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There were many kinds
of medical practitioners in early modern England. Physicians were
educated at university and treated ailments on the inside of the
body. Surgeons were trained via apprenticeship and dealt with problems
on the outside of the body, from fractures to boils to venereal
disease. Apothecaries, also apprentice-trained, were supposed to
make up the medicines prescribed by physicians, but in practice,
they functioned as general practitioners to much of the population
who could not afford a physician's fees. In addition to these three
groups of practitioners, there were midwives, herb-women, oculists,
dentists, and a range of "empiric" practitioners, sometime
labeled "quacks" by their opponents.
The radical herbalist
and medical practitioner Nicholas Culpeper combined traits of all
of these kinds of practitioners. Culpeper was well versed in university
Latin, but he was apprenticed to an apothecary, had a surgeon's
interest in anatomy, and wrote a crucial midwifery text. In his
own day, he was vilified as an empiric by some. Historians of medicine
consider Culpeper an important figure both for his long-lived text
on herbal medicine, The English Physitian (1652), and for
his Directory for Midwives (1651), a book that emphasized
reproductive anatomy, sometimes to the exclusion of midwives' knowledge
gained from experience.
Because his father
had died before he was born, Culpeper was brought up by his maternal
grandfather. Culpeper went up to Cambridge to study theology and
follow in his grandfather's footsteps as a minister. However, after
his fiancée was killed by lightning when they planned to
elope, Culpeper left Cambridge and apprenticed himself to a London
apothecary. He had long been interested in astrology and occult
philosophy, and began to practice medicine among London's poor.
In the 1640s he joined the Parliamentary Army during the English
Civil War. At the first Battle of Newbury he received a chest wound
by a musket ball that likely hastened his premature death at the
age of 38.
Culpeper's first major
work, A Physicall Directory (1649), was an English translation
of the College of Physicians' Pharmacopeia, the Latin text
that listed medicinal preparations that apothecaries could legally
prepare. In theory, the College of Physicians oversaw all of medical
practice, but in actuality, their reach far exceeded their grasp.
However, when Culpeper translated their Latin Pharmacopeia
into English, he made recondite knowledge open to all who could
read. Worse yet, he accused physicians of prescribing fancy, expensive,
imported medicines when local herbs, picked in a hedgerow or bought
for tuppence, would serve as well.
Culpeper's The
English Physitian, or an astrologo-physical discourse of the vulgar
herbs of this nation (1652) solidified his reputation with
the general public. Though the English Physitian was not
the first herbal remedy book to be published in England, nor even
the first to champion the use of English herbs for English ailments,
its appeal has been lasting. Less scholarly and more accessible
to general audiences than earlier herbals, it not only lists medicinal
uses of hundreds of herbs, it also follows the format of popular
medical books of the time by providing recipes for various syrups
and concoctions to improve health, and by offering remarks on how
astrology influences various herbs and their preparations. While
the book lacked the woodcut illustrations that made its competitors
much more expensive, Culpeper's radical language, offering remedies
to anyone who could read his book, seems to have ensured the book's
continuing popularity.
An equally popular
work of Culpeper's was his Directory for Midwives: or, A guide
for women, in their conception, bearing and suckling their children,
published a year earlier than The English Physitian. Scholars speculate
that Culpeper's grief over losing his children—only one of
seven lived to adulthood—was his impetus for writing this
work. It both recycled much of the knowledge that previously was
to be gained from the authoritative obstetrical text prior to this
time—Eucharius Roesslin's A Rosegarden for Pregnant Women
and Midwives (published in German in 1513)—and made new
claims for the importance of anatomy. The English midwifery text
The Byrth of Mankynde (1540) is an English translation
of a Latin edition of Roesslin's work. Five years later, Thomas
Raynalde's edition of The Byrth of Mankynd included the
frequently borrowed anatomical figures from Vesalius's influential
work De Corporis Humani Fabrica (1543), although the text
does not focus upon anatomical knowledge.
In contrast, Culpeper's
A Directory for Midwives insists that midwives need to
know anatomy; indeed, he belittles midwives trained by apprenticeship
because they do not possess such knowledge. His text opens by discussing
"the anatomy of the vessels of generation," by which he
meant the male vessels of reproduction. This was not a trivial point,
for it immediately distinguished him from traditional midwives,
whose purview did not extend to male bodies. Culpeper continued
with a discussion of "the formation of the child in the womb,"
and he repeatedly urged female midwives to gain exact knowledge
of female reproductive anatomy in order to become proficient at
their craft. The posthumous 1671 edition contains two foldout illustrations
bound
in the front. These did not appear in the first edition; in fact,
the first edition had very few illustrations, remarkable for a text
that emphasized anatomy over other ways of knowing. One of the two
foldout illustrations in the 1671 Directory for Midwives includes
images reminiscent of pre-Vesalian illustrations of women in childbirth—particularly
an image of a fleshy fetus i n
a tucked position with its hands wrapped around its knees. But a
fetal skeleton and anatomical organs, with their parts clearly labeled,
are also included. The second foldout illustration in A Directory
for Midwives depicts a full-bodied
fetus placed on the torso of a woman. The woman's legs are severed
at the thighs, and she lacks a head and upper extremities; meanwhile,
below the infant, the woman's reproductive tissues unfold like the
petals of a flower. Similar to the first illustration, this one
reveals a tension between earlier representations of childbirth,
where exteriority and the fruitfulness of women are emphasized,
and newer empirical representations, which focused on the dissection
of internal reproductive organs and tissues. The 1671 edition thus
carries forward Culpeper's polemical advocacy of the necessity of
anatomical knowledge for midwives, while also drawing into the argument
visual modes of representing anatomical knowledge.
Pamela Lieske
Kent State University, Trumbull
Mary Fissell
Johns Hopkins University
Suggested Reading
Fissell, Mary. "Making Bodies Speak:
Prophets and Midwives." In Making Books into Bodies:
Women and Popular Medicine in Early-Modern England. Forthcoming.
Tobyn, Graeme. Culpeper's Medicine:
A Practice of Western Holistic Medicine. Shaftesbury: Element,
1997.
Wear, Andrew. Knowledge and Practice
in English Medicine 1550-1680. Cambridge: Cambridge University
Press, 2001.
On the Web
The English Physitian
http://www.med.yale.edu/library/historical/culpeper/culpeper.htm
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