not a coincidence that the Scottish doctor, Donnchadh Albanach Ó Conchubhair, was collaborating with Cathal Ó Duinnshléibhe. The Ó or Mac Duinnshléibhe were physicians to the Ó Domhnaill lords of Tír Chonaill. Their most famous descendant was Cormac Mac Duinnshléibhe, the fifteenth-​century translator of Bernard of Gordon’s Lilium Medicinae, which became one of the key texts of the Gaelic medical tradition of the late Middle Ages. By the sixteenth century, the Mac/​Ó Duinnshléibhe physicians are primarily identified by the name Ultagh/​Owltagh in the English and Scottish sources. It is with this surname that several Mac Duinnshléibhe are identified in NLS Adv. MS 72.1.33,28 which belonged to the Beaton medical family of Pennycross on the Isle of Mull in the Inner Hebrides.29 Through a close reading of the colophons of the manuscript with information gleaned from the Fiants, we can confidently link the Duncan and Francis Ulltach mentioned by Donald Beaton in the Scottish manuscript, with the Francis Ulltagh, Donogh Ultagh and Owen Ultagh mentioned in a pardon, dated 26 February 1603.30 In the medical manuscript, Donald Beaton mentions how Duncan and Francis Ultach sheltered him while he was in Donegal copying manuscripts to bring back to Scotland. While staying in Donegal, Donald Beaton noted in his colophon that he had been saddened when Duncan and Francis Ulltach had to leave as he could ‘get no one to discuss a single word since they departed’.31 Undoubtedly both Duncan and Francis Ulltach were professional physicians who could converse learnedly with their Scottish colleague. The collaboration between the medical family of Mac/​ Ó Duinnshléibhe of Ulster and the Scottish medical families, the Beatons of Mull and the O’Connors of Lorn, as well as with other Irish Gaelic medical families such as the O’Connors of Upper Ossory, highlights the nature of their schools as places where students from across the Gaelic world could meet and work together, as well as the freedom these families had to travel within Ireland. They also emphasise the strength of the common linguistic and intellectual world that stretched across the Irish Sea between the Gaelic areas of Ireland and Scotland.

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Patronage

The relationship between the medics and their patrons was closer than the usual patron/​client relationship characteristic of the other hereditary professions in Gaelic Ireland. The doctor saw their patron, and their family, usually in private and dealt with their most personal physical complaints. Many doctors visited their patients in their homes, usually touring a geographic area to visit several important patrons and patients. The best evidence for such tours comes from the colophons of the medical manuscript RIA MS 473 (3 C 19) written by Risteard Ó Conchubhair. In the colophons he recorded the route of his journey throughout south Leinster in 1590. The colophons mark the conclusion of sections of the Lilium Medicinae of Bernard of Gordon. The first colophon at the conclusion of the third part of the Lilium sets out Ó Conchubhair’s circumstances: [F]‌ar distant from one another are the places in which this book was written. For none of my temporal lords remain, and my parents, too, are dead, and I myself have neither wife nor home. All I could do when I  was tired in one place was to transport myself to another. And, indeed, I did not write a week’s work of it except in the house of a kinsman or kinswoman, or some great friend of my own.32 Setting out from his home school at Aghmacart in Co. Laois, he travelled north to Kildare to Cluain Each/​Clonagh,33 the home of John Og Alye, then to Baile Feadha/​Ballina,34 the home of Calvagh son of O’More, and on to Carraig Fheoruis/​Carrick,35 the home of Edward Bermingham. All three locations are situated along a routeway that connected Dublin to Nenagh in Co. Tipperary.36 They are in north Co. Kildare on the border with counties Meath and Offaly, an area Ó Conchubhair describes as ‘Clann Fheoruis’, the country of the Berminghams, whose seat was at Carbury Castle. The identities of his patrons reflected the ethnic mix on the borderlands of the Pale and Gaelic Ireland. All three patrons, the Anglo-​Irish Alye and Bermingham, and the Gaelic O’More, lived in the same barony of Carbury in Co. Kildare. From Carrick, Ó Conchubhair journeyed south, visiting Don Uabhair/​Donore, Pollardstown, Almhain Laighean/​Hill of Allen and Dun Muire/​Dunmurry, again all in Kildare.37 This area of the county was dominated by the Fitzgeralds, earls of Kildare, a circumstance reflected in RIA MS 473 (3 C 19). Ó Conchubhair records that he stayed with

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James Fitzgerald and subsequently his son William,38 as well as Garret Fitzgerald, of the ‘family of the Knight of Kerry’.39 Ó Conchubhair’s final stop in Kildare, Dunmurry, was home to another Anglo-​Irish lord, Edward Hussey, though like many of these marchland lords, Hussey was married to a Gaelic woman:  ‘Mary, daughter of Calvagh, son of Tadhg, son of Cathaoir O’Connor, a kinswoman and a sponsor in baptism to me (Risteard Ó Conchubhair).’40 Leaving Co. Kildare, Ó Conchubhair travelled south into Butler-​ controlled territory in Co. Kilkenny, to the home of Edmund, Viscount Mountgarret. Ó Conchubhair does not record where he stayed while he worked for Mountgarret. However, two castles are associated with the family at Ballyragget and Balleen in Co. Kilkenny, both situated on the border between Kilkenny and Laois, and located on a major road that connected Dublin to Kilkenny.41 This was a frontier zone between the lordship of Ormond and the MacGiollapadraig lordship of Upper Ossory, and quite close to Ó Conchubhair’s home at Aghmacart. The connections between the Butler and MacGiollapadraig lordships included the marriage of Edmund Butler to Gráinne, daughter of Brian Fitzpatrick (Brian MacGiollapádraig), first baron of Upper Ossory.42 Ó Conchubhair also claimed a familial connection with Gráinne NicGiollapádraig through her mother, who was the daughter of Brian Ó Conchubhair Failighe. Risteard Ó Conchubhair’s unique position within the society of south Leinster is further illustrated by his stay with Oliver Grace at Courtstown, Co. Kilkenny. The Graces were closely associated with the Butlers. In 1573 members of the family kidnapped Brian MacGiollapadraig’s wife Elizabeth O’Connor and their daughter Gráinne, with Butler collusion, sparking a feud between MacGiollapadraig and the Butlers.43 Twenty years later, Risteard Ó Conchubhair, a self-​ declared kinsman of Elizabeth O’Connor, journeyed to the Graces looking for patronage and a shelter while he completed ‘the third Particle of the Lily’, relating to diseases of ‘the eyes, ears, nose and mouth’.44 His journey through Leinster illustrates the intermixing of Gaelic and settler society, and the capacity of the Gaelic medics to travel freely between otherwise hostile lordships. This draws attention to the potential role of medics as neutral and trusted go-​betweens, carrying messages from one lordship to another. Ó Conchubhair’s account of his journey through Kildare and Kilkenny illustrates not only the workings of the patronage networks in Gaelic Ireland and the Pale, but also the interactions of different social grades, and the strength of familial ties (even distant family connections)

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that bound Gaelic society together. Risteard Ó Conchubhair’s relationship with members of the Ó Conchubhar Uí Failghe points to the strength of the corporate identity of the clan in Gaelic society.45 Risteard Ó Conchubhair is careful to give credit to several female relations for their support of his education and work. Mary Ní Chonchubhair, the wife of Edward Hussey, was his kinswoman and godmother. Elizabeth Ní Chonchubhair, the mother of Viscount Mountgarret’s wife Gráinne Nic Giollapadraig, was also a relative. Both women seem to have taken an interest in Risteard Ó Conchubhair from an early age. Elizabeth took him under her wing and ‘provided for (his) education’ following the death of his father when he was twelve years of age.46 Women, especially wealthy ones, appear to have had a significant role in the patronage of the medical families, and in medicine in general. In many ways, familial health was the domain of the mistress of the house. In the seventeenth and eighteenth centuries, evidence of recipe books of cures and treatments is quite common among the upper classes.47 These recipes were often shared among the lay medical community, to act in combination with, and sometimes as an alternative to, the advice of a medical professional. Risteard Ó Conchubhair’s careful noting of wives of the Gaelic and Anglo-​Irish lords who sheltered him while he worked on RIA MS 439 highlights the personal relationship between physician and the aristocratic household. The familiarity of the doctor–​patient relationship is reflected in some letters from the period exchanged between Gaelic doctors and their patients. An example is the correspondence between Lachlan Mór MacLean, chief of the MacLeans of Duart and Giolla-​Coluim (Malcolm) MacBeath, of the famous Scottish Gaelic medical family the Beatons of Pennycross in Western Scotland.48 In the letter Lachlan Mór asks his personal physician, Malcolm MacBeath, to visit MacLean’s sister Marion and her son ‘the Laird of Coll’ and to give his best wishes to another of Malcolm’s patients, the ‘Stewart of Appin’s daughter and all her offspring’.49 This highlights the familial nature of the patronage network in Gaelic society and the preponderance of women in the sourcing and employing medical practitioners. In Ireland, some seventeenth-​ century correspondence between doctor and patient has survived. For example, a letter dating from 1646 contains Owen O’Shiel’s advice to Thomas Preston. Though Preston was no longer O’Shiel’s patron by that point in time, the physician advises him only to drink ‘Vin du Pays’ and avoid ‘Rhenish wine’, ‘assuring your honour that no other end can be expected than to shorten your own days

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whereby you will be an executioner of your own self if you follow the contrary’.50 In the letter O’Shiel refers to Preston on familiar terms and he reminisces about their time together fighting in the Low Countries, where O’Shiel was ‘appointed chiefe doctor of the Catholic King’s army’ and was nominated ‘chiefe of that facultie in the royal hospital at Macklin (Malines) where for 12 years he had done admirable cures’.51 War and other contexts

The connection between medicine and the military is often overlooked in the historiography of sixteenth-​and seventeenth-​century Ireland.52 It is fair to say that the largest professional group in Ireland in the sixteenth century consisted of soldiers and their logistical support. Recent work by Benjamin Hazard has uncovered evidence of a field hospital used during the Battle of Kinsale campaign by Irish and Spanish soldiers, and illustrates the logistical and material support necessary to maintain a fighting force in the field.53 There is also evidence of members of the Gaelic medical families participating in war-​bands in the sixteenth century. The Mac Cashins (Mac Caisín) were part of an ‘outlaw band’ harassing the area around the O’Connor (Ó Conchubhair) school at Aghmacart, Co. Laois.54 No further details are given as to who led the raids, but the Annals record a raid by ‘Owny, son of Rury Oge, son of Rury Caech, son of Connell O’More’ (Uaithne MacRuaidhri ua Mordha) throughout Laois in which he ravaged ‘its crops, corn and dwellings, so that there was nothing in the territory outside the lock of a gate or a bawn which was not in his power’.55 Such ferocity would have understandably caused the O’Connors to retreat to the security of their castle. The Fiants of Elizabeth I record several individuals from the medical families as having occupations associated with the military in the late sixteenth century. These occupations include horsemen, soldiers, kerns, pikemen and horseboys. The provision of medical services to Gaelic forces is still under-​researched. However, one intelligence report dating from the aftermath of the battle of the Moyry Pass in October 1600 states that to avoid weakening his forces O’Neill left the wounded in their cabins, where they had ‘no other salves applied to their sores more than their country salve, butter’.56 The provision of care for the wounded soldiers of O’Neill’s army may indicate that they were left to recuperate with family members or perhaps with households along the route of the marching armies. It might not be too far a stretch to suggest that some of these households may

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have belonged to the professional medical families. Though evidence for the province of Ulster is lacking, in other parts of the country it is clear that members of these families lived on or adjacent to major overland routes.57 Furthermore, the provision of care and hospitality had always been a major aspect of Gaelic society. The ancient medico-​ legal tracts, for example Bretha Crólige, provide evidence for the care expected to be given to the sick and wounded.58 Though these laws had fallen into irrelevance by the late sixteenth century, the concept and expectation of hospitality for the sick remained alive. Another aspect of the work of these families that needs further investigation is their involvement in veterinary medicine. It should be remembered that Gaelic society throughout the late medieval and Early Modern period was a rural society, with agriculture being the main occupation and source of income for families. Many members of the professional medical families are recorded in English governmental sources as owning land or farming land as freehold tenants.59 As such, it should not be a surprise to find evidence of members of the medical families treating animal as well as human patients. Fergus Kelly in his book Early Irish Farming describes a system of veterinary fees almost as elaborate as the leech fees charged for the treatment of injuries to humans of differing social status.60 Kelly notes that a medical manuscript that belonged to the Ó Longáin medical family records a number of herbal remedies and charms for ailments of livestock.61 Even as late as the nineteenth and twentieth centuries there remained a belief in many parts of Ireland as to the efficacy of cures undertaken by members of the ancient medical families, for example the use of ‘Cassidy’s rag’ to cure livestock in parts of Fermanagh where the Ó Caiside family had served the lords of Fermanagh until their exile in the seventeenth century. Conclusion

The Gaelic hereditary physicians and surgeons were among the few members of the Gaelic elite that had the freedom to travel and work across the ethnic, religious and political boundaries that criss-​crossed sixteenth-​and seventeenth-​century Ireland. They were part of a profession that encompassed a broad range of individuals, from English and European university educated physicians to quacks, charlatans and enthusiastic amateurs. The varieties of medical practitioners is evidenced in the treatment of Walter Devereux, first earl of Essex, who fell ill in 1576 with suspected poisoning. He seems not to have had an

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English physician on staff as he was initially treated by the Secretary of State Sir John Challoner and ‘Mr. Knell, an honest Preacher’. It was only with the arrival of the ‘Irish Physician’, ‘Dr.  Trevor, an Oxford man’,62 that the suspicion of poison was discounted and the earl received proper treatment. This range of medical expertise is one of the reasons why the Gaelic families could move so easily throughout Gaelic, Anglo-​Irish and ‘New English’ society. The surviving Gaelic medical manuscripts belonging to these families indicate that they worked within the framework of European medical knowledge. This would have been reassuring to a non-​Gaelic patient who would recognise the type of medicine that they practised. The antiquity of some of these families and their reputation of ‘good service’ would have also recommended them to important and wealthy patrons. At the dawn of the seventeenth century, many of the Gaelic medical families and their schools were still in operation, and there is evidence of many Gaelic students travelling abroad to study medicine at European universities and keeping up to date with contemporary medical knowledge. As the seventeenth century progressed, however, many of these families and their schools closed as a result of the massive economic, social and political upheavals of the period. Nonetheless, the name-​recognition and reputation of some of these families, for example the O’Cassidy family of Fermanagh, survived long after these families ceased to practise medicine. Appendix

Gaelic surgeons and physicians in Elizabethan Ireland, as mentioned in The Irish Fiants of the Tudor Sovereigns. Co. Cork ‘Eneas O’Lyne, chirurgeon’, Castletown (Fiant 6,762) ‘John O’Leyn, physician’, Ballyveerane (Fiant 6,467) Co. Waterford ‘James Fennell, physician’, Ballybeg (Fiant 6,565) Co. Kerry ‘Awly O’Leyne, chirurgeon’, Ardfert (Fiant 6,569) ‘Donald O’Leyne, surgeon’, Lixnawe (Fiant 5,225) Co. Tipperary ‘Gullucuelly O’Hickie, chirurgeon’ and ‘Donogh O’Hickie, chirurgeon’, Dromline (Fiant 6,505)

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‘Donell Hickie alias Daniel oge O’Hickie, surgeon’, Athnid (Fiant 6,464) Co. Limerick ‘Nich. Hickie, surgeon’, Anhid (Fiant 6,479) ‘Morris Hickie, surgeon’, Caherass (Fiant 6,497) Co. Clare ‘Dermot oge O’Nelan, physician’, Killinaboy (Fiant 6,562) ‘Donell oge O’Hickey, chirurgeon’, Ballymacdonnell (no. 6,615) Co. Wexford ‘Dermot O’Bolger, chirurgeon’, Ballywalter (Fiant 6,549) Co. Carlow ‘Nich. Cullen, chirurgeon’, Timolin (Fiant 6,408) ‘Walter O’Bolgir, chirurgeon’, Bahana (Fiant 6,541) Co. Laois ‘Gillpatrick mcShane McCassen, chirurgeon’, Derrin (Fiant 6,551) Co. Westmeath ‘Murtagh McMulltully, chirurgeon’, Moydrum (Fiant 6,550) Co. Offaly ‘Patr. Cassadie, chirurgeon’, Ballyowen (Fiant 6,500) ‘Fardinand O’Sheill, chirurgeon’, Ballysheil (Fiant 6,574)63 ‘Cormuck, Rory, Hugh O’Shiell chirurgeons’, Camase (Fiant 6,574) ‘Hugh, Cormock, Aghry, Hugh oge, Rorie O’Shiell, chirurgeons’, Camus (Fiant 6,618) Co. Roscommon ‘Laughlen McEnlay, chirurgeon’, Curraghboy (Fiant 6,106) Co. Mayo ‘Art O’Caerny, chirurgeon’, Ballycastle (Fiant 5,798) Co. Sligo ‘Hugh McJames McVehey, chirurgeon’, Leyny (Fiant 5,797) Co. Donegal ‘Moris Ultaghe, Shane Ultaghe, Donell Ultaghe, surgeons’, Offane (Fiant 5,227)64 Notes 1 The study of the Gaelic professional medical families is still in its infancy. Until very recently the agreed number of medical families operating in Gaelic Ireland was about twenty. However, recently Nollaig Ó Muraile has identified a further eighteen families through an investigation of authors mentioned in Ughdair Éreann/​De Scriptoribus Hibernicis and Mac Fhir

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Bhisigh’s Leabhar Mór na nGenealach/​Great Book of Irish Genealogies. See N. Ó Muraíle, ‘The hereditary medical families of Gaelic Ireland’, in L. Ó Murchú (ed.), Rosa Anglica: Reassessments (London, 2016), pp. 85–​113. 2 Quoted in J. Fleetwood, The History of Medicine in Ireland (Dublin, 1983), p. 20. 3 What we know about the native medical tradition can be gleaned from the brehon laws, especially Bretha Crólige and Brethat Déin Checht that deal specifically with restitution for injuries. The laws indicate that the proscribed regimen was bed-​rest and diet to aid the body’s natural healing processes. The treatments for illnesses were not recorded at the time and must have been transmitted orally as part of a physician’ s apprenticeship. There is evidence for surgical interventions such as leg amputation at Ardreigh, Athy Co. Kildare. See www.irishexaminer.com/​ ireland/​remains-​of-​1000-​people-​recovered-​at-​medieval-​site-​104453. html (accessed 18 Dec. 2015). However overall we know very little about the general health of the population in Ireland in the Middle Ages. On the excavations at Ballyhanna, Co. Donegal, see C. McKenzie and E. Murphy, Life and Death in Medieval Gaelic Ireland: The Skeletons from Ballyhanna, Co. Donegal (Dublin, 2018). 4 A. Nic Dhonnchadha, ‘The medical school of Aghmacart, Queen’s County’, Ossory, Laois and Leinster, 2 (2006), pp. 11–​43. 5 Liber Pronosticorum (1295); De Decem Ingeniis Curandorum Morborum (1299); and Lilium Medicinae (1305). 6 Valescus de Taranta (fl. 1382–​1418). The extract on sahaphati comes from his Practica Valesci de Tharanta que alias Philonium dicitur (Practica seu Philonium Pharmaceuticum et Chirurgicum), first published in 1484. 7 Nic Dhonnchadha, ‘The medical school of Aghmacart’, p. 18. 8 F. Shaw, ‘Irish medical men and philosophers’, in B. Ó Cuív (ed.), Seven Centuries of Irish Learning (Cork, 1971), pp. 75–​86. 9 For more precise details on some relevant individuals, see the Appendix to this chapter. 10 In many of the sixteenth-​century sources the MacDuinnshléibhe are instead referred to by the name Ultach or Owltagh. 11 In the seventeenth century, these families produced a number of prominent physicians who were closely associated with the Butlers, earls of Ormond. 12 J. T. Gilbert (ed.), Calendar of Ancient Records of Dublin (19 vols, Dublin, 1889–​1944), ii, pp. 146–​7. 13 A. Nic Dhonnchadha, ‘Medical writing in Irish, 1400–​1700’, in J. B. Lyons (ed.), Two Thousand Years of Irish Medicine (Dublin, 1999), pp. 21–​6. 14 A quaternion in this case refers to the construction of the manuscript of four double leaves or eight leaves. This medical manuscript therefore consisted of at least 176 pages (22 quaternions x 8 leaves).

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15 The key source for identifying the locations of Gaelic practitioners in the late sixteenth century is The Irish Fiants of the Tudor Sovereigns, ed. Kenneth Nicholls (4 vols, Dublin, 1994). 16 For Hickey medics identifiable in the Fiants, see the Appendix to this chapter. 17 The brehons were hereditary legal officers in Gaelic society. 18 There are six distinct septs of the Ó Conchubhair family. Apart from the O’Connors of Aghmacart, Co. Laois, there were the O’Connor Don, O’Connor Roe and O’Connor Sligo in Connacht, the O’Connor Faly (Offaly), and branches in Kerry and Clare. E. MacLysaght, The Surnames of Ireland (Dublin, 2007), pp. 55–​6. 19 For more on roadways in medieval Ireland see, C. Ó Lochlainn, ‘Roadways in ancient Ireland’, in J. Ryan (ed.), Essays and Studies Presented to Professor Eoin Mac Néill (Dublin, 1940), pp. 465–​74 and E. FitzPatrick, ‘Roads and routes’, in S. Duffy (ed.), Medieval Ireland:  An Encyclopedia (New  York, 2005), p. 414. 20 The Irish Fiants, no. 6,615, 1 May 1602. 21 Ibid., no. 6,106, 26 May 1597. 22 Ibid., no. 6,550, 10 June 1601. 23 N. Canny, The Elizabethan Conquest of Ireland:  A Pattern Established, 1565–​1576 (Hassocks, 1976), p. 5. 24 An ‘honour-​price’ was the fine to be paid by a person found guilty of an offence against another. It varied according to the social status of the aggrieved party. The protection that it afforded was not always effective, and bands of armed kernes did attack even the most privileged members of Gaelic society. For an example, see K. Nicholls, ‘The register of Clogher’, Clogher Record, 7 (1971–​72), p. 419. 25 Nic Dhonnchadha, ‘The medical school of Aghmacart’, pp. 29–​30. 26 NLS, Adv. MS 73.1.22 (Gaelic MS CXVII); Nic Dhonnchadha, ‘The medical school of Aghmacart’, p. 29. 27 NLS, Adv. MS 73.1.22, fo. 122rb36-​z; Nic Dhonnchadha, ‘The medical school of Aghmacart’, pp.  30–​1. ‘Máig Bheatha’ may refer to the Mac Veigh medical family of Connacht. ‘Ó Ferghusa’ was possibly related to the Fergus medical family in Connacht. See D. Ó Catháin, ‘John Fergus MD: eighteenth-​century doctor, book collector and Irish scholar’, Journal of the Royal Society of Antiquaries of Ireland, 118 (1988), pp. 139–​62. 28 NLS, Adv. MS 72.1.33 (Gaelic MS XXXIII). 29 J. Bannerman, The Beatons:  A Medical Kindred in the Classical Gaelic Tradition (Edinburgh, 1998), pp. 25–​40. 30 The Irish Fiants, no.  6,761, [26] February 1603. The pardon covers the followers of ‘Rory O’Donell, of Tireconnell, in the province of Ulster, gent’. This is Ruairí Ó Domhnaill, ally of Hugh O’Neill in the Nine Years War. He was created earl of Tyrconnell in September 1603.

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31 NLS, Adv. MS 72.1.33, fo. 84; Bannerman, The Beatons, p. 27. 32 P. Walsh, Gleanings from Irish Manuscripts (Dublin, 1933), p. 129. 33 Ibid. 34 Ibid., p. 130. 35 Ibid. 36 This routeway can be identified on the Down Survey map from the 1650s at http://​downsurvey.tcd.ie/​down-​survey-​maps.php (accessed 18 Dec. 2015). Paul Walsh identified the places mentioned by Risteard Ó Conchubhair in the colophons to RIA, MS 473. Walsh, Gleanings, pp.  123–​53; Nic Dhonnchadha, ‘The medical school of Aghmacart’, pp. 22–​4. 37 Walsh, Gleanings, p. 130. 38 Ibid. ‘James, son of William Og (Son of William), son of Thomas (this William Og was grandson of Thomas Fitzgerald of Coill na Cuirte Duibhe)’. 39 Ibid. 40 Ibid. 41 This routeway was identified using the Down Survey maps at http://​ downsurvey.tcd.ie/​down-​survey-​maps.php (accessed 18 Dec. 2015). 42 Walsh, Gleanings, p.  131. Walsh confuses Brian MacGiollapadraig and his son Brian Óg (Barnaby Fitzpatrick). Gráinne was the daughter of Briain MacGiollapadraig and half-​sister of Barnaby Fitzpatrick, by his second wife, Elizabeth the daughter of Brian Ó Conchubhar Failghe (O’Connor Faly). 43 C. Maginn, ‘Fitzpatrick, Barnaby, second baron of Upper Ossory (c. 1535–​ 1581)’, in Oxford Dictionary of National Biography (hereafter ODNB). 44 Nic Dhonnchadha, ‘Medical writing in Irish’. 45 Though the Ó Conchubhars of Aghmacart originated among the Ó Conchubhar Kerry, the family proudly nurtured their connection with the Ó Conchubhar Uí Failghe for the purpose of patronage. 46 Walsh, Gleanings, p.  131. Elizabeth, daughter of Brian O Conchubhair Failghe, was Brian Mac Giollapadraig’s second wife. 47 J. Kelly, ‘Domestic medication and medical care in late early modern Ireland’, in J. Kelly and F. Clark (eds), Ireland and Medicine in the Seventeenth and Eighteenth Centuries (Farnham, 2010), pp. 109–​35. 48 J. Bannerman and R. Black, ‘A sixteenth-​century Gaelic letter’, Scottish Gaelic Studies, 13 (1978), pp. 56–​65. 49 Ibid., p. 56. 50 P. Logan, ‘Owen O’Shiel (1582–​1650) –​eagle of doctors’, Journal of the Irish Medical Association, 41 (1957), p. 158. O’Shiel left Preston’s service to join Owen Roe O’Neill’s faction in the Confederate Wars. 51 Ibid., p. 157. On O’Shiel, see also ­chapter 2 by Hazard in this volume. 52 P. Logan, ‘Medical services in the armies of the Confederate Wars (1641–​ 52)’, Irish Sword, 4 (1959–​60), pp. 217–​27; C. Brady, ‘The captain’s

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games:  army and society in Elizabethan Ireland’, in T. Bartlett and K. Jeffery (eds), A Military History of Ireland (Cambridge, 1996), pp. 136–​59; B. Hazard, ‘ “Very necessarie instrumente in a company”:  Irish medical personnel and Spanish military medicine, 1586–​1672’, Ossory, Laois and Leinster, 5 (2012), pp. 115–​44. 53 See ­chapter 2 by Hazard in this volume. 54 NLS, Adv. MS 73.1.22 (Gaelic MS CXVII) fo. 185vb7–​ 16; Nic Dhonnchadha, ‘The medical school of Aghmacart’, pp. 31–​2. 55 Annala Rioghachta Eireann:  Annals of the kingdom of Ireland by the Four Masters, ed. John O’Donovan (7 vols, Dublin, 1848–​51), vi, p. 2007. 56 J. McGurk, The Elizabethan Conquest of Ireland: The Burdens of the 1590s Crisis (Manchester, 1997), p. 249. The use of butter as a salve for wounds dates far back into pre-​Christian Ireland and is often linked with the use of charms to aid healing. W. Davies, ‘The place of healing in early Irish society’, in D. Ó Corráin, L. Breatnach and K. McCone (eds), Sages, Saints and Storytellers: Celtic Studies in Honour of Prof. James Carney (Maynooth, 1989), p. 50. 57 For example, the presence of the three surgeons ‘Laughlen McEnlay’ of Curraghboy, Co. Roscommon, ‘Murtagh McMulltully’ of Moydrum, Co Westmeath, and ‘Patr. Cassadie’ of Ballyowen, Co. Westmeath, living on or very close to the major routeway that connected Dublin to Galway. 58 The sick or wounded individual was expected to repose in an environment with little noise or upset where ‘[t]‌here are not admitted to him into the house fools or lunatics or senseless people or half-​wits or enemies. No games are played in the house. No tidings are announced. No children are chastised. Neither women nor men exchange blows … No dogs are set fighting in his presence or in his neighbourhood outside. No shout is raised. No pigs squeal. No brawls are made. No cry of victory is raised nor shout in playing games. No yell or scream is raised’. See F. Kelly, A Guide to Early Irish Law (Dublin, 1990), p. 130. The accommodation was expected to be clean and the injured party was to be fed a diet of bread, meat and honey to aid recovery. See D. Binchy, ‘Sick maintenance in Irish law’, Ériu, 12 (1938), pp. 78–​134. 59 The Irish Fiants, iii, contains references to a large number of individuals recorded as ‘gentlemen’ (sixteen references), ‘yeomen’ (fifty-​nine references), ‘husbandmen’ (thirty-​six references), and ‘labourers’ (five references), among the medical families. In total there are 289 references for the twenty medical families in this study. 60 F. Kelly, Early Irish Farming (Dublin, 1997), p. 217. 61 Ibid., p. 218. The MS records that it derived from an older manuscript that was in the possession of the Munster physician Eoin Ó Callanáin in 1692. 62 Andrew Kippis, Biographica Britannica (5 vols, London 1793), v, 129. There is no further information regarding this ‘Doctor Trevor’. There was one Trever or Trever who graduated with a medical degree from Oxford

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in the period, namely Randall Trever. See Alumni Oxoniensis, 1500–​1714, ed. J. Foster (Oxford, 1891), British History Online, www.british-​history. ac.uk/​alumni-​oxon/​1500–​1714/​pp1501–​1528 (accessed 18 Dec. 2015). 63 There is also a Ballysheil in Co. Down. Whether this is linked to the O’Shiell/​Sheill medical family is unclear. 64 The identification of Offane with the modern Aghaveagh is tenuous.

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2

Early Modern medical practitioners and military hospitals in Flanders and the south-​west of Ireland Benjamin Hazard In Early Modern Europe, the provision of military medical care was one of the many challenges caused by widespread and persistent warfare. During active conflict, warring parties established hospitals to care for personnel in army and naval service. According to Ole Peter Grell, the development of military hospital systems shows the significance that nation states attached to healthcare for their forces.1 Moreover, Geoffrey Parker has referred to first-​rate methods of medical treatment devised by the Spanish Army of Flanders in the sixteenth and seventeenth centuries.2 The persistent occurrence of warfare makes it possible to survey military hospitals and the medical practitioners assigned to them. The provision of adequate medical services was, however, not guaranteed in every theatre of war. Writing on Ireland, Cyril Falls and John McGurk have identified a number of factors that impacted negatively on the availability of military medicine in the sixteenth and seventeenth centuries. Rather than supplying hospitals and providing adequate treatment for the sick and wounded, military forces gave priority to supporting active combatants. Contagion also represented a greater threat than battle wounds.3 Further, armies deliberately under-​reported their own casualty rates while over-​stating the losses sustained by adversaries, thus playing down the need for greater medical support.4 Such factors help to explain why the health facilities put in place for Early Modern armies have been a largely neglected aspect of historical research. Study of the facilities that did exist is, moreover, limited by a

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shortage of extant records. McGurk has accordingly stated that little is known of how the sick and wounded ‘fared on the Irish side’ in contemporary conflicts.5 This chapter seeks to address this lacuna. It focuses attention on two hospitals as a means of exploring both the nature of care for Irish soldiers in Early Modern conflicts and the careers of some of the physicians who treated them. The chapter begins with an overview of the evidence that survives relating to Irish practitioners who trained on the European continent and served in the Spanish Army of Flanders. It then examines the inventory and regulations for the royal hospital at Mechelen in the Low Countries. Mechelen was one of the very few permanent military hospitals in Europe at this time. It was also a key site both for the pursuit of medical practice by Irish physicians and for the receipt of medical treatment by Irishmen and other soldiers in the Spanish army.6 The inventory and regulations are of interest because these documents describe the routine at the hospital and include information about the dispensing of medicines, staff accommodation arrangements and the different types of food prescribed for patients. As a result, these sources shed considerable light on the workings of the hospital. Several historians have signalled the importance of the Mechelen facility, but as yet it has not been studied in depth.7 The Mechelen records do not merely reveal details of medical practice and of soldiers’ experiences there. They also provide a context for understanding aspects of military medicine subsequently in evidence in Ireland. For example, it appears that two fund-​raising measures introduced at Mechelen were reproduced in Ireland in the first half of the seventeenth century. Mechelen furthermore supplies an appropriate background against which to investigate the second hospital discussed in this chapter: a short-​lived field hospital erected by the Spanish at Castlehaven, Co. Cork, in 1601. The medical resources and staffing organised by the Spanish at Castlehaven can be reconstructed from recently discovered sources and usefully evaluated in comparison with the arrangements put in place at Mechelen. By focusing attention on Irish practitioners in Spanish service as well as on the military hospitals at Mechelen and Castlehaven, this chapter sheds light on a key European context for Early Modern Irish medicine. It contributes to understanding of the continental dimension that was often a feature of Irish and British medical careers and provides a rare insight into the character of the medical treatment available to Irish soldiers at home and abroad.

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Irish practitioners in continental Europe

In the period from 1586 to 1681, twenty-​eight medical practitioners from Ireland can reliably be identified in petitions to the Spanish court, college registers, military records and travel accounts.8 The data reveal where in Ireland the medics were from, where they studied and where they subsequently served. Admittedly, the quantity and quality of the evidence differs from one practitioner to another. The origins of many of the Irish practitioners in the group under discussion can be traced to the south-​west province of Munster, where thirteen of them came from. Next in order are those from Leinster (9), principally on the east coast of Ireland, followed by Ulster in the north (6) and, finally, Connacht in the west (2). On occasion, several of these individuals crossed from the Iberian Peninsula, France and the Low Countries, to Italy and Bohemia. The majority were barber-​surgeons, followed by physicians with a university education and one apothecary, who prepared and dispensed medicines. The number of Irish practitioners recorded in the relevant sources fluctuated across the period from 1586 to 1681.9 The maximum number occurs during the years up to 1606, as a consequence of the Nine Years War. The figures decline to their lowest level for the period of peace between Spain and the United Dutch Provinces before increasing again after the collapse of the truce in 1621. The withdrawal of Irish troops from Flanders in 1642 is reflected in reduced numbers of medical practitioners from Ireland in the Spanish Netherlands. The quantity of relevant records recovers to the third highest level following the Restoration of Charles II. Overall, the geographical distribution of practice and domicile for Irish medics can be traced to thirty-​six places in the Low Countries. Practitioners from the Old English regions of Ireland are best represented up to 1606. From then on, physicians, surgeons and an apothecary from Gaelic backgrounds superseded their counterparts in numbers. As was the case with certain families of poets, lawyers, historians and musicians, medicine was among the hereditary occupations in Gaelic society.10 The gradual extension of Tudor and Stuart authority across Ireland dislocated the clan structure of the Gaelic political order on which the hereditary medical practitioners depended.11 Reflecting the relationship between ‘a revived and dynamic Catholicism’ and medical care,12 some individuals made their way to Spain and its dominions seeking education and employment. A good

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example is John O’Neylan, whose forebears studied at Oxford. He emigrated from Co. Clare in 1583 and later graduated at Lérida, a university whose medical faculty was closely connected to that of Montpelier. O’Neylan practised medicine in Paris and Zaragoza, supplementing his income by translating from ‘the Irish, English and Scottish languages’.13 In the summer of 1590, he took part in the blockade of Paris. After treating Red Hugh O’Donnell during his final illness at Simancas, O’Neylan was one of three physicians recommended by the influential Irish Franciscan Florence Conry in 1604 and 1605 for military medicine in the Spanish Netherlands.14 While journeys such as that undertaken by John O’Neylan could facilitate further learning and result in gainful employment, they were undoubtedly costly. When combined with the length of time required to complete such an education, this helps to account for the small numbers embarking on medical travels.15 One option available to doctors who wished to make good the expense was to apply their learning to the practice of military medicine. The experiences of practitioners from Ireland show that, as the seventeenth century progressed, medics employed by the military were gradually expected to be more qualified and better trained than had hitherto been the case.16 The experiences of John O’Dwyer of Cashel, Co. Tipperary, provide a supporting example. Born in 1620, he studied arts at Leuven. He then took the baccalaureate of medicine in 1665 and the licentiate from December 1668 to June 1669.17 O’Dwyer was employed in the Spanish military as a medical officer to Colonel Thomas Taaffe and his infantry. Afterwards, he practised in the town of Mons in Hainaut and in 1686 he published an octavo volume on the state and problems of medical practice.18 Following the preface to the reader, this work contains two Latin poems to the author and the magistrates of Mons, describing O’Dwyer as ‘a most expert and noble doctor pensioner’ and a chief physician to the town governor.19 The work also includes a dedicatory epistle written by Edmund Troy, a physician from Cashel, Co. Tipperary. Like O’Dwyer, he had studied at Leuven in the late 1660s before practising in Antwerp.20 O’Dwyer sought to challenge some of the practices of his time, warning against the dangers associated with the the pursuit of medicine by unlicensed and irregular practitioners.21 This echoes the sentiments of his counterpart in Denmark, Thomas Bartholin, who advised against dabbling in different sciences. Bartholin instructed his sons to concentrate on medicine and to distinguish themselves from

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lesser practitioners.22 O’Dwyer referred fondly to his ancestors the ‘O Dwyriorum atque O Mulrianorum Familiae’.23 On account of continued religious discord, he could see no hope of returning to Ireland.24 That same discord had contributed to large-​scale war in Early Modern Europe and thereby created employment opportunities for men such as O’Dwyer in attending armies and staffing military hospitals. Hospital rules and inventory: Mechelen, 1585–​1717

Improved medical care was a beneficial side-​effect of the Eighty Years War between Spain and the Dutch provinces. From the 1580s, the Low Countries provided an effective learning environment for practitioners. Temporary encampments of soldiers, their families and followers became a recurrent feature of the surrounding landscape. Their restlessness increased with their lack of food, clothing and money. Serious infections soon developed. In crowded conditions, epidemics intensified. In an effort to contend with the high death rate caused by contagion, military chaplains obtained a manuscript of medical recipes from a physician and professor of medicine, but a more adequate response was needed.25 Local facilities, already overflowing, could not be evacuated. Mutinous soldiers in the Spanish Army of Flanders demanded a hospital, field medicine and chaplains.26 To protect Philip II’s territories from external attack and to contain the threat of subversion from within, Alexander Farnese, duke of Parma, sought to raise the standard of healthcare for his troops in the Habsburg Netherlands. In 1585, he founded a permanent military hospital at Mechelen. It was the first such establishment on the continent and it remained the only one for almost a century.27 Its foundation was necessary due to the presence of soldiers who could not easily return home in case of illness or prolonged convalescence. Farnese judged Mechelen’s central position particularly well-​ suited to the reception of the wounded from the battlefield and from garrisons. He appointed a former chaplain of John of Austria, Francisco de Umara, vicar-​general of his troops and administrator general of the royal hospital at Mechelen. It was established along lines of embarkation for those returning from and going to battle. It also provided the administrative base for medical services in the Habsburg Netherlands and was, therefore, pivotal to the whole system.28 Economic and demographic decline at the end of the sixteenth century decreased the demand for and the means to invest in new

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hospitals, to enlarge medical facilities and pay for personnel.29 With regard to the Low Countries, Flemish exports fell and the population of Mechelen lost approximately half of its inhabitants by c. 1600.30 In such circumstances the resilience of the military hospital at Mechelen, in itself an expense incurred to deal with the Dutch revolt, was exceptional. No trace of the hospital now survives. Fortunately, there exists an inventory of its property. This remarkable muster was compiled in 1637 and edited by Lucienne van Meerbeeck, keeper of manuscripts at the Archives générales du Royaume, Brussels.31 In addition, a meticulous description of the hospital organisation is given in the institution’s statutes. These were published in 1685 by Francisco de Agurto, governor and captain-​general of the Habsburg Netherlands. The statutes updated those of the Archduke Albert, which had been issued in 1599. The medical colonel, Parrilla, obtained a facsimile of this rare opuscula from the Bibliothèque royale, Brussels.32 Taken together, these two compilations offer an accurate reflection of the hospital’s administrative decrees from its earliest stages. The regulations compare well with those observed at civil institutions and hospitals instructions of that period in the Iberian Peninsula.33 These consistently emphasised the need for a good diet and clean bedding, a good physician who knew the patients, a competent administrator and charitable helpers. To provide treatment free of charge, the hospital received alms from the monthly pay of ordinary soldiers and from officers. This measure was ahead of its time.34 Further subvention was provided from the royal coffers and by the local bishop. The hospital also obtained the proceeds from the sale of retired horses. When profanities were prohibited from the 1590s, swear-​box contributions were given to the upkeep of the centre.35 Aspects of this system were followed by other armies in succeeding decades. At the height of the Nine Years War in Ireland, the Privy Council recommended military medical services funded ‘by the allowance of a soldier’s pay out of every band’. Further, ‘the house-​ rents, reparations and bedding appertaining to the said hospitals be borne out and provided by the Queen’s majesty’.36 When soldiers died intestate at Mechelen, their clothing and possessions were sold to help maintain the hospital. The clothing of patients with infectious diseases was sold for papermaking.37 In the 1640s, according to Patrick Logan, Irish Confederate troops faced heavy fines for selling the belongings of dead soldiers. Instead, the proceeds were intended for army

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medical services.38 These procedures indicate the possible influence of Mechelen practitioners, such as Owen O’Shiel, of whom more anon. In Catholic and Protestant teaching after the Reformation, prayer and repentance were understood to be the first appropriate source of help against ill-​health.39 At the Mechelen facility, soldiers were expected to attend confession before receiving medical treatment. They were given three days to comply after admission.40 Though contentious, the emphasis on confession was also adhered to at civilian hospitals in Spain and Italy, often at the request of doctors.41 The Mechelen inventory of 1637 detailed the vestments and altar plate, statues and devout images to be found at the hospital chapel. Among the paintings on the walls of St Cosmo’s ward was a watercolour of St Patrick, evidently explained by the presence of Irish troops in Flanders.42 In this setting, visual representations were intended to comfort patients by occupying their minds while inspiring the staff in their decision-​making.43 Mechelen was intended not only for those wounded in combat but also those affected by physical illnesses caused by long-​term shortages, overcrowded living conditions and the intemperance of military life.44 It was a self-​contained centre with its own staff arranged in a well-​ ordered hierarchy. This consisted of the senior doctor and assistant doctors, the surgeon-​major and students of surgery, the barbers and their apprentices. A chief nurse oversaw the infirmary and the wards, with a nurse assigned to each for its supervision. The nursing staff and surgeons at Mechelen were often from the order of St John of God and well-​versed in the art of military surgery.45 The hospital thrived in the years after its foundation. It had thirty-​ five staff in the period from 1585 to 1598, including four doctors, nine surgeons and six pupils of surgery.46 Nevertheless, the number of personnel varied depending on the demands of conflict. As part of the general reform of 1611, the number of staff was reduced considerably. It was restored to its former position six years later, long before the renewal of hostilities with the United Provinces.47 The increase in staff numbers facilitated the opening of campaign hospitals at Rhijnberg, Breda, Cambrai, Gennep and Ruremonde. The centre at Mechelen provided 2,000 hospital days per annum.48 This compares favourably with the total numbers in garrison at this time, which did not exceed 60,000 troops in the Southern Netherlands. By 1637, the hospital was equipped with 330 beds and served by a staff of forty-​nine. In the second half of the seventeenth century, however, it was faced with increasing

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financial burdens. After the Battle of Landen and the siege of Charleroi, it fell into decay before finally closing its doors in 1717.49 Administrative, medical and religious personnel at Mechelen were allocated fixed housing and victuals. By the end of 1605, the hospital consisted of five detached houses next to one another near St Rumbold’s Cathedral. These were acquired gradually, beginning with the main building, the Hof van Saxen.50 On the ground floor were the chapel, a hospital ward and three treatment rooms, a further room which served as the porters’ station, all leading onto a central courtyard, a large garden, two water pumps and the laundry. The first floor comprised more infirmaries. Metal candlesticks were fixed to the walls and set upright on the floor to give light in the wards. The majority of rooms were heated by braziers.51 The next house, Wellemans, accommodated the senior administrators and provided offices for some of the staff with a courtyard, a hall and three habitations, two kitchens and four cellars. The hospital scribe worked on the first floor, registering the admissions and deaths of soldiers, drawing up wills and testaments. Upstairs there were a further eight habitations and an oratory. A third house contained six dwellings. There were also two other smaller buildings. One served as stables for the horses of cavalry soldiers, with hay shed, grain loft and a hop store for the brewing of beer. The fifth property had a small dwelling place, a kitchen equipped with a bread oven, a grain store for making beer, rooms for the drying of grain and a loft.52 For the attending physicians at Mechelen, hospital service and the provision of round-​the-​clock care presumably advanced their training and enhanced their medical careers. It was a teaching hospital where the surgeon major instructed assistants in the necessary principles of surgical practice. When time allowed, pupils of surgery were expected to prepare the dressings and light the braziers. A small brazier was also used by surgeons to heat the irons for the cauterisation of wounds.53 Ward rounds were conducted twice per day.54 These were attended by the doctors and surgeons, their pupils, the head nurse and his assistant. Each morning the hospital accountant and the scribe were also present to take note of the quantities of food and medication recommended.55 Each night, a porter conducted a death watch in all wards, ready to notify other staff when patients were dangerously ill.56 Food was prescribed to each according to their illness and condition. Soups were regarded as essential for the sick to be cured and were easily distributed at mealtimes.57 Food was also prepared in the hospital bakery and prescribed by the doctors.58 The diet that

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soldiers followed in hospital differed considerably from their usual eating habits, with poultry, white bread and stews mentioned in the regulations for Mechelen, while mutton was to be avoided.59 The eating of ‘vnaccustomed meates’ was associated with the spread of ‘plague [and] bloody-​flux’.60 At the lengthy siege of Breda, for instance, the starving scavenged for human corpses and fell prey to severe epidemics. Competition for the production of medicines from both plants and metals led to contention between physicians, apothecaries and charlatans in seventeenth-​century Europe.61 Medicines for the Mechelen hospital were provided by a pharmacy in the town until 1673, when the first apothecary was appointed. The hospital instructions reveal that close control was exercised over the supply and distribution of medication. The apothecary, who did not follow an academic course of training, was unable to obtain supplies without permission from the medical staff.62 Other than infusions, he could only prepare the prescriptions that they provided in the pharmacy. The premises were inspected each month.63 Physicians and surgeons at Mechelen were regularly required to check the quality of their medicines and were authorised to correct any errors found in the pharmacy accounts. These provisions for the Mechelen pharmacy also extended to field hospitals in Flanders.64 One of the physicians who spent time at Mechelen during its long history was Thomas Lodge, a Catholic from London. Raised in the household of the earl of Derby, Lodge had studied medicine at Avignon in 1597, graduating the following year. Afterwards he ‘performed the dutie of a Phisition’ to the infantry of the earl of Arundel in the Spanish Netherlands until its officer staff disbanded.65 He was then assigned as doctor to troops under the command of Colonel Henry O’Neill and practised at the military hospital in Mechelen. From 17 July 1606, he served with three English companies in the Spanish Army of Flanders.66 Among the remedies in his collection of medical cures, The Poore Mans Talentt, is one which Lodge ‘often tried in the Roiall Hospitall att Macklin upon souldiers that grew Lame by cold’: ‘Take of the oile of Peter, pure and true, one ounce; of Deere suett, Twoe ounces; of spirite of Wine, three ounces; mixe them togeather, and with a warme hande, before the fire, rub it in Twoe or three times, and yow shall praise the effectt.’67 A further instance of such work is found in the case of Owen O’Shiel. His family practised medicine in Ireland in counties Offaly, Westmeath, Kildare and Meath.68 O’Shiel studied medicine for three years at Douai

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before becoming chief surgeon with the O’Neills’ infantry units in Flanders. Contemporary sources state that he performed ‘admirable cures’ at the royal hospital of Mechelen where he worked from 1631 to 1638.69 On account of the high admission rate, O’Shiel remained at Mechelen where he could converse with Irish casualties in their own language. Physicians and surgeons complemented hospital service with private medical practice and could be attached to noble households.70 After his return to Ireland, O’Shiel practised medicine in Dublin among the ‘gentrie of Linster’ before serving as chief surgeon to Colonel Thomas Preston and, later, Owen Roe O’Neill in the Confederate wars of the 1640s. O’Shiel was killed at the Battle of Scarrifhollis, Co. Donegal, on 21 June 1650.71 Casualties and medicines: Castlehaven, December 1601 to April 1602

As was the case in many other Early Modern spheres of conflict, soldiers posted to Ireland were confronted with chronic food shortages, harsh weather and inadequate shelter.72 In the 1590s, the four great allies of the Irish were identified in state papers as ‘Captain Travel, Captain Hunger, Captain Sickness, and Captain Cold’.73 Nevertheless, commanders were expected to move casualties to a place of safety. When the wounded were left maimed and disfigured at Armagh Franciscan friary in 1593, Hugh O’Neill agreed that ‘uppon the geiving up of the fort, he should see theise burnt and wounded soldiers to be saffely conducted to the English Pale after they were well’.74 Armies on campaign were accompanied by temporary field hospitals. These were consistently organised along similar lines. The wards were simply tents provided with beds and other equipment.75 A particular insight into the arrangments made in Ireland in one instance can be gained from surviving sources relating to a Spanish field hospital established at Castlehaven. During the winter of 1601, the Spanish authorities sent medical services in support of military intervention in Ireland. To this purpose, Pedro Zubiaur set sail from La Coruña on 7 December. Four days later he landed at Castlehaven, Co. Cork, with six ships ‘earlier detached from the invasion fleet’.76 These were merchant vessels –​transport ships and hulks –​carrying five cannon, supplies and ammunition. Intercepted letters from Spain disclosed that ‘the weakness of Castlehaven’ was known to the Spanish.77 Their arrival there resulted from a storm that separated the fleet.

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In his reports, Zubiaur made it clear that the artillery pieces were his first priority.78 Castlehaven harbour is about one kilometre in width, secure and well-​sheltered. The Spaniards landed the stores carried in these six ships.79 A doctor attached to the naval hospital at La Coruña vouched for the quantity of each commodity and witnessed the transfer of the supplies for Castlehaven to the official apothecary for the expedition.80 Apart from isolated references in Silke’s history of the Kinsale campaign, the field hospital at Castlehaven has passed unnoticed until the recent discovery of its accounts for 1601 and 1602. These are preserved at the Archivo General de Simancas in Spain. These accounts contain a variety of details relating to the medicines brought by the Spanish. They were ‘packed in earthenware jugs, oil-​ bottles of clay and in three wooden boxes’.81 Loading barges brought ashore supplies from the middle of the harbour.82 The tower house commanding Castlehaven was handed over to the Spanish by its proprietors, the O’Driscoll brothers, who piloted Zubiaur into harbour.83 This small fortified structure was a peel tower. It stood on the western side of the mouth of the port. Two of the supply boxes were placed in the tower house and another nearby in the church.84 The supplies in the caskets included apostolic ointment, album rhasis and basilicum. Apostolic ointment was used for disinfecting wounds and consisted of twelve ingredients, exclusive of white-​wine vinegar and olive oil. Five-​and-​a-​half pounds of album rhasis were also included. This white ointment, Arabic in origin, was composed of lead salts mixed with white wax and rose oil. These preparations could either be applied to wounds or rubbed into the skin to relieve internal pain. Basilicum, a mild, inexpensive antiseptic dressing, was applied to wounds which were slow to heal. It was made from beeswax, pine resin, olive oil and lard. Bandages made from esparto grass were also supplied along with camomile oil and comfrey-​leaf poultice, a powder which helped wounds to heal faster.85 The Catholic archbishop of Dublin, Mateo de Oviedo, was placed in charge at Castlehaven, assisted by Thaddeus Farrell, Catholic bishop of Clonfert.86 The appointment of hospital chaplains by bishops was accepted practice during this period.87 A  friar and an attendant, both Spanish, helped those admitted for treatment. The hospital counted on approximately ninety beds, with 5,000 ducats of revenue from the Spanish council of war to purchase beds and equipment.88 This represented less than 1 per cent of the overall budget for the Kinsale expedition. A  further sum of 3,000 ducats

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was intended for the recruitment of medical staff and chaplains but Oviedo had difficulty finding experienced candidates.89 The commander of the Kinsale expedition, Del Águila, believed that too much was spent on the hospital and non-​combatants as opposed to feeding the troops.90 The following spring, the inspector of supplies for the expedition, López de Soto,91 reported that the Castlehaven field hospital had thirty-​three staff since the previous year. This number seems high when compared with the thirty-​five at the permanent hospital in Mechelen. There were fewer patients to treat than during winter but Soto claimed that most of the personnel were still needed.92 They included two doctors and a graduate intern, the surgeon major and one surgeon, an apothecary major and two barbers. There were five nursing staff and three auxiliaries. These were from the Obregón order, founded in 1568 by a former soldier named Bernardino Obregón.93 In addition the hospital retained a cook and kitchen porter. A laundry woman, a scribe and a grave digger completed the personnel. Each received their rations by order of Oviedo.94 Apart from some spending money, senior staff each received a pound of mutton with a pound-​and-​a-​half of beef. Junior staff received a quarter of mutton, bacon and beef, two pounds of bread and a quart of wine. All of the staff members appear to have been from Spain. Six days after the Spanish landed in Castlehaven, Sir Richard Leveson arrived in the harbour with four warships, a merchantman and a caravel.95 This led to hostile naval action. Due to the deployment of artillery, many of the wounded were reported to have lost a limb. According to a letter addressed to Philip III, they were bound to die as there were not enough beds. Zubiaur stated that he gave all his shirts and sheets towards their treatment.96 The sick and wounded were given a mix of beer, cane sugar and raisins.97 Zubiaur’s Irish allies made their way to Castlehaven to meet him. On 20 December 1601, Red Hugh O’Donnell sent a cavalry captain with messages on his behalf.98 Meanwhile, Hugh O’Neill requested medicines for an unnamed brother with a leg wound.99 Apart from biscuits, oil, wheat and rye flour, comparable records show that the foodstuffs included almonds, lentils, prunes, hazelnuts, spices, jams and marmalade.100 To counteract the health risks associated with going barefoot, the supplies also included 120 pairs of shoes. Most of these were given to troops serving with O’Neill and O’Donnell. Twelve pairs of footwear

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were provided to Captain Phelim McCarthy and his infantry company while Donal O’Sullivan More, lord of Bearhaven, received a further fourteen pairs.101 Despite the efforts made to ensure adequate staffing and supplies of medicine and money, a dispute between Soto and Oviedo prevented the hospital from operating efficiently.102 Nevertheless, Soto reported an improvement in the health of all casualties at Castlehaven in April 1602.103 By then, about ninety sick and wounded were receiving treatment. This can be attributed, perhaps, to the supplies in the hospital. These provisions, such as 20lbs of mastic oil, illustrate the prevailing medical philosophy which developed from observations made by Galen in his medical texts.104 Moreover, the contents of the Castlehaven supply chests make it possible to identify the types of treatment that the medical personnel expected to provide. Above all, the hospital appears to have prepared for fluxes and agues, known today as dysentery and typhoid,105 followed by wounds inflicted in battle, respiratory illnesses and syphilis. Produced by the same causes and with similar symptoms, dysentery and typhoid accounted for more deaths than any other epidemic disease at that time.106 Veterans understood that a soldier who survived an attack of dysentery was worth three raw recruits.107 It seems, therefore, that the medics at Castlehaven expected to lose more lives through disease than by wounds sustained in combat. This is suggested by the fact that among the remedies at the hospital were 35lbs of syrup of hops; 28lbs of rue oil; 12lbs of Althaea officinalis; 10lbs of blackberry syrup; 5lbs 10oz of myrobalan plum cherries; 5lbs of oil of quinces; and 1oz of terra sigilata lozenges.108 These were treatments for diarrhoea and fever.109 The next concern, again reflected by the nature of the medical supplies to hand, was the management of wounds and burns.110 The relevant items included 20lbs of ground lead monoxide; 10lbs of poultice bulbs; 5lbs of red lead ointment; 4lbs of poplar salve; 28oz of diachylon; 19oz of dragon blood resin; 15oz of Centaur liniment; 14oz of Apostolic; and 5oz of Gracia Dei dressing. The hospital also held 37lbs of borage syrup; 24lbs of myrtle oil; and 10lbs of maidenhair syrup.111 The latter could be used as part of efforts to counter poor living conditions and the inclement weather that contributed to respiratory illnesses such as influenza, pneumonia, consumption and tonsillitis.112 Of all diseases in the ranks, the most prevalent was syphilis.113 The treatments available

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at Castlehaven therefore included 5lbs of burnt potassium alum; 24oz of Vigo dressing; 7oz of cinnabar powders from mercurial salts; and 5oz of Arrhenicum dressing.114 The various quantities listed above are those recorded upon their return to La Coruña on 20 April 1602. The Spaniards appear to have unloaded their supplies in haste at Castlehaven without documenting what was brought ashore.115 Had the storm not intervened the previous December, the medical supplies and their related records could have been seized or destroyed. Defeated by Elizabeth’s forces at Kinsale, Del Águila surrendered the town. Zubiaur set sail from Castlehaven on 6 January, while Archbishop Oviedo remained behind. Soto gave up the fortified position the following month, before surrender of the ports at Baltimore and Dunboy.116 Conclusion

To lance the boil of political discontent, military migration from Ireland to the Habsburg Netherlands continued during the Cromwellian era and after the Restoration of 1660.117 As had been the case in the 1580s and early 1600s, the recruitment of doctors was also permitted by Dublin Castle and Whitehall.118 The continental wars of the Early Modern period thus helped to shape the context in which Irish men pursued medical education and practice overseas.119 The military hospitals at Mechelen and Castlehaven existed before the ‘Age of Hospitals’ that followed.120 Nevertheless, at Mechelen, the inventory and well-​executed internal regulations show how careful organisation contributed to its longevity. In addition, through the training of practitioners at Mechelen, the hospital improved its own prospects. Medical doctors such as Owen O’Shiel and Thomas Lodge played an active part in its 132-​year history. Measures put into practice at Mechelen were followed in Ireland, with similar methods introduced by Elizabethan and Confederate forces. Although equipped to deal with the sick and wounded, the volatility of front-​line warfare revealed the limitations of the field hospital at Castlehaven. This helps to explain the critical viewpoint of certain officers with regard to casualties and sickness. By studying both the long history of Mechelen and the short-​lived hospital at Castlehaven, we can improve understanding of the role and character of military medicine during a period of frequent armed conflict in Europe. The organisation

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and workings of those institutions throw light on key aspects of Spanish military-​medical infrastructure. Spanish responses to the challenges posed by disease and war wounds had obvious implications for large numbers of Irishmen in arms.121 The attempt to meet those challenges also created career opportunities for a significant number of Irish medics. The universities and battlefields of Spain and northern Europe thus provided an appropriate setting for the transmission of medical knowledge where physicians and surgeons from Ireland and Britain assimilated and imparted learning. Acknowledgements

The author is grateful to Dr Aoibheann Nic Dhonnchadha of the Dublin Institute for Advanced Studies for her advice and comments. Notes 1 O.  P. Grell, ‘War, medicine and the military revolution’, in P. Elmer (ed.), The Healing Arts: Health, Disease and Society in Europe, 1500–​1800 (Manchester, 2004), p. 281. 2 G. Parker, The Army of Flanders and the Spanish Road, 1567–​ 1659 (Cambridge, 1974; repr. 2004), pp. 141–​3. 3 C. Falls, Elizabeth’s Irish Wars (London, 1950; repr. 1996), pp. 137, 232. David Edwards has noted that raids and ambushes were the preferred methods in Gaelic warfare. These could be completed quickly and, therefore, had lower death rates than other forms of warfare. See D. Edwards, ‘The escalation of violence in sixteenth-​century Ireland’, in D. Edwards, P. Lenihan and C. Tait (eds), Age of Atrocity: Violence and Political Conflict in Early Modern Ireland (Dublin, 2007), p. 44. 4 J. McGurk, The Elizabethan Conquest of Ireland: The Burdens of the 1590s Crisis (Manchester, 1997), pp. 240–​61. 5 Ibid., p. 249. 6 B. Jennings (ed.), Wild Geese in Spanish Flanders, 1582–​1700 (Dublin, 1964), p.  131. On 24 May 1611, for instance, six Irish soldiers were discharged from the Mechelen hospital, namely Patrick McCarthy, Richard Burke, Thady Singardel, Oliver Canthon, Thomas Herbert and Edmond Magregiborn. 7 Parker, The Army of Flanders, p. 141; Grell, ‘War, medicine and the military revolution’, p. 280. 8 B. Hazard, ‘ “Very necessarie instrumente in a compani”:  Irish medical personnel and Spanish military medicine, 1586–​1672’, Ossory, Laois and Leinster, 5 (2012–​13), pp. 115–​45.

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9 The numbers are as follows:  1586–​1606 (21); 1607–​21 (5); 1622–​42 (18); 1643–​59 (7); and 1660–​81 (11). 10 J. Bannerman, The Beatons:  A Medical Kindred in the Classical Gaelic Tradition (Edinburgh, 1986), pp. 11, 144; B. Ó Cuív, ‘The Irish language in the early modern period’, in T. W. Moody, F. X. Martin and F. J. Byrne (eds), A New History of Ireland:  iii, Early Modern Ireland 1534–​1691 (Oxford, 1976), p. 519. 11 A. Nic Dhonnchadha, ‘Medical writing in Irish, 1400–​1700’, in J. B. Lyons (ed.), Two Thousand Years of Irish Medicine (Dublin, 1999), pp. 21–​6. 12 O.  P. Grell and A. Cunningham, ‘The Counter-​Reformation and welfare provision in Southern Europe’, in O.  P. Grell, A. Cunningham and J. Arrizabalaga (eds), Health Care and Poor Relief in Counter-​Reformation Europe (London, 1999), pp. 1–​17. 13 Hazard, ‘ “Very necessarie instrumente” ’, pp. 119–​20. 14 The name John occurred in the O’Neylan family from one generation to the next and for three separate individuals during this period. Considering the dates recorded for his medical career, he is perhaps John O’Neylan, son of William, who died c.1636. L. McInerney, Clerical and Learned Lineages of Medieval Co. Clare. A Survey of Fifteenth-Century Papal Registers (Dublin, 2014), pp. 170, 172, 179. 15 O. P. Grell, ‘ “Like the bees, who neither suck nor generate their honey from one flower”: the significance of the Peregrinatio Academica for Danish medical students of the late sixteenth and early seventeenth centuries’, in O. P. Grell, A. Cunningham and J. Arrizabalaga (eds), Centres of Medical Excellence? Medical Travel and Education in Europe, 1500–​1789 (Farnham, 2010), p. 177. 16 Hazard, ‘ “Very necessarie instrumente” ’, p. 24. 17 J. Nilis, ‘Irish students at Leuven University, 1548–​1797’, Archivium Hibernicum, 60 (2006–​7), p. 110. 18 John O’Dwyer, Querela Medica, seu Planctus Medicinae Modernae Status. Authore Joanne O’Dwyer, Cassliensi, Medicinae Licentiato, urbisque Montensis Medico Pensionario (Montibus, 1686). 19 Ibid., ‘Expertisimo nobilisque viro Domino D.  Joanni O Dwyer urbis Montensis Medico Pensionario nec non Illustrissimi Principis de Rache Archiatro. Amplissimo Senatui Montensi librum suum de Querela Medicâ dicanti’. Both poems are anonymous apart from the initials P. B. and I. F. L. 20 Ibid., unpaginated, ‘Epistola clarissimi viri, Domini D.  Edmundi Trohy celebirrimi urbis Anturpiensis Medici, Pensionarii, Ad hujus libri Authorem scripta, sexto die Iunii 1686’. 21 Ibid., p. 1, ‘De Medicinae labefactoribus, ac profantoribus in genere Atque etiam De erroribus in eû vulgò commitri Solitis’. 22 Thomas Bartholin, On the Burning of his Library and on Medical Travel, trans. C. O’Malley (Lawrence, KS, 1961), p. 55. On Bartholin, see Grell, ‘ “Like the bees” ’, pp. 183–​9.

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23 O’Dwyer, Querela Medica, ‘Dedicatory epistle to the magistrates of Mons’, unpaginated. 24 Ibid., ‘Author’s epistle to the benevolent reader’, unpaginated:  ‘ob haereticorum tyrannicum in dies magis magisque grassantem’. 25 B. Hazard, ‘Medical recipes for military chaplains in Spanish Flanders, 1587–​1660’, The Irish Sword, 30 (2016), pp. 375–​7. 26 G. Parker, ‘Mutiny and discontent in the Spanish army of Flanders 1572–​ 1607’, Past & Present, 58 (1973), p. 43. 27 G. Parker, The Military Revolution: Military Innovation and the Rise of the West, 1500–​1800 (Cambridge, 1996), pp. 72–​3. 28 L. van Meerbeeck, Les Sources de l’Histoire Administrative de l’Armée Espagnole des Pays-​Bas aux XVIe et XVIIe Siècle (Brussels, 1949). 29 J. Israel, ‘Counter-​Reformation economic decline and the delayed impact of the medical revolution in Catholic Europe, 1550–​1750’, in Grell et al. (eds), Health Care and Poor Relief, p. 46. 30 G. Parker, ‘War and economic change: the economic costs of the Dutch Revolt’, in J. M. Winter (ed.), War and Economic Development: Essays in Memory of David Joslin (Cambridge, 2008), pp. 49–​71. 31 L. van Meerbeeck, ‘L’Hôpital royal de l’armée espagnole à Malines en l’an 1637’, Bulletin de la Cercle Archéologique, Littéraire et Artistique de Malines, 54 (1950), pp. 81–​125, cited by Parker, The Army of Flanders, p. 141. 32 Constituciones del Hospital Real del Exercito de los Paises Baxos, Ordenados por el Serenissimo Señor Archiduque Alberto año 1599. Renovadas, ajustadas, y ampliadas para su mejor govierno, conforme las ocurrencias del tiempo presente; Por el Exmo Señor Don Francisco Antonio de Agurto, Cavallero del Orden de Alcantara, Governador y Capitan General de los mismos Paises, &c. (Brussels, 1685). 33 E. Maganto Pavón, La Enfermería Jerónima del Monasterio del Escorial. Su Historia y Vicisitudes durante el Reinado de Felipe II (Madrid, 1995), pp.  29–​30. 34 Parker, The Army of Flanders, p. xxv. 35 Van Meerbeeck, ‘L’Hôpital royal’, p. 87. 36 ‘Divers matters touching the service of Ireland’, by Sir Robert Cecil, Lord Treasurer Buckhurst, Sir John Fortescue and Lord Mountjoy, Richmond, 10 Jan. 1600, in Calendar of State Papers Ireland (hereafter CSPI), 1599–​ 1600, p. 396. 37 Constituciones, Article 36: ‘Que se hazer con la ropa de Bubosos?’ p. 26. 38 P. Logan, ‘Medical services in the armies of the Confederate wars (1641–​ 1652)’, The Irish Sword, 4 (1960), p. 224. 39 A. Wear, Health and Healing in Early Modern England: Studies in Social and Intellectual History (Aldershot, 1998), p. 148. 40 Constituciones, Article 23:  ‘Como se han de administrar los Santos Sacramentos a los que entran a curarse?’ pp. 17–​18.

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41 S. de Renzi, ‘ “A fountain for the thirsty” and a bank for the Pope: charity, conflicts and medical careers at the Hospital of Santo Spirito in seventeenth-​century Rome’, in Grell et  al. (eds), Health Care and Poor Relief, pp. 115, 129. 42 Van Meerbeeck, ‘L’Hôpital royal’, p. 113. 43 M. Dinges, ‘Health care and poor relief in regional Southern France in the Counter-​Reformation’, in Grell et  al. (eds), Health Care and Poor Relief, p. 249. 44 Van Meerbeeck, ‘L’Hôpital royal’, p. 83. 45 Ibid., pp.  87–​8; L. White, ‘The experience of Spain’s early modern soldiers: combat, welfare and violence’, War in History, 9 (2002), p. 20. 46 ‘Relación del personal empleado en el hospital de campaña con el sueldo que perciben’; in M. Parrilla Hermida (ed.), El Hospital Militar Español de Malinas en los Siglos XVI y XVII (Madrid, 1964), pp. 173–​5. 47 B. García García, La Pax Hispánica: Política Exterior del Duque de Lerma (Leuven, 1996), pp. 154–​5. 48 Ibid., pp. 40–​1. 49 Parrilla Hermida (ed.), El Hospital Militar, pp. 30, 35, 43, 230–​43. 50 Van Meerbeeck, ‘L’Hôpital royal’, p. 92. 51 Ibid., p. 99. 52 ‘Inventario de todos y qualesquier bienes assi rayzes como muebles pertenecientes al Ospital Real de su Magestad en estos Estados que por muerta de Gervasio Pavesi, enfermero y guarda ropa del, se entregaron por sus testamentarios a Pedro de Wamberchies, su sucessor en la manera siguiente’; van Meerbeeck, ‘L’Hôpital royal’, pp. 104–​25. 53 Constituciones, Article 134:  ‘Los Platicos prevengan con tiempo los parches, y aya uno que recoja las jarcías de Cirujria’, p. 91. 54 Ibid., Article 121:  ‘Quando y como los Medicos han de visitar, y los Cirujanos curar los enfermos?’ pp. 83–​4. 55 Ibid., Article 72: ‘Como ha de asistir a la visita con los Medicos, hazer las libranzas sobre el dispensero, y cuidar este guisada a tiempo la comida de los enfermos?’ p. 54; Article 122: ‘Como han de rubricar los Medicos la receta de la comida; como escrivirla el Escrivano; y que hazer acabadas la visita?’ p. 84. 56 Ibid., Article 26: ‘Guardia que de noche se ha de hazer en las enfermerias, y porque’, pp. 19–​20. 57 Ibid., Article 171: ‘Como guisada la comida ha de repartir las ollas para la mas facil distribucion?’ p. 109; see M. L. López Terrada, ‘Health care and poor relief in the crown of Aragon’, in Grell et al. (eds), Health Care and Poor Relief, p. 191. 58 Constituciones, Article 81: ‘Como ha de visitar la Panaderia y que no se consuetan en ella golosinas’, p. 59. 59 Ibid., Article 167:  ‘Malrugue y no admita oveja por carnero, ni cosa dañada’; Article 169: ‘Quando y como ha de pedir las especies, aves, y lo

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demas’; Article 170:  ‘no admita aves enfermicas’; Article 176:  ‘Procure guisar a gusto de los enfermos’, pp. 107–​8, 111. 60 The Siege of Breda by the Armes of Phillip the Fourt vnder the Gouernment of Isabella Atchiued by the Conduct of Ambr. Spinola, trans. Gerald Barry (Lovanii, 1627), p. 96. 61 De Renzi, ‘ “A fountain for the thirsty” ’, pp. 114, 117. 62 Constituciones, Article 158:  ‘no entregue nada sin receta del Medico, o Cirujano’, pp. 102–​3. 63 Ibid., Article 147: ‘Puntualidad con que deve executar las recetas de los Medicos’, p. 98; Article 150: ‘visita que se ha de hazer de la Botica’, p. 100. 64 Ibid., Article 153:  ‘no componga Medicinas sin pesar y medir los ingredientes’, p.  101; Article 158:  ‘Como ha de hazer el entrego de Medicinas para Campaña y otras partes?’ p. 103. 65 Jennings (ed.), Wild Geese, p. 89. 66 The Complete Works of Thomas Lodge (1580–​1623?) Now First Collected, ed. E. Gosse (4 vols, Glasgow, 1883), iv, p.  83. Lodge also wrote and published plays, poetry, narrative fiction and translations. His Treatise on the Plague is a study of its causes and cures. See A. Halasz, ‘Lodge, Thomas (1558–​1625)’, in  ODNB. 67 The respective ingredients for this recipe are petroleum; the evergreen fern Davallia Canariensis, also known as Hare’s Foot; acetone and ethanol. Lodge recommended combining the ingredients and applying to the legs. 68 P. Logan, ‘Owen O’Shiel (?1584–​1650)’, The Irish Sword, 6 (1964), pp. 192–​5. See also ­chapter 1 by Sheehan in this volume. 69 Jennings (ed.), Wild Geese, pp. 257, 260, 262, 306. 70 De Renzi, ‘ “A fountain for the thirsty” ’, p. 115. 71 Hazard, ‘ “Very necessarie instrumente” ’, p. 133. 72 McGurk, The Elizabethan Conquest, p. 240. See also D. Stewart, ‘Disposal of the sick and wounded of the English army during the sixteenth century’, Journal of the Royal Army Medical Corps, 90 (1948), pp. 30–​8. 73 CSPI, 1598–​1599, p. 441. 74 The Chronicle of Ireland 1584–​1608 by Sir James Perrot, ed. H. Wood (Dublin, 1933), p. 156. I owe this reference to Dr James O’Neill. 75 On campaign hospitals and mobile facilities for the military, such as separate wards for illness and injuries to isolate contagion, see L. Sánchez Granjel, ‘Medicina y Sociedad en la España Renacentista’, in P. Laín Entralgo (ed.), Historia Universal de la Medicina (7 vols, Barcelona, 1972–​ 75), iv, pp. 181–​99. 76 G. Hayes-​McCoy, Irish Battles: A Military History of Ireland (Harlow, 1969; repr. Belfast, 1990), p. 158. 77 J. S.  Brewer and W.  Bullen (eds), Calendar of the Carew Manuscripts Preserved in the Archiepiscopal Library at Lambeth, vol. iv (London, 1870), p. 206.

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78 J. Coombes and N. J. Ware (eds), ‘The letter book of General de Zubiaur: a calendar of the Irish letters’, Journal of the Cork Historical and Archaeological Society, 83 (1978), pp. 50–​8. 79 Falls, Elizabeth’s Irish Wars, p. 300. 80 ‘Report of the medicines assigned to Pedro Salinero, apothecary, and his letter of payment’, La Coruña, 20 April 1602, in E. García Hernán (ed.), The Battle of Kinsale: Study and Documents from the Spanish Archives (Valencia, 2013), pp. 390–​2. 81 Ibid., ‘Todo lo cual recibí envasado en botijas y alcuzas de barro y en tres cajas de madera’. 82 J. Coombes, ‘A Castlehaven episode during the Nine Years War’, Journal of the Cork Historical and Archaeological Society, 77 (1972), p. 40. 83 Pacata Hibernia: or, A History of the Wars in Ireland During the Reign of Queen Elizabeth especially within the Province of Munster under the Government of Sir George Carew and Compiled by his Direction and Appointment by Sir Thomas Stafford, fl. 1633, ed. Standish O’Grady (2 vols, London, 1896), ii, pp.  40–​1. 84 E. García Hernán, ‘Matériel para Kinsale:  Documentos Nuevos sobre la Batalla’, in I. Pérez Tostado and E. García Hernán (eds), Irlanda y el Atlántico Ibérico:  Movilidad, Participación e Intercambio Cultural, 1580–​ 1823 (Valencia, 2010), p. 86. 85 Hazard, ‘ “Very necessarie instrumente” ’, p. 122. 86 J.  J. Silke, Kinsale:  The Spanish Intervention in Ireland at the End of the Elizabethan Wars (Liverpool, 1970; repr. Dublin, 2000), p. 98. 87 G. Risse, Mending Bodies, Saving Souls:  A History of Hospitals (Oxford, 1999), p. 184. 88 García Hernán (ed.), The Battle of Kinsale, p. 393. 89 Ibid., pp. 162–​3. 90 Ibid., p. 163. 91 On Soto, see Silke, Kinsale, p. 104. 92 García Hernán (ed.), The Battle of Kinsale, pp. 389–​90. 93 See M. Mullett, The Catholic Reformation (London, 1999), p. 104. 94 García Hernán (ed.), The Battle of Kinsale, p. 390. 95 Falls, Elizabeth’s Irish Wars, p. 300. O’Sullivan Beare arrived from Bantry with cavalry and infantry, thus preventing Levison from going ashore with his forces. 96 Coombes and Ware (eds), ‘The letter book of General de Zubiaur’, p. 54. 97 García Hernán, ‘Matériel para Kinsale’, pp. 66–​7. 98 C. de Polentinos (ed.), Epistolario del General Zubiaur, 1568–​ 1605 (Madrid, 1946), p. 87, ‘Juebes a la noche ha venido un capitan de cauallos de Odonel’.

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99 Ibid., ‘O Nel me pide unas pocas medicinas para un hermano suyo dize esta malo de un pie’. 100 M. Gracia Rivas, ‘La jornada de Don Juan del Águila de 1591 y sus aspectos sanitarios’, in Ó. Recio Morales, Bernardo José García García, Miguel Angel de Bunes Ibarra and Enrique García Hernán (eds), Irlanda y la Monarquía Hispánica: Kinsale 1601–​2001 (Madrid, 2002), p. 165. 101 Hazard, ‘ “Very necessarie instrumente” ’ p. 123. 102 Silke, Kinsale, p. 158. 103 García Hernán (ed.), The Battle of Kinsale, p. 393. 104 Alphabetum Galieni, the Alphabet of Galen. Pharmacy from Antiquity to the Middle Ages. A Critical Edition of the Latin Texts with English Translation and Commentary, ed. N. Everett (Toronto, 2012), p. 301. 105 On applying modern terminology to historical outbreaks of epidemic disease, see O.  P. Grell and A. Cunningham, The Four Horsemen of the Apocalypse: Religion, War, Famine and Death (Cambridge, 2000), pp. 298–​9. 106 P. Lenihan, ‘Unhappy campers: Dundalk (1689) and after’, in T. Pollard and I. Banks (eds), Studies in the Archaeology of Conflict (Leiden, 2008), pp. 196–​216. 107 P. Logan, ‘Pestilence in the Irish wars: the earlier phase’, The Irish Sword, 7 (1966), p. 179. 108 García Hernán (ed.), The Battle of Kinsale, pp. 390–​2. 109 J.  B. Harborne and H. Baxter (eds), Chemical Dictionary of Economic Plants (New York, 2001), pp. 55, 102, 197, 422. 110 J. Druett, Rough Medicine: Surgeons at Sea in the Age of Sail (New York, 2001), pp. 70, 242. 111 García Hernán (ed.), The Battle of Kinsale, p. 391. 112 P. Teigen, ‘Taste and quality in fifteenth-​and sixteenth-​century Galenic pharmacology’, Pharmacy in History, 29 (1987), pp. 60–​8; E.  G. von Arni, ‘Who cared? Military nursing during the English civil wars and interregnum, 1643–​60’, in G. Hudson (ed.), British Military and Naval Medicine, 1600–​1830 (Amsterdam, 2007), p. 132. 113 Druett, Rough Medicine, pp. 72, 238; J. Frith, ‘Arsenic –​“poison of kings” and “saviour of syphilis” ’, Journal of Military and Veterans’ Health, 21 (2013), pp. 11–​17. 114 García Hernán (ed.), The Battle of Kinsale, p. 391. 115 Ibid., pp. 13–​14. 116 H. Morgan, ‘Disaster at Kinsale’, in H. Morgan (ed.), The Battle of Kinsale (Wicklow, 2004), p. 137. 117 E. de Mesa, The Irish in the Spanish Armies in the Seventeenth Century (Woodbridge, 2015), pp. 215–​16. 118 Jennings (ed.), Wild Geese, pp. 42, 45; McGurk, The Elizabethan Conquest, p. 108.

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119 J. Kelly, ‘The emergence of scientific and institutional medical practice in Ireland, 1650–​1800’, in E. Malcolm and G. Jones (eds), Medicine, Disease and the State in Ireland, 1650–​1940 (Cork, 1999), pp. 21–​39; E. O’Flaherty, ‘Medical men and learned societies in Ireland, 1680–​1785’, in H. Clarke and J. Devlin (eds), European Encounters: Essays in Memory of Albert Lovett (Dublin, 2003), pp. 253–​69. 120 G. Miller, ‘Medical education and the rise of hospitals: I. The eighteenth century’, Journal of the American Medical Association, 186 (1963), pp. 938–​41. 121 L. Brockliss and C. Jones, The Medical World of Early Modern France (Oxford, 1997), pp. 689–​700.

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Sickness, disease and medical practitioners in 1640s Ireland John Cunningham In August 1642 a committee of MPs at Westminster urged the sending of more money to Ireland to maintain Protestant refugees there. Otherwise, they argued, ‘there willbe an inevitable danger of their bringing over the infection of the pestilent fever with them, as hath bene allready done in some parts of Devon’.1 The 1641 rebellion in Ireland clearly posed a risk not only to England’s security, but also to its public health. In wartime Ireland, the dangers of violent death and disease loomed altogether much larger. This circumstance in turn presented opportunities and hazards to medical practitioners of various kinds. Any effort to study practitioners’ experiences, and the Irish medical environment more generally, amidst the upheaval of the 1640s is inevitably hampered by the scarcity of relevant surviving sources. The latter problem is not unique to that decade; for most of Ireland beyond Dublin, we know little about medical practice in the seventeenth century. Fortunately, there is one extant source that enables a range of relevant insights into the situation in the 1640s. The Westminster committee’s resolutions from August 1642 and an enormous quantity of additional information concerning the rebellion in Ireland are preserved in the same archive: the 1641 depositions. The depositions are the best known and most controversial source for the history of Early Modern Ireland. They comprise around 8,000 witness statements and related material concerning the Irish rebellion of 1641 and its aftermath.2 For centuries after the event, the depositions were at the centre of heated debate around the question of what had actually happened in 1641. Protestant writers pointed to their contents as evidence of a premeditated massacre by Catholics of very large numbers of English and Scottish settlers.3 Catholic writers in turn questioned the veracity of the depositions and refused to accept them

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as a reliable source for the history of the period.4 In recent decades the depositions have been put to new uses, for example in addressing questions of social and economic history and in literary studies of women’s writing.5 While the violence and the killings continue to loom large in the historiography, since 2009 the availability of the depositions in edited and searchable format online has facilitated a wide range of fresh investigations. As Mark Sweetnam’s study of Protestant clergymen has shown, the depositions can provide a means to explore the lives and experiences of particular groups of people within the wider context of rebellion and war.6 This chapter seeks to outline what the depositions can tell us about the history of health and medicine and, more especially, about medical practitioners in Ireland in the 1640s. It is important to state at the outset that the relatively small quantity of relevant content in the 1641 depositions means that they are of limited use for the investigation of medical practitioners and practice in this period. While deponents from every county provided sworn statements rich in detail, the nature of the evidence is very far indeed from enabling general conclusions about numbers and types of medical practitioners active in Ireland at the time. Moreover, the medics who feature most prominently do so because of their involvement in war and politics, rather than their activity in the medical sphere. It is thus not possible to determine the extent to which the snippets of relevant evidence found in the 1641 depositions represent an accurate picture of Irish medicine more broadly at this time. While medical doctors, surgeons and apothecaries inevitably feature, as in other sources the wide range of sometimes unorthodox practitioners that existed outside of this triumvirate has left fewer traces. Yet at the same time, the depositions allow us to identify practitioners not mentioned elsewhere. Given the limitations of the wider source base for the first half of the seventeenth century, it is worth paying attention to the depositions. The evidence they contain is sufficient to allow us brief but valuable glimpses into the lives of a number of practitioners located across the island.7 There are at least sixteen depositions directly provided by relevant individuals: four doctors of physic; one man who described himself as a ‘Professor of Physicke’; seven surgeons; one surgeon’s mate; one barber-​surgeon; one barber; and one midwife. More than eighty further depositions sworn by a broad range of people –​esquires, gentlemen, clergymen, widows and others –​refer to named medical practitioners of various kinds. Many are only mentioned in passing; for others more detailed accounts of their

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activities are provided. This evidence relates to practitioners in twenty-​ one of the thirty-​two counties, while a physician and a apothecary from London also feature briefly.8 Before investigating this cohort in more detail, it ought to be worthwhile to explore what the 1641 depositions can tell us about experiences of sickness and disease in Ireland in that period. Sickness and disease in the depositions

The 1641 rebellion encompassed various scenarios that led some deponents to comment on issues of health and sickness. These included:  episodes of violence and physical assault; lengthy sieges; forced dislocation of people; theft of clothing; exposure to inclement weather; and shortages of food and water. Deponents’ reflections on their experiences can provide insights into medical discourse in Early Modern Ireland. The word ‘sickness’ was sometimes used by deponents in a manner that conveyed a change of state due to the impact of the rebellion: a shift from being ‘in health’ into ‘sickness’. On hearing a report of the death of his wife and children, Hilkiah Read of Co. Leitrim ‘fell into sicknes whereof he soone after dyed’.9 Following the imprisonment of her husband in Sligo, Jane Stewart ‘fell extreem sick’.10 Elizabeth Bradley reported how a cold combined with grief to kill her husband:  these ‘did drive him into that sicknes whereof he (languishing) died’.11 Illness that affected a group of people might be described in terms of a ‘visitation’. Jonathan Hoyle, a Protestant minister in Queen’s County, described how his family and servants (nineteen persons in total) ‘were all of them (two or three excepted) visited with sore sickness’.12 George Creighton, also a Protestant minister, deposed that ‘sicknes came amongst us, and … it pleased god this deponents wife died, All his family was visited (the deponent only excepted)’.13 This apparent tendency for clergymen to refer to ‘visitation’ highlights the providential framework within which they could understand sickness.14 Another clergyman, Richard Morse from Co. Fermanagh, was more blunt, ascribing the ‘lamness and sickness’ of his wife and children to ‘the Cruell dealing of the Irish’ in stripping them and forcing them to flee their home.15 For those who ultimately survived such hardship, the process of recovery could be long, or even remain incomplete. Morse reported that his family were ‘scant well recovered’ from their ordeal.16 Richard Gibson fled from Co. Carlow in mid-​November 1641, ‘though very

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sick’. Two months later he swore a deposition in Dublin, ‘where he still languisheth of the same sicknes’.17 In 1643 Calcott Chambre recounted how after ‘falling sick [he] contynued in that sicknes for 16 weekes together’, before recovering and making good his escape from the rebels in Co. Wicklow.18 Others were not so fortunate. William Oulton, a gardener, fled from Wexford by sea, only to be shipwrecked. After swimming ashore he was imprisoned in Arklow, Co. Wicklow, ‘hauing in that restraynte Contracted sicknes & becoming a criple’.19 Oulton’s testimony regarding his illness and disability reflected some of the perils that might accompany dislocation and imprisonment. Deponents usually referred to ‘sickness’ in very general terms, sometimes alongside and interchangeably with ‘disease’. John Massie from Queen’s County reported his ‘affliction by an extreame sicknes … & yet he is not cleared of the dangerous disease thereof ’.20 Richard Hobson, a vintner in Dublin, deposed that following a blow to the head his wife ‘fell into a languishing sicknes & disease which within a weeke killd her’.21 From Co. Clare, John Ward revealed that the defenders of a number of besieged castles had become ‘perplexed with sicknes, & diseases’.22 In the same county, those who fled to Ballyally Castle had to face food shortages as well as ‘an infectious feauer then raigneing amongst them’.23 Deponents were occasionally more specific about the nature of the ailments that they encountered. This reflected the heavy impact of particular diseases, as well as the existence locally of sufficient knowledge to identify the diseases in question. William Dethick, for example, was among the Protestants besieged in two castles at Tralee in Co. Kerry for seven months in 1642. The defenders lost relatively few men in skirmishes, but Dethick reported that about 140 men, women and children ‘dyed out of both Castles through the sicknes called the Scurvey’.24 As refugees crowded into Dublin, observers noted the spread of contagious diseases there. In February 1642 Philip Bysse reported that ‘Here are verie many deade Lately, especially of the poorer sorte, and the Chi[l]‌dren die verie thicke of measells and Poxe, my Cozen Jeffrey Phillips wife died of the Poxe in Childe bed, and now George kinge Grace Colmans husband hath the small Poxe’.25 Two female deponents from the town of Armagh also reported cases of children with smallpox there in the early days of the rebellion. Isabell Gowrly recalled that two of her children ‘hadd the smallpox visibly upvn them’.26 The rebels’ imprisonment of Protestants in cramped conditions and the flight of others to overcrowded places of refuge must have served to magnify the impact of diseases such as measles and smallpox.

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Among the keen observers of disease in Ireland at this time was the Dutch physician Arnold Boate. He moved to Ireland in 1636 and spent eight years there. His observations would help to inform Irelands Naturall  History, a book written by his brother Dr Gerard Boate and published in London in 1652.27 The five ‘diseases reigning in Ireland’ mentioned by Gerard Boate included ‘the Irish Agues’ and ‘the Loosness’.28 The disease profile that he outlined for Ireland was to some extent reflected in the 1641 depositions. Boate explained that ‘the Loosness’ ‘useth to turn to the Bloody flux’, or diarrhoea, and was commonly known as the ‘country disease’.29 In Dublin in January 1642, Peter Bance reported the effects on his family of their being stripped and forced to flee from Co. Wicklow:  ‘his wife and children having gotten the Cuntry disease are now miserably sick … whereby they are Like to perrish’.30 Further north, Francis Sacheverell witnessed the deaths of Irish soldiers at Charlemont in Co. Armagh as a result of ‘the bloudie fluxe’.31 At the end of the decade, the ‘country disease’ would be one of the main challenges faced by Cromwell’s newly arrived army.32 Boate described the ‘Irish Agues’ as ‘a certain sort of of Malignant Feavers’.33 The depositions detail several cases. Katherine Patman and her brother both deposed that their mother had been mortally wounded by a Scot, Thomas Boyd, in Co. Antrim in 1641. At the time, she had been caring for several family members ‘sicke in an Ague’ in the woods near their home.34 While Boate asserted that the ‘Quartan Ague’ was ‘utterly unknown in Ireland’, this is contradicted by the testimony of one deponent.35 In 1653 Edward Butler claimed that he had been ‘surprizd with a quartan Ague’ that forced him to ‘keep his bed’ in Co. Kilkenny for a month in the early days of the rebellion.36 Butler was one of several men who pleaded former ill-​health when being interrogated by the Cromwellian authorities in the early 1650s about their alleged involvement in the killing of Protestants more than a decade earlier. This naturally renders their testimony problematic, both in relation to their reported sicknesses as well as otherwise. It also reflects these men’s hope that their claims of illness would be taken seriously in court. When flatly contradicted by witnesses, however, such pleas evidently carried little weight. Despite Butler’s attempt to refute some of the charges against him by insisting that he had been bed-​ bound, the Cromwellian High Court of Justice found him guilty of five murders at Ballyragget and he was duly executed.37 In Co. Antrim, the murder suspect Michael Doyne also claimed that he had been in poor health in 1641. He insisted that he had been ‘sicke

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of asore flux’, for the treatment of which he sought a ‘botle of Clared wine’ from an acquaintance in nearby Belfast.38 Doyne, however, had not been confined to bed by his sickness and several witnesses provided evidence of his role in the upheaval. He too was found guilty of murder.39 In Co. Tyrone, ill-​health also featured prominently in Patrick Modder O’Donnelly’s account of his actions in 1641. O’Donnelly claimed that ‘for three Moneths before the stirr he lay very sick in his own house’. Despite ‘being very weake & haveing taken Phisicke the day before’, on 22 October he defied ‘his Doctors rule’ and went to the aid of local Protestants at Castle Caulfield.40 This version of events was directly contradicted by Captain John Perkins, who deposed that O’Donnelly had taken the lead in capturing Dungannon Castle from him on the same date.41 O’Donnelly’s fate is unclear, but he certainly had reason to fear for his life in the face of Cromwellian murder investigations. In the town of Galway in 1653–​54, local officials seem to have made a determined effort to implicate the prominent Catholic lawyer and politician Patrick Darcy in an incident in March 1642 where a group of townsmen had surprised Captain Clarke’s ship in the harbour and killed some of those on board. Under interrogation in Dublin in December 1653, Darcy insisted that at that time he had been ‘sick in his owne howse’ for around a month and that upon recovery he had left the town.42 Several witnesses provided evidence to contrary. Captain Hygate Lone recalled seeing Darcy ‘in the streets the very day before the said surprisall but never heard that he was sicke’.43 Both Jane Sheiley and John Morgan deposed that Darcy had been ‘in health’.44 Charles Conway ‘Professor of Phisicke’ expressed his belief that ‘what was then done in Galway was by the direccion of Patricke Darcye, and the rest of the lawyers’.45 Several other deponents were more circumspect, claiming ignorance of Darcy’s whereabouts and his state of health in 1642, and Darcy was ultimately released.46 While the reliability of the testimony provided by Darcy and his fellow prisoners is obviously open to question, claims about ague, flux and months spent sick in bed were all evidently viewed as plausible in the contemporary medical context. The rebellion and the traumatic violent acts associated with it also inevitably had potential to impact on the mental wellbeing of those caught up in it. For this reason, it is worth paying some attention to cases where deponents referred to matters of mind as well as body. Although the relevant evidence is all too brief, it nonetheless offers a glimpse into contemporary perceptions.47 John Sims from Co. Wexford deposed that his wife ‘by frights taken by the cruelties of the Rebells is become very

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weake in body & mynd, & not like to Regaine her former strength’.48 In Tuam, Co. Galway, a rape victim named Mary ‘sayd that shee had layn sick vpon it for 3 or 4 dayes and was in such a condition that she thought shee should neuer bee well nor in her right mynd againe’.49 In Co. Tyrone Mr Brodely’s wife was reportedly ‘fallen into an extreme frenzy’ following robbery and stripping by the rebels.50 A  number of deponents also described the distress experienced by perpetrators of violence and their associates, sometimes with an apparent undertone of divine retribution.51 Jane Stewart reported the murder of a woman by the friars in the town of Sligo, after which the prior of the convent ‘fell franticke & run soe about the streets & contynued in that frenzie for 3 or 4 weekes’.52 In Newry, Co. Down, Elizabeth Crooker claimed that Colonel Magennis was troubled on his death bed by a vision of Mr Tudge, a Protestant minister then recently executed there. In the same town, one of the rebels involved in prophaning the Protestant Church apparently ‘fell into such a trembling … and extasy that other Rebells were gladd to carry him out of the Church as a frantick man’.53 Such episodes can be usefully related to wider scholarship on psychological trauma resulting from Early Modern warfare, some of which has focused on gendered aspects of the relevant surviving narratives.54 In the depositions, perhaps the most frequently mentioned cases requiring medical treatment were the many cuts, stab wounds and gunshot wounds inflicted by the rebels on their victims and their opponents in arms. For example, at the surrender of Longford Castle Mathew Baker was wounded ‘in twenty places with stabbs and cutts’; he died shortly afterwards.55 At Cashel in Co. Tipperary Ellice Meagher sustained ‘11 wounds’; she reported that her captors ‘later plucked of[f]‌ what plaisters were layd to theire wounds lest they should be cured’.56 With medical provision in short supply, such cases very often resulted in a period of ‘languishing’ followed by death. Lack of surgical care was especially felt by soldiers. During the lengthy siege at Duncannon Fort in Co. Wexford, the anxious defenders lamented the garrison’s ‘want of a chirurgion’: they complained that ‘in case any of us Should receive any hurt, we are like to perish’.57 One Protestant soldier who claimed to owe his life to a surgeon was Myles Jenkinson in Queen’s County. Having taken two bullets in the back and a pike wound in his right arm, he prevailed on his captor to allow him to have his wounds dressed.58 Where such treatment was available it could prove expensive, especially for persons already deprived of their income and belongings. Samuel Felgate spend at least ten pounds in Dublin on treatment for two

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gunshot wounds, as well as the ‘seven greivous wounds’ suffered by his maid servant.59 In Co. Antrim a prisoner of the rebels, Thomas Ingram, agreed to pay five pounds towards the ‘cure’ of a sergeant whom he had shot in the thigh while attempting to evade capture.60 Given the extent of the violence and sickness apparent in wartime during the 1640s, it can be no surprise that there was strong demand for the services of medical practitioners of all kinds. What do the depositions reveal about the roles and experiences of such people? Doctors and apothecaries

The relatively high social status enjoyed by medical doctors ensured that they achieved prominence across a variety of roles in 1640s Ireland. One well-​known Protestant doctor who features in the depositions is the aforementioned Arnold Boate. He does so not because of his medical practice but rather because of his involvement in elite politics. In Dublin in July 1643 Boate was investigated for his alleged part in promoting two petitions:  one for the removal of all Catholics from the city; and a second for subscribing ‘some Covenant’.61 These activities were presumably related to the jostling for position ongoing within the Dublin government at that time. This situation arose because of a spilling over of royalist–​parliamentarian tensions from England and also the unpalatable prospect of negotiations with the Catholic rebels. The consolidation of royalist control in Dublin in 1643 under James Butler, earl of Ormond, and the government’s moves to secure Irish Catholic support for Charles I  against the English parliament help to explain Boate’s decision to leave Ireland shortly afterwards.62 Another doctor involved in politics at a high level in the 1640s was Gerald Fennell. He was a member of the Supreme Council of the Catholic Confederation that governed most of Ireland from its seat at Kilkenny and he was also a close associate of Ormond.63 Yet beyond his inclusion in a few listings by deponents of the names of the Catholic leadership, he is, like Boate, hardly mentioned at all in the depositions. This is so because he was not directly involved in the actions that informed much of the content of the depositions: the violence against and displacement of Protestants at a local level. The depositions have far more to say about two other Catholic doctors in that context. In September 1652, Dr Donnogh O’Healy of Carnody in Co. Cork faced questioning about an incident that had occurred almost exactly a decade earlier. In mid-​August 1642 a party of between twelve and

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sixteen Protestants was dispatched under armed Catholic escort from Macroom intending to travel to safe refuge in Cork, a distance of less than twenty-​five miles. None of the prisoners reached their destination. O’Healy asserted that he had been on his way to visit a patient when he met the convoy on the road at Kilmurry. The next day, he heard that two of the prisoners had been hanged nearby, while the rest had been killed between Blarney and Cork. He was unable to recall the identities of most of the members of the escort because of ‘his being soe much a stranger in his owne Country, for that he came but a yeare before out of ffrance’.64 As many Irish Catholics received their medical education in France in the Early Modern period, this aspect of O’Healy’s narrative can be seen as credible.65 Unfortunately for him, four members of the rebel escort deposed that O’Healy had taken custody of the two prisoners who were subsequently hanged at Kilmurry, a version of events reinforced by hearsay evidence from a number of other deponents. In at least fourteen depositions collected in 1652–​53, O’Healy was implicated in the murders. According to this version of events, the doctor and two companions had met the convoy near Kilmurry. Upon identifying a nailer and a collier among the party, O’Healy had compelled them to go along with him, stating that he had need of their skills. Thereafter he was alleged to have hanged the two men and buried them in a sawpit. None of the deponents had actually witnessed these executions. The evidence against O’Healy was problematic, not least because the four key witnesses against him were understandably keen to absolve themselves of any blame for the deaths that had occurred.66 Nonetheless, their testimony was sufficient to ensure that O’Healy was convicted of murder in November 1652 and hanged at Cork.67 Another medical doctor, Daniel Higgins, was also executed by Cromwellian authorities in the early 1650s. In 1641–​42, Higgins was involved in a number of actions in the Limerick region.68 He is mentioned in at least nineteen depositions. Several deponents referred to him as ‘of Limerick’, while Dermod Grady stated that Higgins was from Scoul, a townland situated around eighteen miles south of the city.69 Higgins was among the local Catholic leadership responsible for managing the successful siege of Limerick Castle in May–​June 1642. He was also involved in an attack on Mallow, Co. Cork, in February 1642 and the subsequent siege of Lough Gur Castle about twelve miles south of Limerick. The latter siege lasted from March to September 1642. In two of the depositions collected in 1642–​43 concerning events at Lough Gur, Higgins is identified as responsible for the death

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of Anthony Rindersly, a warder at the castle. Joseph Keanes accused him of ‘first cutting of[f]‌one of … [Rindersly’s] … armes & stabbing of him in seuerall places … and afterwards in a tormenting manner stripped him & kepte him starke naked for Two dayes & Two nights & soe the man dyed’.70 Higgins would never be brought to trial for this alleged murder. Following the surrender of Limerick to Henry Ireton in October 1651, he was one of the defenders executed in retribution for their role in delaying the surrender of the city.71 Higgins provides a good example of how a medical doctor was able, and perhaps expected, to assume a leadership role at the local level. At least one deposition links Higgins to a pursuit in which medical doctors and apothecaries played a key role during the early stages of the war in Ireland:  the making of gunpowder. Apothecaries in particular were evidently expected to possess the expertise necessary to identify the ingredients of gunpowder and to oversee its manufacture. While the siege of Limerick Castle was underway in 1642, Higgins was entrusted with this task alongside others including James Hackett, an apothecary in the city. As part of an effort to procure sufficient quantities of saltpetre, graves were dug up in St Mary’s Churchyard.72 Kilkenny witnessed similar scenes, where the rebels ‘digged the tombes & graues in the churches … vnder colour of getting vp mowldes whereon to make gunpowder’.73 The men who took responsibility for this vital work included Mr Munsell ‘Doctor of Phissick’ and the apothecary Edmund Sallenger.74 In the city of Waterford, the apothecary Richard Neylor was among those who ‘digged vp some corps of protestants … & those they with the earth boyled in greate furnesses till they extracted saltpeeter, & made of them gun powder worth three score pounds a weecke or therabouts’.75 Beyond these instances of apothecaries making macabre use of their ‘transferrable skills’ for destructive ends, they appear to have left little other trace in the depositions. Yet it may be assumed that the war also stimulated demand for their more restorative products.76 The need for gunpowder also helped to shape the fate of one Dr Hodges in Ulster. This was the medic whose advice Patrick Modder O’Donnelly claimed to have ignored when he left his sickbed to go to the aid of Protestants at Castle Caulfield in 1641.77 Hodges’s precise medical qualifications are unknown. One deponent, William Fitzgerald, explained that he was ‘commonlie called in the Countrie Doctor Hodges for his practice of Phisick in the Northerne parts’.78 Fitzgerald identified Hodges as one of Sir Phelim O’Neill’s prisoners and ‘cheife

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workmen’ in a largely unsuccessful attempt to make gunpowder for the Ulster rebels at Charlemont and Armagh.79 George Wirrall from Co. Fermanagh, who had previously been employed as ‘a clerke and paymaster’ to a London saltpetre master, was among those selected to ‘learne the faculty’ of gunpowder manufacture from Hodges. Wirrall discovered that Hodges had only managed to produce seven ounces of ‘very unprofitable stuffe’ and he suspected that the doctor was deliberately sabotaging the process. The rebels’ patience was soon exhausted.80 While Hodges’s wife and two sons escaped, he was reportedly half-​ hanged and then imprisoned for a further three months, before being killed in a massacre near Charlemont.81 The high profile enjoyed by doctors ensured that a number of others were mentioned more briefly in the depositions, either as rebels, as victims, or otherwise. Dr Derby O’Connor in Co. Tipperary and Dr John Field in Co. Kerry were both reported to be in rebellion.82 Stephen Love deposed that Field had taken a local leadership role on the rebels’ county committee in Kerry and he denounced him as ‘a most pestilent and pernitious enemy to the English-​nation’.83 From the Scottish settlement at St Johnstown in Co. Longford, Elizabeth Stewart reported losses worth £162 8s. suffered by her and her late husband Alexander Stewart ‘Doctor of Phissick’. These losses included income from houses and land, books worth fourteen pounds and a salary of twenty pounds payable for running the school at St Johnstown. The deposition does not make clear whether it was Elizabeth or Alexander, or both of them together, who received this salary, nor is there any indication of the scale of Alexander’s income from his medical practice.84 Two prominent English doctors associated with the parliamentarian army, William Petty and Abraham Yarner, were among the commissioners appointed by the government in 1652 to collect evidence relating to murders in 1641. Their signatures appear together on a number of depositions relating to Co. Meath.85 The only physician mentioned in the depositions because of actual practice during the rebellion seems to be William Connery of Carrigrenny in Co. Cork. Under examination in 1652, he recounted having dressed the wounds of two wounded soldiers of Lord Inchiquin’s who came to his house. He was later forced to hand them over to the rebels.86 As other depositions confirm, Connery’s actions in treating soldiers’ wounds were more typically the preserve of surgeons in this period. Yet given the wartime context, it is hardly surprising to find a physician doing the work of a surgeon.

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Barbers, surgeons and barber-​surgeons

In Early Modern Ireland, as elsewhere, the occupational labels of barber, surgeon and barber-​surgeon were not always used consistently in various sources, so that a man described as a ‘barber’ in one place can sometimes appear elsewhere as a ‘surgeon’. For this reason, it cannot be assumed that the labels used reflected any actual division of labour between the tasks of cutting hair, trimming beards, lancing boils, letting blood, performing operations, treating wounds, and so on. The word ‘surgeon’, or its now archaic form ‘chirurgeon’, also provides a good example of the remarkable diversity of spelling evident within the 1641 depositions. For instance, the official responsible for taking down the examination of Mullmory O’Loney from Co. Fermanagh rendered his occupation as ‘kirurgeon’. O’Loney claimed to have arrived in Dublin on 22 October 1641 ‘to gett a service vnder somme Phisician or surgeon’ in the city.87 If this was the truth, then it was his considerable misfortune to have arrived on the same day as a group of rebels intent on surprising Dublin Castle. They were led by Lord Maguire, who like O’Loney was also from Co. Fermanagh.88 The authorities concluded that O’Loney was most likely the rebels’ surgeon; his fate is unknown.89 He is one of the ten surgeons associated with the rebels who can be identified in the depositions. Some of the most detailed relevant information from the rebel side was gathered from men taken prisoner by government forces at Rathcoffey and other castles in Co. Kildare in mid-​1642. Charles Connor of Kildrought, Co. Kildare, was a surgeon who had been part of the company of Captain Gerald Fitzgerald. He recounted to the authorities in Dublin his recent movements around Kildare and in west Co. Dublin, naming and implicating a large number of local Old English gentry families in the rebellion. He had done the ‘Office of his calling’ in the rebel camp at Leixlip, and repaired to Lady White’s house at St Katherine’s ‘there to do cures’. He had also been summoned to let the blood of a priest’s servant at Luttrellstown and of Mr Eustace’s daughter at Confey. According to Connor, Lady White, Mr Luttrell and Eustace were all ‘well knowing’ of his status as a rebel, the implication being that their employment of him showed their sympathy with the rebel cause. Luttrell had even asked Connor to ‘trim’ him.90 The war evidently created new opportunities for Connor in treating rebel soldiers, alongside his addressing the local gentry’s needs for bleeding and trimming.91

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Two other depositions taken from prisoners captured at Clongowes Wood Castle in Co. Kildare provide some further insight into the medical provision available to the rebels in that county. Thomas Fitzgerald explained that following a fall from his horse he had travelled to Clongowes Wood to be treated by ‘a woman called mary barnewall which had skill in Chirurgry’.92 His comrade David Eustace deposed that ‘mary Barnewall tooke … [Fitzgerald] … in hand to cure him and did cure him reasonable well’.93 These references to Barnewall represent rare explicit evidence of a woman practising surgery in Ireland at this time. While the records of the guild of barber-​surgeons in Dublin contain mentions of female practitioners, usually widows continuing their deceased husbands’ trades, a paucity of relevant sources means that such individuals are even harder to uncover in the rural context in which Barnewall was operating.94 The circumstances of her training and of her practice of surgery in the longer term can only be guessed at. As with Connor, the war presumably provided new opportunities for Barnewall to practise. Among the Protestant victims of the rebellion, the depositions record the killing of a barber in Rosscarbery, Co. Cork, and another in Tralee, Co. Kerry, as well as the murder of a surgeon in Armagh.95 The latter, William Wollard, was reportedly killed by a man whom he had recently successfully treated for a wound in his arm.96 The depositions include testimony from four Protestant surgeons relating to their wartime experiences. In Co. Tipperary, Richard Sheapheard, ‘chirurgian’, provided no details of his practice. His reported losses consisted largely of animals and crops, as well as the lease on his house and farm.97 Robert Rawlins was the surgeon on Captain Clarke’s ship when it was attacked at Galway in 1642. Eleven years later, he provided a detailed eyewitness account of the attack, including a tussle during which he had been stabbed in the shoulder and then rescued by a stranger carrying a carbine.98 Two further Protestant surgeons provided some details of their practice during the rebellion. The first was John Mandlefeild, of Dunlavin, Co. Wicklow, seemingly the only person referred to in the depositions as a ‘Barber Chirurgion’. Mandlefeild lost his ‘barbers tooles and instruments’ to the rebels. Despite this, he was able to cure his wife. She had been stabbed in the breast, causing a wound that Mandlefeild had ‘with much difficultie healed after his wiffs great paine endured’.99 Another Protestant deponent, William Sterling of Ballymoney, Co. Antrim, described himself as a gentleman, albeit one ‘who professed Chirurgery’. Sterling claimed to have successfully treated John Hunter

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for ‘fifteene or sixteene stabbs with a pike in his backe’.100 Sterling may have exaggerated his success, however, as a separate deponent reported that Hunter had died of his wounds.101 The example of Sterling moves us towards the final group to be considered: those individuals whose primary descriptors of occupation or status in the depositions do not indicate the practice of medicine. For these, a variety of other clues have to be sought out. Other practitioners

In the 1641 depositions, the status of the vast majority of the female deponents is stated in terms indicating their relationships to men, with most being either described as either ‘wife’ or ‘widow’. This approach is of course characteristic of Early Modern sources more broadly and it reflects broader contemporary assumptions about women’s social status and the nature and value of their work. It also poses a variety of problems for historians interested in the latter subjects. Fortunately, the depositions provided by some women in 1640s Ireland provide indications of particular skills possessed by them, or of the type of specialised work that they could undertake. This can be seen, for example, in cases where impoverished Protestants who escaped to Dublin sought help from officials to secure employment that would enable themselves and their families to subsist. One such individual was Elizabeth Adwick, ‘wife to Thomas Adwick gent’. Adwick was a thirty-​five-​year-​old woman from Castlewaterhouse in Co. Fermanagh. Having been robbed of her possessions at the outbreak of the rebellion, she fled her home and reached Dublin by early January 1642. In her deposition she stated that her husband Thomas was absent, having gone to the West Indies three years earlier. Without her husband and deprived of her land, crops and animals, Adwick faced an uncertain future. But her chances of survival were certainly enhanced by the very valuable skills that she claimed to possess. Her deposition reveals that ‘She hath skill in doeing the office of a midwife, by the which if she had any clothinge to goe abroad, she hopes to live’.102 The latter detail was recorded as a marginal note, while Adwick’s primary social status as ‘wife’ appeared at the opening of her deposition. This document points to some of the difficulties associated with identifying women who engaged in medical practice. While the depositions cannot be expected to tell us much about women’s diverse involvement in household medicine and the care of family members,

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the tendency in such official sources to privilege the labels of ‘wife’ and ‘widow’ makes it much more difficult to identify those who were active beyond their immediate households.103 Adwick is the only one of the hundreds of female deponents who can be positively linked to a medical occupation. Just one other named midwife is mentioned in passing in a deposition: Alls Browne was reportedly killed by the rebels during a siege at Cullen Castle in Co. Tipperary in August 1642.104 A  few more midwives are referred to, accompanying pregnant women in one case, and attending a birth in another.105 Unfortunately, these latter midwives are not identified by name. This is of course a reminder of another of the many difficulties that surrounds efforts to identify female medical practitioners in Early Modern sources more generally. It is one that sometimes arises in connection with male practitioners too, for example in the case already mentioned above of Myles Jenkinson’s treatment by an anonymous surgeon. Another instance in the depositions is the unnamed ship’s surgeon killed in a skirmish near Kenmare in June 1642.106 The case of William Wilkinson of Benburb in Co. Tyrone illustrates another type of challenge that can be encountered in relation to identifying medical practitioners. Two or three years before the rebellion he had reportedly ‘releeved & recovered’ his sick and bedridden Catholic neighbour Shane Ó Hagh. On the outbreak of the rebellion, however, Ó Hagh had seized Wilkinson’s house and murdered him. The evidence here is not sufficient to determine whether Wilkinson was a recognised medical practitioner of some sort, or simply a kind and useful neighbour.107 The depositions also provide some details of other instances where the precise nature of the medical practice concerned is unclear. In King’s County, a gentleman named Henry Aylyffe reported the loss of ‘druggs for Phissick’.108 These may simply have been intended for the use of his household; there is no suggestion in Aylyffe’s lengthy testimony that he or his wife had any particular medical knowledge or skills. Another gentleman, Thomas Andrew of Ballinaglera in Co. Clare, reported more substantial losses of items with obvious medical purpose. In December 1641 he was robbed ‘Of Bookes to the value of foure pounds nine shill[ings] Of siluer Instruments of Chirurgery to the value of seaven pounds 5 s. Of Phisicall druggs potts & glasses belonging thervnto to the value of thirteene pounds’.109 If these were just the house contents of a gentleman seeking to provide against the inevitability of ill-​health among his family, then he was certainly well stocked. It seems possible

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that Andrews was equipped to practise medicine more widely. Yet in terms of the value of his losses in the rebellion, the medical paraphernalia were far outweighed by farm animals, crops and ‘impliments of husbandrie’.110 The ‘chirurgian’ Richard Sheapheard reported mainly losses of an agricultural nature while the ‘gentleman’ Thomas Andrew possessed a range of medical equipment.111 This serves as a caution against seeking to impose too rigid a scheme of occupational differentiation, of medical practitioners and non-​practitioners, especially in remote areas of the Irish countryside in the seventeenth century. It also points to the likelihood of widespread self-​medication, a practice that James Kelly has analysed in Ireland from the mid-​seventeenth century onwards.112 One group of depositions where we might expect to see evidence of cross-​over between medicine and other pursuits is in those relating to clergymen.113 The deposition of George Creighton, vicar of Lurgan in Co. Cavan, reveals his familiarity with medicine of the veterinary kind. While he was a prisoner of the rebels at Virginia, he became aware of an outbreak of ‘a greivous plague amongst the Cowes of Meath and many died by pissing bloud’.114 Creighton advised the rebels to consult the copy of ‘Gowges husbandry’ housed over thirty miles away in the earl of Fingall’s library.115 When the book was brought to him, he was able to find the appropriate remedy, which ‘prooved soe effectuall that the disease stayd’.116 Elsewhere in the depositions, two instances of clergymen using their medical skills for the benefit of besieged Protestants can be identified. Few deponents could boast the degree of diversity in wartime employment attained by Edward Williamson. When the rebellion broke out, he was around sixty years old and possessed of a church living worth eighty pounds per annum at Monasterevin in Co. Kildare. He promptly fled to the castle at Monasterevin, where he served as ‘a preacher Chirurgion & souldjer in the garrison for a yere and nyne moneths vntill it was surrendred’.117 At Knockvicar in Co. Roscommon, Dr Ambrose Frere held out against the rebels for fourteen months.118 The deposition of Ann Frere, his widow, reported his successful ‘cure & help’ of Stephen Bonner, who had been shot in the thigh. Unfortunately for Dr Frere, he later suffered a similar wound ‘in the topp of his thigh soe dangerously with a gnawd or chattered bullett, that the wound festered & grew to a gangrene & contynued soe that within six dayes after hee died’.119 For Frere, as for many others mentioned in the depositions, no indication is given of where he acquired his medical knowledge or how widely he practised.

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Conclusion

In relation to sickness and disease, the 1641 depositions contain brief snippets of evidence concerning a broad group of people. This brevity precludes much by way of in-​depth analysis in many instances. At the same time, the breathless immediacy of the evidence, much of it provided by victims and eyewitnesses who otherwise left no trace in the archive, helps to make the 1641 depositions an intriguing source. Careful sifting of these documents can enrich our understanding of experiences, understandings and representations of violence, pain, death, disability, sickness and disease in Early Modern Ireland.120 The discussion above has offered just a flavour of the relevant evidence, which even post-​digitisation continues to pose a range of practical and interpretative difficulties to scholars. The depositions’ value as a source for medical practitioners is likewise due to their breadth. More than 100 depositions contain some mention of individuals who practised medicine, and again many of these persons are not found in any other source. Yet the depositions are very far from enabling anything close to a systematic analysis of numbers and locations of medics in the 1640s. They instead provide a haphazard snapshot of some medical practitioners in some parts of Ireland in that decade. There are certainly gaps in the picture that they offer, and much blurring at the edges. It is perhaps at these edges that the 1641 depositions are most useful. They emphatically remind us that Ireland’s medical world was not solely comprised of neat categories of clearly labelled practitioners, always distinguishable from the wider population. After all, a gentleman might possess the best stock of medical provisions for miles around, and a surgeon might devote most of his attention to agriculture. In time of war, the edges could become even more blurred. A preacher might take on surgery or soldiery as circumstances demanded. A doctor might heal one man and hang another. And the apothecary might boil the corpse. Notes 1 TCD, MS 840, ‘Reasons for early payments of sums to the poor of Ireland’, 15 Aug. 1642, fos 55r-​6v. 2 The depositions have been edited and digitised. They are freely accessible at 1641.tcd.ie. 3 John Temple, The Irish Rebellion (London, 1646). 4 John Curry, Historical Memoirs of the Irish Rebellion in the Year 1641 (London, 1758); T. Barnard, ‘1641:  a bibliographical essay’, in B. Mac

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Cuarta (ed.), Ulster, 1641: Aspects of the Rising (Belfast, 1993), pp. 173–​ 86; J. Gibney, The Shadow of a Year: The 1641 Rebellion in Irish History and Memory (Madison, WI, 2013). 5 N. Canny, ‘The 1641 depositions as a source for the writing of social history’, in P. Flanagan and C. Buttimer (eds), Cork: History and Society (Dublin, 1993), pp. 249–​308; M.-​L. Coolahan, Women, Writing, and Language in Early Modern Ireland (Oxford, 2010), ­chapter 4. 6 M. Sweetnam, ‘ “Sheep in the midst of wolves”? The protestant ministry in the 1641 depositions’, Journal of Irish and Scottish Studies, 6 (2013), pp.  71–​92. 7 The medical practitioners discussed below have been identified in the 1641 depositions by means of searches of the relevant website at 1641. tcd.ie. The relevant data will be made available in due course on the online database of the Early Modern Practitioners project at Exeter. See practitioners.exeter.ac.uk. 8 In his evidence, Edward Lake, alderman of Dublin, referred to a recent stay in London where he met Thomas Hicks, an apothecary of Fleet Street, and a Doctor Moore. TCD, MS 809, Examination of Edward Lake, 12 Nov. 1641, fos 164r-​5v. 9 TCD, MS 831, Deposition of Ann Read, 12 July 1642, fos 39r-​40v. 10 Ibid., Deposition of Jane Stewart, 16 May 1653, fos 120r-​1v. 11 TCD, MS 813, Deposition of Elizabeth Bradley, 17 Dec. 1644, fos 303r-​4v. 12 TCD, MS 815, Deposition of Jonathan Hoyle, 18 Jan. 1644, fos 330r-​3v. 13 TCD, MS 833, Deposition of George Creighton, 15 Apr. 1643, fos 227r-​42v. 14 On this point, see H. Cleugh, ‘ “At the hour of our death”: praying for the dying in Post-​Reformation England’, in E. Tingle and J. Willis (eds), Dying, Death, Burial and Commemoration in Reformation Europe (Farnham, 2015), pp. 50–​3. 15 TCD, MS 835, Deposition of Richard Morse, 31 Dec. 1641, fos 143r-​4v. 16 Ibid. 17 TCD, MS 812, Deposition of Richard Gibson, 15 Jan. 1642, fos 14r-​15v. 18 TCD, MS 811, Deposition of Calcott Chambre, 24 May 1643, fos 174r-​5r. 19 TCD, MS 819, Deposition of William Oulton, 14 Mar. 1654, fo. 253r-​v. 20 TCD, MS 815, Deposition of John Massie, 2 May 1643, fo. 342r-​v. 21 TCD, MS 810, Deposition of Richard Hobson, 31 Aug. 1644, fo. 296r-​v. 22 TCD, MS 829, Deposition of John Ward, 25 Apr. 1643, fos 80r-​5v. 23 Ibid., Deposition of John Hawkins, 29 Oct. 1642, fos 66r-​7v. 24 TCD, MS 828, Deposition of William Dethick, 27 May 1643, fos 236r-​7v. Gerard Boate claimed that scurvy did not exist in Ireland at this time. See his Irelands Naturall History (London, 1652), p. 178. 25 TCD, MS 840, Letter from Philip Bysse to his brother, Dublin, 16 Feb. 1642, fos 7r-​10v.

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26 TCD, MS 836, Deposition of John and Isabell Gowrly, 8 Nov. 1642, fo. 57r-​v and Examination of Magdalen Duckworth, 10 Feb. 1653, fos 121r-​2v. 27 Boate, Irelands Naturall History. 28 Ibid., pp 182–​3. 29 Ibid. 30 TCD, MS 811, Deposition of Peter Bance, 19 Jan. 1642, fo. 26r-​v. See also John McCan’s report of the death of Henry Stanaway at Armagh in TCD, MS 836, fo. 219r-​v. 31 Ibid., Deposition of Francis Sacheverell, 21 July 1643, fos 107r-​11v. 32 See for example, Cromwell’s letter to Speaker Lenthall, 25 Oct. 1649 in S. Lomas (ed.), Letters and Speeches of Oliver Cromwell with Elucidations by Thomas Carlyle (3 vols, London, 1904), i, p. 496. 33 Boate, Irelands Naturall History, p. 181. 34 TCD, MS 838, Examination of Roger Gill, 28 Apr. 1653, fo. 282r-​v and Examination of Kathrin Patman, 28 Apr. 1653, fos 282v-​3v. 35 Quartan ague is a form of malaria, which causes a fever that recurs every fourth day. 36 TCD, MS 812, Examination of Edward Butler, 16 Feb. 1653, fos 327r-​8v. 37 J. Wells, ‘Proceedings at the high court of justice at Dublin and Cork 1652–​1654 [part 2]’, Archivium Hibernicum, 67 (2014), pp. 234, 249–​50. 38 TCD, MS 838, Declaration of Michael Doyne, undated, fos 108r-​12v, Examination of Michael Doyne, undated, fos 113r-​14v and Examination of Michael Doyne, 24 Aug. 1653, fos 115r-​16v. 39 J. Wells, ‘Proceedings at the High Court of Justice at Dublin and Cork 1652–​1654 [part 1]’, Archivium Hibernicum, 66 (2013), pp. 126–​32. 40 TCD, MS 838, Examination of Patrick Modder O’Donnelly, 30 Mar. 1653, fos 42r-​3v. 41 TCD, MS 839, Information of Captain John Perkins, 8 Mar. 1644, fos 40r-​4v. 42 TCD, MS 830, Examination of Patrick Darcy, 20 Dec. 1653, fos 263r-​4v. 43 Ibid., Examination of Hygate Lone, 23 Feb. 1653, fos 240r-​2r. 44 Ibid., Examination of Jane Sheiley, 25 Jan. 1654, fos 247r-​ 8v and Examination of John Morgan, 13 Jan. 1654, fos 229r-​32v. 45 Ibid., Examination of Charles Conway, 22 Mar. 1654, fos 251r-​2v. By the time that Conway gave his testimony in 1654, he had relocated from Galway to Cork. A  note on his deposition gives his name as ‘Charles Conway (alias Konowan)’. The O’Canavans were hereditary physicians to the O’Flahertys in Connemara. He was the only practitioner in the depositions to use the term ‘Professor of Physicke’. His precise qualifications are unknown. 46 Ibid., Examination of Mary Bowler, 7 Mar. 1654, fos 244v-​ 6v and Examination of Martin Linch, 24 Jan. 1654, fos 261r-​2v.

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47 For a discussion of some of the challenges of studying Early Modern mental illness, see P. Elmer, ‘The care and cure of mental illness’, in P. Elmer (ed.), The Healing Arts: Disease and Society in Europe: 1500–​1800 (Manchester, 2004), pp. 228–​30. 48 TCD, MS 818, Deposition of John Sims, 8 Nov. 1642, fos 104r-​5v. 49 TCD, MS 830, Deposition of Christopher Cooe, 21 Oct. 1645, fo. 172r-​v. 50 TCD, MS 839, Deposition of John Kerdiff, 28 Feb. 1642, fos 12r-​16v. 51 For the case of Lord Clanmorris, see TCD, MS 830, Testimony of John Morgan, 18 June 1653, fos 265r-​6v. For the case of Colonel Brian McHugh Boy O’Neill, see TCD, MS 836, Information of William Fitzgerrald, 4 June 1642, fos 82r-​6v. 52 TCD, MS 831, Deposition of Jane Stewart, 23 Apr. 1644, fos 73r-​4v. 53 TCD, MS 837, Deposition of Elizabeth Crooker, 13 Mar. 1643, fos 4r-​5v. TCD, MS 839, Deposition of John Kerdiff, 28 Feb. 1642, fos 12r-​16v. 54 See, for example, N. McAreavey, ‘Re(-​)membering women:  Protestant women’s victim testimonies during the Irish rising of 1641’, Journal of the Northern Renaissance, 2 (2010), pp. 1–​22. On England in the 1640s, see E. Peters, ‘Trauma narratives of the English civil war’, Journal for Early Modern Cultural Studies, 16 (2016), pp. 78–​94, and M. Stoyle, ‘Memories of the maimed: the testimony of Charles I’s former soldiers, 1660–​1730’, History, 88 (2003), pp. 204–​26. 55 TCD, MS 817, Deposition of Ruthe Martyne, 16 Mar. 1644, TCD, MS 817, fos 209r-​10v. 56 TCD, MS 821, Examination of Ellice Meagher, 23 Aug. 1652, fo. 259r-​v. 57 TCD, MS 818, James Franklyn and Abraham Mootham to Captain Smith, 9 Mar. 1645, fo. 155r-​v. 58 TCD, MS 815, Deposition of William Nicholls, 16 Jan. 1644, fo. 340r-​v. The surgeon involved is not named. 59 TCD, MS 810, Deposition of Samuell Felgate, 8 Jan. 1644, fo. 232r-​v. 60 TCD, MS 838, Examination of Bryan McIlcrany, 5 May 1653, fo. 168r-​v. 61 TCD, MS 810, Examination of Allan Cooke, 7 July 1643, fos 283r-​4v, Examination of William Hilton, 6 Jul 1643, fos 285r-​6v and Examination of Arnold Bote, 6 July 1643, fos 287r-​8v. 62 On the wider political context, see R. Armstrong, Protestant War:  The ‘British’ of Ireland and the Wars of the Three Kingdoms (Manchester, 2005). 63 For the Confederates, see M. Ó Siochrú, Confederate Ireland, 1642–​49: A Political and Constitutional Analyis (Dublin, 1999). 64 TCD, MS 826, Examination of Donnough O’Healy, 16 Sept. 1652, fo. 168r-​v. 65 L. Brockliss, ‘Medicine, religion and social mobility in eighteenth-​and early nineteenth-​century Ireland’, in J.  Kelly and F.  Clark (eds), Ireland and Medicine in the Seventeenth and Eighteenth Centuries (Farnham, 2010), pp. 73–​108. For some specific instances of Irish doctors on the continent, see ­chapter 2 by Hazard and ­chapter 10 by Caball in this volume.

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66 For a near contemporary mention of the massacre where O’Healy does not feature, see TCD, MS 823, Deposition of Walter Baldwin, 22 Oct. 1642, fos 165r-​8v. 67 Wells, ‘Proceedings at the high court of justice [part 2]’, pp. 215–​21. 68 Other medical doctors from Co. Limerick who feature in the depositions are David Gibbon of Kilmallock, in TCD, MS 823, fo. 180r-​v; Thomas Arthur of Limerick, in TCD, MS 829, fos 443r-​6v; and Francis White of Limerick, fos 385r-​6v. 69 Ibid., Deposition of Dermod Grady, 19 Nov. 1642, fos 295r-​6v. 70 Ibid., Deposition of Joseph Keanes, 29 Mar. 1643, fos 314r-​315v; also ibid., Deposition of John Harte, 1 Sept. 1642, fo. 152r-​v. 71 K. Wiggins, Anatomy of a Siege: King John’s Castle, Limerick, 1642 (Bray, 2000), pp. 233–​4. 72 TCD, MS 829, Deposition of John Comyne, 31 May 1643, fos 101r-​2v. 73 TCD, MS 812, Deposition of Joseph Wheeler and others, 5 July 1643, fos 202r-​8v. 74 Ibid.; for another mention of Sallenger, robbing Protestants, see ibid., Deposition of John Moore, 22 Feb. 1642, fos 197r-​9v. 75 TCD, MS 820, Deposition of Lawrence Hooper, 31 May 1643, fos 312r-​15v. 76 For example, at Clonmel, Co. Tipperary, in the early 1650s, the Cromwellian army used the services of two Catholic apothecaries, Walter Brenock and James Sall. National Archives of Ireland, MS CO 451, Extracts from accounts for the precinct of Clonmel, 1650s. 77 TCD, MS 838, Examination of Patrick Modder O’Donnelly, 30 Mar. 1653, fos 42r-​3v. 78 TCD, MS 836, Information of William Fitzgerrald, 4 June 1642, fos 82r-​6v. 79 Ibid. 80 TCD, MS 835, Deposition of George Wirrall, 18 July 1642, fos 231r-​2v. 81 TCD, MS 836, Deposition of Anthony Stratford, 9 Mar. 1644, fos 115r-​16v. 82 TCD, MS 829, Deposition of Thomas Browne, 19 Nov. 1642, fos 150r-​1v; TCD, MS 821, Deposition of Thomas Whiteby, 27 Aug. 1642, fo. 84r-​v; TCD, MS 828, Deposition of Stephen Love, 3 Feb. 1644, fos 124r-​7v. 83 TCD, MS 828, Deposition of Stephen Love, 3 Feb. 1644, fos 124r-​7v. 84 TCD, MS 817, Deposition of Elizabeth Stewart, 26 Aug. 1642, fo. 200r-​v. 85 See for example, TCD, MS 816, Examination of Rose McAwhy, 28 Jan. 1653, fos 274r-​5v. 86 TCD, MS 826, Examination of William Connery, 20 Oct. 1652, TCD, MS 826, fos 59r-​60v and Examination of Phillipp Magragh, 20 Oct. 1652, fo. 59r. 87 TCD, MS 809, Examination of Mullmory O’Loney, 5 Nov. 1641, fos 101r-​2v.

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88 The night before the planned assault, Lord Maguire lodged in the house of Mr Nevell, a barber, on Castle Street; ibid., Examination of Pattricke MaGwyre, 2 Nov. 1641, fos 69r-​70v. 89 Ibid., Examination of Mullmory O’Loney, 5 Nov. 1641, fos 101r-​2v. 90 TCD, MS 813, Information of Charles Connor, 10 Aug. 1642, fos 39r-​41v. 91 Connor also accused ‘Owgan a Barber’ in Dublin of providing supplies to the rebels. This was presumably Edward Wogan, a barber-​surgeon who became a freeman in Dublin in 1632. John Gilbert (ed.), Calendar of Ancient Records of Dublin (19 vols, Dublin, 1889–​1944), iii, p. 259. 92 TCD, MS 813, Information of Thomas Fitzgerald, 5 July 1642, fos 71r-​2v. 93 Ibid., Information of Dauid Eustace, 5 July 1642, fo. 75r. 94 TCD, MS 1447, Records of the Dublin Guild of Barber-​Surgeons. Unfortunately the guild records for the period 1588 to 1688 have not survived. 95 TCD, MS 822, Deposition of Ann Sellers, 4 Oct. 1642, fo. 177r-​v; TCD, MS 828, Deposition of Edward Vauclier, 21 Apr. 1643, fos 284r-​5v; TCD, MS 836, Deposition of Edward Saltenstall and George Littlefeild, 1 June 1642, fos 69r-​79v. 96 Ibid. 97 TCD, MS 821, Deposition of Richard Sheapherd, 7 June 1642, fo. 122r-​v. 98 TCD, MS 830, Examination of Robert Rawlins, 5 Feb. 1654, fos 197r-​8v. 99 TCD, MS 809, Deposition of John Mandefeild, 3 Feb. 1642, fo. 293r-​v. 100 TCD, MS 838, Examination of William Sterlin, 2 Mar. 1653, fos 60v-​1r. 101 Ibid., Examination of Robert ffuthy, 2 Mar. 1653, fos 59r-​60r. 102 TD, MS 835, Deposition of Elizabeth Adwick, 4 Jan. 1642, fo. 71r-​v. The word ‘clothinge’ here is a speculative reading of the manuscript. 103 A related problem is posed by the widespread use in Early Modern sources of the occupational label ‘merchant’. In the Irish context, this complicates efforts to identify apothecaries in particular. 104 TCD, MS 829, Deposition of Thomas Browne, 19 Nov. 1642, fos 150r-​1v. 105 TCD, MS 836, Deposition of John and Isabell Gowrly, 8 Nov. 1642, fo. 57r-​v; TCD, MS 830, Deposition of Mary Hamond, 16 Aug. 1643, fos 136r-​7v. 106 TCD, MS 823, Deposition of Therlagh Kelly, 11 Jan. 1643, fos 173r-​5v. 107 TCD, MS 836, Examination of Thomas Dixon, 15 Mar. 1653, fo. 120r-​v. 108 TCD, MS 814, Deposition of Henrie Aylyffe, 27 June 1642, fos 176r-​9v. 109 TCD, MS 829, Deposition of Thomas Andrew, 10 Sept. 1642, fo. 008r-​v 110 Ibid. 111 TCD, MS 821, Deposition of Richard Sheapherd, 7 June 1642, fo. 122r-​v. 112 J. Kelly, ‘Domestic medication and medical care in late early modern Ireland’, in Kelly and Clark (eds), Ireland and Medicine, pp. 109–​35. 113 TCD, MS 813, fo. 342r, contains a list of four medical book titles with what appear to be sale prices. This sheet is bound between two others

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that make up deposition of Margaret Browne and Edward Browne, vicar of Timahoe in Co. Kildare. There does not appear, however, to be any direct connection between the list of books and Browne’s deposition. The books referred to appear to be sixteenth-​century publications of works by Santes Andoynus, Andreas Baccius and Ulrich Hutten, and a collection of medical texts edited by Henricus Stephanus. The Brownes’ deposition is at TCD, MS 813, fos 341r-​3v. 114 TCD, MS 833, Deposition of George Creighton, 15 Apr. 1643, fos 227r-​42v. 115 This was presumably Barnaby Googe’s translation of Foure Books of Husbandres, Collected by M. Conradus Heresbachius, of which numerous editions were published in London between 1577 and 1631. The nobleman referred to was Christopher Plunket, second earl of Fingall, whose seat was at Killeen Castle in Co. Meath. He joined the rebellion and died in prison in Dublin in 1649 following his capture at the battle of Rathmines. 116 TCD, MS 833, Deposition of George Creighton, 15 Apr. 1643, fos 227r-​42v. 117 TCD, MS 813, Deposition of Edward Williamsonn, 8 Jan. 1644, fo. 312r-​v. 118 TCD, MS 830, Deposition of Ann Frere, 8 Jan. 1644, fos 32r-​3v. The deposition does not explicitly refer to Frere as a clergyman, but there were several churchmen of that name in the period. 119 Ibid. 120 For a recent publication showing some of the research possibilities, see F. Dillane, N. McAreavey and E. Pine (eds), The Body in Pain in Irish Literature and Culture (Basingstoke, 2016).

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4

Promoting medical change in Restoration Ireland: the chemical revolution and the patronage of James Butler, duke of Ormond (1610–​88) Peter Elmer We know precious little of the place of medicine in Early Modern Ireland. By and large, understanding of medicine and its practitioners has been largely neglected by historians of the period, often through a mistaken sense of the unknowable quality of the subject. While our understanding of medicine and medical developments elsewhere in Europe at this time has grown exponentially in recent years, Ireland remains a backwater for Early Modern medical historians. In recent years, however, there is growing evidence that such attitudes are undergoing a radical sea-​change. Despite the severe and very real obstacles posed to researchers in the field by a depleted archival base, new research, allied to older developments, suggests that radical new insights are possible and achievable. In this chapter, I wish to focus on medical developments in the period after 1660, one which has received little scholarly attention hitherto. In the process, I  aim to show that Ireland in this period, like other parts of the British Isles as well as continental Europe, did participate in, and welcome, medical innovation as part of a wider process of cultural and intellectual regeneration. At the same time, I aim to demonstrate that such developments owed much to the support of leading figures within the Irish political establishment, most notably that provided by its most senior and powerful spokesman, James Butler, duke of Ormond (1610–​88). Butler’s long career in British politics has been studied from many angles, though none, as far as I am aware, have commented upon his particular predilection for, and encouragement of, chemical medicine.1

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Most closely associated with the pioneering work of the Swiss alchemist and physician Paracelsus (1493–​1541) and his seventeenth-​century admirer John Baptist van Helmont (1580–​1644), the proponents of chemical medicine threatened to overthrow the classical system of Galen, and to destroy in the process the institutional authority claimed by those who practised the learned art of humoral medicine. During the course of the sixteenth and seventeenth centuries, the chemists came close to achieving such outcomes, often through the support of powerful and sympathetic figures within the courts of Early Modern Europe, including kings and emperors. In such instances, the manipulation of patronage networks, linking client physicians with powerful patrons, provided an opportunity for the chemists to promote new cures and theories and thus inaugurate a new, golden age of medical reform. One such instance is provided by the example of the restored court of Charles II, where large numbers of courtiers shared the new monarch’s taste for chemical experimentation and medical novelty. And among those courtiers, none was a greater fan of the new medicine than James Butler, duke of Ormond, whose own control of an intricate web of Anglo-​Irish patronage networks meant that he was singularly well placed to promote medical change in his native Ireland. Ormond’s support for the purveyors of chemical medicines was undoubtedly underscored by a critical appreciation of the role that he believed such men might play in the wider regeneration of the social, cultural and commercial life of Ireland after 1660. It was such thinking that underpinned Ormond’s patronage of the chemical physician Peter Belon or Bellon in the 1670s, and their joint enterprise in seeking to create a new spa at Chapelizod, which, if successful, promised to integrate Ireland more fully into the cultural and medical life of Europe. Background to medical reform: the Cromwellian advances of the 1650s

The central developments which I discuss in the bulk of this chapter clearly owed something to the important developments that had taken place in Ireland in the years immediately prior to the Restoration of Charles II in 1660. Following the Cromwellian conquest, English medical men, most of whom were distinctively ‘modern’ in their approach to medicine, were to play a prominent role in the government and administration of Ireland. William Petty (1620–​87), Benjamin Worsley (1618–​77), Robert Child (1613–​54) and Robert Wood

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(c. 1622–​85) were all active agents of Cromwellian rule. As members or correspondents of the Hartlib circle, a diverse group of intellectuals and reformers committed to the Baconian principles of scientific improvement and progress, they were also eager to promote Ireland as a laboratory for social, economic, religious, political and intellectual regeneration.2 The use of the term ‘laboratory’ is particularly apt in this respect as many of those medical men who opted to serve in Ireland in the 1650s were often committed exponents of the chemical ideas and practices of Paracelsus and van Helmont. Worsley and Child, for example, were both evangelical in their support for chemical medicine. It has recently been suggested, moreover, that Petty’s desire to effect a ‘transmutation’ in Irish political life was a natural outgrowth of his interest in iatrochemistry, albeit within a mechanistic framework.3 Others supportive of medical chemistry included prominent figures like Cromwell’s close colleague and advisor Jonathan Goddard (d.1675), who accompanied Cromwell to Ireland in 1649, as well as Humphrey Brooke (1619–​93), the son-​in-​law of the Leveller and Helmontian physician William Walwyn, who served as a doctor in the north of Ireland in the early 1650s.4 Contemporary discussion of Ireland’s medical needs frequently depicted it as a land devoid of trained physicians and surgeons. Joseph Waterhouse (d. c. 1668), for example, who came over with Cromwell in 1649, made the outlandish claim that he was the only qualified physician to make the journey.5 The situation was probably made worse by the disaffection of native Catholic physicians, and the subsequent attempt by the Cromwellian authorities to deport many to Connaught in the mid-​1650s. Anthony Mulshenogue escaped this fate in 1656, for example, when he successfully petitioned the Cromwellian authorities in Co. Cork on the grounds that the area would otherwise be ‘destitute of physicians of his ability’.6 Nonetheless, Ireland did become an increasingly attractive option for English medical men seeking employment in the 1650s, while many others, often with no or little previous medical experience, would appear to have cut their teeth here at this time. Interestingly, many were themselves former émigrés and refugees who had fled a Europe convulsed by wars of religion in the 1620s and 1630s. Among their number was the Bohemian exile Adam Strialio or Stryall, who had served in the New Model Army under Sir Thomas Fairfax, as well as the well-​ travelled German Paracelsian Johann Unmussig or Brun (d. c. 1676), who settled in Cork and acted as physician to the English garrison in and about the city.7 To their number,

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we should also add the Dutch-​born brothers Arnold (1606–​53) and Gerard Boate (1604–​50), who both possessed medical doctorates from Leiden University and shared a passionate interest in medical and intellectual reform. In 1652, Gerard published a Baconian natural history of Ireland that was destined to act as a major stimulus to the Cromwellian settlement and exploitation of the country by English newcomers in the later part of the decade.8 One of the more interesting and unexpected aspects of the approach of some of these men to Irish medicine was their belief that native Irish practitioners may have something to teach the newcomers. Robert Child, for example, who had spent many years in America, claimed on the hearsay of van Helmont that Irish physicians were privy to many valuable medical secrets or arcana that were ‘preserved and imparted from one family to another’.9 Likewise, a number of members of the family of Richard Boyle, first earl of Cork, including his celebrated natural philosopher son Robert Boyle and daughter Catherine, Lady Ranelagh (both members of the Hartlib circle), enthusiastically reported the strange and wonderful cures of native Irish healers. In 1649, for example, they informed Hartlib of the cures performed in London by an Irish gentleman named Kertcher, who was said to possess a mysterious sympathetic powder for the toothache as well as the ability to heal agues and even the plague by stroking parts of the body with his hands in a manner highly reminiscent of the later Irish miracle healer Valentine Greatrakes.10 The overriding message imparted by English settlers in the 1650s, however, was to suggest, in the words of Gerard Boate, that the English were ‘the introducers of all good things in Ireland’.11 Ireland thus became in the English imagination a land of opportunity –​a fresh canvas where physicians, like other adventurers, might flourish in a land that lagged far behind its continental and British neighbours. Historians have thus tended to downplay the significance of medical developments in Ireland prior to 1660. For Barnard, ‘it was a measure of how far behind London Ireland lagged’ that progress in the 1650s should consist solely in the establishment in Dublin of a College of Physicians in 1654 (not granted formal recognition until 1667), a belated attempt to create a regulatory body for medical practice that, like its London counterpart, aimed to preserve the monopolistic authority of graduate physicians. He adds, citing Charles Webster, that the disputes between the Galenists and chemical physicians, such a distinctive feature of English medicine in the 1650s, were ‘a luxury which Dublin could not afford’.12

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Restoration Ireland, chemistry and the duke of Ormond

If one accepts at face value the idea that medical reform in Ireland, as in England, was primarily a by-​product of the puritan zeal for change unleashed by the victory of parliamentarian armies in the 1640s  –​a view largely unchallenged since the ground-​breaking work of Charles Webster in 1975 –​then it is natural to assume that the impetus to medical innovation in Ireland, as in England, must have faltered after the Restoration of Charles II in 1660.13 However, there is a great deal of evidence to suggest that such an assumption is erroneous and is open to challenge on numerous fronts. Here, I wish to focus on the Irish context of this issue, and to suggest that far from withering on the vine, support for medical innovation, including iatrochemistry, continued to flourish in Ireland, as in England, after 1660, particularly as a result of the support it received from powerful patrons such as James Butler, duke of Ormond. In England, the most obvious manifestation of the continuing interest in the ideas and practices of the chemical physicians is provided by the attempt in 1665 of a group of like-​minded men calling themselves the Society of Chemical Physicians to overthrow the elitist and monopolistic authority wielded by the College of Physicians in London. Medical historians have proposed numerous explanations for the emergence of this new, reformist group. All of these explanations focus to some extent on the roots of the movement, like that of the Royal Society, in the so-​called ‘puritan revolution’ of the previous two decades.14 Detailed study of the membership of this group, however, reveals that support for chemical medicine far surpassed the narrow boundaries of civil war puritanism. One of the more interesting features of the Society of Chemical Physicians was the ability of its members, many of them based at court, to recruit the support and patronage of many of the leading figures within the restored royalist and Anglican establishment.15 Elsewhere, I  have foregrounded the particular role played in this process by Gilbert Sheldon, archbishop of Canterbury. Here, however, I wish to explore the similar role played by another signatory of the Society’s petition in 1665  –​James Butler, first duke of Ormond  –​within the context of Ireland and Irish engagement with medical reform after 1660. Ormond, through the many offices and posts he held after the Restoration, both in England and Ireland, found himself at the centre of a complex system of patron–​client networks that allowed him free rein

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to support and encourage a range of personal initiatives and aspirations. Among these was a strong faith in the virtues of a reformed medicine based on iatrochemical lines. As chancellor of Oxford University, for example, he supported the grant of an MD to William Aglionby (d.1705), an early fellow of the Royal Society, who was responsible in 1668 for publishing a translation of The Art of Chemistry by the French royal chemist Pierre Thibaut.16 He did much the same in his capacity as lord lieutenant of Ireland in January 1664, when he recommended John Archer for an MD from Trinity College Dublin. In his original petition to Ormond, Archer, an enthusiastic exponent of chemical physic, claimed to have studied and practised medicine in Dublin for seven years and to have been impeded in obtaining a medical degree at Trinity through the obstructive behaviour of unsympathetic colleagues. He may also have harboured royalist sympathies, as he claimed to have lost assets to the value of £1,000 through sequestration in his native England.17 Following the award of his degree, Archer returned to England where, in 1670, he was appointed as ‘chemical physician’ to the court of Charles II. Typically, like so many other chemists, he suffered at the hands of the College of Physicians in London, which frequently sought to prosecute Archer for his perceived medical ignorance. At the same time, he demonstrated himself a true heir to the Cromwellian Hartlibians through his passionate advocacy of numerous schemes and inventions that included a vapour bath, oven and a one-​horse chariot.18 Ormond, moreover, was not merely a passive supporter of the new medicine. He also played a prominent role in promoting its wider benefits by employing a number of high-​profile chemical physicians. Among those who served the duke was the Catholic physician William Fogarty (d.1678), who may have encouraged Ormond’s early interest in matters hermetical and alchemical. In 1652, Hartlib’s son-​in-​law Samuel Clodius (1629–​1702) reported that Fogarty had discovered the manuscripts of one Hugens, former servant to the adept Dr Butler, whose secrets were widely sought after among the Helmontians. They included several volumes of medical and alchemical papers which Fogarty offered to show Clodius ‘upon condition that he should explain the doubtful and enigmaticall passages unto him’.19 The most eminent physician to serve the duke was undoubtedly the Yorkshireman William Currer (d.1668), a medical graduate of Leiden with strong Irish connections. He had served there as a royalist officer in the 1640s and was later appointed physician general to the army in Ireland following the Restoration. Five years later, Currer signed the petition

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of the Society of Chemical Physicians in London, no doubt with the approval of his patron the duke. Currer, it would appear, also served as physician to Ormond and his household. In 1667, the year in which he was appointed one of the founder members of the new College of Physicians in Dublin, Currer was accused by three colleagues of killing a servant of the duke’s with one of his chemically prepared pills.20 Currer, it should be noted, was not alone among the medical signatories of the Chemists’ petition in possessing Irish links. The principal organiser of the petition, Thomas O’Dowde (d.1665), who held a minor post at the court of Charles II, was an Irishman who had suffered for his loyalty in the 1650s and was keen to recover some of his father’s forfeited estates in Ireland.21 Likewise, Robert Bathurst was born at Bandon in Co. Cork, and his brother-​in-​law Edward Bolnest (d.1703), another co-​ signatory, served as a soldier in Ireland in the 1650s.22 The armed forces, of course, frequently provided a breeding ground for medical innovation, and it is noticeable how many of the signatories to the chemists’ petition possessed military and naval connections. One of the most prominent, John Troutbeck (1612–​84), a protégé of George Monck who played a minor role in the restoration of the king, had himself served as an army surgeon in Ireland in 1652. Others such as Everard Maynwaring (d.1713) had studied medicine at Dublin in the 1650s, though in Maynwaring’s case there is no evidence that he was as yet converted to the virtues of chemical medicines.23 The duke of Ormond’s patronage of men like John Archer and William Currer clearly stemmed from a personal preference for the new cures and methods of the iatrochemists. But, as is evident in the cases of other aristocrats who signed the chemists’ petition, such support also stemmed from a more general faith in the wider economic, social and political benefits that powerful figures like Ormond associated with chemistry. Many of those who supported the London chemists in 1665 were actively engaged in schemes designed to exploit the mineral wealth of Britain. Ormond’s brother-​in-​law and co-​signatory Sir George Hamilton (c. 1608–​79), for example, was granted a royal warrant to dig mines north of the River Trent and in Wales in 1661.24 Likewise, Ormond’s friend and fellow royalist Sir Geoffrey Shakerley (1619–​96), part of a network of Cheshire gentry who supported the chemists in 1665, was involved in a scheme to extract silver from lead ore in north Wales in 1670.25 Chemical expertise was clearly highly valued in the mining industry, in which many chemical physicians, not surprisingly, found valuable employ. Currer, for example, had undertaken

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a special study of Irish mines as part of a general investigation into the natural history of the country. At the same time, he invested heavily in coal mining in his native Yorkshire with the Irish aristocrat, Richard Boyle, second earl of Cork, as well as acting as a consultant to Lord Mohun in relation to his mining interests in Cornwall in 1653.26

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Ormond, Peter Belon and the Irish spa

It seems highly likely therefore that Ormond was fully conscious of the wider potential advantages of investment in, and support for, those who claimed an expertise in ‘chymistry’ and chemical medicines. This is strikingly evident in the aged duke’s support for an English chemist of French heritage named Peter or Pierre Belon, who in 1684 proposed, with Ormond’s backing, to create a new spa at Chapelizod, located on the outskirts of Dublin. Belon’s career was strikingly similar to that of a number of his chemical colleagues. He first came to public attention in 1664, when, describing himself as a ‘student in chymistry’, he published a translation of the work of the celebrated French chemist Nicholas Lefevre, who, as operator to Charles II, was to sign the chemists’ petition in 1665.27 In the same year, he sought to secure an ecclesiastical licence to practice medicine and surgery in England, testimonials certifying that Belon was a Londoner by birth, was well skilled in medicine and surgery, including optical ailments, and was well versed in all aspects of pharmacy and chemistry. No licence, however, was granted in 1664, nor in 1667, when it would appear Belon was once more turned down by the licensing authorities.28 A  year later, in 1668, he would appear to have been taken under the wing of the court, where he held minor office as ‘one of his Majesties Servants in Ordinary’.29 In all likelihood, Belon had attached himself to the circle of George Villiers, second duke of Buckingham, whose passion for chemistry was second only to the restored monarch. This much is evident from Belon’s dedication to Buckingham of his translation of a work of religious propaganda entitled The King-​Killing Doctrine of the Jesuits (1679), in which he explicitly states that ‘I could not render your Grace a more acceptable service, during the present respite of my duty in your Grace’s famous Laboratory’.30 Belon, meanwhile, was developing his own medicines from a laboratory at lodgings in Covent Garden, which he advertised in a work published in 1675. In a dedication to the president of the College of Physicians, Sir George Ent (1604–​89), Belon claimed to have travelled

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the Christian world for many years, labouring all of this time in the theory and practice of chymistry. Among those he praised, and with whom he may have worked, was the Huguenot and royal physician Dr Theodore Mayerne (1573–​1655) and the Frenchman Lazare Riverière or Riverius (1589–​1655), both prominent advocates of the benefits of chemically prepared medicines. Unlike many fellow chemists, however, Belon was keen to build bridges with sympathetic colleagues within the London College. He thus went out of his way to defend his decision to publish the composition of his medicines as an act that was done ‘without the least design of entrenching upon the Prerogative of the most Learned and Eminent College of Physicians whom … I humbly intreat, as well as all other Ingenious Artists, and Lovers of the Scientifick Art, to favour me with their Opinion and Approbation of this Remedy, and honour me with their Company at my Laboratory during the time of the Operations’.31 Belon’s cosmopolitan outlook, a product of his French roots and subsequent travels, is also evident in his other career as an author and translator of novels, plays and miscellaneous publications emanating from various parts of continental Europe. Indeed, his appointment at court may well have owed as much to his talents in this field as it did to his interest in chymistry. In 1675, for example, Belon’s comedy The Mock Duellist was performed at the Theatre Royal by the king’s players.32 Belon’s staunch Huguenot sympathies, literary talent and medical interests, honed in London after the Restoration, were clearly in tune with the religious and cultural imperatives of many aristocrats at the court of Charles II, including, as we have seen, the duke of Buckingham. Not surprisingly, they also excited the interest of James Butler, duke of Ormond, whose support for the Huguenot cause was both profound and long-​standing. Following many years in exile in France, Ormond had established firm connections with many leading French Protestants in Paris and Normandy and was eager to encourage Huguenot refugees to settle in Ireland, where he hoped they would stimulate the local economy by introducing new skills and much-​needed industrial expertise.33 There is little doubt then that Ormond’s invitation to Belon to move to Dublin and help establish a medical spa at Chapelizod, close to the viceregal retreat, formed part of the duke’s wider strategy of economic and cultural regeneration for Ireland’s capital city.34 Encouraged by the duke’s passion and commitment, Belon left for Dublin in 1684, where he hoped to spend the ‘remainder of my days, in the Service of my most Gracious King, in this his Kingdom, under your Grace’s Favour and Protection’.35 He would appear to have immediately

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set about the task of subjecting the waters of Chapelizod to chemical examination, publishing the results in a small book that was intended to advertise not only the virtues of the waters but also the wider economic and cultural benefits that were likely to accrue from the establishment of an Irish spa modelled on British and European counterparts.36 Medically speaking, The Irish Spaw is primarily Paracelsian in tone, with frequent references to the spiritus mundi and tria prima or three principles of salt, sulphur and mercury, which Paracelsus upheld as the principal elements of the material world.37 Optimistic as to the likely benefits of Chapelizod’s waters, Belon compared them favourably to those of the duke’s bagnio at Long Acre in London, which, he claimed, unlike those in Dublin, were not conducive to artificial improvement.38 The citation of the example of the duke’s bagnio is interesting given the fact that the London establishment operated as an important social and cultural space in the city, attempting to replicate to some extent the kind of facilities one might expect to find at typical country spas such as Bath, Epsom and Tunbridge. There is little doubt that a similar role was envisaged for Chapelizod. In a post-​script to The Irish Spaw, Belon foresaw the spa as promoting a wide range of cultural pursuits, including music, sport, shooting, lotteries and other pastimes that were intended to ‘disengage the mind from too serious or melancholick thoughts’.39 Conclusion

Little is known of the success or failure of the venture at Chapelizod. The village itself had hosted a small settlement of Huguenots since 1671, which under Ormond’s guidance and that of his deputy Richard Lawrence (d.1684) was intended to form the basis of a revitalised linen industry. In all likelihood, the grand scheme to create a spa was mothballed following the death of the duke in 1688 and the disruptions caused by the Williamite wars. Nonetheless, many Huguenots, including many surgeons and physicians, did continue to settle in Ireland, attracted no doubt by the opportunities of service in the armies of the Protestant settlement. Ormond himself clearly played an important role in this process. In 1682, for example, he tried but failed to encourage the eminent Parisian physician Philip Guide (d.1716), a medical graduate of Montpellier, to serve as his personal physician in Dublin.40 Over a decade earlier, Guide’s co-​religionist Daniel de Mazieres des Fontaines-​ Voutron was chosen as William Currer’s successor as physician-​general to the army in Ireland.41

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Ireland, as in the period of Cromwellian rule, continued to act as a magnet then for both British and Huguenot medical men after 1660. In the process, the country and its institutions became increasingly open to new developments in medicine, including a greater receptivity to chemical medicine. Among those, for example, elected to the re-​established College of Physicians in Dublin after 1660 were two prominent advocates of iatrochemistry, John Unmussig alias Brun and Timothy Byfield (1651–​1723). The former, whose career in Ireland pre-​dated the civil wars, was admitted a fellow in 1667.42 Byfield, on the other hand, would appear to have settled in Dublin sometime around 1670, after a brief period of study at Cambridge.43 He was elected a fellow of the Dublin College of Physicians on 12 February 1676, practising in the city for about five years before returning to England and a prolific career as a publisher of medical works. In a number of these, Byfield makes clear that it was while practising in Dublin that he first encountered the medical ideas of Paracelsus and van Helmont.44 Back in London, Byfield, like John Archer (above), proved to be a thorn in the side of the College of Physicians, who consistently sought to outlaw his practice. Intriguingly, in the light of Belon’s career, he also wrote approvingly of the benefits of several local London spas and bagnios, including the celebrated duke’s bagnio in Long Acre, which Belon had commented upon in his own work on the spa at Chapelizod.45 As the careers of physicians like Archer, Unmussig and Byfield suggest, Dublin was becoming an increasingly congenial location for those open to medical and scientific change. And moreover, this was a process that gathered pace towards the end of the seventeenth century as evidenced by the emergence of new institutions such as the Dublin Philosophical Society, founded by William Molyneux (1656–​98), brother of the physician Sir Thomas Molyneux (1661–​1733). Ormond’s role in promoting schemes such as the spa at Chapelizod should thus be seen as part of a long-​term development in Irish medical and intellectual life, linking the Cromwellian age of the Hartlibians with that of the early Irish Enlightenment. Undoubtedly, there is still a great more to learn about the nature of medicine and medical practice in post-​Restoration Ireland, and many questions remain unanswered. However, as I hope to have shown here, there is strong evidence to confirm the view of Toby Barnard that the period after 1660 did not mark the end of intellectual revival in Ireland but rather witnessed a continuing engagement with, and interest in, those wider medical developments taking place in England and Europe at this time.46

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Notes 1 The best recent study of Ormond can be found in the collection of essays edited by Toby Barnard and Jane Fenlon; see their The Dukes of Ormonde 1610–​1745 (Woodbridge, 2000). 2 The Hartlibian engagement with Ireland is fully discussed in T. Barnard, Cromwellian Ireland (Oxford, 1975), pp. 213–​ 48; T. Barnard, ‘The Hartlib Circle and the cult and culture of improvement in Ireland’, in M. Greengrass, M. Leslie and T. Raylor (eds), Samuel Hartlib and Universal Reformation: Studies in Intellectual Communication (Cambridge, 1994), pp. 281–​97. For Worsley’s service in Ireland, see especially T. Leng, Benjamin Worsley (1618–​1677) (Woodbridge, 2008), pp. 80–​94. 3 T. McCormick, ‘ “A proportionable mixture”:  William Petty, political arithmetic, and the transmutation of the Irish’, in C. A. Dennehy (ed.), Restoration Ireland:  Always Settling and Never Settled (Farnham, 2008), p. 134. 4 Goddard, a Cambridge MP and fellow of the College of Physicians, was subsequently rewarded for his service on campaign in Ireland and Scotland with the wardenship of Merton College, Oxford. He also sat in the Barebones Parliament as MP for Oxford University. Interestingly, the author of a scurrilous royalist account of Goddard’s departure for Ireland in the summer of 1649 seems to have confused Dr Goddard, ‘the Holborne mountebank … who out of a handfull of dead-​mens-​bones can extract an Universall medicine’, with his namesake William Goddard (d.1670); Mercurius Elencticus, no. 10 (25 June–​2 July 1649). Goddard later signed the petition in favour of a Society of Chemical Physicians (see below) in 1665. Humphrey Brooke served the army in the north of Ireland in 1651. A few months prior to leaving, he enquired of Elias Ashmole as to whether he might get ‘any of Dr Currer’s skill in transmutation of metal or not’; Calendar of State Papers Domestic (hereafter CSPD):  Interregnum, 1651, p. 541; C. H. Josten (ed.), Elias Ashmole (1617–​1692): His Autobiographical and Historical Notes, His Correspondence, and other Contemporary Sources Relating to His Life and Work (5 vols, Oxford, 1966), ii, p. 551. For Currer, see below. 5 British Library (hereafter BL), Lansdowne MS 823, fos 58, 282, 284, 285. Waterhouse was rewarded for his services to Cromwell’s armies in Ireland with an Oxford MD. He subsequently settled into practice in Dublin and represented Newry in the Irish Convention in March 1660. Earlier claims of medical deficiencies in the parliamentary armies can be found, for example, in a single sheet petition published on behalf of the soldiery in 1648 in which it was claimed that there was ‘not a Surgeon to dresse us, or if a Surgeon, no chest, nor salve, nor oyntments’; The Humble Petition of Us the Parliaments Poore Souldiers in the Army of Ireland (Dublin, 1648). 6 King’s Inn Library, Dublin, Prendergast Papers, vol. 2, pp. 401–​2.

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7 Stryall, of Kingsbridge, Devon, was licensed to practise medicine in the diocese of Exeter in 1632. He was discharged from the army’s service as physician general by Fairfax at Tiverton in December 1645 in order to attend to ‘urgent business which calls him away’. The earl of Essex described him as Adam Stryall Dr of Physic ‘a Bohemian having been divers times employed by me in the great and weighty affairs of the King and Parliament & Kingdom’. Expenses for Stryall and his family to settle in Ireland were paid in June 1652; Devon Record Office, Chanter MS 43, p.  249; The National Archives, Kew (hereafter TNA), SP 28/​36/​V, fos 596, 597, 598, 599, 601, 602, 603; CSPD: Interregnum, 1651–​1652, p. 605. Unmussig was a native of Nassau Dillenburg in Germany, who enjoyed the patronage of the Boyle family. In August 1655, Colonel Robert Phaire presented a petition to the Irish Council on his behalf, giving details of his ‘great care and paynes in the Administration of Phisick’ in the precinct of Cork, especially with regard to the poor whom he treated gratis; National Library of Ireland, Dublin (hereafter NLI), MS 11,961, pp. 127–​8 [dated in error as 7 Aug. 1656]. 8 G. Boate, Irelands Naturall History (London, 1652). For discussion of the significance of this work, see Barnard, ‘Hartlib Circle’, pp. 282–​96. 9 Sheffield University Library, Hartlib Papers, 28/​1/​63A. 10 Ibid., 28/​ 1/​ 2A, 2A-​ B. I  discuss the Boyle family’s predilection for unorthodox medical treatments, including chemical medicines, in The Miraculous Conformist:  Valentine Greatrakes, the Body Politic, and the Politics of Healing in Restoration Britain (Oxford, 2013), pp.  85–​6. For their engagement with, and support for, Unmussig (above), see The Correspondence of Robert Boyle, ed. M.  Hunter, A.  Clericuzio and L. Principe (6 vols, London, 2001), i, pp. 158, 163–​5, 187–​8, 230, 232; iv, p. 394; Royal Society Library and Archives, London (hereafter RSLA), Boyle Papers, 8, fo. 140; NLI, MS 32, fo. 91. 11 Boate, Irelands Naturall History, p. 114. 12 Barnard, Cromwellian Ireland, pp. 241–​2. 13 For Webster, see The Great Instauration:  Science, Medicine and Reform, 1626–​1660 (London, 1975). The central thrust of this work remains unchallenged, despite concerns raised by some, including the present author, as to the extent to which mainstream puritans might be perceived as intellectual and scientific iconoclasts. I aim to deal more fully with the subject in my Medicine and the Politics of Healing in Seventeenth-​Century England (forthcoming). 14 See especially P. Rattansi, ‘The Helmontian-​ Galenist controversy in Restoration England’, Ambix, 12 (1964), pp. 1–​23; C. Webster, ‘English medical reformers of the Puritan revolution: a background to the “Society of Chemical Physitians” ’, Ambix, 14 (1967), pp. 16–​41. 15 For an attempt to shift the focus of the debate towards the role of the court and patronage in understanding the emergence and ultimate demise of

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the chemists’ goals, see H. Cook, ‘The Society of Chemical Physicians, the new philosophy, and the Restoration court’, Bulletin of the History of Medicine (hereafter BHoM), 61 (1987), pp. 61–​77. For a growing awareness of the important role played by courtly patronage in medicine and medical reform, see V. Nutton (ed.), Medicine at the Courts of Europe, 1500–​1837 (London and New York, 1990); B. T. Moran, The Alchemical World of the German Court:  Occult Philosophy and Chemical Medicine in the Circle of Moritz of Hessen (1572–​1632) (Stuttgart, 1991); F. Dawbarn, ‘Patronage and power: the College of Physicians and the Jacobean court’, British Journal for the History of Science, 31 (1998), pp. 1–​19. 16 Historical Manuscripts Commission (hereafter HMC), Calendar of the Manuscripts of the Marquess of Ormonde, ed. F. E. Ball and C. L. Littleton, new series (8 vols, 1902–​20), iv, p.  618. There is no evidence that the degree was granted. For Aglionby, see G. N. Clark, ‘Dr William Aglionby’, Notes and Queries, 12th series, 9 (1921), pp. 141–​3, and more recently C.  A. Hanson, The English Virtuoso:  Art, Medicine, and Antiquarianism in the Age of Empiricism (Chicago, IL and London, 2009), pp. 93–​107. Hanson provides important evidence affirming Aglionby’s continued engagement with medicine and medical practice despite his career as a diplomat. 17 Bodleian Library (hereafter Bodl. Lib.), Carte MS 144, fo. 44r-​v. He may have been the same as the John Archer who was imprisoned in the Tower of London in 1654 on suspicion of treason; CSPD:  Interregnum, 1654, pp. 12, 93, 273, 353. His conspiratorial activities on behalf of the king in exile are refered to in T. Birch (ed.), A Collection of the State Papers of John Thurloe (7 vols, London, 1742), ii, pp. 189–​205. 18 TNA, LC3/​26, fo. 142. Archer’s trials and tribulations at the hands of the College of Physicians, as well as his various publications, are briefly discussed in the article on Archer in the ODNB. Archer’s advertisement for various inventions, which he claimed formed part of a royal project to promote scientific and technological innovation, appear alongside an advert for an ‘elixir proprietatis’ based on Helmontian procedures in John Archer, A Compendious Herbal Discovering the Physical Vertue of all Herbs in this Kingdome and what Planet Rules each Herb (London, 1671). 19 Sheffield University Library, Hartlib Papers, 28/​2/​27B-​28A. Nothing more is known of the whereabouts of the manuscripts, though it is interesting to note that after the death of Fogarty in Newgate in the aftermath of the Popish Plot revelations, in which he was deeply implicated, the family sought to have his papers delivered into the hands of a legal councillor, Sir James Butler, a distant kinsman and protégé of the duke of Ormond. The duke’s interest in the occult is further suggested by John Heydon’s dedication of his Rosicrucian manifesto The Harmony of the World (London, 1662) to Ormond. A year later, one Samuel Horsington alias ‘Paracelsus’ of Dublin petitioned the duke requesting a licence to

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distil and sell strong waters in Ireland. He may well have been related to Thomas Horsington (d.1666), who pledged his support to the chemists’ cause in London in 1665. Bodl. Lib., Carte MS 49, fo. 263. Currer’s clientele also included other members of the Irish aristocracy. In 1657, Lady Broghill described the violent and rapid death of her sister-​in-​law Lady Kildare (1611–​57) at the hands of Currer after taking some of his ‘fisik’; HMC, Seventh Report, Appendix, Part 2 (London, 1879), p. 249. For Currer, see ODNB; I provide fuller details on his career, as well as those of all the signatories to the chemists’ petition, in an appendix to my forthcoming Medicine and the Politics of Healing in Seventeenth-​Century England (forthcoming). For O’Dowde’s Irish roots and subsequent trials and tribulations, see especially the account of his daughter Mary Trye in Medicatrix (London, 1675), pp. 26–​31. For his attempt to gain compensation for the loss of his father’s Irish estates in the Court of Claims, see Bodl. Lib., Carte MS 67, fos. 36v, 46r, 46v. For Bathurst, chemist, kinsman and ‘servant’ to the duke of Buckingham, see Ralph Thoresby, Ducatus Leodiensis: or, the Topography of the Ancient and Populous Town and Parish of Leedes (London, 1715), p. 13. He was related to Henry Bathurst, attorney general of Munster and recorder of Cork and Kinsale. For Bolnest’s service in Ireland, see TNA, C7/​354/​45. Troutbeck refers to his imminent departure for Ireland with the lord deputy in May 1652 in the course of deliberations with the county committee in Yorkshire over his purchase of sequestrated lands; M. A. E. Green (ed.), Calendar of the Proceedings of the Committee for Compounding, &c, 1643–​1660 (5 vols, London, 1889–​92), iii, pp. 2229–​30. Maynwaring received his MD from Trinity College Dublin, in 1655. For a reappraisal of Maynwaring’s life and career, see especially J. Barry, ‘The “compleat physician” and experimentation in medicines: Everard Maynwaring (c.1629–​ 1713) and the Restoration debate on medical reform in London’, Medical History, 62 (2018), pp. 155–​76. CSPD: Charles II, 1660–​1661, p. 504. For Hamilton, see ODNB. In addition to Hamilton, Ormond’s kinsman Edmund Butler, fourth viscount Mountgarett (d.1679), was another courtier to add his signature to the chemists’ petition. CSPD: Charles II, 1670, with Addenda, 1660–​1670, p. 148. For an overview of Shakerley’s political career, see especially B. Henning (ed.), The History of Parliament: The House of Commons, 1660–​1690 (3 vols, London, 1983), iii, pp. 426–​7. Chatsworth House, Lismore MS 29, Diary of 2nd earl of Cork, sub 27, 29 December, 28 January 1650/​1 and passim; Lismore MS 30, Currer to earl of Cork, 1 December 1658, no. 46; Sheffield University Library, Hartlib Papers 28/​2/​12A; Josten (ed.), Elias Ashmole, ii, p. 654.

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27 Nicolas Lefevre, A Discourse Upon Sr Walter Rawleigh’s Great Cordial (London, 1664). 28 Lambeth Palace Library, London, VX 1A/​10/​3/​1–​2. It was highly unusual for the ecclesiastical licensing bodies in London to reject applications from chemical physicians. The fact that Belon’s testimonials were counter-​ signed by the old puritan Sir Edward Alston, then president of the College of Physicians, may have been a factor. For Sheldon’s antipathy towards the puritan-​dominated College in this period, see my Medicine and the Politics of Healing in Seventeenth-​Century England (forthcoming). 29 Belon was seeking protection from wrongful arrest and distraint of goods as a servant of the crown at Whitehall. The case was heard by the House of Lords in February 1668. Two Westminster under-​bailiffs were subsequently reprimanded and Belon’s goods returned; Journal of the House of Lords (39 vols, London, 1767–​1830), xii, pp. 185, 201. 30 Antoine Arnauld, The King-​Killing Doctrine of the Jesuits (London, 1679), sig. A2v. 31 P. Bellon, Physiomathetes, The Potable Balsom of Life. Being a Collection of the Choicest Preservatives that are Extant within the Three Natural Families of Minerals, Vegetables, and Animals, Reduced into such Essences and Tinctures by the Scientifick Art of Chymie (London, 1675), p. 1. 32 P. B., gent, The Mock Duellist, or, The French Vallet. A Comedy. Acted at the Theatre Royal, by His Majesties Servants (London, 1675). The attribution of this and numerous further novels and plays to Belon is made in S. Halkett and J. Laing (eds), A Dictionary of the Anonymous and Pseudonymous Literature of Great Britain (4 vols, Edinburgh, 1882–​88), ii, col. 1636. Ten further translations and novels followed between 1680 and 1692, many decidedly anti-​Catholic in tone. Belon, moreover, was almost certainly the same as the P.B., gent, who was responsible in 1690 for the publication of Several Letters Written by Some French Protestants Now Refug’d in Germany, from the Tyrannical Persecution of France. Concerning the Unity of the Church (London, 1690). 33 R. Hylton, ‘Dublin’s Huguenot Refuge, 1662–​1817’, Dublin Historical Record, 40 (1986), p. 15. For a broad overview of the Huguenot impact upon Ireland, see especially C. E. J. Caldicott, H. Gough and J. P. Pittion (eds), The Huguenots and Ireland:  Anatomy of an Emigration (Dublin, 1987) and more recently R. Hylton, Ireland’s Huguenots and Their Refuge, 1662–​1745: An Unlikely Haven (Brighton and Portland, OR, 2005). 34 For the growth of Dublin as a social, economic and cultural centre in the late seventeenth and eighteenth centuries, see especially T. Barnard, Making the Grand Figure:  Lives and Possessions in Ireland, 1641–​1770 (New Haven, CT and London, 2004), pp. 282–​309. 35 P. Bellon, The Irish Spaw:  Being a Short Discourse on Mineral Waters in General. With a Way of Improving by Art Weakly Impregnated Mineral

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Waters. And a Brief Account of the Mineral Waters at Chappel-​Izod near Dublin (Dublin, 1684), sigs A2r-​v. 36 For a general account of the development of the spa in Ireland, see J. Kelly, ‘ “Drinking the waters”:  balneotherapeutic medicine in Ireland, 1660–​ 1850’, Studia Hibernica, 35 (2008–​9), pp. 99–​146. 37 Bellon, Irish Spaw, pp. 13, 59. 38 Ibid., pp.  64–​5. The virtues of the waters of the duke’s bagnio had recently been lauded by the London ‘empiric’ Samuel Haworth, who also served as physician to James, duke of York. See his A Description of the Duke’s Bagnio and of the Mineral Bath and New Spaw Thereunto Belonging (London, 1683). 39 Bellon, Irish Spaw, pp. 74–​6. The postscript to The Irish Spaw (pp. 68–​9) also advertised an earlier work by Belon, no copies of which seem to have survived, entitled A New Mystery in Physick, Discovered by Curing of Feavers and Agues with the Jesuits Powder, published at London by William Crook at the Green Dragon without Temple Bar in 1681. 40 HMC, Seventh Report, Appendix, Part 1 (London, 1879), p. 372. Guide opted instead to settle in London, where he was made a licentiate of the College of Physicians and became a founding member of the dispensary movement, which aimed to establish a profit-​sharing group practice in the capital dedicated to the medical needs of the poor; W. Munk, The Roll of the Royal College of Physicians of London (3 vols, London, 1878), i, p. 429; Oracle for the Sick (London, 1687), ‘To the reader’. 41 His tenure was not a happy one. He repeatedly complained about delays in receiving his salary as well as being targeted and undermined by fellow physicians, mostly Catholics, who sought his removal. In desperation, he wrote, among others, to the natural philosopher Robert Boyle, whom he hoped might intercede with his brother, the earl of Orrery, on his behalf; CSPI, 1669–​1670, Addenda 1625–​1670, p.  67; CSPD:  Charles II, 1671, pp. 116, 290; ibid., 1671–​1672, pp. 61–​2; ibid., 1672, pp. 616, 617; ibid., 1672–​1673, pp. 334, 352–​3; ibid., 1673, p. 80; ibid., 1673–​1675, pp. 142–​ 3, 212; Correspondence of Robert Boyle, iv, pp. 211–​14. 42 T. W. Belcher (ed.), Records of the King and Queen’s College of Physicians in Ireland (Dublin, 1866), p. 106. For Unmussig, see above. 43 J. Venn and J. A. Venn (eds), Alumni Cantabrigienses (4 vols, Cambridge, 1922), i, 149. Byfield was the son of the ejected puritan minister Richard Byfield (d.1664), who would appear to have shared his father’s nonconformist sympathies. In 1675, he married Dorothy Harrison, the daughter of another ejected minister, Dr Thomas Harrison (d.1682), at St Michael’s, Dublin. In later life, Byfield became an active supporter of the millenarian French Prophets in England; A. G. Matthews (ed.), Calamy Revised (Oxford, 1934), pp. 96–​7, 250–​1; B.  Cantwell, Memorials of the Dead, volume XI (1990), p. 142; L. Laborie, Enlightening Enthusiasm: Prophecy

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and Religious Experience in Early Eighteenth-​Century England (Manchester, 2015), pp. 128, 223–​4. 44 Belcher, Records of the King and Queen’s College, p. 106. For works dating Byfield’s medical epiphany to about 1675, see Timothy Byfield, Two Discourses. One of Consumptions … the Other Contains Some Rules of Health (London, 1685), unpaginated preface; Timothy Byfield, A Short Discourse of the Rise, Nature, and Management of the Small-​Pox and All Putrid Fevers (London, 1695), p. 21. He was still in Dublin in 1680, when he signed the College’s accounts; Royal College of Physicians of Ireland (hereafter RCPI), Dublin, Dolin’s Book, fo. 6v. 45 Royal College of Physicians, London, Annals, v, fos 34a, 67a, 72a, 72a-​b, 103a, 103b; vi, pp. 78, 86, 87. Byfield’s brother in law Richard Browne, for whom see ODNB, was an equally outspoken adversary of the College. For Byfield’s promotion of the virtues of spas and spa waters, see The Artificial Spaw or Mineral-​Waters to Drink:  Imitating the German Spaw Water (London, 1684); A Short and Plain Account of the Late-​Found Balsamick Wells at Hoxdon (London, 1687). 46 Barnard, Cromwellian Ireland, pp. 246–​8. One further example of the contribution of Restoration Irish physicians to medical progress is suggested by the publication in 1670 of one of the first illustrated guides in English to obstetrics; see James Wolveridge, Speculum Matricis Hybernicum: or The Irish Midwives Handmaid (London, 1670). Wolveridge (d.1682) practised in Cork, and his work contains laudatory verses by another English-​born physician working in the city, Aquila Smith (d.1690).

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The episcopal and institutional regulation of midwifery in Ireland c. 1615–​1828 Philomena Gorey The regulation of midwives in the Early Modern period prescribed the moral and social conduct of the midwife, placing far greater emphasis on her character and integrity than on her practice and competence. This was because of the important role that the midwife was assigned in performing the sacrament of baptism during childbirth. When the infant was frail or in danger of dying, it was required that she carry out emergency baptism. In such cases of necessity, regulation in the form of maintaining sacramental orthodoxy was regarded as essential. Childbirth was central to domestic life. With little possibility of medical intervention, the dangers that accompanied childbearing and the possibility of a fatal outcome suggests that there was little to be done when an obstetric emergency occurred, and maternal or infant mortality became a certainty.1 In this regard, two key elements of a midwife’s office determined that she should be scrutinised in the management of her practice. On the one hand there was the requirement of her knowledge of the rite of baptism and on the other, the perception that the midwife might resort to magical or unorthodox methods of healing. Both were inextricably linked. Nowhere was the reliance on recipes, potions, charms, relics and verbal incantations more widely felt than in midwifery. These were practised alongside remedial treatments compounded from a range of plants, herbs and minerals.2 In the absence of scientific understanding of the cycle of childbearing and the dangers of pregnancy and labour, popular belief and rituals offered reassurance in times of uncertainty and exceptional need.3 Reliance on popular belief and folk practice by midwives in the birth room, coupled with the intimacy of the exclusively female rituals that took place during confinement and lying-​in, could expose the midwife

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to charges of using magic or the supernatural. She could become the target of suspicion of witchcraft.4 Since the turn of the century, however, scholarship has illustrated how misleading and unbalanced this perception is.5 Nonetheless, ecclesiastical authorities’ direct concern with baptism and the soul of the newborn baby meant that they demanded a central role in the regulation of midwives. They feared that women might use unconventional treatments or have recourse to cunning folk or magical healers.6 There is little precedent for a thorough investigation into the office of midwife in Irish medical historiography. Midwives were nameless birth attendants, who like so many women left very little imprint on surviving historical sources. A paucity of records has resulted in a lack of research on the role of the midwife in childbirth and society in Ireland, particularly in the Early Modern period. A dearth of ecclesiastical sources has deterred research into the regulation of midwives. A fire in the Public Record Office of Ireland (PROI) on 30 June 1922, marking the beginning of the Irish Civil War, destroyed almost all records of English administration in Ireland dating back to the thirteenth century. These included the records of the Church of Ireland, comprising a large mass of ecclesiastical, diocesan and parochial material that had been collected and transferred to the PROI for preservation.7 A treasure trove of ecclesiastical and testamentary collections, including legal proceedings, court appointments, ecclesiastical and genealogical records, census returns, parish registers, visitation papers and vestry minute books from parishes throughout the country were accordingly lost in 1922. Many of these sources had not yet been subjected to rigorous historical analysis.8 Evidence of women engaged in midwifery, in the form of episcopal licences to practice, oaths sworn before taking office, vestry minute books and parish records, is now limited and fragmentary. Fortunately, some Church of Ireland diocesan Articles of Visitation dating from the early seventeenth century survive. Although minuscule by comparison to similar records in England and Europe, the extant visitation articles are an important source that can provide us with confirmation that Irish midwives were subject to regulation comparable to midwives elsewhere. The performance of emergency baptism by midwives and lay people formed part of the ecclesiastical policy of the Church of Ireland and the Counter-​Reformation Catholic Church from the early seventeenth century. A broad range of historical scholarship on the churches in Ireland is thus relevant to the subject of this chapter. The writings

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of Bishops Daniel McCarthy and P. F. Moran in the 1860s were the first to allude to doctrinal decrees which emanated from the Catholic Synods that took place in Ireland in the Counter-​Reformation period after 1615.9 Alison Forrestal has examined the factors and institutions influencing synodal policy, such as socio-​religious customs and the input of parish priests.10 Patrick J.  Corish has explored the fate of Irish Catholics from the beginning of the Reformation through to the political upheavals of the 1790s,11 while Raymond Gillespie has written on the nature of religious belief and its relevance to the realities of everyday life.12 Sean Connolly has provided an account of the circumstances in which the power of the Protestant landed elite class was consolidated after 1660.13 Related to this, Alan Ford’s theological and political studies of the Protestant Reformation in Ireland illustrate the efforts made to forge a Protestant Church of Ireland and to create a distinct Protestant identity.14 Among the relevant primary sources, extant Church of Ireland Articles of Visitation and episcopal visitations provide some evidence of the swearing of an oath by women to acquire a licence to practice before undertaking the office of midwife. Visitations by Catholic bishops from the 1750s, in the dioceses of Cashel and Cloyne and Ross, confirm that midwives were presented to the bishop and received instruction on the performance of baptism at the time of the visitation. This suggests that Irish midwives were subject to similar patterns of supervision as midwives in Britain and Europe.15 In addition, the Journals of the Royal College of Physicians of Ireland allow the historian to trace the obligation the College had to regulate midwifery as the field came to be recognised as an adjunct to surgery in the late seventeenth century. This chapter will argue that regulating midwifery in Ireland bore many similarities to patterns of regulation in Britain and other European countries, yet remained uniquely different because of denominational identity. Catholic households, in the majority in every county outside Ulster, were governed by a Protestant Church and state.16 Since religious unease was far greater than medical anxiety for the life of the baby, the performance of emergency baptism while strictly adhering to the correct sacramental rite, particularly the wording during ablution, was vital. This chapter will explore the endeavours of the Church of Ireland and the Counter-​Reformation Roman Catholic Church to maintain religious orthodoxy during childbirth and implement sacramental uniformity when baptism needed to be performed as an emergency. The chapter will examine the evidence of the regulation

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of midwifery through extant Church of Ireland Articles of Visitation and the indications that Protestant midwives acquired a licence from their diocesan bishop to practice. It will also consider three visitation notes dating from 1752–​1828 compiled by the Catholic archbishop of Cashel, James Butler, Bishop Matthew MacKenna of the diocese of Cloyne and Ross and his successor Bishop William Coppinger, respectively, during their episcopal visitations. It will outline the significant responsibility of the churchwarden and the parish priest who acted on behalf of their bishops to observe the midwife in her capacity as birth attendant. Finally, it will consider the role of the King and Queen’s College of Physicians of Ireland in regulating midwifery from the 1690s, a role it accepted reluctantly. The College acted to supervise practitioners –​both male and female –​only when compelled by circumstances, such as the wane of ecclesiastical authority in medicine and the development of man-​midwifery. The sacrament of baptism and its meaning

The sacrament of baptism formed the fundamental basis for leading a Christian life. The cleansing of the infant with water and anointing with oil was symbolic of redemption from sin and the conferring of spiritual graces on the infant, with its social role understood as introducing the newborn into the church community and kin group.17 Protestant and Catholic understanding of the sacrament varied. According to Catholic teaching baptism was a way of accessing the power of God, a gateway to the other sacraments. It cleansed the infant of original sin and conveyed grace so that the infant could be reborn as a member of the Church of Christ.18 Within Protestantism, baptism was understood as an admission rite to the Church, while grace increased by communion with Jesus Christ.19 The Religious Society of Friends rejected baptism and churching rituals. Quakers began relief work soon after their arrival in Ireland in 1654.20 Extending assistance to poor women at the time of their lying-​ in was part of their mission. Quaker midwives who attended the labours of ‘people of the world’ were to be admonished for participation in the ‘sprinkling of children’, attending christenings or accepting offerings or money at this time. At the national men’s meeting in Dublin in 1677 an epistle was issued that directed Irish Quaker women who took up the office of midwife or nurse on how they should acquit themselves at non-​Quaker births. Members at local meetings were asked to

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looke into & consider whether there be amongst you any women who profess truth [that] take upon them [the] office of a midwife, nurse or nurse-​keepers who have occasion to be employed by [the] world whether they keep truth cleare & keep up their testimonys for [the] Lord in faithfulness & whether any such be present at their sprinkling of children & at their gossip feasts, & receive their offerings money, w[hi]ch at such time is usually given, if any be found to practice such things, they are to be reproved and admonished.21 The confessional divisions within Early Modern Ireland meant that the necessity of performing the sacrament according to the correct rite was keenly felt. The majority of the population was Catholic and so did not belong to the official Church of Ireland.22 The rite of baptism underlined the separation and denominational identity of the Protestant and Catholic communities. Each denomination, therefore, had a stake in ensuring that the spiritual graces of the sacrament were bestowed on the infant at birth. It was in this context that each addressed the probability of baptism by women, by ensuring that midwives and lay people knew the actual wording to be used, according to the guidelines laid down by each Church. Early in the seventeenth century the Catholic Church in Ireland undertook to implement the aims of the Council of Trent, which sought to preserve the Catholic faith against the threat of the Reformation through improvement of its practice.23 In the Protestant Church of Ireland, the Convocation of 1615 approved a series of 104 Articles of Religion. These Irish Articles represented a fuller treatment of matters of faith than the Twelve Articles of 1566.24 Among the canons and decrees associated with baptism were guidelines for the administration of baptism by midwives and lay people, when the life of the infant was deemed to be in danger or the child too ill to be brought to a priest or minister to receive the sacrament. Reformation policy and Protestant baptism

Reform of the Church of Ireland and the establishment of a Protestant ministry was a priority for English administration after the Nine Years War (1594–​1603).25 The drive to establish the Church of Ireland as a national church was hindered by a shortage of suitably qualified clergy and a lack of livings capable of supporting such clergy.26 In 1615 a regal visitation set out to establish accurate information about the livings of the clergy throughout Ireland.27 It confirmed that many Irish sees

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were severely impoverished.28 In the same year, the passing of the Irish Articles by Convocation unequivocally defined the doctrine of the Church of Ireland.29 Successful implementation of Reformation policy was overseen at episcopal visitations.30 Churchwardens oversaw the running of the parish in all fiscal and ecclesiastical matters.31 They were effectively the connection between the bishop and his flock. They prepared the presentments for the visitation of the bishop, swearing an oath prior to each presentment that their inquiries were presented according to the articles given to their charge.32 Articles of Visitation issued in the early seventeenth century reflect the anxiety about the practice of midwives. Articles issued in the 1620s, by Archbishops Hampton, Ussher and Bulkeley, consisted of a one-​page document. Item 19 enquired, ‘Whether bee there anie in your parish that doe use and exercise Charmes, sorceries, Incantations, Invocations, Circles, Witchcrafts, soothsaying, or anie like Arts invented by the Divell, and especially in or at the time of Womens travaile?’33 Visitations gave scope to churchwardens to present women who had transgressed. Among parishioners whom they were obliged to present were the names of those who had given birth to, or nursed, ‘bastards or base begotten children’ since the last visitation.34 Parishioners who used charms, spells, sorcery or witchcraft were to be excommunicated, alongside those who were ‘common drunkards, swearers, blasphemers, incestuous persons, adulterers, fornicators, bawds, perjured persons, extortioners, or oppressors, common scolds, brawlers, slanderers, make-​bates, sowers of discord between party and party, especially between man and wife … or are guilty of any other notorious offence belonging to ecclesiasticall cognisance, or are suspected or defamed to be guilty of the same’.35 Article XXV of the 39 Articles of 1562 had reiterated the traditional belief in baptism being an effectual sign of grace and of dominical institution, and Article XXVII stated that ‘the baptism of young Children is…to be retained in the Church, as most agreeable with the institution of Christ’.36 The 1615 Irish Articles restated this belief in the sacrament.37 Therefore, baptism was celebrated publicly, in the Church, on appointed Sundays, so that infants would enjoy the benefit of the prayers of the whole congregation, while the congregation present would testify to receiving the infant into Christ’s Church. Thus, everyone present would remember his own profession made to God in his Baptism.38 Private baptism or baptism in private houses was not ruled out. However, it was not encouraged except ‘upon a great

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and reasonable cause declared to the Curate, and by him approved’.39 Weak and poorly infants should be brought to the minister as soon as possible. Failing this, the infant who was in danger could be baptised in extremis, or as an emergency, by the midwife or one of the women present, without the ministering of a churchman. Such babies were deemed to be lawfully and sufficiently baptised and would die assured of the graces of the sacrament. However, if the baby lived, parents or godparents were obliged to bring the baby to their minister, so that he could establish that the correct matter and wording was used to baptise, in accordance with the Book of Common Prayer, ‘because some things essential to this sacrament may happen to be omitted through fear or haste in such times of extremity’.40 The Council of Trent and Catholic baptism

Prompted by the Reformation, the Council of Trent was held at intervals between 1545 and 1563. The purpose of the Council was to define and clarify doctrine and the teachings of the Roman Catholic Church and to formulate measures which embodied the Counter-​Reformation.41 The reformers set out to implement change in three areas: the organisation of the church at parish level by bishops empowered by the council to enforce it; the administration of the sacraments, particularly baptism, marriage and funeral customs; and catechesis.42 The diocesan bishop was to implement parochial conformity in the administration of the sacraments within his diocese. The effort to establish such a system focused upon the individual parish and its clergy, who would be obedient to their bishop and implement an efficient drive to guide their parishioners towards sacramental observance and catechesis.43 What this meant was that the faithful Catholic was to receive the Church’s sacraments, other than confirmation, from the hands of his parish priest, who would baptise, marry, give extreme unction and bury him.44 With these measures, the Catholic hierarchy resolved to implement a code of uniform parochial practice which would be universally enforced. Progress in implementation was to be examined by the bishop at the annual visitation of his diocese. Thus, he could ensure the successful completion of Trent’s reforming programme and influence his clergy ‘that in conduct, speech and knowledge they be a guide to the people of God committed to them’.45 Reforming measures undertaken by the Catholic hierarchy, in the areas of doctrine, procedure and morals, were debated and issued at

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synods which were held throughout the seventeenth century. The Synods of Dublin and Armagh, in 1614, paid particular attention to the administration of baptism by women or lay people.46 Both dealt with the procedure to be carried out in the event of the death of an infant during birth. According to the Synod of Dublin, if the infant appeared in danger while still in the uterus, baptism could not be carried out. If a foot or hand was released outside the womb, the limb could be baptised, and after the child was born, if it lived, it could be baptised under condition.47 If, on the other hand, the head had been born, the child could be baptised, even though the gender of the child was not known. Re-​ baptism was never to be carried out. Armagh issued instructions to parish priests to teach lay people that the words were to be pronounced at the same time as the pouring of water: ‘On administering baptism, great care must be taken to pronounce the words at the same time with ablution; and the people are to be taught how to baptize in case of necessity, lest midwives or others should commit fatal errors.’48 The canons and decrees laid down by the post-​Tridentine Catholic Church and the Church of Ireland at the beginning of the seventeenth century, and the role played by parish priests and churchwardens  –​ agents of each church respectively –​in the administration and surveillance of their Churches’ teachings, are significant for the impact they were to have on the success of policy thereafter. Hence, at the beginning of the seventeenth century, both Catholic and Protestant faiths had a system in place, in the persons of the parish priest and the churchwarden who would implement ecclesiastical policy and attempt to regulate the moral and spiritual lives of their flocks. In a similar manner as Protestant clergymen were to eradicate unorthodox practices, priests were urged to hide fertility symbols known as shielnagigs,49 prohibit invocations of the devil, witchcraft, a proliferation of dubious relics and curing prayers, prevent the gathering of magical herbs and stop the preparation of virility potions.50 In this way, the midwife could be observed so as to establish her suitability for office and the management of her practice. The evidence for licensing

The suggestion that medical practitioners were licensed appears in the instructions annexed to the Royal Visitation of 1615 in the Prerogative Office. Item 7 stated that ‘You are alsoe then and there to causes all Clergiemen schoolmasters and all practicing Physick to appear before us and to produce their titles faculties lycences and dispensations’.51

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There is no evidence that licences were presented at this time, but the Annals of St Fin Barre’s Cathedral in Cork confirm that a system of licensing of physicians and midwives was in place, similar to that which was administered in England.52 In 1684 physicians were licensed in the bishop’s court, ‘ad fungendam professionem medicinae’.53 In 1685 and 1686 a number of midwives –​Joana Toogood, M. F. Randolf and Anna Sarnam  –​were also sworn and licensed for the diocese of Cork and Kinsale:54 29 November 1685, Joana Toogood, uxor Jooloffe Twogood, de civit Corck, Licentia fuit obstetrix infra Civit et Dioces Corag. 15 April 1686, M F Randolph jurata obstetrix et licentia circa Kinsale. 19 November 1686, Anna Sarman de parochial Sanctae Trinitatis admissa fuit et jurata obstetrix infra Corck.55 There is no record of the preamble of the oath sworn by these women, but it must have borne some similarity to one contained in a collection of oaths, which was sworn by officials before taking office in public employment which was compiled and published in 1649. This work included a lengthy ‘Oath that is to be administered to a Mid-​wife by the Bishop or his Chancellor of the Diocese, when she is licensed to exercise that Office of Midwife’. The oath was detailed in content and included fifteen conditions that the midwife should adhere to in her practice. It was a test of the midwife’s character and integrity, but offered no guarantee of skill. If the conditions of the oath were to be met, the midwife should display not just moral and selfless qualities, but also confidentiality, and she should guard against the darker elements of concealment, infanticide and witchcraft. She ought to show reverence for the internment of the stillborn infant and exercise responsibility for her deputies. The oath reflected concerns that the midwife was able to perform emergency baptism and that she would have knowledge of anyone who would carry out infanticide or abortion. The oath also exhibited anxiety over the question of illegitimacy and about the practice of sorcery. It prescribed moral characteristics for women who chose to become midwives.56 The oath bears many similarities to a shorter oath sworn by an Irish midwife, a Mrs Elliot, a widow from Kilkenny city, when she was licensed by Charles Este, the Church of Ireland bishop of Ossory c. 1740. The preamble of the oath and the oath itself read as follows:

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Greeting –​Whereas by sufficient Certificate by you to us produced we are satisfied of yr ability to practice as a midwife, we therefore by these presents give you full liberty and lycense to practice and follow the art of midwifery in and thro’ our 3rd Dioces during our pleasure, you having first taken the following oath on the holy Evangelists, that is to say –​ I, –​Elliot, above named, do swear that I will be diligent, faithfull, and ready in my profession of a midwife to help every person, as well the poor as the rich, and that in time of necessity I will not forsake the poor to attend the rich. That I will not force any patient by any paine or ungodly ways to give me any more for my service and attendance that such patient would otherwise do, or than by law and custom ought to be paid. That I  will use no unnecessary delays in curing my patients in order to increase fees or rewards to myself. That I will be secret and not open any matter appertaining to my office, unless necessity constrain me so to do. That I will not make or assign any Deputy, but such as I shall perfectly know and for whose ability and diligence I shall answer. That I will not use and sorcery, divination, magic, incantations, witchcraft, or any superstitions, hellish or horrid methods to heal my patients, to the dishonour of Almighty God. And lastly, that I will, when called upon to the sick, if I find the distemper grow dangerous, advise them above all things to send for a clergyman, the physician of the soul, that when their eternal happiness is provided for, due care may be taken of the body. So help me God.57 Catholic episcopal visitations

There is no evidence that Catholic bishops granted licences to Catholic midwives. The surveillance of her practice was noted at annual visitations by the diocesan bishop rather than the swearing of an oath and the issuing of a licence. On the occasion of their visitations, bishops fulfilled their canonical obligation to examine many aspects of parochial life. The parish priest was obliged to present parishioners who did not attend the sacraments, who might be in adulterous relationships or whose morals were not in line with Catholic teaching. The aim of the visitation was to correct abuses and to instruct the laity on their temporal and spiritual obligations. It ensured sacramental observation by

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the laity and the provision for schooling and teaching. The numbers of midwives in each parish were noted and their knowledge and understanding of the rite of baptism was recorded. Instruction of midwives on the administration of baptism in cases of necessity was frequently undertaken. Thus, at parochial level it was possible to oversee the midwife and her observance of Catholic teaching in the conduct of her practice. The visitation book of Archbishop James Butler of Cashel (1750–​ 74) dates from the middle of the eighteenth century and is composed of visitation notes for the years 1752, 1754, 1758–​60 and 1764.58 At his visitation at the parish of Clounty (Clonoulty), Co. Tipperary, in July 1754, Archbishop Butler noted that Fr Walter Bermingham ‘instructs ye midwifes in his walk concerning ye sacrament of baptism’.59 Similarly, in the parishes of Drumbane and Buolick, also in Tipperary, parish priests instructed midwives.60 Records of visitations in 1758 and 1759 state that ‘midwifes learned to baptize in case of necessity’.61 This was the case in nine parishes including Fethard where Nanny Joyns, Catherine Cudyhy and Julian Ryan and ‘other occasional midwife[s]‌ were instructed in ye manner of baptizing’ by the parish priest Fr Dyer.62 In 1764, Butler recorded the name of a midwife, Mrs Cummins, in the parish of Killosty (Killusty) who was ‘well instructed in ye form of baptizing in case of necessity’.63 At a visitation in 1785, the bishop of Cloyne and Ross, Matthew MacKenna (1769–​91) examined over sixty midwives in twenty-​five parishes, noting those who knew the rite of baptism and those who 1830) were ‘skilled’.64 His successor, William Coppinger (1791–​ carried out more detailed examinations in his 1818 visitation. In the parish of Imogeely, Mary Barry came before him and was deemed to be ‘well instructed’.65 In Midleton he saw three midwives who knew ‘how to baptize and got the necessary directions in cases of abortion and illegitimate pregnancy’, while in Aghada and Cloyne he lectured the midwives himself.66 Mary Hallanan and Johanna Brien were examined in the parish of Donoughmore at Coppinger’s 1821 visitation there, when it was recorded that Brien ‘did not know how to administer the sacrament of Baptism’.67 Midwives Margaret Lyons, Margaret Mullane and Johanna Nagle who did not attend this visitation when summoned were named, along with ‘some others in the extremities of the parish whose names the clergyman did not know’.68 Not all midwives presented themselves for examination. In Banteer, Liscarrol and Ballyhea it was noted that the midwives did not appear,

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while in Rushin (Rusheen), ‘the midwives or schoolmasters were not presented to his Lordship for want of time’.69 Towards the end of Coppinger’s episcopacy, at the visitations in 1824 and 1828, midwives and schoolmasters did not present themselves and there is no mention of either in his visitation notes. Episcopal decrees continued to emanate right into the nineteenth century. One of the latest decrees was issued by the archbishop of Dublin, Daniel Murray, in 1831, which contained sections on baptism similar to those emphasised at synods two hundred years earlier.70 Midwifery and the King and Queen’s College of Physicians

By the late seventeenth century, when Narcissus Marsh held his visitations at St John’s Cathedral in Cashel in 1692 and again in St Patrick’s Cathedral, Dublin, in June 1694 and 1698, the term ‘witchcraft’ no longer appeared in articles. Instead, the archbishop enquired of the churchwarden, ‘Do any in your parish practice physic, chirgurgery or midwifery without licence from the ordinary?’71 Definitive evidence of the decline of episcopal licensing occurred in 1697 when Henry Phoenix applied to Marsh to be licensed in the practice of medicine. Marsh ordered him to apply to the King and Queen’s College of Physicians of Ireland ‘to be examined as to his qualifications for practicing physick’. Phoenix was examined accordingly by the censors of the College and his application for a licence was rejected. The censors found ‘that he own’d himself wholly ignorant of all ye parts of Physick except practice, and Chymetry; but on examination he was found very ignorant of ye differences, mystery and method of cure of diseases, and seemed acquainted with very few Chymical processes, or ye use of chymical remedies’.72 This episode marks a distinction between the old ecclesiastical ties with fatalistic, humoral medicine and a developing clinical science. It also suggests that the arrangement between the Church of Ireland and the College of Physicians worked well for both institutions as religion and science began to converge towards the end of the seventeenth century when ecclesiastical jurisdiction over scientific knowledge began to wane in favour of enlightened thinking with its stress on rationalism.73 Notwithstanding this, belief in witchcraft endured among the educated elite into the eighteenth century and much later among the lower orders.74 Despite the rise in judicial scepticism, decriminalisation and repeal of legislation coupled with condemnation by the Catholic

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clerical hierarchy of many popular superstitions, belief in malefic witchcraft persisted.75 Mary Ann Lyons has illustrated how an influx of English and continental-​trained physicians to Dublin following the Confederate Wars resulted in a critical mass of accomplished physicians locating to Ireland. These men had ties to the College of Physicians in London as well as to the universities at Oxford and Cambridge.76 Among them was the physician Abraham Yarner, who was an officer in the lord lieutenant’s horse troop and subsequently president of the College of Physicians in Ireland. Another new arrival was Sir William Petty, a fellow of the Royal College of Physicians in London who was appointed physician to the army in Ireland in 1652, and became a fellow of the College of Physicians in Dublin. Earlier, in 1636, the Dutch physician Arnold Boate had come to Ireland. He became physician to Archbishop James Ussher and Lord Deputy Wentworth and was appointed as surgeon-​ general for Ireland in 1641.77 The presence of such men in Dublin provided the base upon which an College of Physicians could eventually be established in the city. Despite the ever increasing prominence enjoyed by the College in the later seventeenth century, the extent of its obligation to regulate the practice of midwifery was ambiguous. The first charter of the College, granted in 1667, makes no reference to midwives or indeed to midwifery. A second charter was granted in 1692. The latter charter, of the now renamed King and Queen’s College of Physicians of Ireland, gave power to the College to ‘examine all Middwives and to lycense and allow such as they shall find skillfull and fitt to Exercize that profession and to hinder all such as they shall finde unskillfull from practising’.78 Since the rules of the charter only applied to a radius of seven miles around Dublin, it is unlikely that regulation was implemented or extended beyond this area. The declaration to be taken on admission to the College stated that licentiates should observe the statutes and by-​laws of the College and submit to a Diploma in Midwifery when the president and fellows of the College thought it was ‘proper to inflict’.79 Only six people were admitted as licentiates between 1696 and 1742, two of whom were women, a Mrs Cormack and Catherine Banford. Among the men were Bartholomew Mosse, founder of the Dublin Lying-​in Hospital, and Fielding Ould, who succeeded Mosse as Master of the lying-​in hospital and who is credited with discovering the mechanism of labour.80 After this date practitioners appear to have ignored the College licentiate as the next licences were

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not granted until the 1790s.81 During this time the College thought better of having women on a register of licentiates along with men. The physicians altered the licentiate for women to a certificate for midwifery and nurse tending, where a ‘competent knowledge’ was sufficient ‘to exercise the calling of midwife and nurse tender’. The status of this certificate would also appear to have changed as the gulf between new male knowledge and traditional female practices became apparent. The College awarded these certificates until 1899,82 but their significance decreased when other institutions, particularly the Rotunda Lying-​in Hospital, began to teach midwifery to women from 1777. The College considered the practice of midwifery as suitable only for women and surgeons. It was seen as beneath the calling of physicians, not only because of its mechanical nature, but also because birth was largely seen as a natural process. The unease which the College felt with the matter was illustrated in 1736 when it passed a resolution that no one would be licensed to practice ‘midwifery and physic’ together. Anyone in breach of the regulation would have his licence withdrawn and be fined ten shillings.83 Practitioners such as Bartholomew Mosse, Fielding Ould and others who were to have such an impact on Irish midwifery from the 1740s therefore went abroad for training.84 On their return, they found themselves confronted with a number of considerations. First, their profession was largely unregulated. For every competent practitioner there was any number of unskilled operators, who exploited the growing trend of engaging a male practitioner.85 Second, there were no facilities for instruction and teaching. Midwifery was quickly developing into a science. Medical men were anxious to define and name the many foetal presentations which they were encountering in the course of their practice. Most significantly, they were trying to determine the physiology of labour and perfect what they knew of the second and third stages of the process.86 They looked for the causes and treatment of obstetric emergencies and increasingly focused on the abnormalities of pregnancy and disorders associated with reproduction. Third, they were not only faced with a hostile College of Physicians but had to contend with a growing body of public opinion that believed that out of deference to a woman’s modesty, childbirth was best left to women.87 Mosse and Ould were among a small number of male practitioners in Dublin and part of a wider British and European movement that began to consider midwifery as an adjunct to surgery. The fact that the Dublin College of Physicians resolved to prohibit its members from the

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practice of midwifery in 1736 is an indication of an attempt to regulate what was already an existing trend. When these men returned to Dublin, midwives still had hegemony over normal births. The definition of ‘skill’ in maternal and infant care simply meant the delivery of a live infant and the mother’s recovery to health. Loss of life through obstetric emergency was an accepted part of the dangers of childbearing. Male practitioners established practice just at a time when an emerging belief that these dangers could be dealt with by the trained male practitioner was gaining support and when labour came to be treated as a medical event rather than as a natural process.88 Conclusion

While the Catholic Church and the Church of Ireland had placed strong emphasis on maintaining religious orthodoxy during childbirth and implementing sacramental uniformity, the ecclesiastical supervision of midwives and indeed medical men waned gradually throughout the eighteenth century. New models of teaching and learning in lying-​in hospitals and private medical schools demonstrated the management of pregnancy, labour and obstetric emergencies. This left no place for superstition and unorthodox treatments. Training for male students and pupil midwives was well underway at the Rotunda Lying-​in Hospital in Dublin by the late eighteenth century, followed by the Coombe Women’s Hospital, also in Dublin, and the Cork and Belfast lying-​in hospitals. Midwives who were employed as dispensary midwives from the mid-​nineteenth century provided testimonials from Poor Law medical officers when they sought employment with the Local Government Board.89 The Medical Acts of 1858 and 1886 established a medical council and conditions for registration.90 Midwives were eventually registered with their own regulatory body in the Central Midwives Board with the Midwives (Ireland) Act of 1918.91 Notes 1 P. Crawford, ‘The construction and experience of maternity in seventeenth-​century England’, in V. Fildes (ed.), Women as Mothers in Pre-​ Industrial England (London, 1990), pp. 3–​38; L. A. Pollock, ‘Embarking on a rough passage: the experience of pregnancy in early modern society’, in Fildes (ed.), Women as Mothers, pp. 39–​67; A. Wilson, ‘Participant or patient? Seventeenth century childbirth from the mother’s point of view’, in Roy Porter (ed.), Patients and Practitioners: Lay Perceptions of Medicine

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in Pre-​Industrial Society (Cambridge, 1986), pp. 129–​44; C. Tait, ‘Safely delivered: childbirth, wet-​nursing, gossip-​feasts and churching in Ireland’, Irish Economic Social History, 30 (2003), pp. 1–​23. R. Gillespie, Devoted People: Belief and Religion in Early Modern Ireland (Manchester, 1997), pp. 68, 72, 93–​4, 161; M.  E. Fissell, Vernacular Bodies:  The Politics of Reproduction in Early Modern England (Oxford, 2004), pp. 15–​16, 42, 189, 190; E. Leong and S. Pennell, ‘Recipe collections and the currency of medical knowledge in the early modern “medical marketplace” ’, in M. Jenner and P. Wallis (eds), Medicine and the Market in England and its Colonies c.1450–​1850 (Basingstoke, 2007), pp. 135–​52; E. Leong, ‘Making medicines in the early modern household’, BHoM, 82 (2008), pp. 145–​68; T. R. Forbes, The Midwife and the Witch (New Haven, CT, 1966), pp. 64–​93; A. Forrestal, Catholic Synods in Ireland, 1600–​1690 (Dublin, 1998), pp. 71, 188; Jane Sharp, The Midwives Book: or the Whole Art of Midwifery Discovered, ed. E. Hobby (Oxford, 1999), pp. 127–​8, 198–​9. E. Bever, The Realities of Witchcraft and Popular Magic in Early Modern Europe: Culture, Cognition and Everyday Life (Basingstoke, 2008), p. 339; Forbes, The Midwife and the Witch, pp. vii–​ix. K. Thomas, Religion and the Decline of Magic (Oxford, 1971), pp. 112–​32. D. Harley, ‘Historians as demonologists: the myth of the midwife-​witch’, Social History of Medicine, 3 (1990), pp. 1–​26; H. Marland (ed.), The Art of Midwifery:  Early Modern Midwives in Europe (London, 1993); A. Summers, ‘The mysterious demise of Sarah Gamp:  the domiciliary nurse and her detractors, c. 1830–​1860’, Victorian Studies, 32 (1989), pp. 365–​86. There is no evidence that Irish midwives were associated with witchcraft. See A. Sneddon, Witchcraft and Magic in Ireland (Basingstoke, 2015), pp. 42–​52. E.  C. Lapoint, ‘Irish immunity to witch-​hunting 1534–​1711’, Éire-​Ireland, 37 (1992), pp. 76–​92; R. Gillespie, ‘Women and crime in seventeenth-​century Ireland’, in M. MacCurtain and M. O’Dowd (eds), Women in Early Modern Ireland (Edinburgh, 1991), pp. 45–​9; St. J.  D. Seymour, Irish Witchcraft and Demonology (Dublin, 1913). The Fourteenth Report of the Deputy Keeper of the Public Records in Ireland (Dublin, 1882), p. 2. H. Wood, A Guide to the Records Deposited in the Public Record Office of Ireland (Dublin, 1919), pp. 222–​60; H. Wood, ‘The public records of Ireland before and after 1922’, Transactions of the Royal Historical Society, fourth series, 13 (1930), pp. 17–​49. D. McCarthy (ed.), Collections of Irish Church History from the Manuscripts of the late Very Reverend Laurence Renehan (2 vols, Dublin, 1861–​74); P. F. Moran, History of the Catholic Archbishops of Dublin since the Reformation (Dublin, 1864).

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10 Forrestal, Catholic Synods. 11 P.  J. Corish, The Catholic Community in the Seventeenth and Eighteenth Centuries (Dublin, 1981). 12 R. Gillespie, ‘Popular and unpopular religion: a view from early modern Ireland’, in J.  S. Donnelly and K.  A. Miller (eds), Irish Popular Culture 1650–​1850 (Dublin, 1998), pp. 30–​49. 13 S. J. Connolly, Religion, Law, and Power: The Making of Protestant Ireland 1660–​1760 (Oxford, 1995), especially ­chapter 5. 14 Alan Ford, The Protestant Reformation in Ireland 1590–​1641 (Dublin, 1997); Alan Ford, James Ussher:  Theology, History, and Politics in Early Modern Ireland and England (Oxford, 2007). 15 While ecclesiastical regulation bears similarities, I have found no evidence that municipal supervision of midwives took place in Ireland similar to patterns of supervision in European towns and cities. See Marland (ed.), The Art of Midwifery, pp. 80, 81, 88, 89, 194–​205. 16 Connolly, Religion, Law, and Power, p. 146. 17 J. Bossy, Christianity in the West 1400–​1800 (Oxford, 1985), pp. 14–​19; J. Bossy, ‘The counter-​reformation and the people of Catholic Ireland, 1596–​1641’, in T.D. Williams (ed.), Historical Studies, VIII (Dublin, 1971), pp. 155–​69; Forrestal, Catholic Synods, p.  17; C. Tait, ‘Spiritual bonds, social bonds:  baptism and godparenthood in Ireland 1530–​ 1690’, Cultural and Social History, 2 (2005), pp. 301–​27; D. Cressy, Birth, Marriage and Death: Ritual, Religion and The Life-​Cycle in Tudor and Stuart England (Oxford, 1997), pp. 98–​9. 18 Gillespie, Devoted People, p. 76. 19 Ibid., pp. 76, 77. 20 H. E. Hatton, The Largest Amount of Good: Quaker Relief in Ireland 1654–​ 1921 (Montreal, 1993), p. 3. 21 The Friends Historical Library, Dublin, 1/​2 YMA1, National men’s meeting at Dublin 1671–​1688, 47, Epistle 12/​9/​1677. 22 Connolly, Religion, Law, and Power, pp. 144–​7. 23 Forrestal, Catholic Synods, p. 33. 24 A. Ford, The Protestant Reformation in Ireland, 1590–​1641 (Dublin, 1997), pp. 156–​64. 25 Ibid., pp. 48–​62; Ford, James Ussher. 26 Ibid., pp. 64–​6. 27 P.  B. Phair, ‘Seventeenth century regal visitations’, Analecta Hibernica, 28 (1978), pp. 79–​102; M. V. Ronan, ‘Royal visitation of Dublin, 1615’, Analecta Hibernica, 8 (1941), pp. 1–​55. 28 Ford, The Protestant Reformation, pp. 64–​87. 29 Ford, James Ussher, pp.  85–​103; Articles of Religion Agreed Upon by the Archbishops and Bishops and the Rest of the Clergie of Ireland, in the Convocation Holden at Dublin in the Yeare of Our Lord God 1615 (Dublin, 1615).

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30 Articles to be Inquired of by the Church-​Wardens and Questmen of Every Parish in the Next Visitation, to be made by the Right Reverend Father in God John, Lord Bishop of Clogher (Dublin, 1667). 31 Ibid., pp. 5–​7. 32 Ibid., p. 2. 33 Articles Given in Charge to be Inquired Upon and Presented Too, by the Churchwardens, Side-​Men, Quest-​Men and Inquisitors in Every Parish Within the Province of Armagh, in the Course of the Metropoliticall Visitation of the Same, in this Present Yeare Begun, by the Most Reverend Father in God, Christopher, by the Mercy of God, Lord Archbishop of Ardmagh, Primate and Metropolitane of all Ireland (Dublin, 1623), item 19. There are similar articles for Archbishop Ussher in 1626 and Archbishop Bulkeley in 1629. 34 Articles to be to be Inquired of by the Churchwardens and Questmen of Every Parish, in the Ordinary Visitation of the Right Reverend Father in God George by Divine Providence Lord Bishop of Cloyne (Dublin, 1639), pp.  5–​6; Articles to be Inquired of in the Visitation, to be made by John Lord Bishop of Clogher, p. 8. 35 Articles to be Inquired of in the Visitation, to be made by John Lord Bishop of Clogher, pp. 5–​6; Articles to be to be Inquired of in the Visitation of George by Lord Bishop of Cloyne, p. 32. 36 Quoted in J. R. Guy, ‘The episcopal licensing of physicians, surgeons and midwives’, BHoM, 56 (1982), p. 539. 37 Articles of Religion Agreed Upon in 1615, articles 89, 90 and 91. 38 ‘The order of baptism for both publick and private’, in The Book of Common-​ Prayer and Administration of the Sacraments and Other Rites and Ceremonies of the Church, According to the Use of the Church of Ireland (Dublin, 1666); The Charge Given by Narcissus, Lord Archbishop of Dublin to the Clergy of the Province of Leinster at his Primary Triennial Visitation Together with Articles of Visitation (Dublin, 1694), p. 26. 39 ‘On the order of baptism both publick and private’, in The Book of Common Prayer … According to the Use of the Church of Ireland. 40 Ibid. 41 J. Bossy, ‘The counter-​reformation and the people of Catholic Europe’, Past & Present, 47 (1970), pp. 51–​70; Corish, Catholic Community, pp. 18–​42; Forrestal, Catholic Synods, pp. 33–​40. 42 Bossy, ‘The counter-​reformation and Catholic Europe’, p. 52. 43 Forrestal, Catholic Synods, pp.  46–​7, 51–​2; Canons and Decrees of the Council of Trent, ed. H.J. Schroeder (Rockford, IL, 1978), p. 106. 44 Bossy, ‘The counter-​reformation and Catholic Europe’, pp. 52–​3. 45 Canons and Decrees of the Council of Trent, p. 106. 46 Forrestal, Catholic Synods, pp. 55–​7. 47 Moran, History of the Catholic Archbishops of Dublin, p. 444. 48 McCarthy (ed.), Collection of Irish Church History, i, pp. 429–​30.

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49 Sheela na Gig, the earth goddess, in this context is understood as a fertility symbol. See C. Mooney, A Sense of Place (Kinsale, 2009); S. Clancy, ‘Sheela-​ na-​ Gig’, Insight, 3 (n.d.), www.homepage.eircom.net/​~archaeology/​three/​sheela.htm (accessed 17 Aug. 2018). 50 Corish, The Catholic Community, pp. 37, 50–​2, 67–​70. 51 Ronan, ‘Royal visitation of Dublin, 1615’, pp. 1–​55. 52 Church of England. Articles of Visitation and Enquiry Concerning Matters Ecclesiastical Exhibited to the Ministers, Church-​Wardens, and Side-​Men of Every Peculiar or Prebendal Parish Church Belonging to the Cathedral Church of the Blessed Virgin St. Mary of Lincoln, in the Triennial Visitation of the Right Worshipfull Michael Honywood, Doctor in Divinity, Dean of the Said Cathedral Church (London, 1666), p. 9. 53 R. Caulfield (ed.), Annals of St. Fin Barre’s Cathedral, Cork (Cork, 1871), p. 46. See also, I. Mortimer, ‘Diocesan licensing and medical practice in south-​west England, 1660–​1780’, Medical History, 48 (2004), pp. 49–​68; D. Evenden, The Midwives of Seventeenth-​Century London (Cambridge, 2000), pp. 24–​42. 54 Caulfield (ed.), Annals, p. 47. 55 R[ichard] C[aulfield], ‘Midwives’, Notes and Queries, 2nd series, 11 (1861), p. 59. 56 Richard Garnet, The Book of Oaths and Severall Forms Thereof Both Ancient and Modern (London, 1649). 57 N. B. White, ‘A Lycence and oath of a midwife granted to a midwife, Mrs. Elliot, by the bishop of Ossory in 1740’, Journal of the Kilkenny and South East of Ireland Archaeological Society, 5 (1864–​66), pp. 412–​13. 58 C. O’ Dwyer (ed.), ‘Archbishop Butler’s visitation book’, Archivium Hibernicum, 33 (1975), p. 3. 59 Ibid., p. 71. 60 Ibid., pp. 72, 73. 61 C. O’ Dwyer (ed.), ‘Archbishop Butler’s visitation book’, Archivium Hibernicum, 34 (1976–​77), p. 3. 62 Ibid., p. 28. 63 Ibid., p. 41. 64 Cork City and County Archives, U181, Dr. MacKenna’s Visitation Notes, c. 1785, Diocese of Cloyne, no. 25, not paginated. 65 E. A. Derr (ed.), ‘Episcopal visitations of the diocese of Cloyne and Ross by William Coppinger’, Archivium Hibernicum, 66 (2013), p. 337. 66 Ibid., pp. 337, 338. 67 Ibid., p. 347. 68 Ibid., p. 347 69 Ibid., pp. 248, 350, 351, 352. 70 D. Murray, Statuata Dioecesana per Provincium Dubliniensem, Observanda et a Daniel Murray (Archbishop of Dublin) (Dublin, 1831), pp. 83–​6.

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71 The Charge Given by Lord Arch-​Bishop of Cashell to his Clergy at his Primary Visitation Held in the Parish Church of St. John’s in Cashell, July 27 1692, Together with his Articles of Visitation Whereunto are Annext Three Acts of Parliament, Which are to be Read in Every Parish Church Yearly (Dublin, 1694), p. 35; Articles of Visitation and Inquiry to be Made Within the Several Parishes of the [diocese] of Dublin, in the Visitation of the Most Reverend Father in God Narcissus, by Divine Providence Lord Arch-​Bishop of Dublin, Primate and Metropolitan of Ireland held in the Year of our Lord [1698] (Dublin, 1698), p. 6. 72 RCPI, 2/​1/​1/​1, Journal of the RCPI, vol. 1, p. 73. 73 See for example A. Thomson, Bodies of Thought: Science, Religion and the Soul in the Early Enlightenment (Oxford, 2008), pp. 29–​63; P.  J. Bowler and I. R. Morus, Making Modern Science: A Historical Perspective (Chicago, IL, 2005), pp. 341–​62; J. Sharpe, Instruments of Darkness:  Witchcraft in England 1550–​1750 (London, 1996), pp. 248–​9, 256–​75. 74 Sharpe, Instruments of Darkness, pp. 243, 244, 269–​72, 284–​6; Sneddon, Witchcraft and Magic, pp. 121, 123. 75 Sneddon, Witchcraft and Magic, pp. 61–​4, 121–​44, 147; Sharpe, Instruments of Darkness, pp. 213–​33; O. Davies, Witchcraft, Magic and Culture 1736–​ 1951 (Manchester, 1999), pp. 7–​18. 76 M. Lyons, ‘The role of graduate physicians in professionalising medical practice in Ireland, c.1619–​54’, in J. Kelly and F. Clark (eds), Ireland and Medicine in the Seventeenth and Eighteenth Centuries (Farnham, 2010), pp. 17–​37. 77 J.  D.  H. Widdess, A History of the Royal College of Physicians of Ireland, 1656–​1963 (Edinburgh and London, 1963), p. 613; T. Farmar, Patients, Potions and Physicians:  A Social History of Medicine in Ireland (Dublin, 2004), p. 13; E. Boran, ‘Boate, Arnold (1606–​1653)’, in ODNB. 78 The Charter of the King and Queen’s College of Physicians of Ireland (Dublin, 1770). 79 RCPI, TPCK/​6/​4/​71, Sample of a ‘Declaration on admission as licentiate in midwifery’. 80 Fielding Ould, A Treatise of Midwifery in Three Parts (Dublin, 1742), pp. 4,  28–​30. 81 RCPI, 5/​1, Register of Licentiates of the King and Queen’s College of Physicians of Ireland. 82 RCPI, 2/​1/​1/​24, Journal of the RCPI, vol. 22, 5 May 1899. 83 T.  P.  C. Kirkpatrick, History of the Medical Teaching in Trinity College (Dublin, 1912), p. 117; Widdess, History of the RCPI, p. 66; RCPI, 2/​1/​1/​ 2, Journal of the RCPI, vol. 2, p. 146. 84 P. Gorey, ‘Managing midwifery in Dublin:  practice and practitioners, 1700–​1800’, in M.  H. Preston and M. Ó hÓgartaigh (eds), Gender and Medicine in Ireland 1700–​1950 (New York, 2012), pp. 123–​37.

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85 Ibid., p. 129. 86 Ould, A Treatise of Midwifery, pp. 4, 71, 79. 87 R. Porter, ‘A touch of danger: the man-​midwife as sexual predator’, in G. S. Rousseau and R. Porter (eds), Sexual Underworlds of the Enlightenment (Manchester, 1987), pp. 206–​24; John Blunt, Man-​Midwifery Dissected (London, 1793), pp. 66–​93; Philip Thicknesse, Man-​Midwifery Analysed (London, 1765), pp. 5–​10; Francis Foster, Thoughts on the Times, but Chiefly on the Profligacy of our Women, and its Causes (London, 1779), pp.  78–​92. 88 A. Wilson, The Making of Man-​Midwifery: Childbirth in England 1660–​1770 (London, 1995), pp. 161–​9; J. Donnison, Midwives and Medical Men: A History of Inter-​Professional Rivalries and Women’s Rights (London, 1977), pp. 34–​6, 42–​61; Gorey, ‘Managing midwifery in Dublin’, pp. 134, 135. 89 Local Government (Ireland) Act, 1898 (61 & 62 Vict. c. 37). 90 An Act to Regulate the Qualifications of Practitioners in Medicine and Surgery, 1858 (21 & 21 Vict. c. 90); The Medical Act, 1886 (49 & 50 Vict. c. 48). 91 Midwives (Ireland) Act, 1918 (7 & 8 Geo. 5, c. 59).

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6

Causes of death and cultures of care in County Cork, 1660–​1720: the evidence of the Youghal parish registers Clodagh Tait George Crabbe, a Church of England clergyman, published his poem The Parish Register in 1807. He called his registers ‘The simple annals of my Parish poor’, and he reflected on the human stories behind his entries within them, concluding rather gloomily that for his parishioners ‘Their joys come seldom and their pains pass slow’.1 The destruction of so many of Ireland’s historical records in the Public Record Office in 1922 and on other occasions makes the surviving parish registers, however ‘simple’ (and partial) the information they contain, a vital source for the study of the joys and pains of communities in the past. However, there seems to be limited appreciation of them. Though the National Library’s Catholic Parish Registers online2 has rightly been hailed as an important resource for genealogy and family history, little mention has been made of the huge potential of these records as sources for demographic, social and cultural history. Alongside this resource could be placed some earlier and later Catholic registers, the registers of the Church of Ireland not lost in 1922, and the records of other Protestant denominations, few which have yet been digitised in any coherent manner.3 The neglect of the potential of the registers is all the more striking given the models provided by British historical demographers, especially those coming under the umbrella of the Cambridge Group for the History of Population and Social Structure, who have used English parish registers and associated documents as key sources.4 Several historians and geographers have also already used the Irish registers as sources for the study of Early Modern communities in, for example,

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Wicklow, Dublin, Wexford and Derry. Brian Gurrin, Celestine Rafferty, Valerie Morgan and Colin Thomas have coaxed them to reveal valuable information on topics like mortality and population change; baptism and naming practices; courtship and marriage; illegitimate birth, family life and parenthood; mobility and immobility; and the role of networks of kinship, friendship and association within communities. For the historian of medicine, they can provide indirect evidence on topics such as birth spacing and infant rearing, especially breastfeeding. There are also details of life expectancy and causes of death, especially in infancy and childhood and as a result of epidemic disease.5 Of course, there is a myriad of problems with these kinds of documents. Even when they provide good runs of records, they are often incomplete or damaged, and they are variable in the data they provide. For example, does a death record give only name and date of burial, or does it include additional details such as occupation, date of death or family relationship identifiers like ‘son of ’ or ‘wife of ’? Parish registers generally relate to a limited section of the population (usually just one religious denomination and, as noted below, infants and young children might be excluded from burial registers). The information gained from them is therefore often limited, unstable and impressionistic. However, this chapter argues that in situations where alternate sources of information are so hard to come by as in the case of Early Modern Ireland, even an impressionistic picture is better than nothing at all. The focus here is on the surviving Church of Ireland registers of the town of Youghal, Co. Cork, dating from the mid-​1660s to 1720, which directly and indirectly reveal information on medicine, illness and mortality in a middle-​sized provincial town.6 These registers are all the more valuable as despite an increasing volume of publications on the medical history of Early Modern Ireland the late Stuart period has received relatively little attention.7 Youghal in the seventeenth century

The town of Youghal was one of the largest trading ports in Munster in the sixteenth century, though it suffered a blow in 1579 when it was sacked by the earl of Desmond’s troops. Large sections of its hinterland were forfeited by the Desmond Fitzgeralds as part of the Munster plantation from the 1580s. Famously, Sir Walter Raleigh subsequently acquired the manor of Inchiquin to the west, and some property in Youghal itself previously belonging to the Fitzgeralds and to the church

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was also redistributed. Following the collapse of the plantation during the Nine Years War and Raleigh’s fall from favour, his Irish lands were acquired at a bargain price by Sir Richard Boyle, later baron of Youghal and earl of Cork. While Boyle subsequently added significantly to his holdings and began to develop Lismore castle as his primary residence, he also spent a lot of time at Youghal in his house at the former Chantry College. As is well known, in the 1630s he was pursued by Lord Deputy Thomas Wentworth who sought to oblige him to return the extensive ecclesiastical lands he had acquired, including the College: he eventually paid a fine of £15,000 in order to be allowed retain them.8 The population of the town grew during the seventeenth century, in large part due to migration to the region as the result of Boyle’s development of agriculture and industry on his estates.9 While Anthony Sheehan estimates its total 1600 population at about 2,000, by 1659 there were possibly 3,060 inhabitants in the town. Patrick O’Flanagan estimates that roughly half of these were of ‘New English’ origins, mostly Anglicans, with some Independents and others.10 Youghal also had a Quaker congregation from the 1660s. In 1716 an ‘account taken of the parish’ of St Mary’s, counting the male inhabitants between the ages of sixteen and sixty, again showed a population half (313) Protestant and half (316) Catholic.11 The population of Youghal stagnated somewhat during the eighteenth century, due largely to the limitations of the harbour there and competition from the other southern ports. However, by the 1770s there were over 4,000 people in the town, and again over half of them were Protestant.12 Evidence for the significant size of the Church of Ireland congregation worshipping in Youghal is implicit in the expansion of seating within the nave of St Mary’s church in the later seventeenth century. As the chancel was still in ruins, expansion upwards was necessary, with a gallery being built on three sides around the walls of the nave: it was subsequently removed during nineteenth-​ century renovations.13 The congregation would regularly have been enlarged by soldiers quartered in the town (there were two companies there in 1681, five in 1686 and four in 1698, for example).14 Youghal’s relatively large Anglican population means its surviving parish registers allow a case-​study of a significant section of the town’s inhabitants. The registers begin in 1666. However, there are gaps and inconsistencies, even in the limited late seventeenth-​and early eighteenth-​century sample considered here. The worst is the hole in the registers from the end of 1684 to 1694. This reflects the heavy impact of the War of the Two Kings on Youghal, as also evidenced in the town’s

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Council Book. The register ends in 1720 and, apart from odd entries, does not resume until 1727, making it impossible to assess the extent to which Youghal was affected by the subsistence crises of the 1720s.15 Other gaps are also in evidence, probably largely down to the high turnover of clergy in late seventeenth-​century Youghal. Some of these clergy also seem to have had other concerns elsewhere, and may not have been habitually resident –​the curate from 1683 to 1693, Gilbert Heathcote, was also chancellor of Cloyne cathedral, for example.16 The incumbents generally oversaw a similar style of record-​keeping. However, at intervals the amount of information can expand to provide some unusual but telling details. The registers primarily record the Church of Ireland community though some Catholic burials occurring in the churchyard in the 1680s are noted –​it seems that while fees would probably ordinarily have been taken for Catholic burials, those burials would not have been included in the register. There were in any case alternative places for Catholic burial in the large graveyards of the North and South Abbeys just outside the town. The Quakers also had their own burial ground from 1673.17 The registers cover a cross-​section of society. Occupations or rank of the deceased or a father or husband are given in a large number of cases in the seventeenth-​century burial register and include cordwainers, saddlers, sailors, soldiers, vintners, merchants, ministers and others. The burial of ‘Mr Silver’ in 1678 was followed by those of Mason ‘a poor man’, the widow Gaselly, John Jasper ‘a servant to Esquier Villiers’, ‘a stranger’ called James Collomy, Alderman William Gillett, and Alderman John Luther’s wife. Roger Boyle, earl of Orrery was buried in October 1679, and Alice, countess of Barrymore, in 1666: they would have been interred within the church in the vault under the monument that the first earl of Cork had created in the south transept in the 1620s. By the 1660s Youghal’s trading links stretched to Britain, Europe, the Americas and the Caribbean,18 which may account for the two black men mentioned in the registers for the period covered here. ‘David Ben-​Anna (formerly Lampo) a negro, aged 15  years or thereabouts, born in Mountserat, one of ye Cariby Islands in Mere Del Noova in ye coast of America’, was baptised in 1666, while ‘a blackmor servant to Ald[erman] Croock’, was buried on 30 October 1705. The close links between east Cork/​west Waterford and North America are illustrated by a 1719 reference to the baptism in Youghal of an eleven-​ year-​old boy who had been born in Newfoundland. From the 1660s, a number of Huguenot families also settled in Youghal, and in the 1710s

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there are several entries relating to Palatine Protestant refugees, though these families did not go on to settle permanently in the area.19

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The medical and mental world of Early Modern Youghal

Seventeenth-​century Youghal seems to have been considered to be a healthy place to live. The traveller Thomas Dineley who visited the town in 1681 praised its ‘healthfull Air’, and the longevity its inhabitants reputedly enjoyed, citing the case of Edward Crockford who ‘had living six Grandmothers without Interim’, that is, his two grandmothers and four great-​grandmothers were all still alive when he was born.20 One lucky native credited in the register with remarkable longevity was Daniel Adams, who supposedly was 126 when he died in January 1717. Despite its reputation for healthfulness, a variety of practitioners and quacks sought to treat Youghal’s ill and disabled. The work of Peter Elmer has revealed something of the mental and medical world of the inhabitants of Youghal in the 1660s. In his book on ‘the stroker’, Valentine Greatrakes, he describes how in 1662 Greatrakes initially began claiming to be able to heal scrofula (an infection of the lymph nodes caused by tuberculosis), moving by 1665 to a wider variety of ailments such as deafness, convulsions, pain and crippled limbs. He became so famous that clients would come to him from abroad, and he himself travelled to Britain in 1666, attracting royal and scientific attention in the process. Greatrakes ‘was often critical of the medical establishment and orthodox therapeutic methods’. While attributing his abilities to the intervention of God, he also understood his role in terms of providing a counter to Catholic clerical healers such as the celebrated Fr O’Finallty. Both O’Finallty and Greatrakes ‘subscribed to the view that the illnesses from which many of his patients suffered were essentially demonic in origin’, making their cures ‘a form of dispossession’. However, their wide appeal in Ireland lay in the fact that their cures and methods fitted closely with local folk understandings about the methods and effects of medical magic. Greatrakes’s reputation was largely forgotten outside Ireland after he returned to Youghal, but he continued to ‘stroke’ until his death in 1683.21 The case of Florence Newton who was accused of witchcraft in 1661,  in which Greatrakes had testified, makes it clear that some in Youghal, particularly those of British origin, also believed in demonic witchcraft and the ability of witches to cause physical harm. Newton was accused of causing Mary Longdon to fall into fits, and of bewitching

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her jailer, David Jones, to death. Both Elmer and Andrew Sneddon have linked Newton’s case to the fraught environment of Restoration Youghal, where godly former Cromwellians faced encroachments on their religious and secular power from the town’s Anglicans, Quakers, Baptists and Catholics.22 Yet despite such divisions, most in Youghal would have shared providential views of misfortune and illness, seeing both good and bad fortune as expressions of God’s will.23 The council book of Youghal corporation mentions several barbers, barber-​surgeons, apothecaries and surgeons living in the town in the first half of the seventeenth century. The ‘chirurgeons’ and barbers of Youghal were in 1656 somewhat incongruously incorporated within the Victuallers’ Company alongside the victuallers, bakers, brewers, huxters and maltsters.24 The parish registers for 1665–​1720 themselves identify some medical practitioners, including John Davis, described in the record of the burial of his wife Magdalene in May 1669 as a ‘chururgeon’. The same Dr Davis appears in the records of the corporation of April of the following year, when he was charged with the care of Thomas Morley, formerly a draper in the town, who seems to have suffered a mental breakdown that necessitated him being incarcerated. Morley later left the town, clearly still not in the greatest health, and Davis was obliged to petition the corporation for payment of the seven pounds due to him.25 The registers also note the burials of ‘the Chirurgeon wife’ (her surname was erased) in April 1683, ‘Dockter’ Edward Sanders, on 11 May 1703 (he was made a freeman in 1685), and ‘Dockter’ Gough on 18 October 1718. A ‘Dockter’ Wilson baptised his twin daughters in Youghal in the same month. The widow Roe ‘midwiffe’ was buried on 3 September 1711. Coincidentally –​or perhaps not –​the next two entries after Roe’s are those of Elton Howard, son of George, buried on 3 October, and Elizabeth Howard, wife of George, buried twelve days later, the only obvious case in the registers of both a mother and infant dying following childbirth (Elton had been baptised on 21 September). An apothecary called Flood was operating in the town in 1695, when he was ordered by the corporation to shut down his shop.26 The baptisms of four of the children of another apothecary, Peter Carr, were recorded in the registers between 1696 and 1704. Some Youghal medical men had been trained outside Ireland. The Quaker physician, John Dobbs, a Carrickfergus man who received some training in chemistry with Charles Marshall, a Bristol Quaker, ‘and made further progress in the study of physic’ in London, married a Youghal widow and practised in the town from about 1700 until his

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death in 1739.27 Though Youghal was far from Dublin, interpersonal links connected the town to the main late seventeenth-​century Irish centre of medical training, the College of Physicians. William Jephson, dean of Lismore, several of whose children were baptised and buried in Youghal between 1697 and 1704, was the brother-​in-​law of Patrick Dun MP, president of the College on several occasions, and physician-​ general to the army in Ireland from 1705.28 Causes of death 1664–​1720

Causes of death are sometimes noted in the register in cases of accidental death such as that of Thomas Markes ‘a seaman cast away upon the [sand]barr of youghall’ in 1679. In November 1710 Thomas Donovan likewise ‘unfortnatly dround’, and in April 1711 a child of John Moone ‘that was dround’ was buried. One case of infanticide is recorded, in October 1709, when ‘Deckes, a child of Jean’ was ‘kild by her’ –​the naming of only the mother probably indicates an illegitimate birth, of which a few others are recorded in the baptism registers. Some dramatic deaths passed without comment in the registers. For example, the burial of Thomas Spratt is recorded on 13 October 1719. We find from Cooke’s ‘Memoirs of Youghal’, compiled in 1749, that Spratt was killed ‘from the walls of this town’, seemingly having been murdered. He was described as an ‘unhappy gentleman’ who had ‘acted very wrong in what he did [what that was is not stated], but was very drunk, or rather mad’ when he was killed. While several people had initially taken credit for his death, when trials took place first in Cork and then in Dublin ‘everyone deny’d it’. Spratt’s brother only just escaped being murdered on the same occasion.29 In a number of cases husbands and wives died within days of one another. John Games and his wife were buried on 19 and 17 September 1706, respectively, Marttin ffuge and his wife Rebecca on 8 and 11 April 1709 (the Henry ffudg buried a week later must have been a relative), John Broom and his wife Elen on 2 and 29 May 1713, and ‘Writt John, and his wife’ were both interred on 14 June 1705. The latter couple were humourously commemorated in Cooke’s ‘Memoirs’ (albeit in the wrong year) as ‘John Right, and Jane, his wife, who lived in Cross Lane, and did not lie together for 18 years before, died in one day and were buried in one grave’.30 Several entries indicate the heavy impact of high child mortality levels on families poor and wealthy. Mr William Hudson lost a son and daughter within three weeks of one

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another in the autumn of 1699. Another of his children was buried in 1704. Michael and Bridget Jephson, children of Dean Jephson, died in April and July 1704, and a third sibling was buried in 1701. Mr John Merick lost a child in late March and another in early April 1706, and buried others in 1702, 1707, 1713 (a servant in his household also died in this year) and 1717. Two of Abraham Dickes’ children were buried on 16 August 1701, while David Peters lost two children in the spring of 1706, as did Stephen Cats in June 1684, William Moor in May 1697, Mr Thomas Knight in October 1713, James Thrumble in autumn 1716 and Nicholas Martin in September 1718. Joseph Abraham buried three children on 8 and 9 July 1716. On 26 December 1680 both James Knott and his son were buried, and on 1 December 1683 Morice Hogan was likewise buried with his child. Two children of Edward Morphye as well as his servant maid were interred on 24 October 1684. Such cases of members of the same family dying in close succession are usually indicators of epidemic disease or gastric infections that regularly afflicted whole households. Occasions where Youghal was hit by particular disease epidemics can be crudely identified in a few cases in the records just by looking at unusual peaks in mortality. Furthermore, it is possible to map the recorded causes of death onto some known outbreaks of disease. Youghal’s inhabitants had close trade and family links with the south and west of England and beyond. Therefore it is not unreasonable to compare the registers with the sources such as Thomas Short’s 1749 two-​volume Chronological History, which offers a year-​by-​ year account of weather conditions and illness in various parts of Europe, especially southern England, in order to enable some speculation about potential common causes of death in Youghal.31 Mary J. Dobson’s extraordinary historical-​geographical work, Contours of Death and Disease in Early Modern England, also allows for some comparisons between the ‘medical topography’ of the counties of Kent, Essex and Sussex and later Stuart Youghal. Dobson discusses the illnesses common in Early Modern England, and provides a chronological summary of the ebb and flow of epidemics in south-​eastern England between 1601 and 1800, assessing whether each year was healthy, average, unhealthy or showed especially high mortality. It is likely that the diseases prevalent there might overlap with those afflicting other places in the British and Irish Isles at a similar time. However, Dobson also notes the strongly regional and local pattern of English Early Modern mortality rates.32 As soon as the Youghal death registers begin, periodic elevations of mortality become apparent, with peaks appearing in the late

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Table 6.1  Burials by month, 1666–​73

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Year 1666 1667 1668 1669 1670 1671 1672 1673

Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total −​ 4 −​ 7 3 5 5 1

−​ 0 −​ 3 2 3 3 0

5 4 −​ 3 2 3 2 3

6 4 −​ 3 5 1 3 2

3 0 −​ 9 3 4 1 8

10 9 −​ 1 4 3 2 8

2 2 4 0 5 9 1 −​

2 0 3 6 7 17 5 −​

2 0 4 0 4 5 2 −​

4 5 3 5 6 1 0 −​

4 5 2 3 1 1 1 −​

2 −​ 1 2 2 6 2 −​

42 44 58 27

spring and early summer of 1666, 1667 and 1669 (see Table 6.1).33 Combined with scrutiny of the identities of those afflicted, and comparisons with patterns elsewhere we can make some guesses as to the causes. Six of the ten deaths in June 1666, and eight of the nine in June 1667, were of children (crudely indicated by whether or not they are described in the register as a ‘son’ or ‘daughter’), perhaps indicating measles and/​or smallpox may have been at work. Smallpox was prevalent in England in 1669, and may account for the deaths in Youghal that spring in particular.34 A  particularly deadly infection, smallpox is likely to have been responsible for 10 to 15 per cent of all deaths in Ireland in this period. Multiple others would have contracted it at some point in their lives.35 Other increases in the death rate may also be found. The very high rates of death evident in the summer of 1671 –​most of the casualties were again children –​may be related to an ‘Autumnal fever’ (dysentery) that was endemic in Britain in the same year. During this illness, an English source claimed, ‘the sick were affliected with unusual langour, watching vertigo, and frequetly with head-​ach’. The slight rise of mortality in the summer/​autumn of the previous year may reflect a similar complaint: enteric infections were likewise reported as between widespread in the south-​east of England at that time.36 There is evidence in the registers that 1681, 1683 and 1684 (presumably 1682 as well, but there is a gap at that point) were also years of elevated mortality in Youghal. The sections that are available are interesting in that they contain burials of some Catholics (identifiable by their names and notes in the margins: the Catholic community may

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Table 6.2  Child and adult deaths in 1683 Type

Apr.

May

June

July

Aug.

Sept.

Oct.

Child Adult

7 6

5 6

6 3

7 7

1 3

9 3

11 7

Nov. Dec. 13 3

13 11

have lacked a local parish priest at this time) as well as Protestants, giving a fuller picture than usual of the Youghal community. This means that the numbers of recorded burials are larger than might be expected, but even despite this elevated mortality is clear. It was also a matter of anxiety to the members of Youghal town council, for economic reasons more than anything else. They ordered in March 1683 that Whereas the great ringing out of the great Town bell in the Clock Tower or Castle, upon the death of very young children, hath occasioned the country to suspect that there is greater mortality in the Town than (praised be God) there is, which, if not prevented for the future, may spoil the markets, by hindering the resort of the country thereunto. It is ordered, that from henceforth the great Town bell shall not be rung for any person deceasing, without the allowance of Mr Mayor, Mr. Recorder, and the Bayliffes, or any two of them.37 The necessity for bell-​ringing rose at the end of 1683 when child deaths declined just as adult deaths peaked (­tables  6.2 and 6.3),38 probably indicating enteric illnesses or an outbreak of dysentery (Thomas Short claimed dystentry was ‘epidemical’ in Europe in 1683 and 1684) being succeeded by typhus or influenza. Typhus, spread by body lice, is known to be especially virulent during colder months, as people huddle together for warmth and change their clothing less frequently. It also is more likely to be fatal to adults than children. Short described an influenza-​type illness affecting England from the thaw of 1684 which may be an alternate possible culprit for the elevation of adult mortality. Mortality rates were only ‘average’ in England in this period, but reports of severe fevers were recorded on the continent.39 The heavy impact of illness may have resulted in part from the fact that a population weakened by the effects of several unhealthy years –​1679 may have been the worst, but the registers are incomplete –​was then hit by the coldest winter on record.

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Table 6.3  Child and adult deaths in 1684 Type

Jan.

Child Adult

12 12

Feb. Mar. Apr. May June July Aug. Sept. Oct. 6 12

8 10

5 8

6 7

8 2

5 4

6 1

9 6

4 5

Table 6.4  Numbers of recorded deaths, 1695–​97 Year 1695 1696 1697

Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total 6 3 2

6 2 3

2 4 6

5 5 2

2 3 5

6 5 5

1 3 3

2 2 4

4 4 2

3 4 4

1 3 3

5 5 1

43 43 40

A unique feature of the Youghal registers is the run of pages covering the period from December 1694 to the beginning of 1698 where many of the entries not only expand to give the approximate ages of many of the deceased, but also to venture an opinion on the manner of some of their deaths. The curate at the time (and possibly up to 1711) was Richard Davies: he may have had some medical training, or perhaps a friendship with the apothecary, Peter Carr, is indicated by the respectful inclusion of the honourific ‘Mr’ in a number of the entries relating to Carr’s family. Carr himself may have been the writer, as the word ‘clerk’ is deleted in the entry relating to the burial of his six-​month-​old son Peter, who died in June 1695. On the face of it these entries from the mid-​1690s are not that remarkable –​there are no dramatic peaks, and the overall death rates are less than those from the late 1660s (see Table 6.4).40 Dobson has argued that in England, the 1690s was overall quite a ‘healthy’ decade, though severe dearth elevated mortality in Scotland at this time. However, combined with the additional information given, the Youghal material allows consideration of a number of issues. First, we learn something about the way in which the causes of death were understood (Table  6.5):41 in the seventeenth century, diseases tended to be categorised according to their symptoms (fever, fits, dropsy, tissick), or their circumstances (‘suddenly’). Only a few diseases were specifically recognisable to physicians and laypeople –​in Youghal these included measles, smallpox and rickets.42 The deaths of

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Table 6.5  Deaths in 1695–​97 according to attributed cause

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Cause Measles Consumption/​ tissick Fever Flux/​bloody flux Fits Dropsy Rickets Childbirth Suddenly Smallpox Cancer

1695

1696

Child

Adult

6 1

1

1 2

Child

1697 Adult

Child

Adult

2

4 3

5 3

3 1

3 1 1 1

4 1 1

2 1

2 1 1 1 1

adults are more likely than those of children, especially young infants, to be assigned to a specific cause, a sign of the greater difficulty of diagnosing the illnesses of children (and, by extension, the difficulty of prescribing appropriate treatment). The measles epidemic of early to mid-​1695 was described by Thomas Short, as being ‘of a very different kind from [usual]; all the Symptoms were worse … and the Disease more mortal than ordinary’,43 a fact borne out by its high mortality rates in Youghal. In that year, the measles deaths were concentrated in April to June, but outliers occurred in January and December. An outbreak of ‘flux’ (dysentery), including one case of ‘bloody flux’, affected the adults as well as the children of Youghal in March to June 1695: one of the dead was a soldier from the garrison, and this was the type of illness that would have spread quickly among soldiers. There were several deaths of fever, including one soldier in September, and fever returned in late 1695: in the six weeks from mid-​ December 1695 to 1 February 1696, five adults died from fever, out of a total of seven burials. There was then a shift over the next few months to a predominance of child deaths, with some elderly individuals, before the numbers return to a predominance of adult deaths (of tissick, fever, consumption and smallpox) in November and December 1696. The

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pattern of deaths in 1697 was more mixed. Dysentery was widespread in Wales in 1697, and presumably the two recorded deaths from ‘flux’ in Youghal reflect a much wider group afflicted by this ailment. Short describes a ‘Hungarian fever’ in mid-​1697 which may have been the same malady that caused an elevation of deaths from fever in Youghal in June to August that year –​this may have been a form of typhus, which reached epidemic levels in Scotland in 1697 and England in 1698, or another enteric infection. The diarist Elizabeth Freke described how in the summer of that year ‘A plague fever … rained much in London and abundance dyed of itt, and those thatt lived were marked by it’, though Dobson argues that the counties to the north and south of London did not suffer unusual mortality at this time.44 After some breaks and suspicions of under-​recording at around the turn of the century, the more complete registers of the first two decades of the 1700s (Table 6.6)45 also hint at peaks and troughs in mortality Table 6.6  Burials by month, 1703–​19 Year 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719

Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total 3 4 2 6 2 2 5 0 4 1 3 2 4 5 3 2 4

4 2 3 2 4 1 2 1 2 4 4 1 7 4 5 4 6

4 4 3 5 5 0 7 3 4 4 3 3 5 9 4 4 12

3 3 3 7 2 8 7 5 4 1 1 6 5 4 3 5 6

6 2 4 6 7 2 5 1 3 6 8 1 4 3 0 11 2

2 7 6 3 3 6 4 2 2 4 2 1 5 4 6 11 3

1 3 3 1 2 2 3 0 4 1 3 1 0 5 3 8 4

1 2 2 2 4 3 8 1 2 2 4 2 6 2 2 6 0

8 5 4 6 1 1 5 2 1 4 7 4 2 3 4 6 2

1 4 8 1 0 2? 4 1 7 4 10 2 4 2 3 4 4

0 1 7 1 3 2 3 4 2 5 8 0 6 4 1 3 4

2 1 0 1 6 4 4 2 2 4 6 5 2 2 3 4 6

35 38 45 41 39 33 57 22 37 40 59 30 50 47 37 68 53

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levels. The years of greatest mortality were 1718, 1713, 1709 and 1719. The proportions of adult and child deaths might shift year by year. In some of the higher mortality years, such as 1718 and 1713, child deaths reached nearly two-​thirds of the total (43 of 68 [63 per cent] in 1718, 41 of 59 [72 per cent] in 1713), whereas in some lower-​mortality years they were less than half (23 of 47 in 1716; 15 of 37 in 1717, for example). Several of the causes of death in this period were probably similar to the seventeenth-​century cases. Short noted a particularly virulent outbreak of measles in the spring of 1707. Dobson indicates that elevated mortality in south-​eastern England in 1704 may have been caused by scarlet fever. Measles was prevalent there in 1705–​6, and smallpox recurred for several years from 1709 to 1716: Short saw 1715 and 1716 as especially bad years for smallpox infections.46 The reason for elevated mortality in Youghal in 1709 is unclear but Short described the start of the year in England as very cold, causing the deaths of both cattle and people, while in August a ‘malignant Fever’ appeared in Essex which was ‘very mortal’ in the port of Harwich. Short claimed this had spread due to ‘Communion with foreign parts’.47 The port of Youghal may have been similarly vulnerable to maladies arriving from other places –​for example, the one man who died from smallpox in 1696 (Table 6.5) was a sailor. It is striking that in several households in the autumn of 1709 both children and their parents are recorded as dying: for example, John Bumsher and two of his children died in August and September 1709, Peter Carr the apothecary and one of his children died in September, and Widow Chapman’s child was buried at the end of August, followed by the widow herself in mid-​September. Clearly, once an illness was in a household it might linger for several weeks as family members fell ill in succession. Though the ‘Dunkirk Fever’, probably a form of influenza, does not seem to have led to excessive mortality in England in 1713 (some localised outbreaks of fever were recorded in Essex), it may have been the illness that killed elevated numbers in the second half of the year in Youghal.48 Something similar to the ‘putrid fever with very bad Symptoms’  –​shivering nausea, vomiting, ‘alternate Returns of Heat and Cold’, lassitude, anxiety, restlessness and ‘looseness’ –​that Short described in great detail as afflicting southern England in the hot summers of 1718 and 1719 may also have been responsible for some of the elevated number of deaths in Youghal in the same period.49 Dobson also notes the fevers (alongside smallpox) contributing to high mortality in England in 1719 and 1720 in particular:  she also points out

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that the ‘sharpest mortality peaks’ during such outbreaks of enteric infections are usually in summer and autumn, being spread by ‘flies … contaminated food, soils or water’.50 Mortality was not the only consequence of illnesses such as measles and smallpox. As Elizabeth Freke pointed out, individuals might be ‘marked’ after sickness had passed. Those who survived smallpox might suffer blindness, severe scarring or impotence, all of which had the potential to alter the future course of victims’ lives. A bout of one illness might make an individual more susceptible to others. For example, measles has recently been shown to cause immunosuppression which can compromise resistance to other infections for two or three years afterwards.51 Age at death

As noted above, as well as venturing the causes of some deaths, the 1695–​97 records also give rough ages for the dead in a number of cases (Table 6.7).52 In July and August of 1697, for example, John Clerk, aged about fifty-​four, a child of Mr Edward Pery (4) and Madam Mary Silver (50), died of fever, while Mary Mellan (a child) died of ‘convulshins, fitts’ and Alderman Thomas Walter (40) of consumption. On the one hand we see the high levels of child mortality that we expect, with children under the age of five proving most vulnerable. Older children as well as younger ones were especially hit by diseases like the measles epidemic of 1695, though those who had survived to five or six years of age may already have developed some immunity to measles and smallpox. Adults in their twenties to thirties were as susceptible as their older and younger neighbours to vaguely identified afflictions like flux (dysentery) and fever, while those from the middling and older age groups were most likely to have their deaths attributed to consumption (tuberculosis), tissick (a general term for coughing illnesses, but likely in these Table 6.7  Ages at death as recorded in the burial registers of 1695–​97 Year 1695 1696 1697

Under 5 11 13 9

5–​17 5 3 1

Other child 6 6 8

18–​59 7 7 9

60+ 10 12 6

Other adult 4 2 4

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cases to refer to pulmonary tuberculosis) and dropsy (accumulation of fluid: a symptom of heart, liver and kidney diseases). One of the problems of getting a fuller picture of mortality rates during this period is that we cannot be sure that infants, especially those who were stillborn, were always included in parish burial registers. For example, a child of Lieutenant Walker is recorded in the baptism register as having been ‘bapt[ised] & bur[ied]’ on 22 December 1702, but the fact that the death of the infant is not mentioned in the burial side of the register is likely an indication of that document’s unreliability in tracking the deaths of very young infants. There are suspiciously few notes to identify stillborn children or early neonatal deaths. In the 1690s Hanna Cashman was identified as being one day old when she was buried and others recorded were buried at one, three, four and six weeks. Comparisons between baptism and burial records indicate some further children who died soon after being baptised, such as Elizabeth, daughter of John Hamilton, who died three days after her baptism in January 1718. However, it is difficult to make out whether infants dying before baptism or not baptised at the church were recorded at all in the registers. Lay baptism at home and private baptisms by the clergy were permitted in cases when infants were in danger of death and in other circumstances as long as the ceremony was carried out correctly.53 From the 1730s a number of baptism entries are followed by the words ‘priv[atly] & dead’, but it is unclear whether their earlier counterparts made it to the registers. Some indications of the impact of childcare practices on mortality in Youghal

The Youghal registers raise some further issues regarding infant feeding, child health and child loss. As seen above, the 1690s entries record three instances of rickets in Youghal. Rickets was a disease that was increasingly described and diagnosed in Britain from the mid-​seventeenth century, and there was a perception that its occurrence had expanded rapidly. However, given that this rise in numbers afflicted by rickets has been linked with overcrowding in larger cities, malnutrition among the poor and the coal smog that blocked the sunlight crucial to the synthesis of vitamin D, it seems odd that it should appear in Early Modern Youghal. We do know that the people of Youghal burned coal, often the local sea-​coal, but the size of the town, the fact that it straggled along a long main street, rather than being compact and clustered, and the

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prevailing south-​westerly breezes should not have made this much of a problem.54 If what the writer of the registers saw as rickets actually was rickets, it must instead be attributed to other causes, perhaps under-​ nutrition due to the type of food supplied to children, and maybe also the tendency to cover children up during the ‘Little Ice Age’. The use of wet-​nurses among certain sections of Youghal society may also have had a role. One of the earliest British Isles physicians to describe rickets, Francis Glisson, cited as one of its possible causes the wet-​nursing of the children of the ‘highest citizens’. As a recent discussion of pre-​modern rickets points out, ‘calcium in breast milk falls as the duration of feeding is extended, and feeding cereal porridges in weaning, with high phytate content, might have added to the calcium deficiency’.55 I have elsewhere used the Killaloe parish registers which regularly included the father’s occupation, to consider the evidence offered by birth-​spacing in order to make tentative conclusions about differences in infant-​feeding practices between upper/​middling and lower sort inhabitants of the parish.56 It was clear that the wealthier parishioners there displayed a pattern of lower intervals between births, so low in some cases as to suggest that upper-​and middling-​sort mothers habitually did not breastfeed, or curtailed breastfeeding, with the effect that they forewent its contraceptive effects and became pregnant again much more quickly than their neighbours who nursed their own children. In Youghal, the registers are more fragmentary than in Killaloe, children’s forenames are frequently omitted (with just ‘child of ’ used) and evidence of male occupations is inconsistent in the period in question. Some men from the town elites were, however, accorded honorific titles like ‘Mr’, Doctor or Reverend. One case study that can be reconstructed, that of the Hayman family, indicates that similar infant-​feeding procedures to Killaloe prevailed in Youghal among some better-​off women. Samuel Hayman, variously identified in the registers as ‘Mr’ and ‘Alderman’ (he was mayor in 1704/​5), was married in 1700 or early 1701 to Elizabeth Paradise, the daughter and co-​heiress of a French Huguenot immigrant. The couple lived at The College (Myrtle Grove) in Youghal and over the next twenty-​one years they had sixteen children, most of whose baptisms are included in the Youghal register, which can be supplemented after it breaks off in 1720 with genealogical information recorded in Burke’s Dictionary of the Landed Gentry.57 These births occurred at intervals of between 12 and 22 months, the mean being 15.5 and the median 13 (Table 6.8). Notably, the intervals between births grew shorter in later

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Table 6.8  The children of Samuel and Elizabeth Hayman, showing intervals elapsing between their births Name

Birth date

John Jane/​Jean Elizabeth Frances Samuel I George I Atkin I Shussanna Mary Atkin II George II Samuel II Margaret Richard Hannah Robert

Apr. 1702 Aug. 1703 May 1705 May 1706 Jan. 1708 Nov. 1709 Apr. 1711 May 1712 May 1713 June 1714 July 1715 Mar. 1717 Apr. 1718 Apr. 1719 Apr. 1720 Aug. 1721

Interval (months) from previous 16 21 12 20 22 17 13 12 13 13 20 13 12 12 16

Death date

Nov. 1711 Nov. 1713 Dec. 1713

Mar. 1716

c. 1730

years, usually being twelve or thirteen months. This information almost certainly indicates that Mrs Hayman was recruiting assistance with nursing her children. The Hayman family offers insights into other aspects of health and mortality too. Five children did not survive to adulthood (which means that eleven of them did). Only one of these died in infancy –​George II, at nine months in March 1716 –​indicating at the very least that if wet-​ nursing or artificial feeding practices were being used in the family, they were not associated with unusually elevated levels of mortality. The other children who died –​Samuel I, George I, Atkin I and Robert –​ were aged three, four, two-​and-​a-​half and about eleven. Three of these deaths occurred within just over two years, Samuel being buried in November 1711 and George and Atkin in November and December 1713 –​the epidemic in which the latter two died also affected many other families in Youghal. We can only guess at the cumulative emotional toll of such losses on surviving family members. The fact that the names of deceased children were reused for subsequent arrivals is one indication of an impulse to memorialise lost loved ones.58

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Conclusion

Elizabeth Hayman was nineteen when she first became pregnant and was nearly forty when her youngest son, Robert, was born. Her childbearing career could possibly have continued for a few more years, had it not been for the death of her husband Samuel, aged fifty-​four, in 1722. His loss must have had a huge impact on her and his young family. Elizabeth lived a widow for thirty-​four years, dying in 1756 aged seventy-​four: clearly her extraordinary series of pregnancies had not unduly compromised her own health. Her case shows how the Youghal parish registers, and the other Irish registers, can be used to provide useful insights into child-​rearing, healthcare and mortality in pre-​modern Ireland, as well as to illuminate the lives of individuals, and their broader social context. Despite their gaps and inadequacies, information can be gleaned from them about the practical and emotional impact of disease and other ailments on communities for which few other medical sources are available. They allow us to imagine the atmosphere in the town during the measles epidemic of 1695 when the six deaths in the Church of Ireland registers (assuming they represent about half the community) may point to overall mortality of twice that, and hundreds of other infections. They reveal medical practitioners like Mr Carr, the apothecary, whose skills did not prevent the loss of four of his own children. Wringing some glimpses of the ‘joys and pains’ of Early Modern parishioners from their entries in parish registers can be a painstaking and partial process, but as in Crabbe’s ‘simple annals’, even those with ‘names of no mark or price’ can still speak from their pages. Notes 1 G. Crabbe, The Village, The Parish Register, and Other Poems (Edinburgh, 1838), pp. 9–​24. 2 Available at http://​registers.nli.ie (accessed 28 May 2018). 3 Though see the Irish Anglican Record Project, www.ireland.anglican. org/​about/​rcb-​library/​anglican-​record-​project (accessed 17 Jan. 2019); Church of Ireland Parish Register Collections for Cork, www.corkrecords. com/​registers.htm (accessed 28 May 2018). For Anglican parish registers, see: R. Refaussé, Church of Ireland Records (Dublin, 2006) and www.ireland.anglican.org/​cmsfiles/​pdf/​A boutUs/​library/​registers/​ ParishRegisters/​PARISHREGISTERS.pdf (accessed 28 May 2018); for Presbyterian Congregational Records, see www.presbyterianhistoryireland. com/​collections/library/​g uide-​to-​congregational-​records (accessed

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28 May 2018); for others, see www.nidirect.gov.uk/​sites/​default/​files/​ publications/​03%20%20Church%20Records.pdf (accessed 28 May 2018). 4 www.campop.geog.cam.ac.uk/​; see also the Pauper Lives Project, http://​ research.ncl.ac.uk/​pauperlives/​(accessed 28 May 2018). 5 B. Gurrin, Pre-​Census Sources for Irish Demography (Dublin, 2002); C. Thomas, ‘Family formation in a colonial city: Londonderry, 1650–​1750’, PRIA, 100C (2000), pp. 87–​111; C. Rafferty, ‘The Roman Catholic parish registers of Wexford Town from c. 1672’, Journal of the Wexford Historical Society, 15 (1994–​5), pp. 102–​14; V. Morgan, ‘The Church of Ireland registers of St Patrick’s, Coleraine: a source for the study of a local pre-​Famine population’, Ulster Folklife, 19 (1973), pp. 56–​67; V. Morgan, ‘Mortality in Magherafelt, Co. Derry, in the early eighteenth century’, Irish Historical Studies (hereafter IHS), 19 (1974), pp. 125–​35; V. Morgan and W. Macafee, ‘Mortality in Magherafelt, County Derry, in the early eighteenth century reappraised’, IHS, 23 (1982), pp. 50–​ 60; R.  T. Vann and D. Eversley, Friends in Life and Death:  British and Irish Quakers in the Demographic Transition (Cambridge, 2010); C. Tait, ‘Some sources for the study and infant and maternal mortality in later seventeenth-​century Ireland’, in E. Farrell (ed.), ‘She Said She Was in the Family Way’: Pregnancy and Infancy in Modern Ireland (London, 2012), pp. 55–​73; C. Tait, ‘Safely delivered:  childbirth, wet-​nursing, gossip-​feasts and churching in Ireland, 1530–​1670’, Irish Economic and Social History, 30 (2003), pp. 1–​23; C. Tait, ‘Namesakes and nicknames:  naming practices in early modern Ireland, 1540–​1700’, Continuity and Change, 21 (2006), pp. 313–​40; C. Tait, ‘Spiritual bonds, social bonds:  baptism and godparenthood in Ireland, 1530–​1690’, Cultural and Social History, 2 (2005), pp. 301–​27. 6 The documents are held in the Representative Church Body Library, Dublin. Microfilm available at NLI, MFCI 20. There is a transcript of a short run of the registers at www.igp-​web.com/​IGPArchives/​ire/​cork/​ churches/​youghal-​st-​marys.txt (accessed 28 May 2018). I  have mostly consulted the transcript by Rosemary ffolliott in University College Cork Library’s Special Collections. Many thanks to Mary Lombard and her colleagues there for their assistance. 7 See M. Lyons, ‘The limits of Old English liberty: the case of Thomas Arthur, MD (1593–​1675) in Limerick and Dublin’, in S. Ryan and C. Tait (eds), Religion and Politics in Urban Ireland, c.1500–​1750: Essays in Honour of Colm Lennon (Dublin, 2016), pp. 70–​88; J. Kelly, ‘Health for sale: mountebanks, doctors, printers and the supply of medication in eighteenth-​century Ireland’, PRIA, 108C (2008), pp. 75–​113; J. Kelly, ‘Bleeding, vomiting and purging:  ill-​health and the medical profession in late early modern Ireland’, in M. Luddy and C. Cox (eds), Cultures of Care in Irish Medical History (Basingstoke, 2010), pp. 13–​36; J. Kelly and F. Clark (eds), Ireland

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and Medicine in the Seventeenth and Eighteenth Centuries (Farnham, 2010); E.  O’Toole, ‘Medicinal care in the eighteenth-​and nineteenth-​century Irish homes’, in Farrell (ed.), Pregnancy and Infancy, pp. 115–​27. 8 N. Canny, The Upstart Earl:  A Study of the Social and Mental World of Richard Boyle, First Earl of Cork (Cambridge, 1982); D. Edwards and C. Rynne (eds), The World of Richard Boyle (Dublin, 2018). 9 D. Kelly and T. O’Keeffe, Youghal Historic Towns Atlas (Dublin, 2015). 10 A. Sheehan, ‘Irish towns in a period of change, 1558–​1625’, in C. Brady and R. Gillespie (eds), Natives and Newcomers: The Making of Irish Colonial Society 1534–​1641 (Dublin, 1986), p. 97; P. O’Flanagan, ‘Urban minorities and majorities: Catholics and Protestants in Munster towns c.1659–​ 1850’, in W. J. Smyth and K. Whelan (eds), Common Ground: Essays on the Historical Geography of Ireland (Cork, 1988), p. 126. 11 R. Day, ‘Cooke’s memoirs of Youghal, 1749’, Journal of the Cork Historical and Archaeological Society, 9 (1903), p. 61. 12 O’Flanagan, ‘Munster towns’, p. 134. 13 W. M. Brady, Clerical and Parochial Records of Cork, Cloyne and Ross (3 vols, Dublin, 1863–​4), ii, pp. 420–​1; ‘Ruins of the Collegiate Church, Youghal’, Dublin Penny Journal, 190 (1836), pp. 271–​2. 14 R. Caulfield (ed.), The Council Book of the Corporation of Youghal (Guildford, 1878), p.  371; E.  P. Shirley, ‘Extracts from the journal of Thomas Dineley, Esq II’, Journal of the Kilkenny and South East of Ireland Archaeological Society, new series, 4 (1863), p. 337. 15 J. Kelly, ‘Harvests and hardship: famine and scarcity in Ireland in the late 1720s’, Studia Hibernica, 26 (1992), pp. 65–​105. 16 Brady, Clerical and Parochial Records, ii, pp.  420–​1. The corporation complained about the lack of preaching and services ‘in this great Congregation of Youghal’ in 1671: Caulfield, Council Book, p. 333. 17 S. Hayman, Notes and Records of the Ancient Religious Foundations at Youghal Co. Cork and its Vicinity (Youghal, 1854). The South Abbey fell into disuse by the end of the seventeenth century. S. Hayman, The Hand-​ Book for Youghal (Youghal, 1896), pp. 53, 56. 18 D. Woodward, ‘The Anglo-​Irish livestock trade of the seventeenth century’, IHS, 18 (1973), pp. 489–​523. Thomas Dineley in 1681 described how Youghal was ‘renowned for trade and navigation not onely with England but Holland, Hamborough, the Indies etc’. Shirley, ‘Journal of Thomas Dineley’, p. 322. 19 S. Hayman, ‘The French settlers in Ireland, no.  4:  the settlement at Youghal’, Ulster Journal of Archaeology, 2 (1854), pp. 222–​9; G. L. Lee, The Huguenot Settlements in Ireland (London, 1936), pp. 69–​82; V. Costello, ‘Researching Huguenot settlers in Ireland’, BYU Family Historian, 6 (2007), pp. 143–​5. 20 Shirley, ‘Journal of Thomas Dineley’, p. 338.

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21 P. Elmer, The Miraculous Conformist: Valentine Greatrakes, The Body Politic, and the Politics of Healing in Restoration Britain (Oxford, 2013); Lionel Beacher, Wonders if not Miracles. A Relation of the Wonderful Performances of Valentine Greatrux of Affane neer Youghall in Ireland (London, 1665). Greatrakes, and other local healers, were remembered in the folklore of the Affane area in the 1930s Schools Folklore Collection, held in University College Dublin. See www.duchas.ie/​en/​cbes/​4428133/​4380915 and www.duchas.ie/​en/​cbes/​4428133/​4381081 (accessed 22 Aug. 2018). See R. Moore and S. McLean (eds), Folk Healing and Healthcare Practices in Britain and Ireland (Oxford, 2010); P. Logan, Irish Folk Medicine (Dublin, 1999). 22 A. Sneddon, Witchcraft and Magic in Ireland (Basingstoke, 2015); Elmer, The Miraculous Conformist; St. J. D. Seymour, Irish Witchcraft and Demonology (Dublin, 1913). 23 R. Gillespie, Devoted People:  Belief and Religion in Early Modern Ireland (Manchester, 1997), pp. 40–​6. 24 Caulfield, Council Book, p. 302; Day, ‘Cooke’s memoirs’, p. 42. 25 Caulfield, Council Book, pp. 330, 332–​3. 26 Ibid., p. 392. 27 Hayman, The Hand-​Book for Youghal, p.  63; J. Gough, A History of the People called Quakers (4 vols, Dublin, 1790), iv, pp. 426–​31. Marshall was also a preacher and writer. 28 B. Bewley, ‘Ireland’s first school of medicine’, History Ireland, 19:4 (2011), pp. 24–​7; T. W. Belcher, Memoir of Sir Patrick Dun (Dublin, 1866), pp. 38–​41. Dun had married Mary Jephson, sister of Dean William. They were the children of Col. John Jephson and Bridget Boyle, daughter of Richard Boyle, archbishop of Tuam (formerly bishop of Cork, Cloyne and Ross), a cousin of the first Earl of Cork. 29 Day, ‘Cooke’s memoirs’, pp. 61–​2. 30 Ibid., p. 59. 31 Short was from Scotland and settled in Suffolk after having practised for a time in Sheffield. Thomas Short, A General Chronological History of the Air, Weather, Seasons, Meters, &c in Sundry Places and different Times (2 vols, London, 1749). 32 M. Dobson, Contours of Death and Disease in Early Modern England (Cambridge, 1997). 33 ‘-​’ indicates a gap in the records; months with higher mortality levels indicated in italics; totals given only for years that seem to have full records. 34 Dobson, Contours of Death, p. 412. 35 Kelly, ‘Bleeding, vomiting and purging’, pp. 15–​16. 36 Dobson, Contours of Death, p. 413. 37 Caulfield, Council Book, p. 358.

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38 The register restarts in April 1683, and stops again in mid-​November 1684. In the register, children are indicated by prefixes ‘son of ’, ‘daughter of ’ or ‘child of ’. 39 Short, Chronological History, i, pp.  377–​9. On typhus, A.  B. Appleby, ‘Disease or famine? Mortality in Cumberland and Westmorland, 1580–​ 1640’, Economic History Review, 26 (1973), pp. 408, 412; Dobson, Contours of Death, pp. 418, 461–​2. 40 Months with higher mortality levels indicated in italics. 41 Child (under 18) indicated by age given or naming of the individual as ‘child/​son/​daughter  of ’. 42 Dobson, Contours of Death, pp.  236–​41; A. Withey, Physick and the Family:  Health, Medicine and Care in Wales, 1600–​1750 (Manchester, 2011), ­chapter 2. 43 Short, Chronological History, i, p. 401. 44 Ibid., p. 408; Dobson, Contours of Death, p. 421. 45 Months with higher mortality levels indicated in italics. The records for 1710 may not be complete: there are some corrections to the manuscript. 46 Dobson, Contours of Death, pp.  422–​5; Short, Chronological History, i, p. 435; ii, pp. 16, 18. 47 Ibid., i, pp. 442, 458. 48 Dobson, Contours of Death, pp. 422–​4. 49 Short, Chronological History, ii, pp. 16–​22. 50 Dobson, Contours of Death, pp. 425, 469–​74. 51 M. Lindemann, Medicine and Society in Early Modern Europe (Cambridge, 1999), pp. 71–​6; M. J. Mina, C. J. Metcalf, R. L. de Swart, A. D. Osterhaus and B.  T. Grenfell, ‘Long-​term measles-​induced immunomodulation increases overall childhood infectious disease mortality’, Science, 348 (2015), pp. 694–​5. 52 Where age is not given, additional cases are entered as ‘other child’ or ‘other adult’. Three cases in 1697 are so incomplete as to give no sense of the age of the deceased. 53 See Tait, ‘Spiritual bonds’ for a discussion of some of these issues. 54 Coal mines are mentioned in the corporation records: Caulfield, Council Book, pp.  372, 392. See G. Jones, ‘Vitamin D’, in K.  F. Kiple and K.  C. Ornelas (eds), The Cambridge World History of Food (Cambridge, 2001), pp.  463–​8. 55 See J. O’Riordan and O. Bijvoet, ‘Rickets before the discovery of vitamin D’, Bonekey Reports, 3 (2014), no. 478. 56 For details and background, see Tait, ‘Some sources for the study of infant and maternal mortality’, pp. 65–​8. 57 J. Burke and J.  B. Burke, A Genealogical and Heraldic Dictionary of the Landed Gentry in Great Britain and Ireland (London, 1846), pp. 555–​6. There are some further details in the 1849 edition of the Dictionary.

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58 Tait, ‘Namesakes and nicknames’. On emotional responses to the deaths of children in eighteenth-​century Ireland, see R.  Raughter, ‘Pregnancy, childbirth and parenting in the spiritual journal of Elizabeth Bennis’, in Farrell (ed.), Pregnancy and Infancy, pp. 75–​90; R. Wilson, Elite Women in Ascendency Ireland, 1690–​1745: Imitation and Innovation (Woodbridge, 2015), pp. 41–​4.

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Medical practitioners as collectors and communicators of natural history in Ireland, 1680–​1750 Alice Marples In May 1688, the landowner and keen horticulturalist Sir Arthur Rawdon wrote from Moira to his fellow Co. Down-​born friend, the young physician and naturalist, Hans Sloane: Yours from Jamaica with an account of your Voyage I  had, & was overjoyed to hear you got so well there, & that you agree so well with the country, I am sure ours here is a miserable one not a penny of mony to be got for anything in the world, no mannor of Trade the Tennants not able to pay their rents, nor the Landlords to forbear their tenants, so that most of the discourse is of Tenants dayly running away, & tradesmen breaking, so that I believe no country was ever so poor, nor is there any prospect of amendment.1 In a later letter of June 1691, Rawdon apologised for his inability to join in with the reciprocal exchange of useful scholarly news with Sloane. He blamed this, in part, on the disruption caused by the Williamite-​Jacobite War: ‘I am sorry our countrey does not afford news of the same kind to retaliate you with, but now nothing can be done here for the noyse of war, which does not indeed trouble these parts only that the people run up so fast to the camp that we can not get workemen for any price.’2 The following month, Victor Ferguson, a physician of Belfast, also referred to ‘the confusion of these late times’ in a letter to Sloane, but cited deeper issues with Ireland’s intellectual culture as the main problem: ‘It is indeed my great trouble and concern … when I  want converse or improvement; all must be hammered out of books and unpleasant meditation or study: none worth a farthing here to converse with or improve by, but reasoning from wrong sentiments and principals.’3

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In their letters to Sloane, Rawdon and Ferguson painted a bleak picture of the general state of learning in Ireland at the end of the seventeenth century. They felt far removed from the wider European Republic of Letters, unable to contribute news of equally learned activities and therefore unable to take part in this transcontinental community.4 Isolated and in short supply of books, botanical specimens and scientific instruments, they were forced to beg for them in achingly polite terms from the much more advantageously placed Sloane. Born in modest circumstances in Killyleagh in 1660, Sloane had left Ireland at a young age to seek out his medical education in London, Paris and Montpellier.5 He took his doctorate at the University of Orange in 1683, and returned to London to set up an extremely profitable medical practice. As he did so, he became fully involved in the scholarly culture there: he was elected to the Royal Society in 1685 and the Royal College of Physicians in 1687. It was also in 1687 that he accompanied Christopher Monck, the second duke of Albermarle, to Jamaica as his personal physician. Sloane was the first trained naturalist to set foot on the island: he returned with 800 or so specimens (most of which had never before been seen in Europe), fortune, fame and an abundance of international contacts. With their help, Sloane would over his long lifetime ascend the ranks of society and build one of the biggest, broadest and most important collections in Early Modern Europe. Against reports of Sloane’s exploits and international reputation, Rawdon and Ferguson might be forgiven for feeling they had to apologise for their inability to offer him any news of scholarly interest from Ireland. Yet any assumption that Early Modern Ireland was a gloomy and poverty-​stricken intellectual backwater has recently come under intense scrutiny. Concerted efforts have been made to establish the grounds for which there was a distinct Irish Enlightenment in the eighteenth century, and to reinstate the importance of the work of its seventeenth-​ century thinkers, writers and actors, and discuss them within broader British, European and Atlantic trends.6 Ian McBride and others have, for example, established the critical importance of early Irish theological and philosophical discussion to British and American intellectual history.7 The Dublin Philosophical Society was one of the many groups which enabled this: it was established in 1683 by William Molyneux, lawyer and very famous disciple of John Locke, to whom he posed the great thought experiment on perception that was to become known as ‘Molyneux’s Problem’.8 Another was the Belfast Society, formed in 1705 by Irish Presbyterian ministers, James Kirkpatrick and John Abernathy

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of Antrim. It challenged ‘Old Light’ covenanting theology with more liberal ‘New Light’ Presbyterianism (the aforementioned Dr Victor Ferguson was a member).9 Also important was ‘the Molesworth Circle’ of Glasgow graduates in Dublin, a group which included the philosopher Francis Hutcheson and James Arbuckle, the poet and critic who established the Dublin Weekly Journal from 1725.10 Amy Prendergast and Michael Brown attest that a cross-​confessional associational culture of this kind was made all the stronger for the extremely confessional nature of Ireland’s officially recognised (and state-​sponsored) civic public sphere, and fuelled by booming print industries in Dublin, Cork and Belfast.11 These recent works clearly vindicate Brown’s claim that Ireland ‘was not trapped by the sectarian politics of the seventeenth century and was not in a moribund catatonic state in the eighteenth century. Rather it was a vigorous and controversial participant in the transcontinental experiment of creating a modern world, defined by the reimaging of the universe based on the premise that man, not God, was the starting point of understanding’.12 As James Kelly and Toby Barnard have also made clear, Irish physicians were an important part of this increasingly civic and scholarly culture.13 Many sought professional advancement through membership of such clubs, through high positions and offices, or through forms of elite enterprise, like book collecting. The Dublin physician Edward Worth, for example, created a private library of almost 4,400 books, many with exceptionally rare bindings. When he died in 1733, he left this collection to Dr Steevens’s Hospital in his capacity as a governor.14 But Worth was clearly exceptional: many practising physicians did not have physical access to such resources or groups –​they were dispersed across Ireland and simply could not afford to accumulate that kind of cultural capital, particularly during the tumultuous seventeenth century. This is why Victor Ferguson requested in a letter addressed via the Fellows of the College of Physicians that Sloane ‘throw in a letter now and then into the office and aquaint me what books of note come forth … What I already have are the marrow of all antient and modern authors till about 1688. I have none since’.15 However, as this chapter seeks to show, this lack of physical access to scholarly resources and communities did not prevent Irish physicians from being valued members of a wider associational culture of international epistolary exchange. They were not refused entry to such networks on account of their lack of usefulness, as Rawdon and Ferguson’s comments might imply: on the contrary, the medical and natural historical material that

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they collected and exchanged was highly valued by renowned physicians and scholarly collectors, such as Sloane. As shall be demonstrated, this is partly because of the general ways in which medical communities functioned in Britain and Ireland in the seventeenth and eighteenth centuries. But it was also partly because the collection and circulation of natural knowledge took on a new epistemological value during this period. Circulating information in medical communities

The intellectual and practical limitations facing physicians across Britain and Ireland between 1680 and 1750 influenced the ways that they interacted with one another. Conceptual instability, professional factionalism, relative institutional weakness and commercial vagaries all combined to create a culture in which physicians were continually required to circulate news, observations and objects. The flood of new ideas and natural objects from the New World had significantly disrupted established social and intellectual hierarchies in medical practice and theory, and new commercial opportunities were being increasingly exploited.16 As early as 1626, Charles I  had written to the lord deputy, Henry Cary, 1st Viscount Falkland, to suggest that a chartered body like the Royal College of Physicians in London might be able to tackle the ‘wandering, ignorant mountebanks and empirics, who for want of restraint do much abound to the daily impairing of our healths, & hazarding of our lives in general of our good subject there [in Ireland]’.17 But, as Harold Cook has shown, by the end of the seventeenth century the king’s optimistic belief in the strength of the Royal College of Physicians of London had been proven false: its attempts to preserve the authority of academic physic by withholding medical information and publicly prosecuting unlicensed practitioners had backfired spectacularly, severely weakening its overall authority within the medical marketplace.18 They simply could not control the amount of medical information being exchanged, either for cash or credit. The ‘Fraternity’ or College of Physicians established in Dublin in 1667 was equally unable to combat the huge range of healers relied upon by the public. In both countries, a broad range of practitioners were able to practice due to the general lack of access to ‘official’ or educated medical healers, the continuing popularity of folk remedies and the increasing commercialisation of medical remedies and practices.

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The fact that Early Modern medical institutions struggled so much to regulate practice and theory was of little consequence to the patients themselves. Illness was a communal experience in the Early Modern period: long before a practitioner of any kind was called, patients would discuss their symptoms, circumstances and treatments with family, friends and neighbours around them, exploring and evaluating their bodies by calibrating their experiences according to the knowledge or testimonials of others.19 The bishop of Clonfert, Mordecai Carey, for example, reported to his family physician, the English scientist and physician James Jurin, that his wife now ‘wears a Plaister on the left breast, a Plaister that is recommended by some Neighbouring Ladies who have been in her case’.20 Many of these accounts of tried-​and-​tested remedies from the community, often using local herbs or other plants, were captured and stored within manuscript medical recipe books. Elaine Leong recently argued that we should approach such collections as both repositories and archives, created in various collaborations across spatial, geographical and temporal boundaries, and adjusted according to testing and experience.21 In initiating their correspondence with a physician, patients would employ this accumulated experience, combining the knowledge gained from diverse discussions with their surrounding friends and family with any learning or opinion they might have themselves regarding their condition, and any wider knowledge which they were able to obtain, adding any contextual details they believed, for whatever reason, could be relevant or useful in diagnosis.22 Over the course of Carey and Jurin’s correspondence between June 1733 and February 1735, for example, Carey related Catherine’s pain both as described by her and interpreted by him, observed a swelling in her breast, noted limited movement, offered information on possible treatments as well as local discussions of them, and detailed her menstrual cycle and general wellbeing. In a letter dated 9 June 1733, Cary employed a number of sensory descriptions to describe the state of her urine, observing that it now appeared ‘like the grounds of a small yeasty beer’ and ‘leaves a white sediment on the side of a large glass from top to bottom: which sediment to the eye looks white and greasy, but to the fingers feels gritty & indeed when rubbed along the glass you hear the sound of sand’.23 This range of information was included in order to try to overcome the distance between embodied and evaluative understandings of illness. In the attempt to diagnose via correspondence, all physicians had to engage with this muddle of information and

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attempt to create useful meaning from it by comparing many overlapping strands of experience or opinion, be they recipe, ancient herbal or newly published pamphlet. This continuous circulation, comparison and evaluation of information was also reflected in the more explicit regulation of practice that went on between physicians. As Patrick Wallis has shown, the vagaries of the commercial marketplace demanded that practitioners collaboratively evaluate the worth of their material products, techniques and sources of information as ‘the fragmentation and diffusion of production, limitations of assaying techniques and the legitimacy of substitutions and variation in some recipes meant that fraud was widely suspected’.24 Physicians exchanged notes on their own practice as well as that of others in order to ensure best practice and to protect themselves from potentially ruinous public censure. In 1698, Victor Ferguson again got in touch with Sloane regarding the health of one Mr James Hamilton of Bangor, Sloane’s cousin by marriage.25 Ferguson had recently treated Hamilton and was alerting Sloane to an altercation that had arisen between him and an attending apothecary, Mr Fairly, whom Ferguson described as ‘a man of idleness and pleasure’. According to Ferguson, Fairly had given Hamilton a concoction which had made him worse, and then blamed it on him as the physician. In his defence, Ferguson described both Hamilton’s symptoms (which he believed was measles but may have been smallpox) and treatment: an infusion of rhubarb, manna and whey, and a surgeon who unfortunately ‘missed his aim, however sufficient vent was made for the discharge’. He also cited the three local practitioners who could be called on to support his claims of correct treatment: Mr Probey and Mr Cumming, both of Dublin, and one Dr Johnston.26 By collecting all the information he could surrounding the case –​even down to witnesses that could be consulted as evidence  –​and then presenting it to Sloane through a letter, Ferguson was ensuring both that his professional reputation and personal relationship with Sloane remained intact, regardless of whether Hamilton lived to tell the tale. With the wealth of unknown or unlicensed persons practising, individual skill and trustworthiness had to be verified through correspondence. In 1734, for example, a Manchester physician called John Barlow got in touch with Sloane to ask him his opinion of one ‘silver toung’d Maynard’, a man of Irish extraction frequently seen in the local coffeehouses in ‘character of a Physician, who has left Court for retirement’:

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At my first acquaintance, I was mightily taken with his happy way of Elocution, & invited him to settle in our town, which he declining, fixt at Wigan; where, upon my recommendation to a leading Gentleman in that neighbourhood, Mr Dickinson of Wrightington, he was soon introduced to Mr Bradshaw, & most of the families thereabouts, & got into a very promising business; but being sadly afraid of any body enquiring, what, or where he came from, which is very unusual on such occasions, made people more inquisitive of his character; whence arose many discoveries.27 New physicians, like all external visitors to Early Modern communities, were required to present their credentials and have their claims verified.28 Otherwise, prospective patients made their own enquiries: one ‘discovery’ this community made was that Maynard had previously set up as a solicitor in Sheffield, something which was claimed by a ‘travelling Druggist’. Subsequently run out of Wigan by the Rector (whose son was a physician and so, understandably, did not take kindly to imposters), Maynard then made out that he had gone to London before coming back to Manchester apparently on the orders of Sloane, ‘the College, and all the great ones of the profession’. Whether or not Maynard was a fraud is unclear, but it seems not, as some months later he himself wrote to Sloane, saying: ‘As I am convinced I can not otherwise discharge my obligations to you but by shewing my deep sense of them.’ He enclosed a set of stones coughed up by a patient with consumption in the hopes that it would be a gift fit for Sloane’s collection of rarities.29 This implies that, despite all suspicions and appearances to the contrary, Maynard’s reputation and ability to practice had been saved through his confirmation within various correspondence networks and, particularly, Sloane’s endorsement. This affair reveals a number of things. Firstly, that medical knowledge and authority was understood to be limited across geographical distances and social reach. Secondly, that even though many individuals partook in the regulatory circulation of information, this knowledge could only be verified by physicians further up the ladder. Successful medical professionals had more access to contacts and resources, and were therefore regularly called on by the medical community to supply such gaps in knowledge. Finally, it shows that, in return for such circulation and arbitration, participants could receive many possible rewards, ranging from the increased ability of knowing whom to trust, to the addition of items of materia medica or natural history to their collections.

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At all points in medical practice, then, physicians were required to collect and collate information from wildly differing sources, and compare it to the collected knowledge of those who they understood to have a wider access to information. This was an accepted part of successful medical practice: those with more resources were expected to share them. Victor Ferguson himself stated as much in one of his earliest letters to Sloane, addressed via the College of Physicians, where he asked Sloane to send him medical books, leaving ‘that and all others to your candid judgement. As you esteem them and they are in vogue amongst the most learned. I have not time to read, yea I hate quacks and collectors, I  find many of the germans in that strain, and would have nothing but what is new and of value tending to physick directly or indirectly’.30 In February 1697, he wrote again, lamenting his intellectual isolation: The correspondent I  formerly fixed on being now removed, And none of note going from hence lately has necessitated to be almost an Ignoramus of what passes amongst you this year by past except only what I  hear by second hand from Dublin. Your own native goodness then with other items has emboldened me to beg the favour of a short account of what has been lately published amongst you worth reading … [A]‌ny rational practick book may be published or Any natural history may Improve the practick part of Physick; for I would not Spend time in reading, any Empirick or froathy tractate notional books whose hypotheses is grounded in an airy train; nor any that are purely theory. My main drift is to Improve in ordine ad praxim [in order to practice].31 The best and quickest way for physicians all across Britain and Ireland to become more informed about their practice, whether this was regarding the latest books or advice on which practitioners to trust with a particular procedure, was by contacting successful and well-​ connected physicians and asking them. In return, consulting physicians accumulated more contacts, resources, social credit and other by-​ products of enquiry such as items of materia medica (as with Maynard’s stones) or natural history: all could be useful in the further circulation of valuable information. This is why, when Ferguson wrote to Sloane again in 1698, asking to be informed of whether, among other things, any satisfactory trials had been made into the curing of dysentery with the Ipecacuanha root, he offered such exchange:  ‘And if you desire

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any information of any herb, stone or mineral are in this part of the Kingdome I shall do my utmost to answer your desire, for I take liberty to acquaint you I think I know all that has yet been discovered here.’32 The value of such an offer for Sloane is not to be underestimated. In terms of his profession, Sloane would gain more knowledge to help him in the treatment of patients and the regulation of practice. But it would also facilitate a wider goal, which was the consolidation and systematisation of natural knowledge in its very broadest sense. Sloane’s understanding of the ways in which such unreliable information was processed and corroborated within communities of natural knowledge, and the potential value of seemingly unlikely information, was established through his experiences as a physician. As Sloane himself stated in a letter to John Locke (a medically trained philosopher who was also ‘in the habit of jotting down … information passed on to him by other doctors’33), no scrap of information was easily dismissed until it was proven to be useless: I have ventur’d to send those Small books to Mr Churchill to be sent you that you pick out any thing you fancy and distribute the rest for making plumm pyes, I confesse I love to look over such traces because most of them are used to such like purposes that deserve sometimes better usage for which reason I  have turn’d over many thousands within this 10. years and have bound up many volumms, which you know you will doe me a favour at any time to command what may be for Your purpose.34 In an earlier conversation, Locke had urged Sloane to publish the case he had discovered regarding a woman with a giant spleen, in the hopes that it would ‘give great light’ about humours in the abdomen and help the recognition of polyps as a disease in their own right: ‘If there were collections enough of their hystory & symptoms to build any theory on & lay a foundation for their cure.’35 Physicians were to redefine themselves in this period as the ‘natural historians’ of disease, collecting diverse accounts of cases and their treatments in order to build up systems of knowledge.36 Collecting and testing common observations

All kinds of material were therefore deemed valuable by physicians and naturalists of this period. Indeed, the esteemed Restoration natural

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philosopher Robert Boyle had argued for the collection of the broadest range of objects and remedies two decades earlier: ‘Nor should we only expect some improvements to the therapeutic part of physic from the writings of so ingenious [a]‌people as the Chinese, but probably the knowledge of physicians might not be inconsiderable increased, if men were a little more curious about the observations and experiments, suggested partly by the practice of midwives, barbers, old women, empirics, and the rest of that illiterate crew, that presume to meddle with physic among ourselves.’37 Many practitioners put this thinking into practice, and gathered all the remedies and specimens they could find to test. The Irish surgeon and anatomist (and co-​founder of the Dublin Philosophical Society), Allen Mullen, wrote to Robert Boyle in 1685/​86 concerning Boyle’s Of the Reconcileablness of Specifick Medicines (London, 1685) which, he said besides giving me some profitable hints, brought several things into my mind agreeable to what you have there deliver … What you mention out of Hippocrates of elaterium I  have known more than once true of an infusion of senna and manna in water and taken by nurses when the children they suckles were designed to be purged. It is a common observation in this country to have butter stink of garlic when the cattle feed either on crows’ garlic or ramsons.38 In this letter, Mullen also discussed the statement of individuals personally connected with him (in this case the niece of an archbishop and her daughter) regarding ‘Coventry blue’ thread for the relief of cramp, and a terrible bleeding from the mouth which had been cured by poultices made from stamped-​on nettles. A month later, the bishop of Derry and tutor of Jonathan Swift, St George Ashe, wrote to John Bainbrigg: ‘Doctor Mullen tried lately an experiment upon the famous Irish herb called Mackenboy or Tithymalus Hybernicus, which is by the natives reported to be so strong a purge that even the carrying it about one in their clothes is sufficient to produce the effect. This fabulous story, which has long prevailed, he proved false by carrying its root for 3 days in his pocket without any alteration of that sort.’39 Here we can see how individual physicians were concerned with relating new learning back to folk remedies and vice versa. Whether the folk remedies were disproved outright (as with the Irish herb) or were curiously connected to some other kind of new finding, all results of such experimentation would encourage further enquiry and circulation.

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Making comparisons like this could also allow physicians to justify older treatments in an innovative manner –​by tracing antecedents back through medical theory and practice, practitioners were able to neutralise and assimilate potentially damaging new knowledge, and make it work for them and their patients.40 Physicians built their authority on being able to locate, connect and compare diverse strands of medical knowledge, and interrogate information in order to make it conducive to future use. Their authority depended in a large part on the breadth of their connections and the diversity of their resources. Irish physicians were, therefore, highly valuable to physicians and naturalists such as Sloane:  they were able to offer materials from the communities and lands around them, crucial for the kinds of medical and natural historical systematisation many physicians and naturalists were involved in. Another example of this kind of activity is when Reverend John Ray, naturalist of Essex and Sloane’s friend and mentor, sent him a number of observations that he had received from physicians in Ireland regarding hemlock. The first two observations were sent to Ray from Dr Nathaniel Wood of Kilkenny, who related that: ‘A certain woman eating by mistake some Roots (as he supposes) of common Hemlock, among Parsnips, was immediately seized with Raving and Madness, talk’d obscenely, and could not forebear Dancing, on which exercise she would have given her Cow for a Bagpipe.’ Ray, himself, was not convinced and cited a number of printed histories to disprove this source, and recounted that their mutual friend James Petiver claimed to have eaten some pieces of hemlock root in company and been fine. Ray also noted: ‘The common People generally believe that the Roots which cause these Symptoms, are no other than old Parsneps, which have continued for some Years in the Ground, and therefore call them Madneps.’ The other was an observation about a horse which Ray said: ‘I shall give you in his own Words without making any Reflections upon it.’ Both were printed in the Philosophical Transactions of 1695.41 Then, a couple of years later, Ray wrote again with an account of the ‘direfull effects’ of Hemlock-​Water-​Dropwort, which had been sent to him by ‘Dr Francis Vaughun a learned Physitian in Ireland, living at Chonmell in the County of Tipperary’.42 Vaughun had seen some recent dispute between Ray and another writer, Dr Johnson, on the venomous quality of the plant in question and so sent a story which he had had from his brother-​in-​law, who had experienced it. Eight young lads had gone fishing in the county but, after eating ‘a great deale’ of roots, five convulsed and died before the next morning, and of the

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other three ‘one run stark mad, but come to his right reason again the next morning. Another had his hair & nails fall off. The third [Vaughun’s brother in law] alone escaped without receiving any harm’. Vaughun could not say whether this was down to his constitution, or his eating less of the root, but believed his brother-​in-​law had been saved because he had run away when he saw the first man fall and, because it was two miles or so, stopped to drink some milk warm from the cow on the way. Vaughun said that he believed his violent sweating ‘did doubly expell and carry off the venemous particles’ and that the draught of warm milk ‘did acts its part by involving the acid or acrimonious poison particles & rendring them inactive … But this is but my conjecture, wch I willingly submit to more mature judgements’. Though the incident had happened thirty years before, its communication was prompted by Vaughun seeing Ray’s opinion in print, and this also encouraged him to include an account that he knew of a Dutchman who had died through similar circumstances. In his letter to Sloane, Ray then discussed the existence of ‘severall parallel & no less tragical Histories [^of later date] of the … destruction of divers persons by the eating of the root’ and related where he had found them recorded, writing ‘Wherefore I think it is for the interest of mankind that all persons be sufficiently cautioned against venturing to eat of this & [^indeed] any other unknown herb or root, lest they incurr the same fate, and in order thereto that such Histories be made publick & transmitted to posterity as what I send you may be by being inserted into the Philosophical Transactions’. This was something Sloane, as Secretary of the Royal Society, could easily do, and it was published there in 1698.43 Scholarly alliances

Printing this material served a number of purposes:  it widened the reach of potential connections for the information contained therein while simultaneously rewarding all those who participated in the circulation of information and boosting the image of the Royal Society by increasing the breadth of its connections. Increasing the circulation of information across Britain, Ireland and the world in this way encouraged and facilitated all kinds of wider research, something which contemporaries were aware of.44 The physician Thomas Molyneux, for example, wrote in 1697 ostensibly to thank Sloane for reading a letter he had written about some recently uncovered large horns in front of the Society:

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But Sir I should take it very kindly, if you would freely impart to me your own, or any other of the Fellows of the Royall Society’s thoughts concerning the several Particulars I  have there proposed:  and Especially, whether the Large Horned Deer of Ireland was certainly the same with the Moose of America this I  Phancy may be easily made out by you in London, with the greatest Certainty; where I  doubt not, but you may Procure some Genuine Moose-​ Hornes brought from the West Indies, with one or other of the Collectors of Natural Rarietys in the Citty and by Comparing them with the Description and figure I have given of the Hornes found here in Ireland, the Matter may be Determin’d beyond all Doubt or Contest.45 This, Molyneux said, would give him ‘further Encouragement to Spend what Leasure Hours I  Can Command from the attendance on my Troublesome profession in Prosecuting Enquireys about the History of Nature, which I finde is a part of Learning you have very successfully laboured in’. In 1701, too, Molyneux explicitly stated that, as his medical and physical insights appeared to be valued by the Royal Society, he would be sure to send them whenever he could.46 The communication of all kinds of unknown, unusual or even false material was highly valued in overlapping medical and natural historical networks, because it enabled propositions to be tested, systems to be built and practice to be improved. Such exchange used and expanded the correspondence networks that physicians across Britain and Ireland employed in the normal course of their professional duties. Aiding such expansion helped to broaden the range of sources physicians could use to their advantage, thereby improving their evaluative and interpretive abilities, their ability to navigate a dangerous marketplace and their appearance of authority within such correspondence networks. This is why Sloane and other collectors like him rewarded all those who participated in and furthered the circulation of medical and natural historical information by giving them information, books, objects from his collection, the latest Philosophical Transactions or, even better, the opportunity of being published in the Philosophical Transactions. It also appears to be the reason why he sought to strengthen the scholarly alliances between England and Ireland (and, indeed, Scotland): in 1695, the Secretary to the Dublin Philosophical Society, Owen Lloyd, wrote thanking Sloane on behalf of the Society for the ‘valuable present’ of his own Duplicates, saying: ‘We will omitt noe opportunity of making

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you sensible how much We esteem them, and wish We had anything worth your acceptance but hope that time may enable Us to make You Some returne in such naturall Raritys, as may be collected by the joint endeavours of so many of Us, as labour in these Discoverys, and assure Yourselfe that when nothing else can keep us together the Memory of this Favour, with what We have receiv’d from the Illustrious Society will be able to do it.’47 Doing so ensured the broadest coverage of the British Isles and, therefore, the best medical and natural knowledge. Contemporaries recognised the benefits of increasing the dissemination of medical and natural historical knowledge: by the 1750s, collecting and communicating natural knowledge of all kinds was seen to be both fashionable and useful. It facilitated the growth of both journal publications and increasing sociable scholarly activities, such as the founding of the Dublin Society in 1731, with its experimental farm, art school and botanical garden, as well as the Physico-​Historical Society in 1744, in which apothecaries, doctors, lawyers, churchmen and gentlemen came together to discuss all kinds of topics, from agriculture, soil and climate, to mathematics and navigation, to art and antiquities. Conclusion

Despite how intellectually isolated many Irish individuals (particularly those outside of Dublin) may have felt in the late seventeenth century, many actively participated in the growing culture of scholarly exchange through correspondence, allowing them to overcome many physical and material limitations. Repeating his frequent request for accounts of the latest books of medicine, Ferguson wrote to Sloane: ‘You may conjecture the disadvantage of this country practice that thereby we consume much time in riding and spending too much time in conference abstract from our trade when in houses of note; this obliges me to be cautious what I read for I can’t read all.’48 But the help that Irish physicians required to get up-​to-​date information was really just the same as the help physicians in Manchester required to verify unknown practitioners. Their requests were rewarded with the further circulation of medical information through letters, publication or the exchange of natural historical or medical specimens, and this created further obligations and opportunities for exchange. Physicians like Sloane encouraged this, because it helped them build their social and professional authority. This shows how closely intertwined the quest for successful medical practice was with the quest for natural specimens. Sloane and physicians like him regularly

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used their medical expertise and reputations as well-​known and trusted practitioners to cultivate possible contacts for the supply of botanical and other natural historical objects or pieces of information which, in turn, they were regularly called on to circulate to through their medical networks. This meant that, even though scholars and practitioners in Ireland felt they were at a disadvantage, they could participate (and, indeed, be highly valued) in circles of scholarly exchange –​particularly wider cultures of medical collecting and testing –​often simply by providing information about local healing practices or recipes, or communicating items of natural history. This allowed them to participate in wider scholarly cultures of exchange and interaction, connecting them up to a broad range of other international networks, institutions and individuals and, in doing so, transcending geographical, political, temporal and confessional boundaries. Notes 1 BL, Sloane MS 4036, Arthur Rawdon to Hans Sloane, Moira, 10 May 1688, fo. 35. 2 Ibid., Rawdon to Sloane, Moira, 24 June 1691, fo. 105. 3 Ibid., Victor Ferguson to Sloane, Belfast, 14 July 1691, fo. 106. 4 Anne Goldgar, Impolite Learning: Conduct and Community in the Republic of Letters, 1680–​1750 (New Haven, CT, 1995). 5 M. Purcell, ‘ “Settled in the north of Ireland” or, where did Sloane come from?’, in A. Walker, A. MacGregor and M. Hunter (eds), From Books to Bezoars: Sir Hans Sloane and His Collections (London, 2012), pp. 24–​32. 6 J. Livesey, Civil Society and Empire: Ireland and Scotland in the Eighteenth-​ Century Atlantic World (New Haven, CT, 2009); I. McBride, ‘The edge of Enlightenment:  Ireland and Scotland in the eighteenth century’, Modern Intellectual History, 10 (2013), pp. 135–​51. 7 I. McBride, Eighteenth-​Century Ireland: The Isle of Slaves (Dublin, 2009). 8 D. Park, ‘Locke and Berkeley on the Molyneux Problem’, Journal of the History of Ideas, 30 (1969), pp. 253–​60; P. Kelly, ‘William Molyneux and the spirit of liberty in eighteenth-​ century Ireland’, Eighteenth-​Century Ireland:  Iris An Dá Chultur (hereafter ECI), 3 (1988), pp. 133–​48; J. Livesey, ‘The Dublin Society in eighteenth-​century Irish political thought’, The Historical Journal, 47 (2004), pp. 615–​40. 9 I. McBride, Scripture Politics: Ulster Presbyterianism and Irish Radicalism in the Late Eighteenth Century (Oxford, 1998), pp. 41–​62; P. Griffin, ‘Defining the limits of Britishness:  the “New” British History and the meaning of the Revolution settlement in Ireland for Ulster’s Presbyterians’, Journal of British Studies, 39 (2000), pp. 263–​87.

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10 M. A. Stewart, ‘John Smith and the Molesworth Circle’, ECI, 2 (1987), pp. 89–​102; J.  A.  I. Champion, ‘Enlightened erudition and the politics of reading in John Toland’s Circle’, The Historical Journal, 49 (2006), pp. 111–​41. 11 J. Kelly and M. J. Powell (eds), Clubs and Societies in Eighteenth-​Century Ireland (Dublin, 2010); A. Prendergast, Literary Salons Across Britain and Ireland in the Long Eighteenth Century (London, 2015); M. Brown, The Irish Enlightenment (Cambridge, MA, 2016); T. Barnard, Brought to Book: Print in Ireland, 1689–​1784 (Dublin, 2017). 12 Brown, The Irish Enlightenment, p. 7. 13 J. Kelly, ‘The emergence of scientific and institutional medical practice in Ireland, 1650–​1800’, in G. Jones and E. Malcolm (eds), Medicine, Disease and the State in Ireland, 1650–​1940 (Cork, 1999), pp. 21–​39; T. Barnard, ‘Wider cultures of eighteenth-​century Irish doctors’, in J. Kelly and F. Clark (eds), Ireland and Medicine in the Seventeenth and Eighteenth Centuries (Farnham, 2010), pp. 183–​95. 14 There they remain, protected by the terms of the original trust, still in the room and cases originally designed for them. See: W. J. Cormack, ‘Some commercial and other sources for the Edward Worth Library (1733)’, in G. O’Brien and F. O’Kane (eds), Georgian Dublin (Dublin, 2008), pp. 165–​74; D. Westerhof (ed.), The Alchemy of Medicine and Print: The Edward Worth Library, Dublin (Dublin, 2010). See also ­chapter 8 by Boran in this volume. 15 BL, Sloane MS 4036, Ferguson to Sloane, Belfast, 14 July 1691, fo. 106. 16 H.  J. Cook, ‘Physicians and natural history’, in N. Jardine, J.  A. Secord and E. C. Spary (eds), Cultures of Natural History (Cambridge, 1996), pp. 91–​105; Roy Porter, Quacks: Fakers and Charlatans in Medicine (Stroud, 2000); H. J. Cook, Matters of Exchange: Commerce, Medicine and Science in the Dutch Golden Age (New Haven, CT, 2007); M. Jenner and P. Wallis (eds), Medicine and the Market in England and Its Colonies, c.1450–​1850 (Basingstoke, 2007). 17 J.  D.  H. Widdess, A History of the Royal College of Physicians of Ireland, 1654–​1963 (Edinburgh, 1963), p. 4. 18 H. J. Cook, The Decline of the Old Medical Regime in Stuart London (Ithaca, NY, 1986); H. J. Cook, ‘The Rose case reconsidered: physicians, apothecaries, and the law in Augustan England’, Journal of the History of Medicine and Allied Sciences (JHMAS), 45 (1990), pp. 527–​55. 19 L. McCray Beier, Sufferers and Healers:  The Experience of Illness in Seventeenth-​Century England (London, 1987); D. Porter and R. Porter, Patient’s Progress:  Doctors and Doctoring in Eighteenth-​Century England (Oxford, 1989); M. Louis-​Courvoisier and S. Pilloud, ‘The intimate experience of the body in the eighteenth century:  between interiority and exteriority’, Medical History, 47 (2003), p.  452; A. Withey,

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Physick and the Family:  Health, Medicine and Care in Wales, 1600–​1750 (Manchester, 2011). 20 Quoted in W. Wild, Medicine-​By-​Post:  The Changing Voice of Illness in Eighteenth-​Century British Consultation Letters and Literature (Amsterdam, 2006), p. 87. 21 E. Leong, ‘Collecting knowledge for the family: recipes, gender and practical knowledge in the early modern English household’, Centaurus, 55 (2013), pp. 81–​103. 22 L. Wynne Smith, ‘ “An account of unaccountable distemper”: the experience of pain in early eighteenth-​century England and France’, Eighteenth-​ Century Studies, 41 (2008), pp. 459–​80; Wild, Medicine-​By-​Post, p. 462. 23 Wild, Medicine-​By-​Post, p. 84. 24 P. Wallis, ‘Competition and cooperation in the early modern medical economy’, in Wallis and Jenner (eds), Medicine and the Market, p. 60. 25 Hamilton had been in touch with him a few months earlier to thank him belatedly for the gift of scientific books Sloane had sent him while Hamilton was in Jamaica: ‘I designed by the first to return you my thanks for them, but the leaveing the Kingdome at such time as the Small Pox was among my children, I was put by all Rules of Civilitie.’ BL, Sloane MS 4037, James Hamilton to Sloane, Bangor, 30 January 1698, fo. 21. 26 Ibid., Ferguson to Sloane, Belfast, 14 May 1698, fo. 73. 27 BL, Sloane MS 4053, John Barlow to Sloane, Manchester, 22 Aug. 1734, fo. 257. 28 C. Muldrew, The Economy of Obligation: The Culture of Credit and Social Relations in Early Modern England (Basingstoke, 1998); A. Shepard and P. Withington (eds), Communities in Early Modern England: Networks, Place, Rhetoric (Manchester, 2000); A. Shepard, Accounting for Oneself: Worth, Status, and the Social Order in Early Modern England (Oxford, 2015). 29 BL, Sloane MS 4053, William Maynard to Sloane, Wigan, 17 Oct. 1734, fo. 289. 30 BL, Sloane MS 4036, Ferguson to Sloane, Belfast, 14 July 1691, fo. 106. He also requested a ‘one of the best microscopes for herbs, for one Mr Shered of Oxford St’ –​presumably the botanist William Sherard who was, at that point, working for Arthur Rawdon at Moira, and adding several species from the Ulster countryside to Irish flora –​and also the ‘truest and latest, and fullest’ of maps of the Alps, Savoy and Piedmont, Hungary, and Ireland. See also ibid., Ferguson to Sloane, Dublin, 14 Jan. 1693, fo. 139. 31 BL, Sloane MS 4037, Ferguson to Sloane, Belfast, 4 Feb. 1697, fo. 25. 32 Ibid., Victor Ferguson to Sloane, Belfast, 14 May 1698, fo. 73. 33 K. Dewhurst, ‘Some letters of Dr Charles Goodall (1642–​1712) to Locke, Sloane, and Sir Thomas Millington’, JHMAS, 17 (1962), p. 489. 34 Sloane to John Locke, 11 Dec. 1696, in The Correspondence of John Locke, ed. E. S. de Beer (8 vols, Oxford, 1979), v, p. 737.

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35 BL, Sloane 4036, Locke to Sloane, 14 September 1694, fo. 185. 36 H. J. Cook, ‘Physick and natural history’, in P. Barker and R. Ariew (eds), Revolution and Continuity:  Essays in the History and Philosophy of Early Modern Science (Washington, DC, 1991), p. 73. See also W. D. Churchill, ‘Bodily differences? Gender, race and class in Hans Sloane’s Jamaican medical practice, 1687–​1688’, JHMAS, 60 (2005), pp. 391–​44; H.  J. Cook, ‘Markets and cultures:  medical specifics and the reconfiguration of the body in early modern Europe’, Transactions of the Royal Historical Society, 21 (2011), pp. 123–​45. 37 Quoted in Cook, Decline of the Old Medical Regime, p. 166. 38 Allen Mullen to Robert Boyle, Dublin, 26 Feb. 1685/​6, in Papers of the Dublin Philosophical Society 1683–​1709, ed. K. T. Hoppen (2 vols, Dublin, 2008), ii, no.  23. Consulted during a fellowship at the Edward Worth Library in Dublin, with thanks to Elizabethanne Boran. Mullen refers to an unnamed ‘primate’. This was either Francis Marsh, archbishop of Dublin or Michael Boyle, archbishop of Armagh. 39 St George Ashe to John Bainbrigg, Dublin, 26 Mar. 1687, in ibid., no. 357. This letter was read at the Royal Society in London on 13 July 1687. 40 A. M. Roos, ‘Luminaries in medicine: Richard Mead, James Gibbs, and solar and lunar effects on the human body in early modern England’, BHoM, 74 (2000), pp. 433–​57. 41 Philosophical Transactions of the Royal Society (London, 1695), pp. 634–​6. 42 BL, Sloane MS 4037, John Ray to Sloane, Black Notley, 16 Mar. 1697, fos  40–​1. 43 Philosophical Transactions of the Royal Society (London, 1698), pp. 84–​6. 44 E. Yale, Sociable Knowledge: Natural History and the Nation in Early Modern Britain (Philadelphia, PA, 2016). 45 BL, Sloane MS 4036, Thomas Molyneux to Sloane, Dublin, 22 May 1697, fo. 314. 46 BL, Sloane MS 4038, Molyneux to Sloane, Dublin, 22 Feb. 1701, fo. 140. 47 BL, Sloane MS 4036, Owen Lloyd to Sloane, Dublin, 7 May 1695, fo. 209. 48 BL, Sloane MS 4037, Ferguson to Sloane, Belfast, 14 May 1698, fo. 73.

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8

Collecting medicine in early eighteenth-​century Dublin: the library of Edward Worth Elizabethanne Boran The Edward Worth Library, housed in Dr Steevens’s Hospital, Dublin, is regarded as the most important medical collection of Early Modern Ireland. Dr Edward Worth (1676–​1733), an early eighteenth-​century Dublin physician, bequeathed his library to the newly founded Dr Steevens’s Hospital, an institution of which he was a Trustee. In doing so he secured the long-​term preservation of his collection, as all too often such libraries were sold off by family members who had no interest in medicine. As a result, most Early Modern medical libraries in Ireland have not survived intact.1 Dr Edward Worth’s collection is one of the few which do, and it provides us with important information about Worth’s own medical interests and collecting policies. His decision to include in his bequest fifty-​seven book auction and sale catalogues dating from 1723–​33 (the year of his death), not only provide an insight into how, when, where and why Worth himself bought books, but also allows us to compare his medical collection with that of an unnamed ‘eminent physician’ whose library was sold in Dublin in 1731.2 This chapter will investigate the factors determining the content and scale of both these collections and will, in the process, shed light on methods of collecting medical texts in early eighteenth-​century Dublin. An examination of both these collections provides a vital insight into trends in medical care and practice in Dublin in the first decades of the eighteenth century. The contents of their libraries draw attention to the areas practitioners considered important and, moreover, highlight the most popular authors in each medical discipline. In addition, an exploration of their medical collections enables us to explore the interaction of the worlds of medicine and print at a pivotal time of change. For, as James Kelly has demonstrated, the early eighteenth century witnessed

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‘a veritable explosion in the marketing of commercial medicines’.3 As Kelly notes, many of these commercial medicines intersected with the world of print in a number of ways:  not only in being advertised by Dublin printers but also being stocked in their bookshops.4 Significantly, the 1720s also witnessed some of the first serious medical publishing in Dublin (in the main reprints of London editions of popular works by the English physician George Cheyne (1671–​1743)).5 And, as I have argued elsewhere, the 1720s witnessed a growing specialisation in the Dublin medical book trade as evidenced by the medical imports of Dublin booksellers such as Thomas Thornton, who was responsible for the auction of the second medical library investigated here.6 The fascinating auction and sales catalogues emanating from the Dublin firms at this time provide us with untold riches in tracking what importers of books thought might sell well (and we must remember that the Dublin trade continued to be dependent on imports from abroad, especially in the area of medicine). However, only actual collections, such as the extant collection of Worth and the auction catalogue of the unnamed physician of 1731 can tell us what medical texts practitioners actually purchased and which medical disciplines they favoured. Edward Worth (1676–​1733)

Worth himself left no personal archive and, beyond the wonderful library he bequeathed to Dr Steevens’s Hospital in Dublin, there is little information about him. What facts we have are sparse: he was the second surviving son of John Worth, Church of Ireland Dean of St Patrick’s Cathedral in Dublin, who died in 1688 when Worth was twelve years old. Like his elder brother Michael, Edward Worth studied at Merton College in Oxford in the 1690s but, unlike Michael who decided to train as a lawyer, Worth travelled to the University of Leiden, where he enrolled in the medical faculty in 1699, taking his degree two years later from the University of Utrecht. By 1702 he was back in Dublin, establishing himself as a physician. He was evidently successful:  the Fellows of the Royal College of Physicians elected him as their president on not one but two separate occasions, and the library which he left to Dr Steevens’s Hospital is very much that of a connoisseur collector, able to buy rare printings and fine bindings.7 Clearly the development of his library, which reached almost 4,400 volumes in total, was a central activity and source of identity throughout Worth’s life. The overall collection reflects both Worth’s

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professional concerns (medicine accounting for almost a third of the 4,400 volumes), and his keen interest in all things scientific.8 The rest of the collection mirrored what was the norm for an early eighteenth-​ century gentleman’s library:  many classics, historical and antiquarian works, with some vernacular literature. There were, however, two significant differences between Worth’s personal collection and those of earlier scholars: Worth collected very little theology, and he was clearly fascinated by the book as material object. We are able to track three different stages of development in his collecting with varying degrees of success: the early library, which he inherited from his father (and before him his grandfather and namesake who was Church of Ireland Bishop of Killaloe (d.1669)), can be identified due to provenance inscriptions by John Worth (1648–​88), who always signed his name on the title-​pages of his books.9 Worth’s purchases during the last ten years of his life, the period 1723 to 1733, may be tracked in his collection of fifty-​seven sale and auction catalogues for this period. It is the intermediate period, when Worth was a student at Oxford and Leiden and during his early years as a doctor in Dublin, which provides more difficulty, for unlike his father, who sometimes gives information about when and where he purchased books, Edward Worth rarely annotated his books in any fashion. The inherited collection

From his father and grandfather, Worth inherited not only much of the very small theological cohort in the library but also a number of medical and scientific works. John Worth had been a founding member of the Dublin Philosophical Society, a sister body of the Royal Society, and he shared with his son a fascination for all areas of natural philosophy.10 Like many other late seventeenth-​century ministers, John Worth also had a small collection of medical texts: twenty-​one of these items are now in the Worth Library and these include a composite volume of five early sixteenth-​century printings of tracts by Galen as well as texts by later seventeenth-​century medical commentators such as Thomas Willis (1621–​75). John Worth had two works dealing with obstetrics:  English translations of Jakob Rüff ’s The expert midwife (London, 1637) and François Mauriceau’s The diseases of vvomen with child, and in child-​bed (London, 1683). Their presence here probably relates to the unfortunate deaths in childbirth of a number of his children, which are outlined in the Worth Family Bible.11 John

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Worth’s 1676 copy of Robert Burton’s Anatomy of Melancholy is one of the few books devoted to psychology in the Worth Library and reminds us of the close linkage between psychology and theology in the seventeenth century. In the main, Worth senior collected books printed in England, including such therapeutic staples as Nicholas Culpeper’s Pharmacopœia Londinensis; or, The London dispensatory further adorned… (London, 1683) and Oswald Croll’s Bazilica chymica, & Praxis chymiatricæ or Royal and practical chymistry (London, 1670). One of his few continental purchases, Descartes’ Tractatus de homine, et de formatione foetus (Amsterdam, 1677), a work on embryology, is part of a set he bought while in Amsterdam in 1682. It is clear though, that while his son Edward Worth shared some of his father’s interests, particularly in obstetrics and gynaecology, allegiance to Descartes (1596–​ 1650) was not something the two collectors had in common. The fact that Edward Worth’s surviving auction and sales catalogues date from 1723, two years after a rich uncle died leaving him a financial bequest, has often been linked as cause and effect: the inference being that it was only as a result of his uncle William Worth’s generosity that Worth began collecting books in a serious way. As an argument this certainly does not hold true for his medical collection (or, for that matter, his scientific collection), and it would have been strange if it did, since Worth clearly would have needed to build up his medical collection for professional purposes. Of the 1,012 items which make up the medical collection in the Worth Library 75 per cent are not mentioned in the auction catalogues (i.e. 1723–​33), but unfortunately we cannot deduce from this that they all represent purchases pre-​1723 since a number of these works have printing dates up to the time of Worth’s death.12 However, an analysis of the two groups (i.e. medical books with auction catalogue provenance and those without) demonstrates that there is little difference subject-​wise between the two groups, suggesting that Worth’s medical book-​buying did not change radically over the period.13 Subject divisions of Worth’s entire medical corpus

Combining both groups together can give us a picture of Worth’s medical book-​buying over the entire period. The picture that emerges is shown in Table 8.1. Unsurprisingly the group denoted as ‘Collected works’ is the largest:  this refers to works usually but not exclusively by individual authors, on more than one topic. When we delve a little deeper we can

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Table 8.1  Subject divisions of Worth’s entire medical corpus

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Subject

Percent

Collected works/​Philosophy of Medicine Anatomy Surgery Physiology Pathology Psychology Therapeutics Obstetrics Other

25.4 8.9 7.7 8.0 16.7 1.5 17.9 4.1 9.9

see that Worth’s collection covers the entire panoply of medical philosophy on offer. What is surprising, though, is the strong showing for ancient authors, either editions of their works or later commentaries on them. The dominant ancient authors here are Hippocrates, Galen and Celsus. For Galen and Celsus we are mainly dealing with early to mid-​sixteenth-​century editions or commentaries on their work, and it may well be that Worth was buying these works for their rare printings rather than for the continuing relevance of their subject matter. Hippocrates in the early eighteenth century

But if Galen and Celsus belonged to medical history, Hippocrates was still considered to be essential reading. For Hippocrates we not only find the Aldine 1526 edition but also many later commentaries, such as John Freind’s 1717 edition of Hippocrates’s work on epidemics.14 This is in line with the enduring appeal of Hippocrates (or the various Early Modern interpretations of the Hippocratic corpus), which continued to exercise such fascination for Early Modern physicians. As the sixteenth and seventeenth centuries progressed, more and more emphasis was put on the empiricism of Hippocrates by writers such as Paracelsus (1493–​ 1541), and Jean Baptiste van Helmont (1577–​1644). Paracelsians were among the first to appropriate the ancient Hippocrates as a supporter of their chymical philosophy and Worth had a copy of one of the most important books on the subject:  Petrus Severinus’s Idea Medicinae (Erfurt, 1616). Hippocrates represented a propaganda opportunity for Paracelsians, so often castigated by their Galenical colleagues as being

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purveyors of ‘innovation’. By re-​presenting the ancient and lauded Hippocrates as a chymical forerunner, Severinus sought validation for the Paracelsian project.15 Paracelsians were not the only ones to appropriate Hippocrates. Worth himself had commented on Aphorism XXII for his medical dissertation and Hippocrates’s Aphorisms continued to be the set text for academic disputations in Leiden in the eighteenth century.16 Indeed, the influential Leiden professor, Herman Boerhaave (1668–​1738), had specifically recommended the study of Hippocrates to his students.17 In England too, Hippocrates was lauded as the ancient physician par excellence, a process which received further affirmation with the writings of Thomas Sydenham (1624–​89), whose works were likewise collected by Worth. For Sydenham, the example of Hippocrates was seminal, not only because he had, in Sydenham’s words, ‘laid the solid Foundation for building the Art of Physick’ but also because he had seemed to do this ‘without pressing any Hypothesis for his Service’.18 Newtonianism in the Edward Worth Library

Given the comprehensive nature of Worth’s body of collected works it is tempting to think that, like Sydenham, he held no allegiance to any of the medical philosophies of the day, be it iatro-​chemical or iatro-​ mechanical. He had works belonging to all of the dominant sixteenth-​ and seventeenth-​century medical philosophies and his choice seems to have been deliberately eclectic. There was, however, one medical philosophy which Worth particularly favoured:  the application of Newtonian concepts to medicine. We know from his scientific collection his fascination with the works of Sir Isaac Newton (1642–​1727), and it is striking that texts by all the members of a group of Scottish physicians and astronomers who formed a close-​knit nexus of Newtonianism in Scotland, England and the Netherlands are represented in the Worth Library. Undoubtedly chief among these were Archibald Pitcairne (1652–​1713) and David Gregory (1659–​1708). The mathematician and astronomer David Gregory had influenced Pitcairne, John Keill (1671–​1721) and John Freind (1675–​1728), and, in turn, Pitcairne influenced George Cheyne (1671/​ 72–​ 1743) and Richard Mead (1673–​1754). Pitcairne’s inaugural lecture as professor of medicine at the University of Leiden, delivered on 26 April 1692, emphasised the importance of Newton’s natural philosophy for medical teaching.19 His

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lectures, which emphasised the application of mathematics to medicine (iatromathematics) and the importance of vascular hydraulics, proved a great success and were later published (with other material) under the title Dissertationes medicae at Rotterdam in 1701 –​Worth duly bought a copy. Though Pitcairne’s time at Leiden was short (he only stayed a year), and though it pre-​dated Worth’s time there, Pitcairne’s lectures on the theory and practice of medicine made a great impression on other Dutch and English physicians whose works would subsequently be collected by Worth:  Herman Boerhaave (1668–​1738), George Cheyne, Richard Mead and William Cockburn (1669–​1739). George Cheyne also gravitated to Leiden and it was at Leiden that Pitcairne’s influence began to be felt. The first tangible evidence of this came in 1701 when Cheyne defended Pitcairne’s views on fever in his book A New Theory of Continual Fevers (London, 1701), which was one of three books by Cheyne collected by Worth (Worth had the third London edition of 1722). It was in this text that Cheyne (following his mentor Pitcairne), advocated Newtonian natural philosophy as a basis for a new medical system. Cheyne sought to extend the reach of Newtonian natural philosophy into the area of natural religion in the second book which Worth collected:  Philosophical principles of natural religion (London, 1705), which, as Guerrini reminds us, showed Cheyne’s adherence to the Newtonian concept of short-​range forces.20 Worth also collected books by four other Newtonians who formed part of this Scottish Newtonian nexus (though not all were Scots): John Freind, Richard Mead and the brothers James (1673–​1719) and John Keill. Worth had five texts by John Freind, including his lectures as Ashmolean Professor of Chemistry at Oxford which demonstrated his Newtonian approach to chymistry, which Worth bought in a 1710 Amsterdam copy.21 It included a fulsome dedication to Newton whose unpublished De natura acidorum formed the bedrock of the interpretative structure. Worth’s other works by Friend included the latter’s Emmenologia (Oxford, 1703), a work on menstruation which was heavily influenced by the writings of Pitcairne, and his The history of physick; from the time of Galen, to the beginning of the sixteenth century (London, 1725–​26), which emphasised Newtonian ideals as a return to classical principles. Worth likewise collected works by other noted Newtonians who had been influenced by Pitcairne, such as Richard Mead, who proved to be one of the most successful physicians of his age, and James Keill, whose An Account of Animal Secretion not only explained the circulatory system

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as a mathematical model but also used Newtonian ideas of short range forces to explain animal secretion. Guerrini suggests that Newton’s concept of short-​range attraction ‘reached its apogee’ with the publication of this work.22 By 1713 Newton was beginning to resurrect the idea of the aether, a concept which he had examined in his 1675 paper on ‘Hypothesis of light’. At first physicians paid little heed to it but by the 1720s the role of the aether in physiology was becoming part of mainstream debate. The Worth Library contains one of the most famous Irish explorations of the subject: Bryan Robinson’s A dissertation on the aether of Sir Isaac Newton (Dublin, 1743), as well as two editions of Robinson’s Treatise of the Animal Oeconomy (Dublin, 1732; Dublin, 1734–​37), which sought to apply Newtonian ideas to medicine. As Roos points out, the Treatise of the Animal Oeconomy was concerned with atmospheric acids and acidic salts and used experiments in Newton’s Opticks and his ‘De natura acidorum’ to support the theory that respiration was dependent on a chymical interaction of acidic parts of the air.23 This book is one of at least three books which were given by Robinson to the Worth Library following Worth’s death in 1733. It is also likely that Robinson was the donor of the 1739 first edition of Richard Helsham’s A course of lectures in natural philosophy (Dublin, 1739), given that he had published it. Robinson gave these books because he was a friend of Worth and was, like him, a Trustee of Dr Steevens’ Hospital, which houses the Edward Worth Library. Their inclusion may, however, distort our picture of Worth’s reception of Newtonian medicine. When we examine the core of Worth’s collection of Newtonian medical texts it is clear that the vast majority of his Newtonian medical library reflected the concerns of the earlier eighteenth-​century interpretation, most notably the circle of Scottish Newtonian physicians. Pathology and therapeutics

If we look beyond works of compilation or, more generally, the philosophy of medicine, and delve deeper into the various medical subject disciplines, we can see some clear themes emerging in Worth’s collection. The dominance of pathology and therapeutics is readily apparent. Within pathology, infectious diseases account for 50.3 per cent, with chronic diseases at 11.8 per cent and then a range of specific diseases at 23.1 per cent and texts on the theory of disease at 14.8 per cent. When we focus on the different types of infectious diseases that Worth concentrated on, fevers account for most of his works (42.4

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per cent), undoubtedly because most medical writers writing on disease necessarily discussed fever and its many different forms, both as a symptom and as a disease or, as Thomas Sydenham argued, as part of Nature’s cure. The constantly changing epidemiological landscape ensured that Worth’s texts dealing with fever present the reader with a chronological survey of the rise and fall of fevers in Early Modern Europe. Fever and plague, Worth’s second topic of interest (25.9 per cent of his infectious diseases cohort), were necessarily interlinked:  as Paul Barbette (1620–​66?), commented: ‘Sometimes the Plague is accompanied with a Fever; and again, there are some Pestilent Fevers without the Plague.’24 Worth’s copy of the works of the Dutch physician Paul Barbette is but one of a host of works dealing with ‘that greatest Disease or Casualty of all, The Plague’.25 Though Worth’s collection held works on early plagues, such as the great Athenian plague described by Thucydides, it is clear that the vast majority of his plague collection focussed on contemporary tracts concerning the 1720 plague at Marseilles. This is not surprising since the 1720 plague was not only the last great European plague, it was the greatest plague of his own lifetime. Worth’s library holds no less than five tracts written by François Chicoyneau (1672–​ 1752), who had been sent to Marseilles after the civic authorities there had appealed to the Regent for assistance.26 Chicoyneau’s tracts, all written in French, had a very different view of the nature of plague from that of his English counterpart Richard Mead, whose seminal work on plague, written in reaction to the outbreak at Marseilles, was likewise collected by Worth.27 In Chicoyneau’s view, the cause of the disease was pestilential air, so a cordon sanitaire made little sense: indeed, he viewed the social and economic effects of a cordon as contributing to the rise of fatalities rather than minimising the spread of the disease by limiting movement. Richard Mead, ruefully admitting that he was advocating measures to be taken for a disease ‘which I have never seen’, vehemently disagreed:  his theory of contagion, a theory based on human to human contact, meant that quarantine would play an all important role in the defences of England against the Marseilles plague in 1720.28 If treatment for Chicoyneau had necessarily focused on cure, for Mead it concentrated on prevention. Once the plague had struck, the emphasis necessarily shifted to finding a cure. If Mead emphasised the role of the state in prevention of plague, other physicians focused on what individuals might do when faced with a possible epidemic. They were keen to point out that there

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were other methods by which the healthy might avoid falling sick with the plague. Older accounts focused on the health regime of the individual in the hope that a strong constitution might withstand the dreaded disease:  in particular, sixteenth-​century authors condemned excess in all aspects of life, and were keen to emphasise the idea of moderation in all things which had marked medical writing since Hippocrates. Others pointed to specific precautions which might be undertaken to minimise infection, but undoubtedly the principal focus of much of the medical literature dealing with plague lay in the realm of specific treatments for plague once the disease had been caught. Worth’s collection makes it readily apparent that in this genre, old remedies and new cures might stand side-​by-​side: the unknown physician from Bordeaux, author of Worth’s copy of Lettres sur la peste, ecrites a un medicin de Bordeaux (Bordeaux, 1721), was certainly as anxious to recount older remedies as the newest cures. While his focus was on plague literature, Worth also collected a small body on texts on smallpox, syphilis and tuberculosis. As John Woodward, the author of Worth’s copy of The state of physick: and of diseases; with an inquiry into the causes of the late increase of them: but more particularly of the small-​pox (London, 1718), argued, smallpox was a relatively new phenomena on the disease landscape and it is striking that all five of the texts collected by Worth were written by contemporaries. The same was true of his small collection of works on syphilis and tuberculosis. What is noteworthy in these collections on infectious diseases is not only the continuing impact of a humoral understanding of cause and treatment of infectious diseases, which we can see in François Calmette’s Riverius reformatus (London, 1706), and Sir Richard Blackmore’s A treatise of consumptions and other distempers (London, 1724), but also the overarching importance of chymical cures. The latter trend is readily apparent when we look more closely at Worth’s collection of texts devoted to therapeutics. Here we can see the vital importance of medical botany and pharmacology, represented here by the umbrella term ‘Materia Medica’. Pharmacology was a dominant subset of Materia Medica and Worth assiduously bought any new pharmacopoeias coming on the market. Undoubtedly this was an approach that would have recommended itself to Worth not only because he was interested in the works of Paracelsus and Van Helmont, the chief exponents of the ‘chymical philosophy’ in the sixteenth and seventeenth centuries, but also due to his fascination with chymistry in all its forms –​his collection included a large section of works dealing not

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only with academic approaches to chymistry but also the popularisation of experimental chymistry taking place in the late seventeenth century.29 This close inter-​relationship between materia medica and chymistry is readily apparent in a very physical way in the Worth Library where chymical texts are often intermingled with Worth’s sections on pharmacological remedies. Given the importance of chymistry in the Leiden medical curriculum, where Boerhaave had simultaneously taught as Professor of Botany, Medicine and Chemistry, it is unsurprising to find Boerhaave’s Elementa chemiae standing side by side with Worth’s copy of the Codex medicamentarius, seu Pharmacopoea Parisiensis (Paris, 1732). Clearly for contemporaries, the dividing line between chymistry and pharmacology was a very porous one indeed, and, as the Worth Library demonstrates, the same held true for works on medical botany which were inevitably shelved alongside works solely devoted to plants. Medical disciplines in early eighteenth-​century auction and sales catalogues

An even better indicator of early eighteenth-​century attitudes to disciplinary distinctions may be found in Worth’s auction and sales catalogues. Some of these catalogues are difficult to use (being partial in nature and lacking their title-​page, so we don’t know where Worth was buying from), but others represented the cream of the bibliographical crop and were designed to aid the connoisseur collector in his search for items. They did this not only by commenting on the nature of the binding and the rarity of the printing, but, more crucially, they also divided and sub-​divided the various disciplines, giving us a vital insight into early eighteenth-​century attitudes to disciplinary interaction. In most, medical books are simply included in an overarching section named ‘Historia Naturalis, Medici, &c’ –​we see this in the celebrated sale of the library of Louis Henri Loménie, Comte de Brienne (1724), and similar formulations in a number of auction catalogues emanating from the Dutch firm Groenwegen and Vanderhoeck.30 For libraries which had relatively little medical material it made sense to do this but it was a trend that could also be found in more scientifically minded collections, such as the 1727 auction of Nicolas Hartsoeker (1656–​1725).31 The position of chymistry as a medical subject was acknowledged by more than one auctioneer: in the catalogue of the library of Don Vincent Bacallar y Sanna, which was produced by The Hague booksellers Jean Swart and Pierre de Hondt in 1727, we find the following sub-​sections

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in their medical section:  ‘Medici veteres & recentiores; Tractatus varii Medicorum’, ‘Anatomia & Chirurgia’ and ‘Pharmacia, Chymia & Alchemia’.32 Three years later, Swart and De Hondt used a roughly similar demarcation in their catalogue for the auction of the library of Samuel van Huls (1655–​1734):  here we find ‘Medici Antiqui’, ‘Medici Recentiores’ and, finally, ‘Anatomici, Chirurgici, Chymici & Pharmaceutici’, the latter all in one grouping.33 However, not everyone agreed: in the huge three-​volume auction catalogue of the Amsterdam merchant, Goswin Uilenbroek (1658–​1740), dating from 1729, we find medicine and natural history sub-​divided in a slightly different manner: medicine is simply divided between ‘Medici Veteres, & Arabes, eorundemque Commentatores’ and ‘Medici Recentiores’ but now chymistry is placed as a subsection of ‘Historia Naturalis’.34 Chymistry was not the only sub-​section to move between medicine and natural history: mineral waters, a subject which Worth was clearly interested in it for its therapeutic value, was included with other medical works in the 1726 auction catalogue of the library of Esprit Flechier (1632–​ 1710) bishop of Nîmes, but elsewhere could be found in the natural history sections of other catalogues.35 This evidence would seem to suggest that we should be wary of being too categorical about disciplinary distinctions in the early eighteenth century. Clearly the distinctions of the auction and sales catalogues were the work of the various publishers involved, but they were men who were keenly aware of the changing intellectual landscape of medicine and its sister, science, in the late seventeenth and early eighteenth centuries. The interdisciplinary nature of their catalogues is replicated in the arrangement of the medical collections within the Worth Library, collections which mirrored Worth’s own preoccupations with both medicine and science in all its forms. It is especially apparent in Worth’s collection of anatomical, surgical and physiological works, works which could be said to compose a coherent whole given the amount of overlap in their source material; indeed anatomy and physiology were considered to be two parts of the same whole in the seventeenth century.36 The Leidenisation of early eighteenth-​century Dublin medicine

An analysis of this section of Worth’s library reveals that apart from Newtonian medicine there was another dominant factor influencing Worth’s medical collection: his education at the University of Leiden.37

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Table 8.2  Places of printing of texts on anatomy, surgery and physiology in the library of Edward Worth

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Country Unknown England Ireland France Spain Italy Netherlands Belgium Germany Denmark Poland Czech Rep. Switzerland Subject total

Anatomy

Surgery

Physiology

0 12 0 15 0 3 44 1 6 5 0 0 4 90

1 12 0 23 1 10 16 1 8 2 0 1 3 78

0 13 3 14 0 12 16 1 17 1 1 0 3 81

Country total 1 37 3 52 1 25 76 3 31 8 1 1 10 249

Like many students from Ireland, Britain and northern Europe, Worth had travelled to Leiden, drawn by the reputation of its faculty of medicine.38 As the cross-​tabulation of Worth’s anatomical, surgical and physiological collections makes clear, the dominant influence on Worth’s concept of anatomy was Dutch (see Table 8.2). The cross-​tabulation refers to places of printing but when we break down the list of authors this too corroborates that Worth, like many other Leiden-​trained physicians, was heavily in thrall to the anatomical discoveries emanating from Leiden and Amsterdam. Even his edition of Vesalius was the 1725 edition produced by the Leiden medical heavy-​weights Herman Boerhaave and Bernhard Siegfried Albinus  (1697–​1770).39 But whereas the sixteenth century had focused on such descriptive anatomy, the Dutch anatomists of the seventeenth century, particularly during the latter half of the century, were obsessed with investigating physiological processes. Worth owned three such works by Johannes van Horne (1621–​70), professor of anatomy and surgery at Leiden in the mid-​seventeenth century, and he assiduously collected the texts published by van Horne’s students: Jan Swammerdam (1637–​80), Reiner de Graaf (1641–​73), Nicholas Steno (1638–​86) and, last but certainly not least, Frederick Ruysch (1638–​1731).

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Worth likewise collected the works of Johannes van Horne’s successor at Leiden, Charles Drelincourt (1633–​ 97), who had concentrated on microscopes. His successor, Govard Bidloo (1649–​ 1713), who was professor of anatomy at the time Worth was in Leiden, is, surprisingly, represented by only one book, his Exercitationum anatomico-​chirurgicarum (Leiden, 1708), but Worth didn’t need to purchase a copy of Bidloo’s magnum opus, his anatomical atlas Anatomia humani corporis (Amsterdam, 1685), because he already possessed a copy of it by default in his 1698 edition of William Cowper’s Anatomy of Human Bodies since the latter had plagiarised most of Bidloo’s text and engravings. Worth’s purchase of this book reminds us that though many of these works, especially those of Ruysch, were relatively small affairs (pamphlets in the form of epistolary exchanges), Worth was both willing and able to buy much larger (and hence more costly) volumes. The 1731 Dublin auction catalogue of an unnamed ‘eminent physician’

How unusual was Worth’s medical collection? Certainly he created an un-​paralleled library of medical texts at a time when such texts were relatively hard to find in other institutions of eighteenth-​century Dublin. A  bequest to Trinity College Dublin by Charles Willoughby (d.1694), had sought to remedy the College’s deficiencies in the fields of natural philosophy and medicine, but was different in scale from that of Worth, being much smaller. Willoughby had been one of the founding fathers of the Dublin Philosophical Society, set up in 1683, which had been championed by other Irish physicians such as Thomas Molyneux (1661–​1733) and Allen Mullen (1654–​90). Given his very active role in the Dublin Philosophical Society (DPS), Willoughby’s medical collection reflects the dominant medical concerns of the DPS (a keen interest in anatomy and chymical experiment).40 Willoughby’s interesting collection pre-​dates Worth’s benefaction to Dr Steevens’s Hospital by almost forty years and therefore necessarily echoes the medical debates of its time. A more useful comparator for Worth’s medical collection may be found in the auction catalogue of the library of an unnamed ‘eminent physician’ whose books were sold on 2 April 1731 at Dublin. The latter’s library was far less extensive than that of Worth, numbering only 326 items in total. Evidently the ‘eminent physician’ did not have the same financial resources as Worth, but what money he had he devoted to building up quite a large medical

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collection. In fact, though his medical collection had far fewer items than that of Worth, it represented a far greater percentage of his overall library: 168 out of 326 items (51.5 per cent) were medical in nature. Nor did he limit himself to cheaper smaller volumes, for his collection was evenly balanced with folios accounting for 29 per cent, quartos 29 per cent, octavos at 14 per cent and a grouping of octavos and duodecimos at 28 per cent, unlike Worth’s own collection which evidently favoured quartos and octavos. But if the 1731 Physician’s library differed in size, a cross-​tabulation of his medical works demonstrates that it mirrored many of the themes visible in Worth’s collection, particularly in the section on anatomical, surgical and physiological works. As Table 8.3 makes clear, the dominance of Dutch innovations is striking, with many of the same works being purchased by both. It seems likely that the unnamed Physician had also studied at Leiden, so assiduous was he in purchasing Dutch medical texts. This is not the only parallel between the collections, for the 1731 Physician similarly bought a large section of ‘collected works/​philosophy of medicine’. This was an area in which the 1731 Physician was particularly interested, for it accounts for 39.9 per cent of his collection (compared to Worth’s 25.4 per cent). This was not the only divergence in taste for it is quite clear that the 1731 Physician was not as fascinated with Newtonianism as Worth was. Another difference is evident in the subject breakdown of the 1731 medical collection: unlike Worth, whose interests in disease and cures were almost equally balanced (16.7 per cent and 17.9 per cent, respectively), the unnamed Physician paid far more attention Table 8.3  Places of printing of texts on anatomy, surgery and physiology in the 1731 library of the ‘eminent physician’ Country England France Italy Netherlands Germany Denmark Switzerland Subject total

Anatomy 2 0 2 13 2 1 3 23

Surgery 1 1 1 1 1 0 1 6

Physiology 3 0 0 10 3 0 0 16

Country total 6 1 3 24 6 1 4 45

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to therapeutics than pathology (20.2 per cent as opposed to 10.1 per cent). Equally, he seemed considerably more interested in anatomy and physiology than had Worth, suggesting that the men’s professional expertise had focused on different areas of medicine. Thus, while there were parallels between the two collections, there were also significant differences, differences which undoubtedly reflected not only different personal medical tastes, but also disciplinary affiliations and financial resources. Dr Edward Worth: a medical connoisseur collector in early eighteenth-​century Dublin

Worth differed also from these other collectors because he collected with more than subject matter in mind. I  mentioned earlier that Worth was a connoisseur collector and this clearly impacted on how he constructed his collection, including the medical part of his library. Worth’s choices in the sales/​auction catalogues demonstrate that the subject matter of a book was not always the sole determining factor for its purchase. On a number of occasions he bought more than one edition of a text, a trend readily apparent in his classics section but also identifiable in his medical collection. For example, he collected two editions of Nicander’s Theriaca et Alexipharmaca, a book about poisonous venoms and their antidotes. We know that he bought both editions from the one auction (that of the Dutch collector Henrik van der Marck), so it was not a case of forgetting he already had the text. Instead, it is clear that Worth was buying the books as much for their rare printing status as for their subject matter: his Greek edition was a product of the famous Venetian Aldine press, printed in 1523, while his Latin translation, by Jean de Gorris, was a 1549 publication of the noted (and eminently collectable) Parisian Vascosan Press.41 Tracing Worth’s purchases, even using the auction and sales catalogues as a guide, is not always straightforward. At times the same book (the exact same edition) crops up in more than one catalogue and it is unclear from which auction Worth purchased his copy. Much depends on the level of description in the auction and sales catalogues and the Marckiana, with its brief but vital notes, is an exception which proves the rule. Unfortunately the vast majority of catalogues give little information and in some cases only an abbreviated title is provided. This difficulty is mirrored by Worth’s own habits of annotating his catalogues. In some, such as the Marckiana, he helpfully included prices, a sure

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indicator that he had bought the book, but in the main he either has a pencilled ‘?’ and/​or a dash in ink and these are beside books he both bought and, in the vast majority of cases, did not buy.42 Such marks are useful, however, in showing us the type of works he was interested in and the catalogues themselves provide vital information about what was available in Early Modern Dublin. His auction and sales catalogues illustrate the advantages and disadvantages of collecting medical works in early eighteenth-​century Dublin. First, they demonstrate that Worth had access to auction and sales from individual Irish, British, French, Spanish and Dutch collectors whose libraries were coming on the market in Dublin, London, Amsterdam and The Hague. Some of these might be of little value to his medical collection (for example, the library of a clergyman such as Jacques Saurin (1677–​ 1730), whose library was sold in 1731, held far fewer medical works than those of scientists such as Nicolas Hartsoeker), but the libraries of collectors like Louis Henri Lomenie, Comte de Brienne (1635–​98), which came on the market in 1724, and that of the Dutch merchant Goswin Uilenbroek (1729) were huge affairs which covered all disciplines and were clearly avidly consulted by Worth.43 A second source of supply were the auctions of composite collections or imported books and Worth had access not only to the imports of Dublin booksellers such as John Smith I and William Bruce I, but was also able to benefit from well-​ positioned international booksellers who had London shops: Groenwegen and Van der Hoeck, and Nicholas Prevost (indeed we know that the latter acted as his factor).44 The Dublin medical book trade

The latter grouping of trade (as opposed to individual collection) auction catalogues provide us with a vital insight into what was available in the some of the London and Dublin bookshops of the period. The catalogues of local booksellers such as Smith and Bruce work on at least four levels:  they demonstrate what was available; what booksellers thought would sell; what Worth was interested in; and, finally, what he eventually bought. If we move the focus away from Worth and turn instead to what was available, a somewhat surprising picture emerges: evidently Dublin booksellers were expecting medical books to sell well, judging by the amount of medical books on offer.45 In fact, at least one bookseller, Thomas Thornton, expressly advertised for medical libraries.46 Thornton may have specialised in the auction

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of medical libraries for it was he who was responsible for the sale on 2 April 1731 of the library of the ‘eminent physician’ whose collection we have investigated. If we compare the book buying of Worth and the 1731 Physician in the areas of anatomical/​surgical/​physiological books with the stock on offer in Dublin book shops, a number of definite characteristics emerge. First, most of the books on sale/​auction in Dublin were as up-​to-​date as possible  –​i.e. unlike the personal collections being sold at The Hague which included much antiquarian material, Dublin booksellers concentrated on contemporary volumes. Secondly, the most important influences were English and Dutch authors, especially works emanating from Leiden and Amsterdam by noted Dutch anatomists such as Frederick Ruysch, Isbrand Diemerbroek, Reiner de Graaf and Charles Drelincourt (a trend we have already witnessed in both Worth’s collection and that of the 1731 Physician). Thirdly, in conjunction with this dominance of Leiden anatomy (and, more generally, medical works on other topics by Leiden authorities), there is a pronounced interest in the works of the famous Danish anatomist Thomas Bartholin (1616–​ 80). This trend too, is replicated in the collections of Willoughby, Worth and the 1731 Physician. Thus Worth’s collection of anatomical, surgical and physiological texts and those of the 1731 Physician match trends in contemporary Dublin book shops of the period. However, there the similarity ends, for the Dublin auction and sales catalogues suggest that the market for medical works in early eighteenth-​century Dublin was not confined to connoisseur medical collectors such as Worth, but was targeted at a far wider medical book-​buying public, a public which comprised not only physicians, surgeons, apothecaries and dentists, all of whom had to be catered for, but perhaps even more importantly, given the dearth of medical practitioners in the early eighteenth century, the educated lay reader of medical texts. Conclusion

Worth’s financial resources allowed him to go beyond what was physically on offer in Dublin to avail of the medical riches coming on the market in London, Amsterdam and The Hague. His sale and auction catalogues highlight the important role these international entrepôts of the book trade played in the development of his collection in the last ten years of his life but they are not the whole story. It is clear that he purchased some books which are not listed in them and these he might have bought from

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sale/​auction catalogues which are no longer extant, or, simply, he may have ordered them via his Dublin, London or Amsterdam links. Smith and Bruce, like many other Dublin booksellers, were anxious to assure their customers that they could supply them ‘with any Books from Abroad’ in ‘the most expeditious Manner, and at reasonable Rates’ and it is likely that Worth was not the only physician in Dublin who availed of this particular offer.47 Perhaps the true significance of the medical collection of Worth, and that of the unnamed ‘eminent physician’ of 1731, coupled with Worth’s collection of auction and sales catalogues, is that they remind us of the interconnections between the Irish, English and Dutch book trade and the importance of viewing Irish medical education and disciplinary development in the early eighteenth century in a European context. The medical world of early eighteenth-​century Irish book collectors spread far beyond the banks of the Liffey to avail of medical advances emanating from continental Europe. Notes 1 Sir Patrick Dun (1642–​1713), who similarly bequeathed his library to an institution (the RCPI), was not as lucky as Worth: following his death in 1713 it took decades for his library to be properly catalogued and by the time it was (1794), it was clear that many books from the original library had gone missing. The 1794 catalogue lists about 150 books printed prior to 1713 but it is unclear how many of these belonged to Dun. On this see T. P. C. Kirkpatrick, ‘Sir Patrick Dun’s library’, Irish Journal of Medical Science, 149 (1920), pp. 49–​ 68 and T. W. Belcher, Memoir of Sir Patrick Dun (Dublin, 1866). Equally, this cohort certainly does not represent the extent of his library which had been numbered in 1742 as comprising 300 books (and that after depredations had already taken place): J. G. H. Widdess, A History of the Royal College of Physicians of Ireland, 1654–​1963 (London, 1963), p.  78. Some of the mid-​ seventeenth-​century physician John Stearne’s books undoubtedly form part of the collection of his son, John Stearne, Bishop of Clogher (1660–​1745), now housed in Marsh’s Library, Dublin, but their identification remains difficult. In some cases, library catalogues, rather than collections, survive in manuscript form: for example, the catalogue of Thomas Arthur (1593–​1675), now BL, Additional MS 31885, fos 8r-​14v, and that of the late seventeenth physician, Charles Willoughby (c. 1630–​94), now TCD, MS 10. 2 A Catalogue of Choice Physick Books &c. of an Eminent Physician Deceas’d. To be Sold by Auction … The 2d of April, 1731 … (Dublin, 1731). 3 J. Kelly, ‘Domestic medication and medical care in late early modern Ireland’, in J. Kelly and F. Clark (eds), Ireland and Medicine in the Seventeenth and Eighteenth Centuries (Farnham, 2010), p. 123.

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4 J. Kelly, ‘Health for sale: mountebanks, doctors, printers and the supply of medication in eighteenth-​century Ireland’, PRIA, 108C (2008), pp. 83–​8. 5 J. Kelly, ‘Print and the provision of medical knowledge in eighteenth-​ century Ireland’, in R. Gillespie and R. F. Foster (eds), Irish Provincial Cultures in the Long Eighteenth Century. Essays for Toby Barnard (Dublin, 2017), pp. 33–​56. 6 E. Boran, ‘Buying and selling medical books in early eighteenth-​century Dublin’, ECI, 32 (2017), pp. 105–​35. The Thornton firm of the father and son, Robert and Thomas Thornton, led the charge in this regard but the trend may be seen in the auction catalogues of other Dublin booksellers also. 7 On Worth see T. P. C. Kirkpatrick, The History of Doctor Steevens’ Hospital, Dublin, 1720–​1920 (Dublin, 1924), pp. 58–​65 and D. Coakley, ‘Edward Worth and his library’, in D. Westerhof (ed.), The Alchemy of Medicine and Print, The Edward Worth Library, Dublin (Dublin, 2008), pp. 36–​47. 8 In all 1,012 items in 1,030 volumes are concerned with medical topics (this includes some cusp scientific areas such as medicinal botany and chymistry). More information about Worth’s scientific collections, which favoured natural philosophy (58 per cent) over natural history (42 per cent), may be found at the following url: http://​podgeist.com/​podcast/​ 566181/​science-​scientific-​collections-​of-​the-​edward-​worth-​library-​ elizabethanne-​boran/​ (accessed 20 May 2018). 9 On the inherited part of the collection see E. Boran ‘The library of John Worth, 1648–​1688: bookbinding and the book trade in late seventeenth-​ century Ireland’ (Masters in Library and Information Management dissertation, University of Northumbria, 2009). 10 Papers of the Dublin Philosophical Society, 1683–​1709, ed. K. T. Hoppen (2 vols, Dublin, 2008), ii, pp. 974–​5. 11 The Worth Family Bible, printed at Cambridge in 1629, was annotated by John Worth. It was donated to the Worth Library by Peter and Cleone Blomfield in 2014. 12 It is clear that the fifty-​seven sale catalogues, though illuminating, do not represent the full extent of Worth’s methodologies for collecting books. We know, for example, that he purchased a number of books from the sale of the library of the Colbert family, yet his library does not contain a copy of the Bibliotheca Colbertina (Paris, 1728). 13 Pre-​1723 Worth demonstrates marginally more interest in collected works and texts on surgery, therapeutics and obstetrics, but the differences are minimal (less than 2 per cent in each case). On the difficulties of determining subject divisions see the discussion in this chapter on Early Modern disciplinary distinctions. 14 John Freind, Ippokratous Epidemion … Hippocratis De Morbis Popularibus Liber Primus … (London, 1717).

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15 J. Shackelford, ‘The chemical Hippocrates:  Paracelsian and Hippocratic theory in Petrus Severinus’ Medical Philosophy’, in D. Cantor (ed.), Reinventing Hippocrates (Aldershot, 2002), pp. 59–​88. 16 Edward Worth, Dissertation Medica inauguralis sive Commentarius in Magni Hippocratis Lib. I. Aphor. XII … (Utrecht, 1701). An English translation of this is available at www.dublincity.ie/​main-​menu-​services-​culture-​and-​ amenities-​dublin-​city-​public-​libraries-​and-​archive-​eresources (accessed 20 May 2018). 17 Herman Boerhaave, ‘Oration to recommend the study of Hippocrates’, in Boerhaave’s Orations, trans. E. Kegel-​Brinkgreve and A. M. Luyendijk-​ Elshout (Leiden, 1983), pp. 54–​84. 18 Thomas Sydenham, The Whole Works Of that Excellent Practical Physician, Dr Thomas Sydenham … The Eighth Edition corrected … by John Pechey (London, 1722), ix. 19 A. Guerrini, ‘Pitcairne, Archibald (1652–​1713)’, in ODNB. 20 On the influence of Newtonian theory on early eighteenth-​century medical theory see A.  Guerrini, ‘Newtonian matter theory, chemistry, and medicine, 1690–​1713’ (PhD dissertation, Indiana University, 1983); on Cheyne in particular see A. Guerrini, ‘Isaac Newton, George Cheyne and the Principia Medicinae’, in R. French and A. Wear (eds), The Medical Revolution of the Seventeenth Century (Cambridge, 1989), pp. 222–​45 and A. Guerrini, ‘James Keill, George Cheyne, and Newtonian physiology, 1690–​1740’, Journal of the History of Biology, 18 (1985), pp. 247–​66. 21 John Freind, Praelectiones Chymicae (Amsterdam, 1710). Freind’s Praelectiones Chymicae also acknowledged the influence of another member of the Scottish group, John Keill, who was at Oxford at the same time as Freind and who, like him, had been taught by Gregory. 22 Guerrini, ‘Keill, Cheyne, and Newtonian physiology’, p. 248. 23 A.  M. Roos, The Salt of the Earth:  Natural Philosophy, Medicine, and Chymistry in England, 1650–​1750 (Leiden, 2007). See also, A. M. Roos, ‘Irish Newtonian physicians and their arguments:  the case of Bryan Robinson’, in E. Boran and M. Feingold (eds), Reading Newton in Early Modern Europe (Leiden, 2017), pp. 116–​43. 24 Paul Barbette, Thesaurus Chirurgiae: The Chirurgical and Anatomical Works of Paul Barbette … (London, 1676), p. 345. 25 John Graunt, Natural and Political Observations … (London, 1665), p. 64. 26 See, for examples, Chicoyneau’s Relation Touchant les Accidens de la Peste de Marseille, son Prognostic, et sa Curation (Lyon, 1722). On the Marseilles plague see J.-​N. Biraben, ‘Certain demographic characteristics of the plague epidemic in France, 1720–​1722’, Daedalus, 97 (1968), pp. 536–​45, and S. T. McCloy, ‘Government assistance during the plague of 1720–​22 in south western France’, The Social Service Review, 12 (1938), pp. 298–​318.

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27 Richard Mead, A Short Discourse Concerning Pestilential Contagion … (London, 1722). 28 Ibid., p. ii. 29 See, for example, his copy of George Wilson’s A Compleat Course of Chymistry (London, 1721). 30 Illustrissimi & Excellentissimi Ludovici Henrici, Comitis Castri-​Briennji … (London, 1724). In their Catalogus Insignium & Omnis Generis Studii Librorum. Being a Catalogue of Choice, Valuable, and Very Scarce Books in Greek, Italian, French, Spanish (London, 1724), the Dutch booksellers use an even broader heading: ‘Philosophici, Medici, & Historia Naturalis’. 31 Bibliotheca Hartsoekeriana … (The Hague, 1727). 32 Catalogue de la Bibliotheque de Feu son Excellence Don Vincent Bacallar y Sanna … (The Hague, 1727). 33 Bibliotheca Hulsiana … (3 vols, The Hague, 1730). 34 Bibliotheca Uilenbroekiana (3 vols, Amsterdam, 1729). 35 Illustrissimi ac Reverendissimi Præsulis Domini Domini Esprit Fléchier (London, 1726). 36 On the disciplinary interaction see A. Cunningham, The Anatomist Anatomis’d: An Experimental Discipline in Enlightenment Europe (Aldershot, 2010). 37 On medical teaching at the University of Leiden in the seventeenth century see various chapters in T.  H. Lunsingh Scheurleer and G.  H.  M. Posthumus Meyjes (eds), Leiden University in the Seventeenth Century: An Exchange of Learning (Leiden, 1975). More specifically, on anatomy at Leiden see T. Huisman, The Finger of God:  Anatomical Practice in 17th Century Leiden (Leiden, 2009). 38 On this see P. Froggatt, ‘Irish students at Leiden and the renaissance of medicine in Dublin’, Journal of the Irish Colleges of Physicians and Surgeons, 22 (1993), pp. 124–​32. On the factors influencing the choice of graduate medical education at continental universities see L. Brockliss, ‘Medicine, religion and social mobility in eighteenth and early nineteenth-​century Ireland’, in Kelly and Clark (eds), Ireland and Medicine, pp. 73–​108. 39 Andreas Vesalius, Opera Omnia Anatomica & Chirurgica Cura Hermanni Boerhaave … & Bernardi Siegfried Albini (Leiden, 1725). 40 On Willoughby’s library see K. T. Hoppen, ‘The library of a seventeenth-​ century Irish physician –​Charles Willoughby MD, c. 1630–​1694’, Analecta Hibernica, 48 (2017), pp. 170–263. 41 Bibliotheca Marckiana (The Hague, 1727), p. 5, no. 79, and p. 38, no. 591. 42 On Worth’s methodology of collecting see E. Boran, ‘Dr Edward Worth: a connoisseur book collector in early eighteenth-​ century Dublin’, in E. Boran (ed.), Book Collecting in Ireland and Britain, 1650–​1850 (Dublin, 2018), pp. 80–​103. 43 Catalogus Librorum Bibliothecae Viri Reverendi Jacobi Saurin (The Hague, 1731).

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44 John Smith I (d.1771), was active as a bookseller between 1725 and 1758. His partnership with William Bruce I (d.1755), lasted between 1724 and 1737: M. Pollard, A Dictionary of the Members of the Dublin Book Trade 1550–​1800 (London, 2000), pp. 60 and 532. Johan Groenewegen had a bookshop at the ‘Sign of Horace’, The Strand, London between 1715 and 1728, while his partner, Abraham Vanderhoek, was active in London between 1717 and 1724:  H. R.  Plomer, H.  G. Aldis, G.  H. Bushnell, E.  R. McC. Dix, A.  E. Esdaile and R.  B. McKerrow, Dictionaries of the Printers and Booksellers who were at Work in England, Scotland and Ireland 1557–​1775 (London, 1977), pp. 112 and 250. The Huguenot bookseller Nicolas Prevost opened a shop at the Ship in the Strand in 1728, having previously been active at The Hague from 1722–​25: ibid., p. 203 and J. A. Gruys and C. de Wolf, Thesaurus 1473–​1800. Nederlandse Boekdrukkers en Boekverkopers met Plaatsen en Jaren van Werkzaamheid (Nieuwkoop, 1989), p. 141. 45 This subject was addressed in E.  Boran, ‘Buying and selling books in early eighteenth-​century Dublin’ (Bolton-​King Lecture, University of Limerick, 2017). 46 At the end of his 1733 sale catalogue of the contents of the library of Nicholas Knight, he states that he was interested in the libraries of ‘Clergymen, Lawyers, [and] Physicians’:  A Catalogue of a Choice Collection  … The Library of the Reverend Doctor Nicholas Knight … (Dublin, 1733), sig. F4v. 47 A Catalogue of Books Sold by John Smith and William Bruce … (Dublin, 1728), title page.

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The multiple meanings of an eighteenth-​century account of a Caesarean operation Lisa Wynne Smith Sarah McKinna’s birth of a stone child  –​or, in medical terms, a lithopaedion –​was sad and horrifying. Her story, recounted by John Copping, the dean of Clogher, begins like a folk tale: set in the recent, but vague, past. In 1736 or thereabouts, a poor woman of Brentram, Co. Tyrone, Sarah McKinna, was delivered by Caesarean operation of a stone baby, or perhaps two, that she had carried unknown inside of her for seven years. And she had given birth to two living children, or perhaps none. Copping wrote to Sir Hans Sloane, president of the Royal College of Physicians and president of the Royal Society, twice in 1738 about the case. The first time, Copping transcribed a letter from a young, unnamed clergyman who knew Mrs McKinna.1 McKinna married at sixteen, menstruating only after marriage. McKinna gave birth ten months later, and to a second child after another ten months. She again seemed pregnant after two months, but her symptoms dwindled after nine months. She suffered violent abdominal pains for six years. Seven years after the disappeared pregnancy, she again appeared pregnant. This time, the symptoms lasted seven months, only to fade over six weeks. A  painful boil (as she called it) developed an inch and a half above her navel. The second letter recorded Copping’s own visit.2 His timeline differed. McKinna became pregnant eight to ten years after the marriage. She went to term with the child and a midwife attended, but the pregnancy simply disappeared. Everyone concluded that there was no child. Seven years later, she again seemed pregnant for nine months. She developed a goose-​egg size swelling above her navel. It burst, discharging a watery humour.

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The accounts overlap in grisly details, but the surgical particulars differ. An elbow of a child forced itself out and ‘hung some days by the skin, visible to abundance: at length [McKinna] cut it off for her own Relief ’.3 The young clergyman indicated that she sent for Turlogh O’Neill, though Copping claimed that she only requested him after a midwife and several physicians gave her over as dying. Either way, McKinna’s suffering was clear. In Copping’s version, she believed she was dying; in the young clergyman’s, O’Neill ‘administer[ed] relief ’ at the request of McKinna and her friends.4 The operation described by the young clergyman was quick and efficient. O’Neill made a large vertical incision and easily pulled out the jawbone. On spotting something black inside McKinna’s belly, he reached in to extract in pieces an infant’s perfect skeleton and pieces of black putrefied flesh. He ‘swathed her up’; within six weeks, ‘she pursued her domestic Business’.5 According to Copping, though, the operation was brutal. He described O’Neill’s terrified response to the prospect of doing the surgery: ‘The Man was frightened, and went to sleep; but, when he got up, gave her a large Draught of Sack, and, I suppose, took one himself.’6 Only then did he cut open the stomach. From a hole as big as Mr McKinna’s hat, O’Neill removed a second bone, pulling it back and forth to loosen it. He noticed something black inside the stomach, but was unable to remove all the bones, despite inserting his hand into the hole. The remainder came out painfully over time, ‘some came by the Navel, others from the Womb the natural Way’.7 Fifteen months after surgery, McKinna could not move beyond the house. Her rupture was still big enough that Copping could insert his finger ‘a Pretty Way up into the Body’.8 Both versions agreed that O’Neill had not bandaged McKinna properly. Copping did not mention Mrs McKinna’s fate, though he noted that foetal remnants ‘were carried away by different Physicians’. He raised a collection for Mrs McKinna to visit Mr Dobbs, a Dublin surgeon who could treat the rupture.9 Whether she travelled to Dublin remains unknown. The main sources for this chapter are published and manuscript versions of Copping’s two letters to the Royal Society, published in the Philosophical Transactions of the Royal Society, to which I applied a close reading. Although the story is about Sarah McKinna, the fragments of her experience are buried beneath John Copping’s narrative of discovery and heroism. But it was to McKinna that I was drawn: what pain and physical limitations did she have from her surgery? What suffering

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did she feel as a mother? How did her community respond to this curiosity in its midst? Mrs McKinna’s story grew in my imagination, informed by Early Modern folk tales and miracle accounts. To understand her experience, I have used a microhistorical approach that allows a permeable border between history and imagination. McKinna’s case provides insight into the medical world of Early Modern Ireland. Although Copping’s letters were intended to be objective reports about a medical curiosity for the Royal Society, they reveal medical practices, cultural clashes and bodily experiences. For the historian, Copping’s letters point to several layers of tensions –​urban and rural, educated and uneducated, Protestant and Catholic, English and Irish –​and allow the voices of Mrs McKinna and her community to emerge. Situating Copping’s suasive techniques and McKinna’s experiences within the history of Tyrone, I argue that the case cannot be separated from a distinctly Irish and local context, even if Copping scarcely referred to it. The structure of his narrative relied on the juxtaposition of his expertise as a learned, English man with that of the inferior local knowledge. However, his account also exposes McKinna’s experience of pain and motherhood, which can be set against wider cultural meanings: supernatural belief, popular religion, famine and poverty. The case reflects the medical world of early eighteenth-​century Ireland, while the tale of Sarah McKinna’s strange birth of a stone baby can be read as an embodiment of the colonisation of Ireland. In my interpretation of McKinna’s experience, this chapter responds to wider scholarship on the history of pain. Historians rely on the written word. When it comes to the history of pain, this makes us attend carefully to the voices of sufferers in the past, finding an articulate language for pain.10 We are attuned to the nuances of language, carefully constructed narratives, performed dramas, even looking for the experience of pain on the body itself, through acts and gestures.11 For Early Modernists, this prioritises the experiences of the literate and the wealthy. Many sufferers, such as the poor or children, left few accounts, although it is possible to access their stories through descriptions left by others.12 This is not a new method for historians; those who use court documents or study women have long read against the grain to reconstruct voices.13 It is time for historians of pain to take more interest in finding the experiences of the non-​literate. To imagine Mrs McKinna’s experience, I  use microhistory methods.  The goal of microhistorians has been to find everyday life, especially for people who left few records. This requires creatively

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using scattered references in documents that happen to exist. In this method of ‘clues’, as Carlo Ginzburg describes it, the historian reads ‘between the lines’ for details that are routine or unusual, marginal or even unconscious.14 Microhistorians also place the individual within the wider context of place and time. Individuals can thus become, according to Jill Lepore, ‘an allegory for broader issues affecting the culture as a whole’.15 Lepore’s use of the word ‘allegory’ hints at microhistory’s dangers: reading too much into the symbols of the past, reconstructing a ‘worldview’ that is a convenient catch-​all, sliding too close to fiction, and inserting our modern sympathies into the past.16 Natalie Zemon Davis even wondered whether her own interpretations in The Return of Martin Guerre might be wrong, while Sue Peabody deliberately teased out the similarities and differences between her fictional and microhistorical versions of one incident.17 The problem with telling hidden stories is that they do, after all, draw on unclear information, while detail-​based narratives border on fiction. In the case of Mrs McKinna, I  offer multiple possibilities for how we might understand her story, though it is difficult to know which, if any, might be true. For me, the question is: given what we know about the period, are these interpretations plausible? The ambiguity of her story means that it can be held up within its historical context to represent wider issues of the time for the modern reader, whether or not her contemporaries agreed. Encountering Clogher

Clogher had long been a place of encounter between the Irish and the British. The Clogher valley was an area of heavy plantation settlement. Much of Ulster became a ‘zone of dislocation’ in the 1641 rising, with proportionately more atrocities by the Irish against the settlers than elsewhere. One such massacre took place in Augher, less than two miles from Clogher and even nearer to Brentram.18 By the 1730s, the Clogher area was even more heavily settled. Hugh McMahon, Catholic bishop of Clogher, reported in 1714 that ‘from the neighbouring country of Scotland Calvinists are coming over here daily in large groups of families, occupying the towns and villages, seizing the farms in the richer parts of the country and expelling the natives’.19 The British presence was firmly entrenched and the Church of Ireland in the region, wealthy. The Catholics, however, were increasingly impoverished. After McMahon became archbishop of Armagh in 1715, Clogher remained a vacant see until 1727.20

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In 1738, John Copping became the new Protestant dean of Clogher. His tombstone at St Anne’s Parish, Dublin, indicates that he was born in Norfolk in 1691 and died in 1743 at the age of fifty-​two.21 Cambridge-​ educated Copping met Sir Hans Sloane while living in London, where they had dealings through the Society for the Promotion of Christian Knowledge.22 Copping was part of the London literary scene. For example, he sent letters to Alexander Pope and Thomas Tickell in 1722–​23, with the goal of sharing poems by Henry Baker. He wrote, on behalf of widow Sarah Hughes, a dedication to the duchess of Bedford for Jabez Hughes’s Miscellanies in Verse and Prose (1737).23 Copping’s interests in the moral improvement of society, as well as literature, would have made him an appealing appointment for the Clogher position. For example, the Protestant bishop of Clogher, John Stearne, actively promoted improvement and was friendly with Jonathan Swift and Esther Johnson.24 By 1740, Copping was a member of the Incorporated Society for Promoting English Protestant Schools in Ireland.25 The goal of the project, as the society’s Royal Charter stated, was to instruct the Papists and the poor in English and ‘the Principles of true Religion and Loyalty’.26 Appointees such as Copping –​English loyalist, Anglican and improvement-​minded –​had an important political role: preventing the spread of Irish patriotism.27 Copping’s correspondence began in January 1737/​38, just before his institution.28 In his first letter, Copping apologised for taking so long to write to Sloane as invited. The air of his new home agreed with his constitution better than London, he claimed, but he seemed homesick. Being away from Sloane’s conversation (and presumably England) was a ‘removal’ and ‘banishment’, with constant ‘reflection[s]‌upon what [he] ha[s] left’. His wife ‘suffer’d in health ever since she came, by the distemper incident to strangers’. Copping apologised for not reporting to the Royal Society, owing to unfamiliarity with Ireland: ‘I know little of the place I am in but by report, & can hardly yet form an Idea to the change of life.’29 Ireland did not agree with the Coppings. Copping made himself useful to Sloane by sending items for his collection. Within this context, Copping visited McKinna and forwarded another case. By 1740, he was attending meetings as a member of the Royal Dublin Society.30 He may have had his eye on fellowship in the Royal Society as reward for sending information, or publication in the Philosophical Transactions. Historian Steven Shapin has argued that matters of fact were determined by multiple accounts

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by credible witnesses (educated, elite, male) and that virtual witnessing could stand in for replication; a clear, detailed narrative that allowed the reader to observe along with the author was crucial.31 Although Copping did not obtain a specimen, he examined and interviewed the participants in the case. In early 1740, Copping was rewarded for his efforts when Sloane and his nephew, William Sloane, proposed him as a fellow for the Royal Society. They commended Copping’s zeal for the Society and great knowledge in natural philosophy and polite literature.32 Copping never mentioned Catholicism or Ireland specifically. But his letters cannot be detached from their circumstance:  an incoming English Protestant into a newly settled area. Copping had much to gain, such as friendship of Sloane and Royal Society membership, crucial links for an educated man who was at the peripheries of the Republic of Letters. He discussed at length, for example, the learnedness of the bishop, as if to prove that Clogher was not such a backwater after all.33 Or perhaps he was pleasantly surprised; the bishop had an extensive library.34 Seeking out curiosities offered Copping an entrée into the wider learned world, within and beyond Ireland. In his letter about McKinna, Copping contrasts his own expertise as a man of science with that of local knowledge, whether it was O’Neill, the young clergyman, or the McKinnas. Copping distanced himself in the narrative from the young clergyman –​another man of learning who had even studied physic. Copping never named him, though the reference to his age implied a lack of experience. The young clergyman, moreover, ‘knows the Woman’, suggesting that he was a part of the community in a way that Copping was not. Personal knowledge was to his disadvantage; as a local, he might be less reliable. Copping established himself up as a sceptic from the outset, questioning what the McKinnas told him. ‘If they speak true’, Copping wrote, then the young clergyman’s version had underestimated how remarkable the case was.35 Copping emphasised his reliability as a man of science through his scepticism and outside status. Even more important were his other attributes: mental acuity and charity. The young clergyman had one non-​pejorative reference to ‘ignorance’, indicating lack of knowledge: O’Neill was ignorant of the correct method of bandaging. In three pages, Copping used ‘ignorant’ three times, ‘bad language’ (flawed grammar and accent) and ‘frightened’ (referring to O’Neill and McKinna). McKinna’s priest and friends gave ignorant advice, keeping her from accepting help; O’Neill was ignorant

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of doing surgery; the McKinnas’ language was so ‘bad’ that he could hardly understand them. He mentioned his superior intellectual abilities nine times, with words such as: seen, inquired, particular, master, surprising, apprehend, examined and answering. This suasive tactic was common in printed medical case histories.36 Copping had no medical expertise, but he could demonstrate Christian charity. He raised money to buy McKinna new clothes and to take her to Dublin. This was a significant act of charity, which drew attention to his growing associations. The Dublin surgeon, William Dobbs, was active in establishing Mercer’s Hospital in 1734 to treat the incurable poor.37 Dobbs, a member of the Royal Dublin Society since 1733, was also well-​connected.38 The young clergyman, however, offered no material help, while physicians and surgeons had taken foetal bones. Copping bragged: ‘They are so thankful to me for entering so much into their Condition that they now say she shall go to London, or where-​ever I please.’39 Copping’s account, however, has several problems for the modern reader. His vagueness about some details  –​timelines or numbers of live babies and lithopaedions –​makes the reader wonder what else he overlooked because it did not fit his own interpretations, or because he misunderstood, given that he couldn’t ‘make myself master of what they said’.40 In particular, Copping did not interview Turlough O’Neill, the butcher, which further adds to the confusion. Was ‘butcher’ meant to indicate an occupation, describe a surgeon pejoratively, or refer to an action of (what Copping suggested was) a drunken buffoon?41 The young clergyman specified that O’Neill ‘did, and does now live with Capt. George Gledstanes, about a Mile from Clogher’.42 The Gledstanes were wealthy landowners, with George Gledstanes a man of sufficient substance to be sheriff in 1722.43 Copping’s vague descriptions could equally suggest a servile role, a household physician, a tenant or a familial relationship. Although Copping, whose account was published in the Philosophical Transactions, successfully established his reliability, his account is confusing. The medical context

In 1793, Dr James Reynold of Tyrone complained that there were only two physicians in the county.44 Although charitable medical institutions were established in Dublin during the early eighteenth century, there was no system of infirmaries in rural areas until late in the century.45 The number of physicians and surgeons was insufficient for

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the population. Care tended to occur within the household (especially falling to women) or others with some medical knowledge, ranging from apothecaries or farriers to priests and cunning-​folk.46 Sufferers like McKinna were practical, combining do-​it-​yourself efforts with consulting practitioners when necessary. Medical methods co-​existed with supernatural explanations and treatments for illness, whether making pilgrimages or blaming the fairies for mysterious illnesses.47 Ill people had a range of possibilities, despite the lack of physicians and surgeons. Mrs McKinna saw several practitioners, including Dr Gabriel King –​ a Presbyterian Scots-​Irish physician in Armagh who wrote an account of her case in 1740.48 King remained at the periphery of learned society. He was not a member of the Royal Dublin Society or improvement projects, though he was interested in medical developments. For example, he replied to William Hunter’s queries on smallpox inoculation in Ireland.49 In 1733 King visited the wife of a farmer from Augher. The woman had previously borne children and was again pregnant around 1726, but no labour pains came after nine months. When the swollen belly disappeared, midwives concluded ‘that she had no Child to bear’. For six years, she was sick and pained, but conceived again. Eight months later, she felt ‘extraordinary pain’ in her belly. An ulcer appeared below her navel. Within days, a child’s elbow poked from the hole. She removed it using a bodkin, but ‘continued in Misery’ for days until her relative, a footman to a local gentleman, ‘had the Courage to pull out the remaining Body of the Child’. The child, according to two gentlemen who viewed it immediately after, was whole.50 King visited three weeks later, noting a nearly healed wound. King concluded that there were two extra-​uterine, or ectopic, pregnancies. On examination, he felt foetal bones beneath Mrs McKinna’s skin. She said that she voided them with her urine and faeces. After several visits, King assumed that she would die, given her emaciation. He was later surprised to see her walking about the fields: ‘she has lived Seven years since, her Viscera falling out at the old Wound’, though against his advice she refused to bind them with a canvas belt. Apparently ‘when troubled by the Wind’ –​which she was frequently (because of her diet of potatoes, King claimed)  –​the binding made the pain ‘intolerable’. Their relationship continued, as King mentioned recently treating her for a ‘monstrous hernial Tumour’, surely a long-​term complication of her operation.51 King also omits names and specific dates, though admittedly he described his encounters years after they had occurred.

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King’s version also indicates how quickly medical news and techniques spread in Ireland. Even as the kinsman operated, gentlemen arrived to see the curiosity. The case suggested possible new techniques, too. King shared the case in response to a similar event. It is an unlikely coincidence that in January 1739, Alice O’Neal of Charlemont, Tyrone, some twenty miles away, was also delivered by Caesarean section of a dead child. Midwife Mary Donnelly undertook the operation, suturing the wound as she would a hare-​lip.52 Stories about Mrs McKinna’s strange delivery must have circulated, at least in Tyrone. Copping, for example, learned about it several years afterwards and Donnelly tried the method during a difficult birth. Elsewhere in the British Isles, Caesarean operations were widely opposed until the late eighteenth century, but here are two rare examples, geographically and temporally close.53 Mrs McKinna’s case was a curiosity and medical innovation, but also reveals everyday domestic medical practices and the local transmission of medical knowledge. Meeting Mrs McKinna

Sarah McKinna is difficult to trace, especially as a woman whose maiden-​ name and husband’s forename are unknown. No relevant records come up in genealogical searches. ‘MacKenna’ (and its variants) could be either Irish or Scottish, but it was a common Irish name in Early Modern Tyrone. The clan’s heartland was in nearby Monaghan, though its power was destroyed during the seventeenth century.54 The servanthood of McKinna’s kinsman, Turlogh O’Neill (another common Irish Catholic name), is a clue to the family’s ethnicity and religion. Eighteenth-​ century Ulster was culturally divided, with Irish Catholics working the poorest land or employed as servants.55 McKinna’s humble background is further implied by King’s reference to her ‘Diet of Potatoes’ –​a staple of the Irish peasant diet by the eighteenth century, but associated with coarse foodstuffs.56 Despite Copping’s charity, McKinna was at least able to afford midwives. Less clear is whether McKinna paid King, but his language suggests charitable assistance in that he approached her rather than being requested. He ‘went about three Weeks after to see’ her and later ‘found her walking out in the Fields’.57 The McKinnas’ economic circumstances appear marginal. When it comes to McKinna’s physical experience, the operation and its aftermath was devastating, no matter which account we take. There was first the uncertainty of pregnancy in Early Modern Europe, as

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discussed by Cathy McClive.58 Just as early pregnancy signs were easily mistaken for other illnesses, it was possible for what appeared to be full-​ term pregnancies to disappear. The bodily interior was mysterious and hidden. McKinna suffered pain throughout the seven years of carrying a stone baby, which would have been woven into her daily life. In the first letter from March 1737/​38, the young clergyman noted that for four years after the disappeared pregnancy, ‘she was perpetually afflicted with most violent Pains’. The skin eruption came ‘with very great pain’. The details of the surgery  –​an act that suggests her desperation  –​ make for uncomfortable reading, although her pains are not explicitly referenced. But we can all picture having surgery without anaesthesia, with someone inserting their hand into an abdomen to remove bits gradually. Also absent from the accounts are specifics about the surgical process: how many people had to hold her down? Testicular surgery, for example, had two strong men to hold the legs, two more to hold the knees apart, and one to hold down the shoulders.59 Perhaps no pain description was necessary for the eighteenth-​century audience familiar with such images. Pain plays a larger role in Copping’s account. McKinna was ill enough that medical practitioners thought she would die; we envision her pain as she cut off the protruding elbow ‘for her own Relief ’. We cringe at the image of O’Neill pulling the bone to loosen it. After surgery, Mrs McKinna suffered ‘great Pain each time’ that bones came out. A year later, Mrs McKinna still had a deep abdominal wound into which Copping could insert his finger. In 1740, King described her ongoing difficulties with protruding viscera, though she was able to walk through fields. The descriptions suggest a worse injury than other badly healed wounds discussed by François Rousset in a 1581 treatise on Caesareans; one woman had a sort of hernia that never went away, while another needed to wear a compress over her terrible scar, a single layer of skin over her intestines.60 Whether Mrs McKinna’s recovery was six weeks (unlikely, given King’s description of her a month after) or fifteen months, many household activities would have been painful and challenging owing to the open wound and inadequate bandaging. She would have needed assistance from friends and family for many activities. Mrs O’Neal, from King’s other case history, was ‘capable of doing something for her Family’, but only when well-​bandaged –​and she had received better suturing.61 The suffering would have been bad enough, but the limitations to her daily life must have been frustrating. As Copping put it, the first clergyman may have said that she pursued

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domestic business within six weeks, but she had been limited to the household ever since. All accounts described her pain, suggesting it was integral to her own account. One wonders, though, did Copping play up the horrific elements to get a better story of McKinna’s victimisation? The first account dealt with the surgery and recovery matter-​of-​factly. King focused more on McKinna’s state after the surgery. In Copping’s more brutal version, there is a hat-​sized wound; elbow poking out for days; giving her over for dead; a gradual expulsion of foetal body parts. Or the young clergyman might have lacked awareness of her suffering, overlooking the long recovery and skipping through details. Copping may have been a more empathetic listener, ‘entering so much into their Condition’. There is also the possibility that the McKinnas played up the story for Copping, a stranger in their community in more ways than one. It seems like an exaggeration when Copping notes that O’Neill ‘made such a hole as the Man describes to be as large as his Hat’. That said, to a conscious woman undergoing agonising abdominal surgery and her worried husband, the hole may have seemed vast. Memory and experience are tricky matters. Interpreting the stone babies

All accounts agree on another issue: the first lithopaedion developed around 1727. Lithopaedions often develop from an ectopic pregnancy. Causes include pelvic inflammatory disease, fibroids, endometriosis and stress.62 When the foetus remains in the body, a calcified shell forms, protecting the mother’s health. McKinna apparently had at least one successful pregnancy, suggesting that psychological or physiological stress played a role. Such stress might, in turn, be caused by famine. For example, studies of modern famines have shown the effects of antenatal stresses on lifelong health, as well as increasing rates of mental illness and coronary disease in later generations.63 Significantly, miscarriage and stillbirth incidences also rise during famines.64 There was, in fact, a major famine in Ireland in 1728–​29. By 1727, after wet weather ruined three harvests in a row, the Protestant archbishop of Armagh found that peasants had depleted their potato stocks months earlier than usual. There had been a state of near-​famine among the poor since Boulter had arrived two years before. In 1726, the ‘dearness of [corn] was such that thousands of families quitted their habitations to seek bread elsewhere, and many hundreds

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perished’.65 Worse yet, as Sir John Browne pointed out in 1728, more than a third of the 1727 crop had failed because of bad weather. Although Great Britain had sent relief, its own rising grain costs meant that it was unlikely to send more.66 The famine occurred within the context of endemic poverty and food shortages.67 The Irish economy of the early eighteenth century was also unstable: absentee landowners, haphazard poor relief, colonial problems and money shortage. Economic problems exacerbated the famine, slowing recovery even when food was available. In Ulster, weak trade depressed linen prices. Producers were unable to escape debt. Ulster was also depopulated; emigration increased, while mortality rates remained high from the effects of malnutrition and disease.68 Catholics were disproportionately affected, but relief efforts targeted Protestant settlers.69 Worse was soon to come, with one of Ireland’s worst famines in 1739–​41.70 The McKinna family lived in Co. Tyrone, Ulster: one of the poorest counties in Ireland, in a province hit hard by hunger and disease in 1728.71 Jonathan Swift, of course, immortalised the year 1728–​29:  ‘It is a melancholly Object to those, who walk through this great Town, or travel in the Country, when they see the Streets, the Roads, and Cabbin-​ Doors, crowded with Beggars of the female Sex, followed by three, four, or six Children, all in Rags, and importuning every Passenger for an Alms.’72 The solution, of course, was raising babies to sell as food to the wealthy: ‘a young healthy Child well Nursed is at a year Old, a most delicious, nourishing, and wholesome Food, whether Stewed, Roasted, Baked, or Boyled, and I  make no doubt that it will equally serve in a Fricasie, or Ragoust’.73 The deliverance of the McKinnas’ stone baby is Swiftian, allowing the family to profit from the horror several long years later. It is unlikely that an enterprising peasant, with husband, friends and clergyman to advise her, would have allowed people to take away the foetal bones without some profit. Copping cannot have been the only person to give her charity in exchange for viewing the curiosity. Satire aside, this is a story of the trauma of famine in Ireland written upon Mrs McKinna’s body; the lost child, and her two other infants crying hungrily in the background; the stone babies, who filled her belly instead of food, emerging years later. Is it too much to make this imaginative stretch? Not necessarily, given that some types of individual or collective pain were considered meaningful for Early Modern Irish communities.74 There are several contextual reasons that make this a plausible interpretation. Irish beliefs existed within a wider European framework, though with local particularities. Accounts of

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wonders travelled far, considered revelations of God’s work. Orally transmitted stories changed regionally. For example, Irish communities localised their saintly traditions. They created genealogies or drew on associations with landmarks to place the saints within the area. Across Ireland, popular religious practices and beliefs existed independently of the established church. The landscape was marked by stories of saints or sites of popular veneration. Saintly power was accessible to all through prayer, visiting sites or touching physical remains (many in laypeople’s possession).75 The tale of a wondrous event, like Mrs McKinna’s, might easily have localised significance. The role of maternal imagination, widely accepted, offered one interpretation.76 Women’s porous bodies were thought to absorb outside influences. A  mother’s emotional state, from cravings to fears, affected the unborn child. For example, a child whose mother craved strawberries might be born with a strawberry birthmark; a mother frightened by a violent act might give birth to a child with deformities. Maternal imagination was hotly debated among the educated elite, particularly after Mary Tofts’s case of 1726 in Godalming. Tofts claimed she gave birth to rabbits, caused by craving rabbit meat. Physical evidence from the case initially appeared to support the theory of maternal imagination affecting foetal development.77 The Cult of St Vincent Ferrer (1350–​1419) was popular during the Early Modern period, with a miracle centring around the danger of pregnancy cravings and maternal imagination. The miracle tale, originating in Brittany, involved St Vincent resurrecting a baby who had been chopped up by its pregnant mother when she craved meat.78 Within the context of widespread belief in maternal imagination, a baby turned to stone during a famine, caused by its mother’s distress, would make perfect sense. European mythology and folklore included other tales of dismembering and eating children.79 Continental witchcraft (though not embraced in Ireland) contained a cannibal element, with babies being roasted by witches at the Sabbat.80 There were also accounts of cannibalism in Ireland during warfare and famine. As historian Martyn Powell has pointed out, the body politic of Ireland was depicted as sick, consumptive, consuming and animal-​like. The idea of Irish cannibals pre-​dated Swift, with cultural and political references throughout the seventeenth and eighteenth centuries.81 Several of the examples that might have resounded in cultural memory came from 1641, including the case of a woman who allegedly ate another woman’s child.82 Satire, political uses of an image, and historical memory had unclear

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boundaries in Early Modern Ireland, but many stories about baby-​ eating circulated around Europe. Supernatural beliefs emphasise the widespread understanding that pregnancy, birth and lactation were vulnerable times for women. This reflected the reality of a high infant mortality and childbearing risks.83 Elsewhere in Europe, a woman who lost her baby or whose milk dried up might wonder if a neighbour had cursed the family.84 In Ireland, a woman whose child seemed sickly or discontented might wonder if fairies had replaced her child with a changeling.85 Depositions from the 1641 rebellion reveal the cultural importance of this trope in Ireland, as Naomi McAreavey finds. Women’s stories emphasised the vulnerable maternal body and mother–​infant dyad; rebels wounded pregnant women in the belly, assaulted women during labour, murdered babies, killed breastfeeding mothers and left living infants beside their dead mothers to perish. These were direct attacks against the ideal of womanhood and domesticity, reflecting the deponents’ sense that there was a Catholic plan to kill off the Protestant community.86 The liminal, parturient body, with its relative defencelessness, was innately symbolic. Throughout the Catholic world, miraculous tales abounded that paralleled stones with childbirth or bread. Stones had reproductive significance in the cases of Clare of Montefalco (1268–​1308) and failed living saint Cecilia Ferazzi (1609–​84). Visionary power was thought to leave physical marks, with the saintly body as open as the maternal body to the effects of imagination.87 In the case of Clare, her encounters with God resulted in several relics found inside her body, including three gallstones, which the nuns believed was the Trinity and others linked to female fertility. The objects were enclosed within the body, like a foetus, and her autopsy was like a Caesarean.88 Her relics were displayed at Santa Chiara church in Montefalco and her stories circulated through hagiographies and sermons.89 In her account to the Venetian Inquisition in 1664, Cecilia Ferazzi evoked Clare of Montefalco and childbirth narratives when she described passing kidney stones while kneeling on the church floor.90 By 1710, the Catholic world rediscovered a beata with a stigmata: Lucia Brocadelli (1476–​1544). In her lifetime, Brocadelli was just as suspect as Ferazzi. Her claims of stigmata were only proven at her death when her stomach wound offered proof.91 Between the stone babies and gaping stomach wound, one can only wonder how the Catholic faithful in a small Irish town might have seen Sarah McKinna’s body. Mysterious objects within the body or exterior marks were imbued with supernatural meaning.

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Ireland had its own popular saints and miracles. Co. Tyrone was known for its devotion. When Hugh McMahon, the Catholic bishop of Clogher, reported on the state of his diocese in 1714, he noted that he was the first bishop there since 1686 and that there were too few priests for the area.92 Priests served large areas, offering Masses in alternate weeks in different places, but the Clogher people came: ‘they must rise early and travel through frost and snow; some, many of them advanced in years, leave their homes the previous day to make sure they will arrive in time’.93 Thirty-​nine miles from Clogher, St Patrick’s Purgatory (Lough Derg) was a pilgrimage site where Catholics practised freely. The bishop noted the superstitious tinge to the locals’ belief  –​with stories of ghosts and spectres surrounding St Patrick’s Purgatory –​and the lack of an educated clergy, but at least they were faithful.94 Brigid was also associated with Lough Derg. With her homely ways, she was a popular patron saint of midwives, childbirth and newborns. One of her miracles included helping a lapsed nun who had become pregnant by making the conception disappear and restoring her to health without childbirth or pain.95 Stories about Brigid were primarily about the household, food and livestock.96 On one occasion, she even turned a stone into bread during a famine.97 Stones appear repeatedly in miracle accounts, a substance for transmogrification into food or a product of communion with God. Stories of Brigid’s domestic miracles must have had resonance during times of famine, especially in a staunchly religious area like Tyrone. Ultimately, Copping’s interactions with the McKinnas can be read as a colonial encounter. Although Copping sympathised with McKinna, many of his comments expose the English elite’s casual contempt, such as insisting that he could not understand the locals. Rather than consider why Mrs McKinna’s neighbours might be reluctant for her to accompany him to Dublin, he contemptuously dismissed ‘her ignorant Priest, and some other ignorant Neighbours, [who] told her they would keep her till she dies’.98 This resistance to Copping’s plan is the only suggestion of the Brentram community’s reaction to the case. Even this act can be read in multiple ways. To a local, Copping was a Protestant and a foreigner, just another educated man overly interested in the curious body of Mrs McKinna. If the community attached religious significance to her suffering, perhaps seeing her as a wonder, they would have wanted to keep her close.99 Copping also promised a cure that would have seemed impossible after so long. The trip to Dublin would entail dragging a woman with limited mobility and constant pain nearly 100 miles across

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tough, mountainous terrain. McKinna seemed willing to make the difficult journey, despite the need to leave her community. Or perhaps leaving was desirable: being a wonder or curiosity was not for everyone. Either way, Mrs McKinna presumably longed to be whole again in her own wounded, suffering body. She could hope to be restored, even if the bones of the babies that she had carried within for so many years were now scattered to unknown parts. Sadly, if she did make the journey, it did not help and may have worsened her condition. King, over a year later, was still trying to fix the ‘monstrous hernial Tumour’. Conclusion

The case of Sarah McKinna provides a glimpse into the medical world of Early Modern Ireland. From the start of the story, there are hints of what happened during a difficult childbirth; McKinna was surrounded by a midwife, physicians, and friends and family. The Caesarean attracted wide interest, with medical men and clergymen visiting McKinna. The path of medical care was typical of Early Modern treatment, in that McKinna dealt with the situation on her own, only seeking when the problem worsened. The rarity of undertaking a Caesarean operation was emphasised by O’Neill’s anxious response and inexpert bandaging after the surgery. Yet, nearby midwife Mary Donnelly later tried the operation, highlighting the local transmission of medical knowledge. O’Neill and Donnelly, whatever their experience, innovated when it helped sufferers, highlighting the practical nature of their medical techniques. McKinna’s personality, too, emerges occasionally:  tough (walking the fields), pragmatic (the arm removal) and defiant (refusing the belt because of her flatulence). This is in marked contrast to Copping’s perception that the locals were ignorant. Copping’s account aimed to emphasise his own suitability as a potential fellow for the Royal Society. For the readers of the Philosophical Transactions, the point of his account was the double curiosity of the stone baby and the Caesarean operation. The wondrous details of Mrs McKinna’s pregnancy and delivery must have intrigued her community, who would have been aware of potential supernatural and religious interpretations, even if they believed it was natural. In any case, the community was willing to provide support to McKinna and to protect one of its own from men like Copping, who were strangers in every way: education, faith, ethnicity, place and status. The letter is also a story of a poor woman’s pain, her loss of a child and the physical marks left by

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famine. It is a distinctly Irish story that cannot be readily detached from its wider context of colonisation; the body of Sarah McKinna represents the wider suffering of the poor Irish Catholics who watched their loved ones die by the hundreds in 1728 and by the hundreds of thousands in 1739–​41. By attending closely to the clergymen’s accounts and using an imaginative leap, it becomes possible to find traces of Mrs McKinna’s voice and a story about the maternal body, poverty and suffering more meaningful than Copping ever would have guessed. It is hard to say what really happened in Brentram, or how the community understood her case. However, if we ignore hidden and imperfect stories such as Sarah McKinna’s, we re-​inscribe the power of the written word on the lived experience of the past, privileging once more the select few: the literate, the wealthy, the colonisers, the male. Notes 1 John Copping, ‘Extracts of two letters from the Revd Dean Copping, F.R.S.  to the president, concerning the Caesarian operation performed by an ignorant butcher; and concerning the extraordinary skeleton mentioned in the foregoing article’, Philosophical Transactions of the Royal Society, 41 (1739–​41), pp. 814–​19; RSLA, LBO/​24, ‘Extract of a letter from the Revd Dean Copping to the president containing an account of two abdominal foetus’s of different ages, cut out of a woman at one time, without occasioning her death’, 16 Mar. 1737/​8, fos 248–​50. 2 Copping, ‘Extracts of two letters’, pp. 814–​19; RSLA, LBO/​24, ‘Extract of a letter from the Revd Dean Copping to the president, containing a further account of the two abdominal foetus’s already mention’d: with some account of an universal anchylosis’, 2 June 1738, fos 420–​3. 3 As per Copping’s own account: Copping, ‘Extracts of two letters’, p. 817. 4 Ibid., p. 816. 5 Ibid. 6 Ibid., p. 817. 7 Ibid., p. 818. 8 Ibid. 9 Ibid. 10 See S. Pilloud and M. Louis-​Courvoisier, ‘The intimate experience of the body in the eighteenth century: between interiority and exteriority’, Medical History, 47 (2003), pp. 451–​72; L. Smith, ‘ “An account of an unaccountable distemper”:  the experience of pain in early eighteenth-​ century England and France’, Eighteenth-​Century Studies, 41 (2008), pp. 459–​80. This counters Elaine Scarry’s argument that pain destroys language: The Body in Pain (Oxford, 1988).

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11 J. Moscoso, Pain: A Cultural History (London, 2012); J. F. van Dijkhuizen and K. A. E. Enenkel (eds), The Sense of Suffering: Constructions of Physical Pain in Early Modern Culture (Leiden, 2009); F. Dillane, N. McAreavey and E. Pine (eds), The Body in Pain in Irish Literature and Culture (London, 2016). 12 H. Newton, The Sick Child in Early Modern England, 1580–​1720 (Oxford, 2012); K. Walker, ‘Pain and surgery in England, circa 1620–​circa 1740’, Medical History, 59 (2015), pp. 255–​74; K. Harvey, ‘What Mary Toft felt: women’s voices, pain, power and the body’, History Workshop Journal, 80 (2015), pp. 33–​51. 13 C. Ginzburg, The Cheese and the Worms: The Cosmos of a Sixteenth-​Century Miller, trans. J.  and A. Tedeschi (Baltimore, MD, 1980); W.  G. Pooley, ‘Independent women and independent body parts:  what the tales and legends of Nannette Lévesque can contribute to French rural family history’, Folklore, 121 (2010), pp. 190–​212; J. Arnold, ‘The historian as inquisitor:  the ethics of interrogating subaltern voices’, Rethinking History, 2 (1998), pp. 379–​86; N. Z. Davis, The Return of Martin Guerre (Cambridge, 1983). 14 C. Ginzburg, Clues, Myths and the Historical Method, trans. J.  and A. Tedeschi (Baltimore, MD, 1989), pp. xi–​xii. 15 J. Lepore, ‘Historians who love too much’, Journal of American History, 88 (2001), p. 133. 16 D. LaCapra, ‘Chartier, Darnton, and the great symbol massacre’, Journal of Modern History, 60 (1988), pp. 95–​112; R. Finlay, ‘The refashioning of Martin Guerre’, American Historical Review, 93 (1988), pp. 553–​71. 17 N. Z. Davis, ‘On the lame’, American Historical Review, 93 (1988), p. 572; S. Peabody, ‘Microhistory, biography, fiction: the politics of narrating the lives of people under slavery’, Transatlantica, 2 (2012), pp. 1–​19. 18 The most likely candidate for ‘Brentram’ (which exists on no map) is Branter/​Bréntír, two miles from Clogher and a mile from Augher. The term ‘zone of dislocation’ comes from W.  J. Smyth, ‘Towards a cultural geography of the 1641 rising/​rebellion’, in M. Ó Siochrú and J. Ohlmeyer (eds), Ireland 1641: Contexts and Reactions (Manchester, 2013), p. 72. 19 H. MacMahon and P. J. Flanagan, ‘The diocese of Clogher in 1714’, Clogher Record, 1 (1954), p. 40. 20 Hierarchia Catholica Medii et Recentioris Aevi: V (1667–​1730) (Monasterii Sumptibus et typis librariae Regensbergianae, 1952), p. 162. 21 C. Hunt and M. Taylor, ‘St. Anne’s Parish Church, Dublin’, Irish Genealogy Projects Archives, www.igp-​web.com/​IGPArchives/​ire/​dublin/​cemeteries/​st-​annes.txt (accessed 23 April 2017). 22 As discussed in BL, Sloane MS 4053, Henry Newman to Sir Hans Sloane, 5 Dec. 1734, fo. 336; ibid., Newman to Sloane, 9 Apr. 1734, fo. 193. A

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Cambridge Alumni Database, http://​venn.lib.cam.ac.uk/​Documents/​ acad/​2016/​search-​2016.html (accessed 1 Aug. 2018). The dates are incorrect, but closer than those of an Oxford John Copping: Alumni Oxonienses 1500–​1714, ed. J.  Foster (Oxford, 1891), British History Online, www. british-​history.ac.uk/​alumni-​oxon/​1500–​1714 (accessed 1 Aug. 2018). 23 Yale University Library, New Haven, OSBORN FC109, H.  Baker, Letterbook, ‘Copies of letters by John Copping to Alexander Pope and Thomas Tickell’, fos 109/​I/​1,2,3; J. Nichols, Literary Anecdotes of the Eighteenth Century (9 vols, London, 1812–​15), viii, p. 268. 24 J. Falvey, ‘Stearne [Sterne], John (1660–​1745)’, in ODNB. 25 A Continuation of the Proceedings of the Incorporated Society in Dublin for Promoting English Protestant Schools in Ireland for the 25th of March, 1738 to the 25th of March, 1740 (Dublin, 1740), pp. 28, 38. 26 Ibid., p. 3. 27 A. Sneddon, Witchcraft and Whigs: The Life of Bishop Francis Hutchinson, 1660–​1739 (Manchester, 2008), pp. 130–​1, 178–​9. 28 He was instituted on 25 May 1738, delivering a later-​published sermon on obedience to rulers (Titus III.1) before the Bishop. H. Cotton, Fasti Ecclesiae Hibernicae (6 vols, Dublin, 1845–​78), iii, p. 88; R. Watt, Bibliotheca Britannica (4 vols, Edinburgh, 1824), i, p. 257; J. Copping, A Sermon on Tit. iii. 1 at the Visitation of His Grace the Primate (London, 1740). 29 BL, Sloane MS 4055, John Copping to Sloane, 24 Jan. 1737/​8, fos 271–​2. 30 He attended a meeting in February 1740. H.  F. Berry, A History of the Royal Dublin Society (London and New York, 1915), p. 55. 31 S. Shapin, ‘Pump and circumstance: Robert Boyle’s literary technology’, Social Studies of Science, 14 (1984), pp. 487–​91. 32 RSLA, London, EC/​1740, ‘Certificate of election and candidature for John Copping’, 13 Nov. 1740, fo. 16. 33 BL, Sloane MS 4055, Copping to Sloane, 24 Jan. 1737/​8, fos. 271–​2. 34 Falvey, ‘Stearne, John’, in ODNB. 35 Copping, ‘Extracts of two letters’, p. 816. 36 On the various tactics used to establish textual authority, see L. McTavish, Childbirth and the Display of Authority in Early Modern France (Aldershot, 2005). 37 K. Sonnelitter, Charity Movements in Eighteenth-​ Century Ireland: Philanthropy and Improvement (Woodbridge, 2016), pp. 80–​3. 38 Berry, History, p. 25 39 Copping, ‘Extracts of two letters’, p. 818. 40 Ibid., p. 816. 41 The images of butcher and surgeon blurred in the early eighteenth century. See C. Lawrence, ‘Medical minds, surgical bodies: corporeality and the doctors’, in C. Lawrence and S. Shapin (eds), Science Incarnate: Historical Embodiments of Natural Knowledge (Chicago, IL, and London, 1998), pp. 183–​94.

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42 Copping, ‘Extracts of two letters’, pp. 815–​6. 43 S. Belmore, Parliamentary Memoirs of Fermanagh and Tyrone, from 1613 to 1885 (Dublin, 1887), p. 363; B. Burke, A Genealogical and Heraldic History of the Landed Gentry of Ireland (London, 1912), pp. 268, 498. 44 J. Kelly, ‘Domestic medication and medical care in late early modern Ireland’, in J. Kelly and F. Clark (eds), Ireland and Medicine, p. 109. 45 P. Grace, ‘Patronage and health care in eighteenth-​century Irish county infirmaries’, IHS, 41 (2017), pp. 1–​21. 46 Ibid., p.  17; J. Kelly, ‘ “Bleeding, vomiting and purging”:  the medical response to ill-​health in eighteenth-​century Ireland’, in C. Cox and M. Luddy (eds), Cultures of Care in Irish Medical History, 1750–​1970 (Basingstoke, 2010), pp. 18–​22; A. Sneddon, Witchcraft and Magic in Ireland (Basingstoke, 2015), pp. 124–​6; R. Gillespie, Devoted People: Belief and Religion in Early Modern Ireland (Manchester, 1997), p. 67. 47 Sneddon, Witchcraft and Magic, pp.  99–​100; Gillespie, Devoted People, p. 72. 48 She is unnamed, but the time, place and events are similar. R. Whan, The Presbyterians of Ulster, 1680–​1730 (Woodbridge, 2013), pp. 141, 152; Gabriel King, ‘The history of one child extracted by an opening in the abdomen, and part of another passed by stool’, in Medical Essays and Observations, Revised and Published by a Society in Edinburgh: Volume V, Part I (Edinburgh, 1742), pp. 441–​4. 49 Early Modern Letters Online, Gabriel King to George Cleghorn, March 1762,     http://​emlo.bodleian.ox.ac.uk/​profile/​work/​09dacde7–​8868–​ 4531–​82ff-​f5ccaf527284 (accessed 1 Aug. 2018). 50 King, ‘History of one child’, pp. 441–​2. 51 Ibid., p. 443. 52 Duncan Stewart, ‘The Caesarean operation done with success by a midwife’, in Medical Essays and Observations, pp.  439–​41; King, ‘History of one child’, p. 444. 53 For a brief overview of Caesareans in the British Isles, see J. O’Sullivan, ‘Caesarean birth’, The Ulster Medical Journal, 59 (1990), pp. 2–​4. On the transmission of stories, rumours and oral tradition in Ireland, see C. Tait, D. Edwards and P. Lenihan, ‘Early modern Ireland: a history of violence’, in D. Edwards, P. Lenihan and C. Tait (eds), Age of Atrocity: Violence and Political Conflict in Early Modern Ireland (Dublin, 2007), pp. 26–​30. 54 J. O’Hart, Irish Pedigrees; or, The Origin and Stem of the Irish Nation (2 vols, Dublin, 1892), i, p. 543–​5; County search, www.rootsireland.ie (accessed 1 Aug. 2018). 55 T. Barnard, A New Anatomy of Ireland: The Irish Protestants, 1649–​1770 (New Haven, CT, 2003), pp. 20, 290. 56 D. Gentilcore, Food and Health in Early Modern Europe (London, 2016), pp. 150–​2; K.  H. Connell, ‘The potato in Ireland’, Past and Present, 23 (1962), pp. 58–​9.

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57 King, ‘History of one child’, pp. 442–​3. 58 C. McClive, ‘The hidden truths of the belly:  the uncertainties of pregnancy in early modern Europe’, Social History of Medicine, 15 (2002), pp. 209–​27. 59 John Greenfield, A Compleat Treatise of the Stone and Gravel (London, 1710), p. 172. 60 François Rousset, ‘New treatise on hysterotomotoky, or childbirth by Cesarean (1581)’, ed. and trans. V. Worth-​Stylianou, in V. Worth-​ Stylianou (ed.), Pregnancy and Birth in Early Modern France: Treatises by Caring Physicians and Surgeons (1581–​1625) (Toronto, 2013), pp. 40–​1. 61 Stewart, ‘Caesarean operation’, pp.  440–​1; King, ‘History of one child’, p. 444. 62 I. Stable, Ectopic Pregnancy:  Diagnosis and Management (Cambridge, 1996), p. 6. 63 B. T. Heijmas, E. W. Tobi, A. D. Stein, H. Putter, G. J. Blauw, E. S. Susser, P.  E. Slagboom and L.  H. Lumey, ‘Persistent epigenetic differences associated with prenatal exposure to famine in humans’, Proceedings of the National Academy of Sciences, 105 (2008), pp. 17046–​9. 64 Y. Cai and W. Feng, ‘Famine, social disruption, and involuntary fetal loss: evidence from Chinese survey data’, Demography, 42 (2005), pp. 301–​ 22; S. Scott and C. J. Duncan, Demography and Nutrition: Evidence from Historical and Contemporary Populations (Oxford, 2002), pp. 52–​7; K. J. Pitkänen, ‘Famine mortality in nineteenth-​century Finland: is there a sex bias?’, in T. Dyson and C. Ó Gráda (eds), Famine Demography: Perspectives from the Past and Present (Oxford, 2002), pp. 65–​92. 65 Hugh Boulter to the duke of Newcastle, 7 Mar. 1727, in Letters Written by His Excellency Hugh Boulter (2 vols, Dublin, 1770), i, p. 181. 66 John Browne, The Memorial of the Poor Inhabitants, Tradesmen, and Labourers of the Kingdom of Ireland (Dublin, 1728), pp. 4–​5. 67 J. L. McCracken, ‘The social structure and social life, 1714–​60’, in T. W. Moody and W. E. Vaughan (eds), A New History of Ireland, IV: Eighteenth-​ Century Ireland, 1691–​1800 (Oxford, 1986), pp. 33–​4, 53; L. M. Cullen, ‘Economic development, 1691–​1750’, in ibid., pp. 145–​8. 68 J. Kelly, ‘Harvests and hardship: famine and scarcity in Ireland in the late 1720s’, Studia Hibernica, 26 (1992), pp. 66–​9, 100–​1. 69 Ibid., p.  92; J. Kelly, ‘Coping with crisis:  the response to the famine of 1740–​1’, ECI, 27 (2012), p. 121. 70 Kelly, ‘Coping with crisis’, p. 99. 71 McCracken, ‘Social structure’, p. 44; L. A. Clarkson and E. M. Crawford, Feast and Famine:  Food and Nutrition in Ireland 1500–​1920 (Oxford, 2001), pp. 125, 155. 72 Jonathan Swift, A Modest Proposal for Preventing the Children of Poor People from Being a Burthen to their Parents (Dublin, 1729), p. 3. 73 Ibid., p. 6.

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74 For example, Dianne Hall examines how war survivors articulated the suffering of their dead comrades (as a group) and leaders (as individuals). D.  Hall, ‘ “Most barbarously and inhumaine maner butchered”:  masculinity, trauma, and memory in early modern Ireland’, in Dillane et al. (eds), Body in Pain, pp. 39–​55. 75 Gillespie, Devoted People, pp. 70–​2, 84–​8, 91–​2, 108, 115–​16. 76 Ian Campbell discusses the influence of continental authors on Early Modern Irish medicine, for example:  Renaissance Humanism and Ethnicity before Race: The Irish and the English in the Seventeenth Century (Manchester, 2013), pp. 136–​65. 77 L.  F. Cody, Birthing the Nation:  Sex, Science, and the Conception of Eighteenth-​Century Britons (Oxford, 2005), pp. 120–​51. 78 L.  A. Smoller, The Saint and the Chopped-​Up Baby:  The Cult of Vincent Ferrer in Medieval & Early Modern Europe (Ithaca, NY and London, 2014), pp.  144–​5. 79 Ibid., p. 152. 80 L. Roper, Witch Craze:  Terror and Fantasy in Baroque Germany (New Haven, CT and London, 2004), pp. 69–​81. 81 M. Powell, The Politics of Consumption in Eighteenth-​Century Ireland (London, 2005), pp. 33–​41. 82 C. Ó Gráda, ‘Eating people is wrong: famine’s darkest secret?’, University College Dublin Centre for Economic Research Working Paper Series, WP13/​ 02 (2013), pp.  16–​21, http://​irserver.ucd.ie/​bitstream/​handle/​10197/​ 4267/​WP13_​02.pdf?sequence=1 (accessed 6 Sept. 2017). 83 Cody, Birthing the Nation, pp. 40–​1. 84 Roper, Witch Craze, pp. 127–​59; D. Purkiss, ‘Women’s stories of witchcraft in early modern England: the house, the body, the child’, Gender & History, 7 (1995), pp. 408–​32. 85 J. Simpson, ‘The folklore of infant deaths: burials, ghosts, and changelings’, in G. Avery and K. Reynolds (eds), Representations of Childhood Death (Basingstoke, 2000), pp. 11–​27; Sneddon, Witchcraft and Magic, p. 100. 86 N. McAreavey, ‘Re(-​)membering women:  Protestant women’s victim testimonies during the Irish rising of 1641’, Journal of the Northern Renaissance, 2 (2010), www.northernrenaissance.org/​re-​membering-​ women-​protestant-​womens-​v ictim-​testimonies-​during-​the-​irish-​rising-​ of-​1641/​ (accessed 4 Mar. 2017), paragraphs 12–​17. 87 Thank you to Alicia Spencer-​Hall for noting the connection to living saints. S. Ritchey, ‘Illness and imagination: the healing miracles of Clare of Montefalco’, in B. R. Franco and B. A. Mulvaney (eds), The World of St. Francis of Assisi: Essays in Honor of William R. Cook (Leiden, 2015), pp.  80–​1. 88 K. Park, ‘Relics of a fertile heart: the autopsy of Clare of Montefalco’, in A. McClanan and K. Encarnación (eds), The Material Culture of Sex, Procreation, and Marriage in Premodern Europe (New York, 2002), pp. 115–​33.

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89 She is on the list of beata in an eighteenth-​century Irish book:  James White, The Spiritual Treasury, or Sacred Diary (Dublin, 1753), p. 331. 90 C. Ferrazzi, Autobiography of an Aspiring Saint, ed. and trans. A. J. Schutte (Chicago, IL and London, 1996), pp. 51–​2. 91 T. Herzig, ‘Genuine and fraudulent stigmatics in the sixteenth century’, in M. Eliav-​Feldon and T. Herzig (eds), Dissimulation and Deceit in Early Modern Europe (London, 2015), pp. 142–​64. 92 H. MacMahon and P.  J. Flanagan, ‘The diocese of Clogher in 1714 (continued)’, Clogher Record, 1 (1955), pp. 125–​30; MacMahon and Flanagan, ‘The diocese of Clogher in 1714’, pp. 39–​42. This resulted from the Penal Laws, which aimed to make it difficult for Catholics to practice. 93 MacMahon and Flanagan, ‘The diocese of Clogher in 1714’, p. 41. 94 MacMahon and Flanagan, ‘The diocese of Clogher in 1714 (continued)’, pp. 129–​30. 95 S. Connolly and J.-​M. Picard, ‘Cogitosus’s “Life of St. Brigit”:  content and value’, Journal of the Royal Society of Antiquaries of Ireland, 117 (1987), p. 16. 96 Cogitosus discusses mostly domestic miracles, but the ‘Bethu Brigte’ includes a mix of medical and domestic miracles. ‘Bethu Brigte’, ed. B.  Färber and trans. D.  Ó hAodha, CELT:  Corpus of Electronic Texts (2001), http://​celt.ucc.ie/​published/​T201002/​ (accessed 1 Sept. 2017); Connolly and Picard, ‘ “Life of St. Brigit” ’, pp. 5–​27. 97 C. B. Walker, Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women (Berkeley, CA, 1987), p.  90. This miracle is not in Cogitosus’s ‘Life of St. Brigit’ or in ‘Bethu Brigte’. 98 Copping, ‘Extracts of two letters’, p. 818. 99 Some laypeople were considered close to God’s power, even in Protestant Ireland. Gillespie, Devoted People, p. 78.

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Transforming tradition in the British Atlantic: Patrick Browne (c. 1720–​90), an Irish botanist and physician in the West Indies Marc Caball Patrick Browne was a significant figure among scholars of botany and tropical medicine in the eighteenth century. Born in Co. Mayo around the year 1720, Browne’s publication in 1756 of The civil and natural history of Jamaica was important contemporaneously in terms of the development of botanical nomenclature and the discovery of plants previously unknown to European experts. Although his original contribution to the science of botany was recognised by his better known peer, the Swedish naturalist Carl Linnaeus (1707–​78), Browne has been described recently as a ‘bit of an enigma and is scarcely celebrated in his native land’.1 In fact, Browne was the first English-​speaking botanist to deploy Linnaeus’s binary system of plant classification in a published study. Moreover, Browne discovered many plants which he could not accommodate within the Linnaean system of classification and described them in terms of new genera.2 It is proposed to review the career of Browne with particular reference to his writings on the botany of the West Indies. Moreover, it is also argued that Browne is culturally significant not just because of his Caribbean research. On his return to Ireland in 1770, Browne began work on a study of plants in Galway and Mayo listing their names in Latin, English and Irish. Browne’s experience provides a fascinating case study of a medical doctor raised within an Irish-​speaking environment, educated on the continent and working as a physician and botanist in the West Indies. If Browne succeeded in incorporating knowledge of Gaelic botanical terminology within a contemporary global template of such expertise, his achievement is singular in the context of contemporary Gaelic scholarship, which was

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largely characterised by an insular focus and manuscript dissemination. It is suggested that Browne’s incorporation of Irish terminology within a comparative context illustrates a broader epistemological weakness within Gaelic intellectual life in the eighteenth century.

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Ireland and the British Atlantic

Before proceeding to examine Browne’s scientific achievements, it is useful, in historiographical terms, to situate him within a British Atlantic context in order both to understand better the history of the Irish in the Caribbean and the broader regional, social and cultural framework in which he worked. Influenced by an emphasis on global historical perspectives, historians are increasingly drawn to the examination of themes and topics which extend beyond the parameters of the nation state and which are best understood within an international frame of reference.3 Furthermore, it has been suggested that the dissemination and exchange of botanical and medical information between cultures was one of the characteristics of Early Modern globalisation.4 The rise of Atlantic history over recent decades, although its intellectual lineage is arguably to be traced at least as far back as the post-​war period and the Cold War, has enabled new readings of intersecting histories. Applied as a framework of analysis to topics as diverse as the history of sexualities, the family and indigenous Americans, the concept of Atlantic history is potentially fluid and elusive given its attention to multiple histories which unfolded within a wide geographical continuum. In the context of the emergence of what historians call the British Atlantic, it has been claimed that English expansion into the Atlantic was inaugurated in Ireland in the sixteenth century. The historian D.B. Quinn argued that ‘Ireland in a real sense turned English minds toward America’ while Nicholas Canny has suggested that experience acquired in Ireland provided a template for the later management of transoceanic territories.5 On the other hand, Hiram Morgan has proposed that the interpretation of Early Modern Ireland as a phase in a larger English process of expansion into the Atlantic distorts the island’s experience as a component of a western European multiple kingdom.6 In reality, Ireland’s ambiguous status as both kingdom and colony integrated the country within a dense pattern of European and colonialist networks and social relations which were often oppositional but also possibly just as often complementary. The expansion of English influence and subsequent consolidation of crown dominion in the new world from the establishment of the first

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permanent settlement in Jamestown in 1607 also provided new opportunities for the Irish. With the exception of Maryland, it is arguable that the Protestant character of English colonies in continental north America rendered them unattractive to Irish Catholic migrants during the course of the seventeenth and eighteenth centuries. However, the Caribbean islands which were less overtly sectarian in foundational character and considerably more economically dynamic proved attractive as a destination. From the outset, the agency and social discernment of Irish merchants active in Amazonia from about 1612 to 1632 are suggestive of the capacity of Irish settlers to adapt to new environments It has been argued that the Irish ventures in Amazonia are probably the earliest example of autonomous Irish colonial projects in the New World. More concerned for profit than monopoly, unlike their English peers, the Irish established small-​scale factory plantations enabled by Indian labour. Until the 1630s, the Irish took advantage of the Amazon as a frontier zone and they traded with the English or the Dutch as different circumstances prevailed.7 Likewise, from the 1630s Irish Catholic settlers on Montserrat in the English Leeward Islands negotiated a relatively high degree of autonomy within a society dominated by an elite of Irish trading and plantation families served by Irish indentured servants recruited through home networks. In the absence of a formal Irish colonial project, Irish planters on Montserrat and to a lesser extent on St. Kitts ambitiously exploited the financial opportunities available in the Leeward Islands while accommodating their Catholicism to superficial compliance with Anglicanism. Certainly, the story of the Irish in the Early Modern Caribbean was not exclusively one of successful adaptation on the part of an elite of planters and merchants. The possibility of depositing troublesome Irish elements in Virginia and replacing them in Ireland with English settlers was mooted early in the seventeenth century.8 The development of the plantation system from the mid-​seventeenth century was predicated on a ready supply of cheap labour, which initially was dependent on indentured servants from Britain and Ireland. Large numbers of Irish indentured servants in the West Indies elicited hostility and suspicion from English masters. Of course, not all servants were voluntary migrants since many had been banished by the state especially during the years of the Commonwealth.9 During the 1650s it appears that the greater part of the English and Irish servants on Barbados had been transported to the West Indies as political prisoners.10 Given that many of those selected for transportation were adolescents, it is difficult to

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consider them political prisoners in the classic sense.11 Such were the numbers of Irish servants on Barbados in 1667 that its governor, Baron Willoughby, wrote home seeking instead Scots migrants.12 Nonetheless, it is clear that Irish Catholics were at this juncture also emerging as an important commercial interest in the West Indies. By the 1670s, the English, Scots and Irish were portrayed as the masters of Barbados.13 An elite cohort of Irish landowners on Montserrat was prominent in the development of tobacco cultivation on the island from the mid-​ 1650s onwards.14 A  census taken of the population of the English Leeward Islands in 1678 likewise reveals the emergence of a relatively wealthy cohort of Irish settlers of Munster origin located on the islands of Nevis, St. Kitts, Antigua and Montserrat.15 For instance, members of the Trant family of Kerry prospered on Antigua and Montserrat.16 Moreover, an affluent Irish interest continued on Barbados down to the end of the eighteenth century.17 In light of Patrick Browne’s experience in the West Indies, it is instructive to consider that recent research by Natalie Zacek and Jenny Shaw has emphasised a high degree of agency on the part of Irish Catholics within the context of evolving racial and ethnic hierarchies in the early English Caribbean.18 Patrick Browne: education and early career

Therefore, when Patrick Browne first arrived on the island of Antigua in 1737 aged around seventeen, he entered a frontier world which potentially offered great opportunity for material and social advancement to an entrepreneurial Irish Catholic. The greater part of the little that is known about Browne’s biography derives from an account of him which was published in the January 1793 issue of Anthologia Hibernica and authored by an individual who initialled themselves ‘R.O.’. The fourth son of Edward Browne, Patrick was born about 1720 to a middling family resident at Woodstock in the vicinity of Claremorris in southern Co. Mayo. In receipt of a good education, he was sent to live with a relative in Antigua where he remained for about a year but left due to the adverse impact of the climate on his health. The dispatch to the West Indies of a teenager presumably reflected his parents’ desire to have him apprenticed either as a merchant or planter. Opportunities for advancement in trade were available at this stage. Although a navigation act of 1696 had prohibited the landing of all goods from the American plantations in Ireland, successful lobbying by West Indian and Irish interests in London resulted in a new act in 1731 which permitted the

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import to Ireland of a range of goods.19 Irish exports to the West Indies and the British colonies in North America in the early decades of the eighteenth century centred on provisions, linen and people. At this period, salted beef, butter, pork and cheese from Ireland were readily consumed in the West Indies. As competition from North American producers grew and as the white population in the West Indies decreased over the course of the eighteenth century, the export of provisions from Ireland across the Atlantic declined. However, increased levels of exports of salted fish from Ireland to feed slaves in the West Indies compensated for the decline in the general provisions trade.20 While the remaining balance of exports from Ireland centred on linen, Thomas Bartlett has argued that a third category of trade centred on Irish migrants. It has been suggested that about 400,000 people migrated or were transferred from Ireland to British North America from the late 1600s down to 1815.21 Exports from the colonies to Ireland were dominated by sugar and tobacco, landed first in Britain and then re-​shipped to Ireland. Direct imports to Ireland included flax seed from North America and rum distilled in the West Indies.22 The links of Galway merchants with the West Indies which dated from as early as the 1630s possibly also informed the decision of Browne’s parents to send him to Antigua. Louis Cullen has argued that ‘the Galway interest was easily the largest Irish interest in the West Indies’. Men from Galway also owned plantations and worked as overseers on both British and French islands in the West Indies. While these settlers started families locally, their presence attracted an ongoing influx of relatives from Ireland.23 A map of Barbados published in Richard Ligon’s 1657 account of the island featured three plantations owned by individuals named Browne.24 Significantly, the Galway family of Browne based at Nantes was active in the colonial trade in the early eighteenth century. Therefore, family connections were also possibly instrumental in enabling Patrick Browne’s initial sojourn in the West Indies.25 Returning to Europe, Browne apparently proceeded directly to Paris where he regained his health and with his parents’ support embarked on the study of physic and botany. Clearly, the fact that the Browne family was in a position to fund their son’s passage to Antigua and afterwards to cover the costs of his education on the continent suggests a relative degree of affluence on their part. Limited by penal legislation in terms of professional opportunities at home and as medicine was the sole profession not subject to a confessional test of entry, Irish Catholic students in relatively large numbers undertook medical studies at European universities.26 The inadequate nature of medical

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training in the British Isles for much of the eighteenth century further encouraged students to travel to the continent in search of a medical education. Toby Barnard has proposed that the necessity to train abroad broadened the intellectual horizons of Irish medical graduates which in some measure accounts for their disproportionate contribution to the broader culture of eighteenth-​century Ireland.27 Significantly, after clergymen and lawyers, medical doctors were the most prominent group of book collectors in eighteenth-​century Ireland.28 The 1730s witnessed a peak in the number of Irishmen who graduated with medical degrees from continental universities.29 The university at Reims was the most popular institution of qualification for Irish medical students and 554 Irish doctors of medicine graduated from that institution in the eighteenth century.30 However, Reims was not an especially distinguished centre of academic medicine. The majority of Irishmen who graduated from Reims had previously actually studied medicine in Paris. In fact, Irish students simply came to Reims to graduate as it was inexpensive and easy.31 Accordingly, Charles Nelson has suggested that, although Browne was awarded the degree of doctor of medicine from the University of Reims in December 1742, he had actually studied at Paris. It is known that Browne matriculated at the University of Leiden in February 1743 but it is not clear if he remained long at Leiden before moving to London where he practised as a physician at St Thomas’ Hospital. However, Browne returned to the West Indies by 1746 living first on Antigua and other islands before ultimately settling in Jamaica. Unlike the eastern Caribbean which had a significant Irish demographic presence in the seventeenth and eighteenth centuries, Jamaica was essentially an English colony settled directly from England or other parts of British America.32 Resident at Kingston where he worked as a physician, Browne devoted his spare time to the study of botany and the collection of plant specimens for medicinal purposes. The author of the Anthologia Hibernica essay on Browne also claimed that he was a competent astronomer and mathematician and no doubt his skills in the latter discipline enabled him to produce a map of Jamaica which apparently netted him a handsome profit. Browne’s history of Jamaica

By way of supplement to these scanty biographical details, it is necessary to turn to Browne’s preface to The civil and natural history of Jamaica to envision a sense of his milieu during his time in the Caribbean. The

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research which informed Browne’s study was undertaken in the West Indies during the years 1746 to 1754 when he returned to London to arrange its publication. In his prefatory remarks, Browne noted that while Jamaica attracted talented and learned individuals, the impact of the climate dissipated the energies of what he termed ‘the most determined minds’.33 By way of consequence, no credible account of the island had been undertaken and such publications that had appeared were marred by ‘the evident marks of imbecility, inattention, or erroneous information’. However, in contrast, Browne claimed that he was ‘happy in a large share of health and strength; enured to the climate; and with a mind strongly disposed to the cultivation of natural knowledge’ and, mindful of the neglect of Jamaica’s history, he had undertaken to provide an account of ‘the past and present state of the island’. Therefore, over the course of a number of years, Browne used his spare time to collect materials for his proposed study. Two areas in particular claimed his attention. As a physician, the diseases prevalent on the island were of especial interest to him and secondly as a naturalist, he was drawn to the study of the island’s natural environment. Browne adduced a further rather more vague but strategic motivational factor when he claimed that as a subject of Great Britain and as a member of the island community that he aspired ‘to afford satisfaction to mankind in general’. Browne’s description of himself as a British subject finds a rhetorical counterpoint in his verbally lavish dedication of the volume to George, Prince of Wales. In biographical terms, Browne is fundamentally an elusive figure and the lack of evidence precludes exploration of his political outlook. However, the latter references seem to suggest that Browne was not without agency within the ecology of English colonial hierarchies. Moreover, Browne was no less adept in the matter of his scientific self-​presentation. Of course, Browne had been disingenuous in his claim that Jamaica’s natural history had essentially been neglected. In fact, Browne had been preceded in this respect by a highly distinguished polymath and collector. Hans Sloane, who was born in Co. Down in 1660, had served as physician to the governor of Jamaica, the duke of Albemarle, over a period of fifteen months during the years 1687/​88. During his time on the island, Sloane recorded details of around 800 new species of plants which he catalogued in Latin in 1696. Subsequently, Sloane published an account of his experience in Jamaica in two folio volumes, which appeared in 1707 and 1725 respectively. Created a baronet in 1716, Sloane went on to serve as royal physician to Queen Anne, George I and George II. After his death

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in 1753, Sloane’s extensive library and cabinet of curiosities featured among the core collections of the British Museum, which opened to the public in 1759. In making the case for the originality of his work, Browne was obliged to allude to the research of his prestigious predecessor in the field. Acknowledging that Sloane had collected more than 800 species of plants during his Caribbean travels, Browne boasted that in Jamaica alone he had studied about 1,200 plants. Additionally, he had collected fossils and insects, which had not been mentioned by Sir Hans. Browne’s praise of Sloane was indeed faint when he admitted that while his work merited praise, it was also inaccurate.34 A newcomer on the English botanical scene and given that he published the Jamaica study largely at his own expense, Browne must surely have decided that its best prospect of success critically rested on his implicit denigration of Sloane’s work. Certainly, the evidence of the book’s subscription list indicates that Browne’s research elicited attention from contemporary scientists and physicians. Leading London physicians such as William Heberden, Anthony Askew and Edward Wilmot as well as the zoologist John Ellis, the natural philosopher Stephen Hales, the botanist Peter Collinson and the physician naturalist John Fothergill subscribed in advance to the publication of the history of Jamaica and such engagement on the part of the scholarly community suggests that Browne was skilled in the negotiation of metropolitan scientific networks. Indeed, it is probable that Browne corresponded widely with scholars in Britain and elsewhere in Europe. For instance, the Dutch physician and naturalist Johannes Albertus Schlosser subscribed to the book’s publication and is mentioned in the text by Browne as having provided him with a plant specimen.35 Carl Linnaeus, who also subscribed to the history of Jamaica, maintained a sustained, though at times infrequent, correspondence with Browne between 1755 and 1771. Browne’s letters to Linnaeus were largely written in Latin.36 Moreover, Browne’s considerable intellectual ambition complemented the importance of his subject. While Jamaica was a geographically peripheral colony, its economic importance for Britain was considerable. Browne as ever was frank in his appraisal of the economic ties which linked England to its island colony when he stated that it ‘continues to supply us with a necessary appendage to our present refined manner of living’ and accordingly he emphasised that ‘the wealth of many, the subsistence of multitudes, the extent of our navigation, the revenues of the crown, and in short the emolument of the whole nation, are deeply interested and augmented by the perpetual intercourse with

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this distant island’.37 Jamaica had been seized from Spanish control by the English in 1655 as part of Cromwell’s ‘Western Design’, which aimed to destabilise the Spanish empire in the West Indies in order both to enrich England and to promote Protestantism at the expense of Catholicism. Although the poor and sparsely populated island of Jamaica hardly seemed an auspicious acquisition at the time, it quickly assumed considerable significance for its strategic location within the maritime centre of Spain’s empire and for its consolidation of the prestige of the restored English monarchy’s colonial aspirations in North America. If the early years of the government-​sponsored settlement of Jamaica were uncertain and tentative, the island’s fortunes were soon to be transformed by the cultivation of sugar. Introduced from Brazil in the 1640s, sugar quickly became a popular and lucrative crop across the Caribbean which could be exported to Europe to satisfy exponential consumer demand for the commodity. The expansion of the trade in slaves, which had been pioneered by the Dutch, complemented and facilitated the rise of sugar as an agricultural commodity. Indeed, English interest in the Caribbean was further encouraged by the profits to be made from the sale of enslaved Africans whose labour was essential to the efficient and cost-​effective operation of sugar plantations. The highly profitable combination of sugar and slavery that underpinned the economy of the West Indies meant that the region was considerably more attractive in commercial terms than continental North America and as such subject to intense rival European ambitions. In fact, the later seventeenth century witnessed the emergence of the Caribbean as a dynamic locus of imperial consolidation whose economy would be transformative in its impact on the British Isles and on British settlement in continental North America.38 If by the beginning of the eighteenth century, Jamaica was a potential source of great wealth for white planters and settlers, it was also a place which instilled fear on account of its high rates of mortality. Life expectancy for whites in Kingston, the island’s main urban centre and port, was not encouraging.39 For instance, it is recorded that between 1722 and 1774 nearly 18,000 funerals occurred in Kingston as opposed to 2,699 baptisms in the same period. Yellow fever and malaria proved lethal to Europeans as they did in other tropical climates. Moreover, as the general use of inoculation was not adopted in Jamaica until the early nineteenth century, the arrival of each new slave ship brought with it the threat of a smallpox epidemic. When smallpox extended beyond Kingston and Port Royal, the impact was devastating as it spread

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through the plantations.40 It has been estimated that, during the middle years of the eighteenth century, settlers could not expect to survive more than thirteen years on the island. Native-​born whites (creoles) who were lucky enough to survive childhood were likely to die before they reached the age of forty.41 Vincent Brown has described Jamaica in the eighteenth century as a place where death was imminent. More generally, Brown depicts Jamaica as a ‘brutal and volatile slave society, contentious and unstable at the best of times’. Blacks outnumbered Europeans on Jamaica in 1750 by ten to one.42 The violence and brutality inherent to master slave relations resulted in an environment riven by suspicion, aggression and resentment. Slave revolts and conspiracies took place almost once a decade between 1740 and 1838. If Jamaica formed part of a wider Atlantic world which integrated it within networks which connected Europe, Africa and North America, it was also characterised by internal dependencies between Europeans and African slaves. Vincent Brown has argued that ‘whites depended for their livelihood on black slaves as surely as the institution of slavery constrained the life chances of Africans and their descendants’.43 Notwithstanding the impact of adversity, disease and death, Jamaica’s sugar industry grew apace during the middle of the eighteenth century. Over the period 1740 to the mid-​1770s, the total number of plantations grew by 45 per cent and in addition to sugar, other crops such as coffee were introduced. The total value of the island’s economy expanded fivefold. Economic development was accompanied by a concomitant rise in the island’s population from 4,000 in 1661 to 255,000 in 1788. However, such generic figures mask the malignant dynamic of slavery. Almost 90 per cent of the population was enslaved in 1788 and 93 per cent of the inhabitants then were of evident African descent.44 Therefore, it should be stressed that when Patrick Browne returned to London around 1754 to publish his account of Jamaica, he did so at a time when the island had begun to emerge as the single most profitable British colony.45 Mindful of Browne’s agency as an Irish Catholic professional in the context of Jamaica’s expansive economy, it is useful to examine the treatment of questions of demography and medical botany in his work. As indicated in its title, Browne’s study comprises both an account of the civil and natural histories of the island. Given his birth in Ireland, it is especially instructive to review his comments on the island’s population in chapter one of the civil history. He distinguishes between the island’s inhabitants on a tripartite basis premised on their

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parent countries: English, Irish and Scots. The island’s natives were the descendants of all three national cohorts. However, displaying a sense of political expediency previously noted, Browne proceeds to disregard ethnic distinctions when he proposes to classify them ‘as one united people’, which he subdivides into ‘planters, settlers, merchants, and dependents’. In his broadly positive comments on the planters, he touches in a remarkably frank manner on the shortage of white women of equivalent status to the male planters. As a result, unmarried planters were to apt to develop what Browne calls ‘vicious habits, which they seldom fail of acquiring in the more early state of manhood’. By way of textual discretion, Browne elaborates on his reference to ‘vicious habits’ in a footnote where he writes of the planters’ ‘great attachments to Negroe-​women: there being but few gentlemen but what have several of those ladies very early in keeping’.46 Proceeding less controversially with his comments on the island’s European inhabitants, he describes settlers as less financially secure than planters while merchants or ‘the trading part of the people is not at this time so numerous’.47 The fourth class composed ‘mechanics, clerks, and servants of all sorts’. However, the fifth class, which comprised the greater part of the island’s population, is considered in remarkably concise detail. Alluding to those inhabitants he terms ‘negroes’, he simply reports they number around 120,000 people and as a result of their ‘labours and industry almost alone, the colony flourisheth, and its productions are cultivated and manufactured’. Browne returns to the question of slavery in subsequent remarks on the lifestyles of his five enumerated classes. As in his previous comments, he is dispassionate but arguably not unsympathetic to the slaves’ situation. He observes that for the most part negroes are the property of whites and as such they could be bought and sold like any other commodity. He describes in detail the conditions in which slaves lived with an account of their accommodation and diet. However, dispassion yields to concern in his remarks on the health of slaves. Considering the harsh conditions in which they labour, and given their exposure to extreme weather conditions and their subsistence on poor quality food, Browne expresses surprise at their relatively good state of health. However, he bemoans what he considers the defective nature of their medical care. Claiming the diseases of the slaves were frequently of a particular kind, he insists on the need for appropriate medical expertise, which he argues should be informed by ‘consummate knowledge of symptoms and disorders, to discover the real sources of them’.

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Instead, their owners commit them to the care of youths and ignorant practitioners who Browne claims were ‘hardly skilled enough to breath a vein, or dispense a dose of physic’. However, Browne is careful to avoid an accusation of inhumane behaviour on the part of planters and instead bemoans a generalised lack of medical capacity on the island. In this respect, he wrote that it was frequently possible to witness gentlemen of the first rank ‘vomited and blistered to death in a yellow fever, and the ladies, poisoned with bark in verminous inflammations’. On the other hand, many were neglected at the early stages of illness so that their worsening condition eventually precluded effective treatment.48 In an adept blend of diplomacy and candour, Browne provides a relatively blunt account of the slaves’ condition while concurrently seeking to absolve their owners of the charge of intentional cruelty. In terms of his income as a physician, Browne, who returned to the West Indies in 1756, was no doubt dependent on the Caribbean elite and accordingly would hardly have sought to confront them in print in respect of slavery. It is telling, however, that at the end of his study, Browne provided a classification of the human species which although racialist implied no differentiation based on assumed racial hierarchies. Under the term Homo, Browne enumerated four categories: the Indian; the African or Negro; the American; and the European.49 In contrast, the Jamaican planter Edward Long in his 1774 history of the island infamously characterised Africans as sub-​human and inherently inferior to whites.50 Moreover, Browne was also dependent on plantation owners’ benevolence in terms of access to their estates to study and collect specimens. For instance, in his discussion of minerals Browne records that he found samples in the vicinity of Sir Simon Clarke’s estate and that he had examined iron ore in the mine owned by Mr Anderson.51 In another example of his apparently relatively unrestricted access to properties, Browne records that he observed the plant or vegetable known as Melanium ‘among the cane-​pieces in Capt. Fuller’s estate at Luidas’.52 The presence on the 1756 volume’s subscription list of important Jamaican plantation owners such as Joseph Foster Barham, Sir Alexander Grant, Rose Fuller, William Beckford and Henry Moore, a leading colonial administrator, is indicative of Browne’s social and cultural agility. Although many of the leading magnates in the British West Indies had returned to live in England by the middle of the eighteenth century, their plantations were administered by a powerful cohort of managers and overseers.53 Even when in pursuit of scientific knowledge, Browne was obliged to negotiate the social and political complexities of colonial society.

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Botany and medicine were mutually integrated in Browne’s scientific outlook and methodology. In his preface, Browne had promised the inclusion of a third part to his book consisting of what he termed ‘a few dissertations’. One such dissertation was intended to focus on the island’s diseases, particularly on what he called ‘the yellow and remittent Fevers’. However, in a note at the end of the book, Browne states that the large size of the work prevented the inclusion of these dissertations. However, he intended to publish the omitted material with an additional discussion of worm fevers as a ‘small volume in 8vo, to be printed the ensuing season’.54 There is no indication that any such work was published. Indeed, as late as 1771 in a letter to Linnaeus, Browne mentioned his plans to publish a number of medical tracts, including on yellow fever, venereal disease and worm fevers and on the notorious tropical disease called yaws.55 However, it is possible to discern how Browne utilised his botanical research with therapeutic objectives in mind. In this regard, comments or observations on the medicinal value or use of plants are incorporated across the text. In his entry on the ginger plant, for example, Browne provides a comprehensive description of its cultivation and use. Conscious of commercial considerations, he notes that while ginger was often planted in sugar colonies, demand for it was uncertain and its price varied accordingly. In fact, he expresses regret that what he calls ‘so valuable a commodity’ was not more regularly cultivated. He proceeds to provide an account of the type of soil best suited to the plant’s growth, when and how it should be best planted and subsequently harvested. Providing instructions as to the appropriate preservative treatment of the harvested root, he notes that a syrupy residue of this latter process was ‘fermented into a small and pleasant liquor, commonly called cool drink’. The root of the ginger constituted what he termed ‘a warm pungent aromatic’ and was suitable for the treatment of stomach ailments and for what Browne describes as ‘viscera proceeding from cold, or inertion’. Moreover, the root was also useful in response to what he termed ‘defluxions of the breast, or weakness of the nerves’. Indeed, in suitably prepared form, ginger was beneficial to those working in colder or harsher climates as it enabled such persons ‘to rarify their chilly juices, as well as to promote the tonic action of their contracted fibres’.56 In general, Browne’s botanical entries provide a wealth of incidental detail which sheds valuable light on diet and lifestyles in Jamaica. Typically, Browne was attentive to African dietary practices. In his comments on the sour sop tree, for instance, Browne writes how its succulent fruit was at first much enjoyed by all

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classes. However, such was its popularity among blacks that ‘it is now hardly ever used among the better sort of people’.57 Browne’s interest in the customs and habits of enslaved Africans is illustrative of the diverse and intersecting confluence of cultures which informed new world science and the important contribution of black slaves to the production of knowledge.58 Indeed, the historical importance of Browne’s work on Jamaica arguably derives from its ethnographic evidence as much as from its significance for the history of science. However, the subject of religion is noticeably absent from Browne’s book. Like his fellow Irish Catholics elsewhere within the Protestant-​dominated English colonies in the West Indies, he was surely acutely aware of the need for discretion in matters of faith. Browne’s later experience in the West Indies

On publication of his Jamaica book, Browne returned to the West Indies, living first on the Danish island of St. Croix. His choice of St. Croix was almost certainly informed by its popularity as a location for Irish Catholic settlement at this period.59 Purchased by the Danish West India and Guinea Company from the French in 1733, the island was ideally suited to the cultivation of sugar cane as a result of its rich and fertile soil. However, the Danes initially lacked both the experience and capital necessary to develop the island’s sugar economy. Consequently, Irish Catholic creoles experienced in sugar production and in the international trade in sugar were considered useful settlers. Orla Power has demonstrated that under the direction of Nicholas Tuite of Montserrat, a cohort of Irish settlers purchased plantations on St. Croix and in the process acquired a high degree of influence and status on the island. Tuite was known to Browne as he is listed among the subscribers to the history of Jamaica.60 Tuite’s bequest of monies to both the Danish Lutheran and Irish Catholic churches on St. Croix is suggestive of the cultural and religious malleability of the Irish elite in the West Indies in the eighteenth century.61 A number of Galway families such as the Bodkins, Skerretts and Kirwans established themselves as planters and traders on the island. St. Croix became a royal colony in 1754.62 In 1755, the Danish monarch recognised the right of Irish Catholics to practise their faith openly on St. Croix and Irish labourers and artisans were attracted from other islands and from Ireland.63 The outbreak of the Seven Years War (1756–​63) between Britain and France greatly disrupted the French trade in sugar due to the superiority of

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the Royal Navy in the Atlantic. Power has argued that as settlers on a Danish island that the Irish became subjects of the Danish crown, and as such they were able to trade as neutrals. Leveraging connections with kinsmen in London and elsewhere, the planter-​merchants of St. Croix traded in smuggled goods and slaves with neighbouring French islands.64 When St. Croix was purchased by the Danish in 1733, it no longer came within the remit of French missionaries. Now under the ecclesiastical direction of the Sacred Congregation of Propaganda Fide, two Irish Dominicans were dispatched in 1758 to the island to minister to a mostly Irish population of about 250 Catholics. Over the following decade, eight Irish Dominicans served in the area.65 One of the first two Dominicans, Father Kennedy, reported in 1760 that twelve plantations on the island were Irish-​owned and Irish merchants, traders and ship captains resided in the island’s town. Additionally, he stated that ‘about one hundred lads of our country’ were overseers on plantations. The inherently exploitative nature of the European presence in the West Indies is apparent from Kennedy’s observation that the settlers sought exclusively to enrich themselves as quickly as possible and to return home with their wealth.66 An emphasis on the accumulation of personal wealth at the expense of broader societal benefit has been identified as widespread in the Early Modern British Atlantic world.67 The Irish Dominicans encountered challenges on St. Croix that are illustrative of the day-​to-​day difficulties of life which generally faced European settlers such as Browne. Intense heat, fear of ill-​health and sudden death, geographical isolation and constant dread of overwhelming slave rebellions impacted adversely on the quality of life experienced by Europeans in the region.68 Following the collapse of his marriage in a scandal, Browne moved to Antigua in 1763 where he acquired a sugar plantation called Mount Eagle. His move to Antigua was possibly facilitated by Martin Blake who owned a plantation in the parish of Parham and Willoughby Bay on the island.69 A member of the Blake family of Ballyglunin in Co. Galway who had first settled in the West Indies in 1720 and converted to Anglicanism, Martin was listed as a subscriber for four copies of the history of Jamaica.70 In the book itself, Browne named a wild rose ‘Blakea’ after ‘Mr Martin Blake, of Antigua, a great promoter of every sort of useful knowledge; and a gentleman to whose friendship this work chiefly owes its early appearance’.71 Ironically, Blake had complained in a letter home in 1738, a year after the first arrival of Browne on Antigua, of an influx of importunate and unqualified genteel young Irishmen seeking his assistance.72 Having

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sold his estate on Antigua, Browne apparently lived on the island of Montserrat during the years 1765–​70.

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Browne’s return to Ireland

Returning to Ireland in 1770, it appears that he visited Antigua for the final time in the early 1780s.73 Browne started work on an Irish flora shortly after his arrival in Dublin in late 1770. Observing and collecting plants in Galway and Mayo, he made detailed descriptions of living plants such as fungi, mosses and ferns. Most of these were observed in their natural settings but some had been transplanted to his garden at Rushbrook southwest of Claremorris. He wrote a draft of his Irish flora in the winter of 1771. His work on the project was probably sporadic as the only surviving copy of the ‘Fasciculus Plantarum Hiberniae’ extant in manuscript format is dated 1788.74 The manuscript flora contains records of plants with their names in English, Irish and Latin. No doubt encouraged by the appearance of a new edition of his Jamaican book in 1789, Browne was anxious to have his Irish flora published.75 In a letter written in 1790 to a Dublin bookseller, William Wilson, Browne asked to have the Irish names of plants printed in italics noting that he had written them ‘as much to the pronunciation of Irish as I could, but not according to the Irish orthography, which I could not find in any book’. As Irish was the first language of many of the Munster and Connacht settlers in the West Indies, it is likely that Browne frequently spoke the language during his time in the region.76 In the effective absence of print in Irish, Browne’s knowledge was essentially oral. However, the envisaged publication never appeared in print. Fortuitously, a copy of the flora manuscript had been acquired by the English botanist and member of the Linnean Society, Alymer Bourke Lambert from Browne when he visited him in Mayo in 1790 and, in due course, it was presented to the Linnean archive in London.77 Conclusion

It is proposed that Browne’s career as a physician and botanist is significant in two respects. Firstly, as an Irish Catholic operating within a British colonial context, Browne was remarkably successful in his pursuit of a professional and scientific career given his minority status within a marginal and challenging geographical context far removed from European learned communities and centres of expertise. Furthermore, Browne’s

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assured and strategic use of the metropolitan print trade to disseminate his research enabled and ensured both his contemporary and ensuing reputation as a pioneering botanist. Secondly, his successful use of print as a tool for dissemination and international scientific interchange in the case of his work on the West Indies is neatly counterpointed by the extremely limited manuscript circulation of his Irish flora and its consequent absence from the canon of eighteenth-​century botanical research. Indeed, his inclusion of Irish botanical names in this unpublished manuscript is in many ways emblematic of the limits of manuscript publication which was central to Gaelic intellectual and literary activity in the seventeenth and eighteenth centuries. Browne’s career exemplifies innovation by reason of his adept negotiation of a scientific agenda within an Atlantic context while his contribution to Irish botany was fundamentally circumscribed by the constraints of tradition in the form of manuscript publication. Notes 1 E. C. Nelson, ‘Patrick Browne (ca. 1720–​1790), an Irish physician, historian and Caribbean botanist:  a brief biography with an account of his lost medical dissertations’, Huntia: A Journal of Botanical History, 11 (2000), p. 10. 2 Unpaginated foreword by W.  T. Stearn in E.  C. Nelson (ed.), Flowers of Mayo:  Dr Patrick Browne’s Fasciculus Plantarum Hiberniae 1788 (Dublin, 1995). 3 J. Belich, J. Darwin, M. Frenz and C. Wickham (eds), The Prospect of Global History (Oxford, 2016). 4 M. P. Romaniello, ‘True rhubarb? Trading Eurasian botanical and medical knowledge in the eighteenth century’, Journal of Global History, 11 (2016), p. 3. 5 D.  B. Quinn, The Elizabethans and the Irish (Ithaca, NY, 1966), p.  106; N. Canny, Kingdom and Colony: Ireland in the Atlantic World, 1560–​1800 (Baltimore, MD and London, 1988), p. 29. 6 Hiram Morgan, ‘Mid-​Atlantic blues’, The Irish Review, 11 (1991/​92), pp. 50–​5. See also A. Horning, Ireland in the Virginian Sea: Colonialism in the British Atlantic (Chapel Hill, NC, 2013). 7 J. Lorimer (ed.), English and Irish Settlement on the River Amazon 1550–​ 1646 (London, 1989), pp. xiv–​xv. 8 BL, Lansdowne MS 156, ‘An advise for Ireland’, fo. 265r. 9 R. S. Dunn, Sugar and Slaves: The Rise of the Planter Class in the English West Indies, 1624–​1713 (Chapel Hill, NC, 1972; repr. 2000), pp. 56–​7; H. McD. Beckles, ‘A “riotous and unruly lot”: Irish indentured servants

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and freemen in the English West Indies, 1644–​1713’, William and Mary Quarterly, 47 (1990), pp. 503–​22. 10 BL, Additional MS 12,410, Extracts from Col. D’Oyley’s journal, 1653–​ 1661, fos 76v and 137r. 11 Ibid., fo. 137v. 12 BL, Stowe MS 755, William Willoughby to Lord [?]‌, Barbados, 16 Sept. 1667, fo. 19v. 13 Richard Blome, A Description of the Island of Jamaica (London, 1678), p. 36. 14 BL, Egerton MS 2395, Debts due to Jacob Clause from the inhabitants of Montserrat, fo. 54r-​v; H. A. Fergus, Montserrat: History of a Caribbean Colony (2nd edn, Oxford, 2004), p. 30. 15 V. L. Oliver, Caribbeana being Miscellaneous Pages Relating to the History, Genealogy, Topography, and Antiquities of the British West Indies (3 vols, London, 1909–​14), ii, pp. 68–​9, 73–​4, 316–​20 and 342–​7. See also L. M. Cullen, ‘The Irish diaspora of the seventeenth and eighteenth centuries’, in N. Canny (ed.), Europeans on the Move: Studies on European Migration, 1500–​1800 (Oxford, 1994), pp. 126–​7. 16 NLI, MS D.27812, Bundle of Trant wills; V. L. Oliver, The History of the Island of Antigua, One of the Leeward Caribbees in the West Indies, From the First Settlement in 1635 to the Present Time (3 vols, London, 1894–​99), iii, pp. 140–​2; V. L. Oliver, The Monumental Inscriptions of the British West Indies (Dorchester, 1927), p. 60. 17 BL, Additional MS 37,067, Index to wills in Barbados, 1776–​1800, pp. 24–​5,  32–​3. 18 N.  A. Zacek, Settler Society in the English Leeward Islands, 1670–​ 1776 (Cambridge, 2010); J. Shaw, Everyday Life in the Early English Caribbean: Irish, Africans, and the Construction of Difference (Athens and London, 2013). 19 T. Bartlett, ‘Ireland, empire and union, 1690–​1801’, in K. Kenny (ed.), Ireland and the British Empire (Oxford, 2004), p. 63. 20 Ibid., p. 64. 21 In respect of the contested question of numbers of emigrants from Ireland to North America see T.  M. Truxes, Irish-​American Trade, 1600–​1783 (Cambridge, 1988), pp. 129–​30; K.  A. Miller, A.  Schrier, B.  D. Boling and D. N. Doyle (eds), Irish Immigrants in the Land of Canaan: Letters and Memoirs from Colonial and Revolutionary America, 1675–​1815 (Oxford and New York, 2003), pp. 656–​9. 22 Bartlett, ‘Ireland, empire, and union’, p. 66. 23 L.  M. Cullen, ‘Galway merchants in the outside world, 1650–​1800’, in D. Ó Cearbhaill (ed.), Galway:  Town and Gown 1484–​1984 (Dublin, 1984), p. 87. 24 Richard Ligon, A True & Exact History of the Island of Barbados (London, 1657).

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25 Cullen, ‘Galway merchants’, pp. 68–​9. 26 T. Barnard, ‘The wider cultures of eighteenth-​century Irish doctors’, in J.  Kelly and F.  Clark (eds), Ireland and Medicine in the Seventeenth and Eighteenth Centuries (Farnham, 2010), p. 184. 27 Ibid., pp. 183–​4. 28 M. Pollard, Dublin’s Trade in Books 1550–​1800 (Oxford, 1989), p. 215. 29 L. Brockliss, ‘Medicine, religion and social mobility in eighteenth-​and early nineteenth-​century Ireland’, in Kelly and Clark (eds), Ireland and Medicine, p. 76. 30 Ibid., p. 79. 31 Ibid., p. 85. 32 T. Burnard, ‘European migration to Jamaica, 1655–​1780’, William and Mary Quarterly, 53 (1996), pp. 769–​96. 33 Patrick Browne, The Civil and Natural History of Jamaica (London, 1789 edition), p. v. 34 Ibid., p. vi; J. Delbourgo, Collecting the World: The Life and Curiosity of Hans Sloane (London, 2017), p. 112. 35 Browne, Civil and Natural History, p. 269. 36 The Linnaean Correspondence, http://​linnaeus.c18.net/​ (accessed 3 May 2017). 37 Browne, Civil and Natural History, p. v. 38 A. McFarlane, The British in the Americas 1480–​1815 (London and New York, 1994), pp. 107–​8. 39 Burnard, ‘European migration to Jamaica’, p. 777. 40 V. Brown, The Reaper’s Garden: Death and Power in the World of Atlantic Slavery (Cambridge, MA and London, 2008), p. 49. 41 Ibid., p. 17. 42 R. S. Dunn, A Tale of Two Plantations: Slave Life and Labor in Jamaica and Virginia (Cambridge, MA and London, 2014), p. 4. 43 Brown, The Reaper’s Garden, p. 9. 44 Ibid., p. 15. 45 Ibid. 46 In regard to the sexual exploitation of enslaved women in eighteenth-​ century Jamaica see M. Ogborn, Global Lives:  Britain and the World, 1550–​1800 (Cambridge, 2008), pp. 249–​52. 47 Browne, Civil and Natural History, pp. 22–​3. 48 Ibid., pp. 25–​6. 49 Ibid., p. 490. 50 Edward Long, The History of Jamaica (3 vols, London, 1774), ii, pp. 351–​60. 51 Browne, Civil and Natural History, p. 59. 52 Ibid., p. 215. 53 Dunn, A Tale of Two Plantations, p. 4.

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54 Browne, Civil and Natural History, pp. vii, 490. 55 Nelson, ‘Patrick Browne’, p. 11. 56 Browne, Civil and Natural History, pp. 120–​1. 57 Ibid., pp. 255–​6. 58 J. Delbourgo and N. Dew (eds), Science and Empire in the Atlantic World (New York and Abingdon, 2008), pp. 1–​28; J. Delbourgo, ‘Science’, in D. Armitage and M. J. Braddick (eds), The British Atlantic World, 1500–​1800 (2nd edn, Basingstoke, 2009), p. 107. 59 Robert Brown who owned land on St. Croix in 1766 may have been a kinsman of Patrick. See W. Westergaard, ‘A St. Croix map of 1766: with a note on its significance in West Indian plantation economy’, The Journal of Negro History, 23 (1938), p. 228. 60 Of a Westmeath lineage, Tuite was born on Montserrat in 1705 and was a prominent land and slave-​owner on the island and on St. Croix. See N. Rodgers, Ireland, Slavery and Anti-​Slavery:  1612–​1865 (Basingstoke, 2007), p. 58; Zacek, Settler Society, p. 92. 61 TNA, Prob 11/​983/​95, Will of Nicholas Tuite of London, 27 Nov. 1772. 62 Westergaard, ‘A St. Croix map of 1766’, p. 216. 63 O. Power, ‘Friend, foe or family? Catholic creoles, French Huguenots, Scottish dissenters: aspects of the Irish diaspora at St. Croix, Danish West Indies, c.1760’, in N. Whelehan (ed.), Transnational Perspectives on Irish History (New York and London, 2015), p. 32. 64 Ibid. See also O. Power, ‘Beyond kinship:  a study of the eighteenth-​ century Irish community at Saint Croix, Danish West Indies’, Irish Migration Studies in Latin America, 5 (2007), pp. 207–​14; O. Power, ‘The “Quadripartite Concern” of St. Croix: an Irish Catholic experiment in the Danish West Indies’, in D. T. Gleeson (ed.), The Irish in the Atlantic World (Columbia, SC, 2010), pp. 213–​28. 65 H. Fenning (ed.), ‘The mission to St. Croix in the West Indies:  1750–​ 1769’, Archivium Hibernicum, 25 (1962), p. 76. 66 Ibid., pp. 84–​5. 67 T. H. Breen, ‘Looking out for number one: conflicting cultural values in early seventeenth-​century Virginia’, in J. Lorimer (ed.), Settlement Patterns in Early Modern Colonization, 16th–​18th Centuries (Aldershot, 1998), pp.  73–​91. 68 Fenning, ‘Mission to St. Croix’, pp. 84, 85, 90, 87, 96, 116. 69 The will of Martin Blake of Sevenoaks in Kent was proved in London on 16 October 1767. Among the provisions in his will, Blake stipulated that ‘my wife shall have all her negroes and slaves which were her property before her marriage and the issue and increase of the females of such slaves’, TNA, Prob 11/​932/​368, Will of Martin Blake of Sevenoaks, Kent, 16 Oct. 1767. One of the witnesses to Blake’s will, Richard Maitland, was listed as a subscriber to Browne’s history of Jamaica. Maitland was

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involved in trade with the West Indies: Richard Baldwin, Baldwin’s New Complete Guide to All Persons who have Any Trade or Concern with the City of London (London, 1768), p. 139; The London Directory for the Year 1768 (London, 1768), p. 52. 70 P. Walsh, ‘The Blakes of Ballyglunin: Catholic merchants and landowners of Galway Town and County in the seventeenth and eighteenth centuries’ (PhD dissertation, University College Dublin, 2017), p. 181. 71 Browne, Civil and Natural History, p. 323. 72 L.  M. Cullen, Economy, Trade and Irish Merchants at Home and Abroad, 1600–​1988 (Dublin, 2012), pp. 172–​3. 73 Nelson, ‘Patrick Browne’, p. 8. A family connection with Jamaica may have continued if the Charles Patrick Browne of the parish of St John’s was related to Patrick Browne. Charles Browne dictated his last will and testament in 1796 and was dead by the following year. TNA, Prob 11/​1296/​ 315, Will of Charles Patrick Browne of Saint John, Jamaica, 19 Oct. 1797. 74 Nelson, Flowers of Mayo, pp. 31–​2. 75 E. C. Nelson, ‘Dr Patrick Browne and Sir Joseph Banks: a letter about a “lost” Irish flora’, ECI, 21 (2006), pp. 145–​7. 76 D.  H. Akenson, If the Irish Ran the World:  Montserrat, 1630–​ 1730 (Liverpool, 1997), pp. 247–​8. 77 The List of the Linnean Society (London, 1790); Nelson, Flowers of Mayo, pp. 32–​3.

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The evolution of the medical professions in eighteenth-​century  Dublin Susan Mullaney During the eighteenth century, the status of Dublin surgeons and apothecaries underwent a transformation. Having been long regarded as mere tradesmen, by the end of the century they were perceived as being members of a profession and both groups had initiated countrywide regulation of their professions. In the case of the apothecaries, the Irish parliament approved the relevant legislation twenty-​four years prior to the enactment of similar legislation in Britain. This chapter will trace the rapid evolution of the surgeons and the apothecaries and will situate their progress in the wider context provided by Britain and, to a lesser extent, France. In contrast to Britain, Dublin surgeons had by 1800 attained a status equal to their physician colleagues, and for those educated in Ireland they were now examined prior to commencing practice. The chapter will also assess why the apothecaries, and particularly the surgeons, had evolved, in terms of organisation and practice, at a faster pace than the physicians in Dublin, despite the latter group having unique opportunities. A key factor was the Irish county infirmaries legislation in mid-​century, which was vital to the rise in status of the surgeons. The uniqueness of that legislation partly accounts for the divergence of Irish surgeons from their contemporaries in Britain. The establishment of the Royal College of Surgeons in Ireland in 1784 was also imperative for this group as it provided them with a new identity and allowed them to regulate the profession. For the apothecaries’ trade, commercial competition expedited the enhancement of regulation. By the end of the century, the apothecaries were the largest of the official practitioners in the city and they faced increased pressure from the druggists. As was the case across Europe, the practice and regulation of medicine evolved differently in Ireland compared with

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neighbouring countries. This chapter will assess why Ireland, despite close governmental and political ties, pursued a path independent of England in attempting to educate and regulate the practice of official medicine in the eighteenth century. Research into the history of medicine in Ireland has expanded rapidly in the last two decades. This development has involved a greater scholarly emphasis on the eighteenth century. The latter has been enabled by the substantial primary sources that have survived for the Dublin medical Colleges, St Luke’s Guild (Apothecaries), the Apothecaries’ Hall and, to a lesser extent, the Barber-​Surgeon’s Guild. These sources are most useful for study of the groups covered by the classic tripartite division of regular medical professions, into physicians, surgeons and apothecaries. In other respects, the available sources are limited. The number and variety of irregular practitioners in Ireland, from the skilled bone-​setters to quacks and empirics, is impossible to trace or describe. Few records of their practices are extant, and the issue is further complicated by barriers of language and geography. There are, moreover, few accounts surviving of the income of medical practitioners and it is almost impossible to recover much, other than through anecdotal reference, about the patient’s viewpoint. Data generated by institutions and the details published in trade directories contribute to the picture, but do not accurately reflect the overall numbers who practised in the city. As a result, one can really only estimate the total. Within a research context that is shaped by incomplete and problematic sources, Laurence Geary’s overview of the voluntary hospitals and dispensaries provided an important starting point. The volume Ireland and medicine in the seventeenth and eighteenth centuries is another important contribution examining contemporary domestic medication and the role of graduate physicians, placing them within the broader culture of eighteenth-​century Irish society.1 Particular subgroups such as midwives and dentists have also received much-​needed attention.2 Research into the establishment of the mid-​century national hospital system and statutory regulation of the apothecaries has also been conducted, providing evidence that Irish medicine pursued a unique path.3 An assessment of the numbers of students who studied in France and Leiden has provided valuable evidence that the majority of those seeking a medical education went abroad.4 Numerous useful medical and institutional biographies have also been published. This chapter builds upon the foundation provided by recent research and attempts

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to assess how increased regulation and education within two subgroups of practitioners affected them and their contemporaries.5

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The number of practitioners

One indication of the number of apothecaries who practised in Dublin in the early years of the eighteenth century can be found in a petition dating from 1725. On 7 December in that year, a group of Dublin apothecaries placed a petition before the House of Commons against the heads of a bill to ‘prevent abuses in the practice of physic’.6 The heads of this bill had been brought by the president and fellows of the King and Queen’s College of Physicians of Ireland (KQCPI), who were attempting to reform what they referred to as ‘the great abuses daily committed in the practice of physic’.7 A counter petition against the proposed bill was sponsored by a group of twenty-​three Dublin apothecaries. This suggests that there could have been at least thirty apothecaries in the city, since it is possible that not all of them signed the petition.8 A decade later, the Apothecaries’ Act of 1735 required all apothecaries in the city of Dublin to register with the College of Physicians.9 The resulting extant register provides evidence to show that there were sixty-​seven apothecaries working in Dublin in 1736. The register gives their names and locations, with most working in the area around Dublin Castle. One cannot assume that this equates to the total number of apothecaries working in the city, as some may have chosen not to register. Of particular interest is the fact that nearly one-​third of the apothecaries who registered also described themselves as druggists. This suggests that there was no clear demarcation between those who chose to describe themselves either as apothecaries or druggists. This is in contrast to the clearer separation of roles noted by Irvine Loudon in late eighteenth-​ century London, where druggists stayed in their shops and prescribed cheaper medicines, whereas apothecaries visited patients.10 Moving forward to the 1760s, the Dublin trade directories for 1762 listed forty-​nine physicians, fifty-​five surgeons and very few apothecaries.11 This assessment of apothecary numbers was obtained from the voting register of the previous year; it was certainly not accurate. Turning to guild records, in 1762 there were 125 members of the Guild of St Mary Magdelene, which was comprised of apothecaries, barbers and periwigmakers. This number does not correlate with the trade directory estimates.12 It is, moreover, not possible to discern how many of the members of this guild were actually working as apothecaries or

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barber-​surgeons, as many became freemen of the guild for political and social reasons. An anonymous pamphlet published in 1703 estimated that only one-​tenth of the members of the guild were surgeons, and that most were barbers.13 The London trade directories list 322 apothecaries in the city in 1763. Allowing for a population of 650,000, this equates to one apothecary for every 2,018 citizens.14 Dublin, allowing for a population of 150,000 in 1750, had approximately one apothecary to every 2,500 citizens, a ratio not dissimilar to London. By 1791, the number of apothecaries in Dublin had risen to ninety-​ seven, with ninety-​five surgeons and sixty-​four physicians also listed in Wilson’s trade directory of that year. One can thus estimate that Dublin, with a population at the end of the eighteenth century of approximately 170,000, had approximately one apothecary to 1,773 citizens.15 If all of the various categories of regular medical practitioners are included (apothecaries, physicians and surgeons), there was approximately one practitioner to every 700 persons in Dublin in 1791. Add the irregular practitioners to this estimate and, to use a much-​quoted phrase, it was a very busy medical marketplace. This increase in practitioner numbers must be assessed against a very rapid rise in Ireland’s population in the eighteenth century, and increased consumer demand.16 A survey of the members and licentiates of the KQCPI between 1693 and 1799 reveals that only seventy-​seven physicians were admitted to the college during that time.17 Prior to 1750, only ten licentiates were admitted to the college, and between 1750 and 1800, a further sixty were admitted.18 This is a very small number, equating to less than one a year over the century. Laurence Brockliss estimates that in mid-​century only 40 per cent of Dublin physicians were registered as licentiates or fellows of the College of Physicians and that by 1798 this number had increased to just under 60 per cent.19 Hence, one may assume that the overall number of physicians may have been double that of the physicians actually licensed by the College to practise in the city. As there was little chance of being prosecuted by the College for not joining, many chose not to submit to the examination and or to paying the requisite fees. To place the numbers of Dublin physicians in some wider context, in 1754 only twenty-​five Britons gained a degree in medicine. This was from a far larger population base, as Laurence Brockliss notes in his assessment of professional identities in eighteenth-​century Britain.20 He estimates that there was unlikely to have been more than 750 graduate physicians in the whole of the British Isles in the eighteenth century. He also notes that 554 Irish doctors graduated from Reims during the eighteenth century alone. Very few of this latter

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grouping can be traced back to Ireland post-​graduation, with one notable exception being the physician Nathaniel Barry.21 It is equally difficult to estimate accurately the number of practitioners working throughout England and Scotland in the early part of the century; however, the creation of the medical register in 1779 by the London physician Samuel Foart Simmons was an important step towards quantifying their numbers. While not fully complete, this gives a snapshot in time of the number of practitioners working in the country, and shows that there were 3,120 regular practitioners. Just over 11 per cent were listed as physicians, 2.5 per cent as apothecaries, and just over 2 per cent as surgeons. The majority, 83 per cent, were listed as surgeon-​apothecaries, mainly located in market towns.22 The role of practitioners

In theory, physicians treated internal problems, such diseases internal to the body, while surgeons treated external problems. The latter included ailments on the surface of the body and minor surgical procedures such as removing lumps and bumps. The remit of the surgeon also included bleeding, leeching, blistering and cupping, all adhering to the tenets of humoral medicine. The apothecary was supposed to compound and dispense medicines under the direction of a physician. However, it is clear from a schedule of fees listed by St Luke’s Guild in 1784 that by that date the Dublin apothecaries went well beyond this notional boundary.23 The apothecaries were diagnosing and prescribing, letting blood, dressing and blistering among other practices. They were thus encroaching on the practices of both physicians and surgeons.24 This fee schedule from 1784 is an invaluable commentary on the role and practice of the Dublin apothecary, as it describes their practice in intimate detail, and what fees they charged for each visit and treatment. As such, the Dublin apothecaries were more like surgeon-​apothecaries and were the forerunners of the general practitioner. Surgeon-​apothecaries were quite distinct from ‘surgeons’, who did not make or sell medicine. Until the end of the century the remedies and treatments provided by all types of practitioners were very similar. But as surgery became pathologically and organ based at the end of the century, it also became more specialised, thus separating it further from the work of the physicians. With the establishment of the voluntary hospitals in Ireland in the eighteenth century, apothecaries, physicians and surgeons could work

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in these institutions, and in dispensaries later on. Physicians attended gratis, but it was important for a young physician’s profile to be seen to work in these institutions as this helped them in establishing a private practice.25 After 1777, apothecaries and surgeons were also paid to visit the gaols.26 The fact that in 1795 the Apothecaries’ Hall in Dublin could not find an apothecary to work in its newly established laboratory for a salary of less than £200 per year suggests that a good income could be made.27 In 1795, Henry Hunt, Governor of the Apothecaries’ Hall, was in a position to lend the Hall £1,000 to ensure that it would be able to acquire a mortgage for the Hall, for which Hunt retained the lease.28 The surviving account book of Charles Daly, covering a fifteen-​month period from July 1765 until the end of September 1766, also provides evidence of an apothecary’s income.29 The expenditure by one customer, Thomas Burnett, for Daly’s services to himself, his family, the servants and even the family’s horses totalled £34 17s 1d. Daly called himself by the title ‘Dr’. However, he appears to have been an apothecary. As was common at the time, he made multiple visits to the Burnett family, two or three times a week, prescribing on each occasion. This account provides a valuable mid-​ century insight into apothecaries’ practice; few other such accounts are extant. The fee schedule compiled by St Luke’s Guild in 1784 offers evidence of the services provided to both adults and children by Dublin apothecaries and the fees charged, both by masters and by apprentices.30 A  visit from an apothecary within one mile of Dublin cost 5s 5d. However, for those between three to six miles from the city, the charge was £1 2s 9d. If they were called out at night to attend the sick, the same rate applied. If the apothecary spent the night with the patient, the fee was £2 5s 6d. Being bled by a master cost 5s 5d. However, if this was done by the journeymen, or apprentice, the fee was 2s 8d. Generally, according to the 1784 schedule, the latter’s fees were half those of a master. The charge for providing a blister for a child was half that for an adult. The schedule also provides a list of prices for various commodities such as calomel pills (2d), mercury pills (1d), emetics draughts (8d), tooth powder (1s 1d per box) and castle soap (3d/​oz.), providing evidence of the commercial aspect of an apothecary’s practice. A comparison of this schedule with a second schedule compiled by the Apothecaries’ Hall 1792 shows that there was little room to increase the prices despite an era of increasing consumerism. There was one notable addition in 1792, as there was now a fee for inoculation. According

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to the schedule, the fee could vary from one guinea to £5 13s 9d. It is difficult to account for this wide variation in the fee.31 For many surgeons, bleeding, leeching and blistering provided their bread and butter, just as diagnosis and prescription were theoretically the brief of the physicians. At the same time, the wide range of the apothecaries’ practice meant that they transgressed theoretical remit of the other professional groups. By 1795, the apothecaries had acquired enough status to have their own separate category within the city’s trade directories, rather than being grouped with general merchants and traders as previously. This elevation of their status may partly account for the rise in their numbers. There are no similar descriptive accounts of the fees and practices of contemporary Irish physicians or surgeons. It is accordingly impossible to estimate their earnings, or the type of clinical practice that they pursued. Education

The College of Physicians in Dublin did not actually confer medical degrees, as only University of Dublin had the authority to do so. But until 1800, anyone who had a medical degree could automatically become a licentiate of the College of Physicians, without the need for an examination. The first recorded medical degree conferred by the university was a ‘Dr of Physicke’ conferred on John Archer in 1660.32 However, it was 1711 before the medical school was founded in Trinity College Dublin, when lectureships were established in anatomy, botany and chemistry. Only students from the established church were admitted to Trinity College. As the vast majority of the population were Catholics, they had to travel abroad to acquire a university education, a consequence of the Penal Laws. Many also chose to further their education in Europe and, on returning to Ireland, brought with them contemporary European ideas. This is particularly relevant to those who attended the Parisian hospitals and schools of surgery, where the surgeon’s status rose dramatically as the century progressed.33 There were only fourteen fellows in the KQCPI in the early part of the eighteenth century, two of whom left substantial bequests in 1710 and 1713. The first of these was Dr Richard Steevens, who left his estate to found the hospital which would bear his name. Grissel Stevens, Richard’s sister, expedited the project and Dr Steevens’s Hospital was opened in 1733, fulfilling Steevens’s wish to establish a ‘hospital for maintaining and curing from time to time such sick and wounded

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persons whose distempers and wounds are curable …. and [be a] fit reception of sick and wounded persons’.34 Sir Patrick Dun was born in Aberdeen and furthered his medical education in France before pursuing a high-​profile career in Dublin. At his death in 1713, he left a bequest to fund one or two professors of physic to read public lectures and make public anatomical dissections of the several parts of the human body or bodies of other animals, to read lectures on osteology, bandage and operations of Chirurgery, to read botanic lectures, demonstrate plants publicly and to read public lectures on materia medica for the instruction of students of physic, surgery and pharmacy.35 Dun left the proceeds of his estate, after his wife Mary’s death, to the College of Physicians so that they would establish the chairs in medicine. The first chair was established by charter 1715 and at that time the profits of the estate were approximately £58 per year. A private act in 1748 insured that control of this estate was passed to the College of Physicians. By the end of the century the estate yielded £1,200 per annum, money that theoretically should have been channelled into providing clinical tuition for students. It took five acts of parliament, two House of Commons enquiries and a House of Lords enquiry before Dun’s wishes were eventually brought to fruition and regular tuition was provided for medical students in Dublin.36 What should have been a small facet of Irish life clearly occupied a lot of parliamentary time, but the existence of the parliament in Dublin probably allowed easier access for such local issues. The saga of Dun’s request is emblematic of the inter-​institutional rivalry between Trinity College and the College of Physicians. The inertia displayed by the physicians was such that they did not capitalise on the opportunities created by Dun’s legacy. Legal difficulties resulting from incomplete documentation, poor management of the estate and greed meant that it took the establishment of a House of Lords enquiry in 1799 to ensure that Dun’s wishes were enacted. This committee, established to enquire whether the proceeds of Dun’s estate had been correctly utilised, came to the conclusion that ‘the intentions of Sir Patrick Dun as explained by the Acts of the 25th and the 21st of the present reign had not been carried into effect’. By the unanimous admission of every witness examined ‘the trust confided in the said College of Physicians, appears to have been grossly misused’.37 This was the impetus for the final piece of legislation in the story: the School of Physic Act of 1800.38 This Act transferred control of Sir Patrick

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Dun’s estate from the College of Physicians to a Board of Governors and also appointed eight commissioners with the authority to construct and establish the new hospital that was to be named Sir Patrick Dun’s hospital.39 The commissioners appointed were not medical men, which was probably important in expediting the process, in that their varied and independent skills could be applied to the completion of project.40 It was accepted in the last quarter of the eighteenth century that clinical tuition was a necessity to educate medical students, and the last four pieces of legislation in this episode attempted to ensure that the proceeds of Dun’s estate were channelled towards establishing a hospital where such clinical tuition could take place. Between 1724 and 1740, no medical degrees were conferred by Trinity College, and in the period of 1743–​73, twenty-​nine medical doctorates and twenty-​seven bachelors of medicine degrees were awarded.41 The matriculants’ register for Trinity College for the years 1786–​99 shows that the average number entering the medical school was between three and four annually, and obviously not all may have graduated.42 Thus it can be seen that very few medical students matriculated in Dublin in the eighteenth century. Despite Dun’s generous bequest, most went abroad to acquire an education. While clinical teaching was recorded as taking place in Padua in the sixteenth century, and in the seventeenth century in Leiden, most of this tuition was sporadic and did not follow any structured system, until regular clinical teaching commenced in Edinburgh in 1748. As Underwood notes, the numbers of English-​speaking students going to study in Leiden reached a peak in the 1730s, and dwindled thereafter. In the period 1739–​ 1817, eighty-​ six Irish students matriculated in Leiden, and seventy obtained a medical doctorate.43 This equates to approximately one per year matriculating at the university during this period. In France, a Royal decree in 1730 demanded that all practising surgeons were required to have a certificate from a surgeons’ guild, and an earlier edict of 1707 had stipulated that all practising physicians must hold a degree from a French medical faculty.44 As Brockliss noted, the existence of such a decree did not necessarily mean that it was implemented. As the eighteenth century progressed, the training for French surgeons became more academic and better structured, such that by 1789 there were seventeen stand-​alone surgical schools or colleges, the first of which was the École de Chirurgié of Paris, founded in 1724. As the numbers of surgeons increased in France, the numbers

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of apothecaries decreased, in part due to a lack of structured education. Reims was very popular with Irish students and in the period 1547–​ 1794, 657 students of a total of 3,322 were of Irish origin.45 Brockliss notes that 554 Irish doctors graduated from Reims during the eighteenth century alone, and they came from all over Ireland. A  surprisingly small number of these, less than 10 per cent, came from Dublin.46 The majority of the Irish medical graduates from Reims were Catholics, and many had studied in Paris prior to graduation, but chose not to take a degree there, possibly due to the expense, instead travelling to smaller centres for examination. The medical education provided by Edinburgh University in the second half of the eighteenth century could not have been more different to that of Oxford or Cambridge. Edinburgh admitted students with no restrictions regarding religious affiliation. Importantly, the university medical faculty also allowed all types of students to attend the various courses provided, and they were not required to be affiliated to the medical faculty, with only one-​third of matriculants actually graduating.47 Lindemann has noted that while approximately 3,000 medical students graduated from Scottish universities in the eighteenth century, only approximately 860 graduated from Oxford and Cambridge in the same period. Despite Dun’s legacy, there was no regular clinical teaching in Dublin prior to 1800, and the King’s Professorships were in essence sinecures. Very few students chose to stay in Ireland to pursue a medical education. By mid-​century, Edinburgh became the destination of choice for Irish medical students. Regulation of the professions: apothecaries

Until the establishment of St Luke Guild of Apothecaries in 1745, surgeons and apothecaries could become freemen of the barber-​surgeon’s guild. However, there is no evidence to suggest that either apprentices, or prospective master apothecaries, were examined prior to commencing practice. The KQCPI had the authority to regulate the practice of physicians and apothecaries in Dublin, and within a seven-​mile radius of the city. In theory, the College’s charter of 1692 also gave it the right to regulate physicians on a nationwide basis, but this was never attempted.48 Its charter also gave it the right to search and examine apothecaries’ shops in Dublin and to examine apothecaries’ apprentices prior to the commencement of their service; but the clause relating to examination does not seem to have been implemented.49 In 1717, the

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College of Physicians noted that ‘several apothecaries of this city have presumed to practice physic and in many cases to the great detriment of the sick’.50 The College exerted its regulatory authority in a very sporadic fashion and even if someone was cited for malpractice, it was very difficult to bring a court case due to the costs that this entailed.51 The same can be said of the London College of Physicians, in that offenders were rarely prosecuted, primarily due to the expense involved. The decision of the House of Lords in the Rose case in London in 1704 created further problems for the London College. The relevant judgement stated that apothecaries could diagnose and prescribed for patients, but were not allowed charge for the this advice and any recompense they received was at the discretion of the patient.52 Loudon believes that this did little to change the status quo for the apothecaries who continued an established tradition of prescribing for patients, but it did hasten the decline of the power of the London College to exert its authority to police the practice of medicine in the city.53 This also meant that, in London, apothecaries now had a legal a right to treat patients, but it is difficult to know whether this case ruling was ever applied in Ireland. The Dublin College of Physicians petitioned the Irish House of Commons in 1725 as it felt it had insufficient powers to regulate what it called ‘abuses of the necessary art of physic in this kingdom by the practice of mountebanks and empirics’.54 This petition did not have any immediate impact. Inspection of the apothecaries’ shops by the physicians took place intermittently during the first half of the eighteenth century. The 1735 Apothecaries’ Act required that two apothecaries also be involved in the inspection process. Despite this, there does not appear to have been any prosecutions for malpractice. A report of the examinations by the College of Physicians is extant for the years 1742–​44; however this is not very detailed and only provides a vague account of whether the various apothecaries were ‘good, indifferent, middling’ or, as in the case of one apothecary named Barnwell, ‘incorrigible’.55 For the first half of eighteenth century, surgeons could become freemen of St Mary Magdalene’s Guild of Apothecaries, Barber-​ surgeons and Periwigmakers, which received its first charter in 1446. The formation of St Luke’s Guild of Apothecaries in 1745 heralded the ultimate demise of the barber-​surgeon’s guild, but this guild continued to use the old title, until 1781, when it changed the name to the ‘fraternity of Barbers and Chirurgeons of the Guild of St Mary Magdelene’.

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This name change signalled its acceptance that the apothecaries were now represented by a separate guild.56 St Luke’s Guild was the last of the traditional trade guilds formed in Dublin and it remained a small and rather unimportant guild in the city and over the next fifty years. Only 110 free brethren in total were admitted to the guild over forty-​six years, with over 50 per cent of these admitted by grace especial.57 However, the new guild was an important step for the apothecaries in establishing their own identity and in beginning the process of achieving the right to regulate their own trade. These developments finally came to fruition with the passage of the 1791 Apothecaries’ Act.58 The 1735 Apothecaries’ Act had not been sufficient to create adequate regulation and appropriate standards for the time. This was noted by Charles Lucas in his pamphlet Pharmacomastix, addressed in 1741 to an unknown Member of Parliament.59 In this, Lucas noted that it was ‘scarcely profitable for a man to learn the art fully and then get an honest livelihood from that profession’ and that he hoped ‘to offer some means to prevent such horrid malpractice for the future, whereby the public is robbed of the chief blessing of this life, health’.60 Much of what he proposed became the basis for the 1761 Apothecaries’ Act. For example, Lucas recommended that apothecaries’ shops in rural towns should be examined by physicians.61 He also proposed that should the College of Physicians not enforce this regulation, the chief magistrate of a town ought to have the authority to call on two ‘properly educated’ physicians to perform this duty. If this clause had been implemented it would have led to the creation of a rudimentary register of apothecaries working in the country’s towns, since an annual report was, in theory, to be submitted to the College of Physicians. This act was not implemented and, despite numerous attempts in the 1770s and 1780s, it was only with the passage of the 1791 Apothecaries’ Act that regulation of apothecaries’ business on a nationwide basis was implemented.62 This latter act now referred to the apothecaries as a ‘profession’ and gave them the right to regulate their own affairs, free from the control of the College of Physicians. This was most important because the Dublin apothecaries were in direct commercial competition with the physicians, but charging much lower fees. Competition from druggists, quacks and empirics was an important stimulus for the apothecaries to establish their own professional identity. It highlighted the necessity of distancing themselves from the untrained practitioners in the city by creating a new professional identity, recognisable by the public, and thus the consumer.

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Regulation of the professions: surgeons

For surgeons, acceptance of the need to ensure a certain standard for of education and practice was implicit in the Irish County Infirmaries’ Act of 1765. This legislation established a countrywide network of hospitals in Ireland.63 Ireland was the only country in Europe where statutory provision was made to establish such a network and before long there was a hospital in almost every county in the country.64 There was no such statutory provision in contemporary England or Scotland. The county infirmaries were established with the same ethos as the contemporary voluntary hospitals in that a ticket of admission was required from a governor in order to be admitted. Only patients who were perceived as being curable were admitted and those who had epilepsy, fevers or venereal disease were excluded, as were those late on in pregnancy, and so-​called ‘Lunaticks’.65 These restrictions on admissions were with a view to enhancing the public subscriptions on which the hospital partly depended, and reflected the belief that unless the hospital was perceived to be successful, the public would not donate money. The county infirmaries also received some local and state funding. Charles Lucas, who had studied in France during a period of exile, played a role in the design of this act. He was probably responsible for the clauses relating to employing a salaried surgeon in these infirmaries. Under the 1765 Act, a surgeon, rather than a physician, was to be the primary medical officer in the new infirmaries. This was an innovative move as previously physicians had been placed in authority in hospitals. However, given that only curable patients were being admitted, it was a very practical step; the majority of patients in the eighteenth century who were likely to be ‘curable’ would have had minor surgical problems.66 Enshrined in this act also were the standards required of an applicant for a county infirmary surgeon’s post. In order to comply with the act, the County Infirmary Surgeons’ Examination Board was established. The candidates were required to have completed a five-​year apprenticeship and were examined by the Surgeon General, a visiting surgeon, two assistant surgeons, a surgeon from Dr Steevens’s Hospital and five senior surgeons from Mercer’s hospital, or a quorum thereof.67 Between 1766 and 1795 the Irish County Surgeon’s Examination Board examined 110 candidates, rejecting only 10 per cent of them, mainly due to incorrect certification of indentures.68 Under this system, an appropriately certified surgeon was placed in charge of each of the county infirmaries, and the achievement of specified educational

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standards helped to distinguish him from his early eighteenth-​century guild equivalent. Thus, by 1766 there was now a new form of certification for surgeons, which provided them with an endorsement of a particular standard and which was beyond the remit of the guilds. The rise in status of Irish surgeons was an unintended consequence of the 1765 Act. The Dublin physicians were well aware of the possible effects of the elevation status of the surgeons. The issue was duly noted by Edward Foster in his Essay on Hospitals published in 1768 and addressed to Charles Lucas, Member of Parliament for Dublin.69 Referring to the fact the surgeons were now the prime medical practitioners in the state hospitals, he wrote:  ‘they will soon become distributors of medicine and death instead of relief ’.70 His fears regarding elevation status of the surgeons were well placed. By the end of the century, the status of surgeons equalled, and for those who had received their education in Ireland, probably surpassed their physician colleagues. In mid eighteenth-​century England, physicians were in ascendancy in the voluntary hospitals, and regarded themselves as both socially and intellectually superior to their surgeon colleagues. The standards required by physicians or surgeons appointed to hospitals were not enshrined in legislation in Britain and indeed, in most cases, hospitals rarely stipulated what was necessary as the hospital’s governing board made the choice. One exception to this was the Middlesex Hospital, where in 1770 the rules stated that in order to apply as a house physician to the hospital, an applicant was required to be a graduate of either Oxford, Cambridge or Dublin or a member of the College of Physicians.71 In contemporary France, the opposite case was the case, where the surgeons by far outnumbered the physicians in the hospitals. In the Hôtel-​Dieu in Paris, there were one hundred surgeons to eight physicians and similarly in Marseille surgeons outnumbered physicians by eighteen to two.72 These ratios did not necessarily arise from the types of patients in these hospitals. They arose, as Toby Gelfand argues, from social and economic factors.73 The Irish surgeons’ elevation in status was greatly enhanced by the foundation in 1784 of the College of Surgeons in Ireland. The newly established college had the authority to examine and regulate surgical candidates and give them ‘letters testimonial’ as a certification of their skill. Very quickly it was realised that, like London, the Dublin college could have a role examining army and navy surgeons, and assistant surgeons. With a view to this, the surgeons quickly passed a bylaw that

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allowed them to examine provincial surgeons and army surgeons.74 This was an important move by the embryonic college as it allowed it to demonstrate its potential usefulness to the government. By 1786, the new college had commenced lectures in anatomy and physiology. Having begun to examine army surgeons, it proceeded to apply to the lord lieutenant of Ireland for funds to establish a hall.75 While these requests were initially unsuccessful, in 1790 the government granted the college £1,000, no doubt partly in recognition of the useful service provided to the defence of the realm.76 The sphere of influence of the College of Surgeons extended rapidly, as can be seen by the fact that it received a letter from Sir John Blaquiere in 1791. He expressed a wish to meet with officials of the College to draw up proposals to improve the regulation of the network of county infirmaries.77 The ensuing report provided the government with advice regarding the management of the county infirmaries and the College later proposed improvements to the running of the Lock Hospital such that surgeons should be placed in charge.78 It is evident that within seven years of its establishment, the College had become the accepted authority in the country to regulate army and navy surgeons’ education and provide advice to the government on institutional matters. By 1807, parliament had granted the Royal College of Surgeons in Ireland over £20,000 to enable it to provide a system that would both educate and regulate the profession, and importantly, from the government’s perspective in a time of prolonged warfare, to provide a similar service for the army’s surgeons.79 Thus, in a few short years, the newly established surgeon’s college was taking a leading role in the medical world of Dublin. This rapid elevation of the College of Surgeons to become an advisor to the government was partly as a result of the lack of leadership by physicians in the Irish medical arena in the last quarter of the eighteenth century. The Dublin physicians did not keep pace with the other practitioners in the eighteenth century, despite the apparent opportunities they had. As a result, by the end of the century the physicians could no longer be regarded as the elite of the Dublin medical world. Analysis

Many of the developments described in this chapter were intertwined and some occurred by chance. That said, as evidenced for example by the respective cases of Ireland and England, medical practice did not

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develop in the same manner in any two countries in Europe. The demise of the previously strong guild structure in the British Isles also meant that a new type of governance was required for all arts and trades. Both the apothecaries and the surgeons at the start of the eighteenth century were regarded as tradesmen. A  hundred years later, both disciplines were perceived as being professions and they had secured the authority to regulate themselves. The number of practitioners in both groups increased as the century progressed. By the 1790s, the apothecaries were the largest group of medical practitioners in Dublin. While it is difficult to make an absolute estimate, it would appear that the number of physicians in Dublin did not increase at the same rate as the apothecaries or the surgeons, possibly due to lack of demand due to expensive fees. However, the clinical practice of medicine for all practitioners changed very little during this era, until surgery developed into a pathologically oriented discipline at the end of the century. Practitioners applied the humoral concepts of medical theory and patients sought help from anyone who could alleviate their symptoms, whether from the ranks of the regular healers or from irregulars, or often both at the same time. All groups were competing for the same patients, albeit the physicians were more likely to treat those from the uppers echelons of society; more people were able afford an apothecary’s consultation fee of 5s 5d. Apothecaries in Dublin diagnosed and treated patients and also conducted many of the minor procedures performed by surgeons –​in essence, they were practising surgeon-​apothecaries similar to England and Scotland. Consequently, apothecaries were in direct commercial competition with surgeons and, as they were often called to the patient first, they were the gatekeepers of the consultative process. There was also increasing commercial pressure from the druggists and the ever-​ present empirics and quacks. Following the 1791 Apothecaries’ Act, this profession was regulated on a nationwide basis, twenty-​four years before similar legislation was passed in Britain. Irish surgeons, meanwhile, were the beneficiaries of the terms of the County Infirmaries Act, which elevated them to the role of primary medical officers in the country’s network of hospitals, ensuring that their educational standards were regulated and assessed. The enhancement of the status of Irish surgeons following this act was unplanned, and the design of the act was unique in the British Isles in this respect. The result was that by the end of the century, Irish surgeons were afforded far greater respect than their English

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contemporaries, who were regarded as inferior to physicians. The foundation of the College of Surgeons in Dublin allowed the surgeons establish an official identity, distinct from the barber-​surgeons, with the authority to regulate the standards in the profession, and also provide training for students in Ireland. Since the surgeons, by the 1790s, had a representative college and a strong profile in the city, the apothecaries needed to increase their profile also. This was one of the reasons why the 1791 Apothecaries’ Act was so important, as it gave them a new corporate identity. The rapid transformation in the Dublin medical arena by the end of the century also meant that the physicians needed to enhance their profile. Early in the eighteenth century, the Dublin physicians were the beneficiaries of two bequests that provided them with the opportunity to establish a hospital and chair of medicine; however poor management of these bequests meant that the benefits were not fully realised for nearly 100 years. This may have resulted from complacency; it was emblematic of the failure by the physicians to address general regulatory problems in the Dublin medical world. By the end of eighteenth century, due to their inertia, there was a lacuna in leadership in the Dublin medical world that was very amply filled by the College of Surgeons. However, after the passage of the final School Physic Act in 1800, the physicians demonstrated that they had come to terms with the changes that were needed in order to educate and regulate the profession in the new century. With the opening of Sir Patrick Dun’s Hospital in 1808, Dublin was able to provide students with a systematic theoretical and clinical training. Conclusion

This chapter has provided an overview of the evolution of the medical professions in eighteenth-​century Dublin. This was a period in which the number of both apothecaries and surgeons in Dublin increased substantially. By the end of the century, both groups had new corporate identities that distinguished them from unregulated and untrained practitioners. The surgeons, for example, achieved a profile equal to the physicians, and advised the Dublin executive on medical matters. Such developments, combined with more stringent nationwide regulation of all aspects of the regular medical profession, heralded what has often been called the golden era of Irish medical education at the beginning of the nineteenth century. At that time, Dublin became a major

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centre of medical education, equalling Edinburgh in this regard. The changes that occurred in the eighteenth century, and particularly in its final two decades, were thus crucial to the development of the medical professions in Ireland in the longer term.

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Notes 1 L. Geary, Medicine and Charity in Ireland:  1718–​1851 (Dublin, 2004); J.  Kelly and F.  Clark (eds), Ireland and Medicine in the Seventeenth and Eighteenth Centuries (Farnham, 2010). See also J. Kelly, ‘Bleeding, vomiting and purging:  the medical response to ill-​health in eighteenth-​ century Ireland’, in C. Cox and M. Luddy (eds), Cultures of Care in Irish Medical History, 1750–​1950 (Basingstoke, 2011), pp. 13–​36. 2 P. Gorey, ‘Managing midwifery in Dublin’, in M.  H. Preston and M. O hÓgartaigh (eds), Gender and Medicine in Ireland 1700–​1950 (New York, 2012), pp. 123–​37. J. Kelly, ‘ “I was right glad to be rid of it”: dental medical practice in eighteenth century Ireland’, in ibid., pp. 9–​32. 3 S. Mullaney, ‘ “A means of restoring the health and preserving the lives of his majesty’s subjects”: Ireland’s eighteenth century infirmary system’, Canadian Bulletin of Medical History, 29 (2012), pp. 223–​42; S. Mullaney, ‘The 1791 Apothecary’s Act’, ECI, 25 (2010), pp. 177–​90; A. Sneddon, ‘State intervention and the provision of health care: the county infirmary system in late eighteenth-​century Ulster’, IHS, 38 (2012), pp. 5–​21. 4 L. Brockliss, ‘Medicine, religion and social mobility in eighteenth and early nineteenth-​century Ireland’, in Kelly and Clark (eds), Ireland and Medicine, pp. 73–​108. E. A. Underwood, ‘The first and final phases of Irish medical students at the University of Leyden’, in E. O’Brien (ed.) Essays in Honour of J. D. H. Widdess (Dublin, 1978), pp. 5–​42. 5 J.  D.  H. Widdess, A History of the Royal College of Physicians of Ireland 1654–​1963 (Edinburgh, 1963); R. B. McDowell and D. A. Webb, Trinity College Dublin, 1592–​1952: An Academic History (Cambridge, 1982). 6 Journals of the House of Commons of the Kingdom of Ireland (4th edn, 21 vols, Dublin, 1796–​1801) (hereafter JHCI), iii, p. 430. 7 Ibid., p. 429. 8 Ibid. 9 RCPI, 11/​1/​1, Register of Apothecaries of Dublin, 1736–​55. 10 I. Loudon, Medical Care and the General Practitioner: 1750–​1850 (Oxford, 1986), pp. 132–​6. 11 S. Mullaney, ‘ “The poorman’s comfort”: the apothecaries in the medical world of Dublin, 1745–​95’ (MA dissertation, University College London, 2008), p. 11. 12 TCD, MS/​1447/​10. Minutes of the St Mary Magdelene Guild of Barbers, Chirurgeons and Apothecaries, 1762.

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13 Anon., Reasons for Regulating the Practice of Surgery in the City of Dublin (Dublin, 1701). 14 The London Trade Directory (London, 1763). 15 Mullaney, ‘ “The poorman’s comfort” ’, p. 11. 16 D. Dickson, C. Ó Gráda and S. Daultrey, ‘Eighteenth-​century Irish population: new perspectives from old sources’, The Journal of Economic History, 41 (1981), pp. 601–​28. 17 RCPI, RCPI/​5, Licentiates and Fellows of the King and Queen’s College of Physicians of Ireland, 1693–​1800. 18 Ibid. 19 Brockliss, ‘Medicine, religion and social mobility’, p.  89. For numbers outside of Dublin, see T. Barnard, A New Anatomy of Ireland:  The Irish Protestants, 1649–​1770 (London, 2003), pp. 130–​3. 20 L. Brockliss and D. Eastwood, ‘Introduction’, in L. Brockliss and D. Eastwood (eds), A Union of Multiple Identities: The British Isles, 1750–​1850 (Manchester, 1997), p. 20. 21 Brockliss, ‘Medicine, religion and social mobility’, pp. 79–​80. 22 J. Lane, A Social History of Medicine:  Health, Healing and Diseases in England, 1750–​1950 (London, 2001), p. 15. 23 RCPI, AH/​1, Transactions of St Luke’s Guild of Apothecaries of Dublin, 8 January 1784. 24 Ibid. 25 John Boland was appointed as an apothecary to Mercer’s Hospital in 1747, at an annual salary of £20, with lodgings, coals and cancles included. The Dublin General Dispensary employed an apothecary at a salary of £60 in 1785. Surgeons were paid £100 per annum to work in the county infirmaries. 26 ‘An Act for Preserving the Health of Prisoners and Preventing Gaol Distemper’, 1771 (26 Geo III, c. 28). 27 RCPI, AH/​1, Transactions of the Apothecaries’ Hall of Ireland (1791–​ 96), 2 Sept. 1791. 28 Ibid., 27 Jan. 1795. 29 NLI, MS 8720, Account Book of Charles Daly. 30 RCPI, AH/​1, Transactions of St Luke’s Guild, 8 January 1784. 31 Wilson’s Trade Directory (Dublin, 1791). 32 T. P. C. Kirkpatrick, History of Medical Teaching in Trinity College Dublin and of the School of Physic in Ireland (Dublin, 1912), p. 44. 33 For an account of eighteenth-​century French surgical education see T. Gelfand, Professionalizing Modern Medicine:  Paris Surgeons and Medical Sciences and Institutions in the 18th-​Century (Westport, CT, 1980). 34 T. P. C. Kirkpatrick, The History of Doctor Steevens’ Hospital Dublin, 1720–​ 1920 (Dublin, 1924), p. 303. 35 There is no extant copy of Dun’s will, but there is a copy in Belcher’s biography, T. W. Belcher, Memoir of Sir Patrick Dun (Dublin, 1866), p. 50.

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36 For a full account of this see S. Mullaney, ‘Sir Patrick Dun and the complete school of physic in eighteenth-​century Ireland’, The Irish Journal of Medical Science, 184 (2015), pp. 167–​73. 37 Ibid., p. 170. 38 ‘An Act to Explain and Amend an Act for Establishing a Complete School of Physic in this Kingdom’, 1800 (40 Geo III, c. 84). 39 Ibid. 40 The commissioners appointed were Sackville Hamilton, George Knox, Arthur Browne, Frances Hutchinson, William Digges Latouche, Abraham Wilkinson, the Provost of Trinity College and the president of the College of Physicians. 41 Widdess, A History of the RCPI, p. 97. 42 TCD, MS 758, Register of Matriculants 1786–​99, Trinity College Dublin. There were seventeen entrants in 1787. When this year is omitted, the average is three per year. 43 Underwood, ‘The first and final phases’, p. 14. 44 L. Brockliss, ‘Medical education and centres of medical excellence in eighteenth century Europe’, in O. P. Grell, A. Cunningham and J. Arrizabalaga (eds), Centres of Medical Excellence? Medical Travel and Education in Europe, 1500–​1789 (Farnham, 2010), p. 18. 45 H. de Riddder-​Symoens, ‘The mobility of medical students from the fifteenth to the eighteenth centuries: the institutional context’, in ibid., p. 88. 46 Brockliss, ‘Medicine, religion and social mobility’, pp. 79–​80. 47 See L.  Rosner, ‘Students and apprentices:  medical education at Edinburgh University, 1760–​1810’ (PhD dissertation, Johns Hopkins University, 1985). 48 Belcher, Memoir of Sir Patrick Dun, p. 51. 49 Ibid., pp.  34–​6. See also A  Sneddon:  ‘Institutional medicine and state intervention in eighteenth-​century Ireland’, in Kelly and Clark (eds) Ireland and Medicine, pp. 137–​62. 50 RCPI, Journal of the RCPI, 2 July 1717. 51 Ibid., 2 May 1720 and 20 Apr. 1724. 52 A. Wear (ed.), Medicine in Society:  Historical Essays (New  York, 1992), p. 230. 53 H. J. Cook, ‘The Rose case reconsidered: physicians, apothecaries, and the law in Augustan London’, JHMAS, 45 (1990), pp. 553–​5. 54 JHCI, iii, p. 429. 55 RCPI, 11/​1/​2, Reports of Visitors of Apothecaries’ Shops, 1742–​44. 56 RCPI, AH/​1, Transactions of St Luke’s Guild, 1781. 57 Ibid., 1747–​91. 58 ‘An Act for the More Effectually Preserving the Health of His Majesty’s Subjects, for erecting an Apothecary’s Hall in the City of Dublin and for Regulating the Profession of an Apothecary throughout the Kingdom of Ireland’, 1791 (31 Geo III, c. 34).

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59 Charles Lucas, Pharmacomastix (Dublin, 1741). 60 Ibid., p. 10. 61 ‘An Act for Preventing Frauds and Abuses in the Vending, Preparing and Administering Drugs and Medicines’ 1761 (1 Geo. III, c. 14). 62 Mullaney, ‘The Apothecarys’ Act’. 63 ‘An Act for Erecting and Establishing Publick Infirmaries or Hospitals in this Kingdom’ 1765 (5 Geo III, c. 20) 64 Mullaney, ‘ “A means of restoring the health” ’. 65 ‘An Act for Erecting and Establishing Publick Infirmaries’, 1765 (5 Geo. III, c. 20). 66 Mullaney, ‘ “A means of restoring the health” ’, p. 233. 67 ‘An Act for Erecting and Establishing Publick Infirmaries’. 68 RCSI, Records of the County Infirmary’s Examination Board, 1766–​95. 69 Edward Foster, An Essay on Hospitals (Dublin, 1768), p. 22. 70 Ibid., p. 28. 71 See S. C. Lawrence, Charitable Knowledge: Hospitals, Pupils and Practitioners in Eighteenth-​Century London (Cambridge, 1996) for an account of the medical personel in the British voluntary hospitals. 72 L. Brockliss and C. Jones (eds), The Medical World of Early Modern France (Oxford, 1997), p. 703. 73 Gelfand, Professionalizing Modern Medicine, p. 143. 74 RCSI, Minutes of the RCSI, 5 December 1785. 75 Ibid., 7 August 1786 and 2 September 1786. 76 Ibid., 2 April 1790. 77 Ibid., 5 April 1791. Sir John Blaquiere was MP for Charleville in 1791 and Chief Secretary 1772–​76. 78 Ibid., 2 May 1791. 79 RCSI, Minutes of RCSI, 1784–​1807.

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Index

Note: ‘n.’ after a page reference indicates the number of a note on that page. Aberdeen 239 Abernathy, John 148 Adwick, Elizabeth 74 Aghmacart, Co. Laois 21–2, 25, 27 Aglionby, William 89 Ague 64 Águila, Juan del 50, 52 Agurto, Francisco de 44 Albinus, Bernhard Siegfried 177 Amazonia 213 America 159, 215, 219 Andrew, Thomas 75 Anne, Queen 217 Antigua 214, 216, 225, 226 Antwerp 42 Apothecaries’ Hall 233, 237 Arbuckle, James 149 archaeology 34n.3 Archer, John 89, 97n.17, 238 Argellata, Petrus de 26 Askew, Anthony 218 Avignon 47 Aylyffe, Henry 75 Bacon, Francis 85 Ballyglunin, Co. Galway 225 Banford, Catherine 114 Barbados 213, 214, 215 Barbette, Paul 173

Barlow, John 152–3 Barnewall, Mary 73 Barry, Mary 112 Barry, Nathaniel 236 Bartholin, Thomas 42, 182 Bathurst, Robert 90 Beaton, Donald 26 Belfast Society 148 Belon, Pierre 11, 85, 91–3, 99n.28 Bernard of Gordon 21, 22, 26, 27 Bidloo, Govard 178 birth intervals 139–41 Blackmore, Richard 174 Blake, Martin 225, 230n.69 Blaquiere, John 246, 252n.77 Boate, Arnold 65, 68, 87, 114 Boate, Gerard 65, 87 Boerhaave, Herman 170, 171, 175, 177 Bohemia 42 Bole, John, archbishop of Armagh 25 Bolnest, Edward 90 botany 211, 215, 217–18, 226 Boulter, Hugh, archbishop of Armagh 198 Boyle, Richard, first earl of Cork 87, 125 Boyle, Richard, second earl of Cork 91

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Boyle, Robert 87, 156 Brazil 219 breastfeeding 138–9 Brien, Johanna 112 Bristol 128 Brocadelli, Lucia 201 Brooke, Humphrey 86, 95n.4 Browne, Edward 82n.13, 214 Browne, John 199 Browne, Patrick 15, 211–27 Browne family 215 Bruce I, William 181, 187n.44 Bulkeley, Lancelot, archbishop of Dublin 107 Burnett family 237 Burton, Robert 168 Butler, Dr 89 Butler, James, archbishop of Cashel 105, 112 Butler, James, duke of Ormond 11, 68, 84–5, 88–93 Byfield, Timothy 94, 100n.43 Bysse, Philip 64 Calmette, François 174 Cambridge 240, 245 cancer 134 Carey, Mordecai, bishop of Clonfert 151 Caribbean 212–14 Carr, Peter 128, 133, 141 Cary, Henry, Viscount Falkland 150 Cashel, Co. Tipperary 42 Cashin, Conly 11 Cassadie, Patrick 25 Castlehaven, Co. Cork 40, 48–52 Catholic Church 6, 12, 45, 103–4, 106, 108–13, 224–5 Celsus, Cornelius 169 Chapelizod, Co. Dublin 91–3 Charles I 68, 149 Charles II 85, 93 Cheyne, George, 166, 170–1

Index

Chicoyneau, François 173 Child, Robert 85 child mortality 129–36, 137–41, 201 China 156 Church of Ireland 6, 12, 103–4, 106–8, 109–11, 113 Clare 42 Claremorris, Co. Mayo 214, 226 Clarke, Simon 222 Clodius, Samuel 89 Clogher 191–3 Cockburn, William 171 College of Physicians, Dublin and education 238–40 foundation of 6, 150 membership of 94, 166, 235 and midwifery 113–15 and regulation 12, 87, 105, 234, 241–3 and training 129 College of Physicians, London 11, 87, 89, 148, 150, 188, 242, 245 Collinson, Peter 218 Connery, William 71 Connor, Charles 72 Conry, Florence 42 consumption 134 Conway, Charles 66, 79n.45 Copping, John 14, 188–204 Coppinger, William, bishop of Cloyne 105, 112 Cowper, William 178 Crabbe, George 123 Crampton, Philip 1 Creighton, George 63, 76 Croll, Oswald 168 Cromwell, Oliver 86, 219 Cudyhy, Catherine 112 Culpeper, Nicholas 168 Cumming, Mr 152 Cummins, Mrs 112 Currer, William 89–90, 98n.20

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Daly, Charles 237 Darcy, Patrick 66 Davis, John 128 Denmark 42, 224–5 dentistry 233 Descartes, René 168 Devereux, Walter, earl of Essex 31–2 Devon 61 Diemerbroek, Isbrand 182 Dineley, Thomas 127 Dobbs, John 128 Dobbs, William, 189, 194 domestic medicine 29, 74, 195 Dominican order 225 Donnelly, Mary 196, 203 Douai 47 Drenlincourt, Charles 178, 182 dropsy 133 Dublin 9, 22–3, 232–49 see also hospitals; Trinity College Dublin Dublin Philosophical Society 148, 156, 159, 167, 178 Dun, Mary 239 Dun, Patrick 129, 144n.28, 183n.1, 239–41, 248 dysentery 131, 132 Edinburgh 240, 241, 248 education continental 15, 42, 47, 69, 87, 148, 166, 215–16, 233, 238, 240–1 in Ireland 21, 71, 232, 238–41 Elizabeth I 44 Elliott, Mrs 110 Ellis, John 218 Ent, George 91 epilepsy 244 Este, Charles, bishop of Ossory 110 famine 199 Farnese, Alexander, duke of Parma 43 Farrell, Thaddeus, bishop of Clonfert 49

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Fennell, Gerald 68 Ferazzi, Cecelia 201 Fergus family 35n.27 Ferguson, Victor 147, 149, 152, 154, 160 fevers 65, 133, 134–5, 136, 219, 222, 223, 244 Field, John 71 fits 133 Fitzgerald, Gerald, earl of Kildare 23 Flanders 42 flux 65, 66, 134, 135 Fogarty, William 89, 97n.19 Fontaines-Voutron, Daniel de Mazieres des 93, 100n.41 food 46–7, 50, 137, 138, 196, 199, 223–4 Foster, Edward 245 Fottergill, John 218 France 15, 41, 69 Freind, John 170–1 Freke, Elizabeth 135 Frere, Ambrose 76 Gaelic medicine 8, 15, 20–33, 41–3 Galen 51, 85, 167, 169 Galway 66, 215, 224–5, 226 George I 217 George II 217 Gledstanes, George 194 Goddard, Jonathan 86, 95n.4 Googe, Barnaby 83n.115 Gough, Dr 128 Graaf, Reiner de 177, 182 Greatrakes, Valentine 87, 127, 144n.21 Gregory, David 170 Guide, Philip 93, 100n.40 gunpowder 70–1 Hackett, James 70 Hales, Stephen 218 Hallanan, Mary 112 Hamilton, George 90

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Hampton, Christopher, archbishop of Armagh 107 Hartlib Circle 11, 85, 87, 89 Hartsoeker, Nicolas 175, 181 Hayman, Elizabeth 139–41 Hayman, Samuel 139–41 Heathcote, Gilbert 126 Heberden, William 218 Helmont, Jan Baptist van 20–1, 85, 87, 94, 169, 174 Helsham, Richard 172 Hicky, Nicholas 22–4 Higgins, Daniel 69–70 Hippocrates 23, 156, 169–70 Hodges, Dr 70–2 Horne, Johannes van 177 hospitals in Belfast 2, 116 in Cork 116 in Dublin 114–16, 149, 236, 238–40, 244, 248 histories of 2 in London 216, 245 military 9, 30, 39–53 Huguenots 12, 93, 126 Hunt, Henry 237 Hunter, William 195 Hutcheson, Francis 149 infanticide 129 influenza 132, 136 Ireton, Henry 70 Italy 41 Jamaica 147, 148, 211, 217–24 Jamestown, Virginia 213 Jephson, William 129, 130 John of Gaddesden 21 Johnson, Esther 192 Johnston, Mr 152 Jones, Catherine, Lady Ranelagh 87 Joyns, Nanny 112 Jurin, Catherine 151 Jurin, James 151

Keill, James 171 Keill, John 170–1 Kennedy, Father 225 King, Gabriel 195, 197, 203 King and Queen’s College of Physicians of Ireland see College of Physicians, Dublin Kingston, Jamaica 216, 219 Kirkpatrick, James 148 Lambert, Aylmer Bourke 226 Lawrence, Richard 93 Leiden 87, 89, 166, 175, 176–8, 179, 216, 233, 240 Lérida 42 Leuven 42 libraries 13–14, 23, 71, 75, 76, 149, 165–83 Ligon, Richard 215 Linneaus, Carl 211, 218, 223, 226 Lloyd, Owen 159 Locke, John 148, 155 Lodge, Thomas 47 London 216, 235 Lucas, Charles 243, 244, 245 Lyons, Margaret 112 MacBeath, Malcolm 29 McCarthy, Phelim 51 McCormack, Mrs 114 Mac Duinnshléibhe, Cormac 25–6 McEnlay, Laughlen 25 Mac Fhirbhisigh, Dubhaltach 33n.1 MacKenna, Matthew, bishop of Cloyne 105, 112 McKinna, Sarah 14, 188–204 MacLean, Lachlan Mór 29 McMahon, Hugh, bishop of Clogher 191, 202 McMulltully, Murtagh 25 malaria 219 Mandlefeild, John 73 Marseilles 173, 245

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Marsh, Narcissus, archbishop of Dublin 113 Maryland 213 Mauriceau, Francois, 167 Mayerne, Theodore 92 Maynwaring, Everard 90 Mayo 15, 211 Mead, Richard 170–1, 173 Meara, Edmund 11 measles 64, 131, 133–4, 136, 141, 152 Mechelen 40, 43–8, 52–3 medicines 47, 49–52, 75, 152, 154–8, 222, 223, 237 mental illness 66–7, 128, 244 midwifery 12, 74–5, 102–16, 196, 233 migration 9, 25–6 Mohun, Warwick, Baron 91 Molesworth Circle 149 Molyneux, Thomas 94, 158–9, 178 Molyneux, William 94, 148 Monck, Christopher, duke of Albermarle 148, 217 Mons 42 Montefalco, Clare of 201 Montpellier 42, 93 Montserrat 213–14, 224–5, 226 Moore, Henry 222 Mosse, Bartholomew 114–15 Mullane, Margaret 112 Mullen, Allen 156, 178 Mulshenoge, Anthony 86 Munsell, Dr 70 Murray, Daniel, archbishop of Dublin 113 Nagle, Johanna 112 Nantes 215 natural history 13, 15, 154–60, 217–18, 222, 226 Netherlands 42 see also Leiden; Orange Nevis 214

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Newfoundland 126 Newton, Florence 127 Newton, Isaac 170–2, 179 Neylor, Richard 70 Nicander of Colophon 180 Nic Giollapadraig, Gráinne 29 Ní Chonchubhair, Elizabeth 29 Obregón, Bernardino 50 O’Brien, Murrough, Lord Inchiquin 71 Ó Caiside family 31, 32 Ó Callanáin, Aonghus 23 O’Canavan family 79n.45 Ó Conchubhair, Donnchadh Albannach 25–6 Ó Conchubhair, Risteard 21, 27–9 O’Connor, Derby 71 O’Connor family 21, 25 O’Donnell, Red Hugh 42, 50 O’Dowde, Thomas 11, 90 Ó Duinnshléibhe, Cathal 25–6 O’Dwyer, John 42–3 Offaly 25 O’Finallty, Fr 127 O’Halloran, Sylvester 1 O’Healy, Donnogh 68–9 Ó hÍceadha, Nicol 23 O’Hickey family 23–4 O’Loney, Mullmory 72 Ó Longáin family 31 O’Neal, Alice 196, 197 O’Neill, Henry 47 O’Neill, Hugh, earl of Tyrone 48, 50 O’Neill, Owen Roe 48 O’Neill, Phelim 70 O’Neill, Turlough 189, 193–4, 198, 203 Ó Néill of the Fews 25 O’Neylan, John 42 Orange 148 O’Reilly, Edward 1 O’Shiel, Owen 29–30, 45, 47–8

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Index

O’Sullivan More, Donal 51 Ould, Fielding 114–15 Oviedo, Mateo, archbishop of Dublin de 49 Oxford 42, 89, 166, 240, 245

Royal Society 148, 158–9, 188, 192–3, 203 Rüff, Jakob 167 Ruysch, Frederick 177, 182 Ryan, Julian 119

Padua 240 Paracelsus 85, 93, 94, 169, 174 Paris 42, 215–16, 240, 245 Petty, William 10, 71, 85, 86, 114 Phoenix, Henry 113 Physico-Historical Society 160 Pitcairne, Archibald 170–1 plague 5, 22–3, 173–4 Presbyterian Church 148–9 Preston, Thomas 29–30, 48 Proby, Thomas 152 Public Record Office of Ireland 6, 103, 123

Sallenger, Edmund 70 Sanders, Edward 128 Sarnam, Anna 110 Scarrifhollis, Co. Donegal 48 Schlosser, Johannes Albertus 218 Scotland 25–6 scurvy 64 Severinus, Petrus 169–70 Shakerley, Geoffrey 90 Sheapheard, Richard 73 Sheldon, Gilbert, archbishop of Canterbury 88 Sherard, William 163n.30 Simmons, Samuel Foart 236 slavery 219–24, 230n.69 Sloane, Hans 13, 147–50, 152–61, 188, 192, 217–18 Sloane, William 193 smallpox 64, 131, 133–4, 136, 152, 219 Smith, Aquilla 1 Smith I, John 181, 187n.44 Society of Chemical Physicians 88, 90 Soto, López de 50, 51, 52 sources 5–6, 12, 24, 44, 61–2, 103, 123–4 Spain 9, 41–2 spas 12 St Brigid 202 St Croix 224–5 Stearne, John 10 Stearne, John, bishop of Clogher 192, 193 Steevens, Grissel 238 Steevens, Richard 238 Steno, Nicholas 177 Sterling, William 73

Quakers 105–6, 126, 128 Raleigh, Walter 124 Randolf, M. F. 110 Rawdon, Arthur 147–8 Rawlins, Robert 73 Ray, John 157 rebellion of 1641 61–77, 200–1 Reims 15, 216, 235, 241 Reynold, James 194 rickets 133, 138–9 Riverius, Lazare 92 Robinson, Bryan 172 Roe, Widow 128 Roscommon 25 Rose, William 242 Rousset, François 197 Royal College of Physicians of Ireland see College of Physicians, Dublin Royal College of Surgeons in Ireland 232, 245–6, 248 Royal Dublin Society 160, 192, 194

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Index

Stewart, Alexander 71 St Kitts 213, 214 St Luke, guild of 233, 236, 237, 241–3 St Mary Magdelene, guild of 73, 233, 234, 242 St Patrick 45 St Patrick’s Purgatory 202 Stryall, Adam 86, 96n.7 St Vincent Ferrer, cult of 199 Swammerdam, Jan 177 Swift, Jonathan 192, 199 Sydenham, Thomas 170, 173 Taranta, Valescus de 21 Thornton, Thomas 166, 181–2 Thucydides of Athens 173 tissick 133, 134 Tofts, Mary 199 Toogood, Joana 110 Trant family 214 Trever, Randall 37n.62 Trinity College Dublin 6, 89, 178, 238–40 Troutbeck, John 90, 98n.23 Troy, Edmund 42 Tuite, Nicholas 224 typhus 131, 135 Tyrone 14 Ultagh, Donogh 26 Ultagh, Francis 26 Ultagh, Owen 26 Umara, Francisco de 43 Unmussig, Johann 86, 94, 96n.7 unorthodox practitioners 7 Ussher, James, archbishop of Armagh 107, 114 Vaughun, Francis 157–8 venereal disease 51, 174, 223, 244 Vesalius, Andreas 177

259

veterinary medicine 31, 76 Villiers, George, duke of Buckingham 91 Virginia 213 Walwyn, William 86 war 9, 10, 30, 39–53, 61–77, 147, 201, 224 Waterhouse, Joseph 86 Wentworth, Thomas 114, 125 West Indies 159, 211, 213–14, 215, 224–5 Westmeath 25 Westminster 61 Wilkinson, William 75 Williamson, Edward 76 Willis, Thomas 11, 167 Willoughby, Charles 178, 182 Willoughby, Francis, Baron Willoughby 214 wills 6 Wilson, Dr 128 Wilson, William 226 witchcraft 103, 107, 113, 114, 127, 200 Wollard, William 73 Wolveridge, James 101n.46 Wood, Nathaniel 157 Wood, Robert 85 Woodward, John 174 Worsley, Benjamin 85 Worth, Edward 13, 149, 165–83 Worth, Edward, bishop of Killaloe 167 Worth, John 166, 167–8 Yarner, Abraham 10, 71, 114 yaws 223 Youghal, Co. Cork 12, 124–41 Zaragoza 42 Zubiaur, Pedro 48, 50, 52