Renaissance Medicine (Radio Edit)

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1:42Hello, and welcome to You're Dead to Me, the Radio 4 comedy podcast that takes history seriously. My name's Greg Jenner. I'm a public historian, author, and broadcaster. And today, we're putting on our plague masks and rummaging in our doctor's bags as we head back to 16th century England to learn all about Renaissance-era medicine. And to help us, we are joined by not one, but two esteemed doctors. In History Corner, she's an associate professor in the Department of English Literature at the University of Reading, where her research focuses on medicine and the body from the 16th to 18th centuries.

2:12And luckily for us, she's also the author of the fantastic new book, The Surgeon, The Midwife and the Quack, How to Stay Alive in Renaissance England. It's Dr Alana Skoos. Welcome, Alana. Hello, nice to be here. Lovely to have you here. And in Comedy Corner, she's a comedian, actor and writer. You might have seen her on all the TV, on Live at the Apollo, QI, Pointless and Have It Good News for You. Maybe you've caught her live shows or heard her on Radio 4's The News Quiz, but you'll definitely remember her from our show, episodes of Chungi Sao and Marco Polo, of course. It's Dr Rialina. Welcome, Dr Rialina.

2:43Thank you so much. I rarely use that title, so it's nice to use it. I mean, you're such a sort of renowned comedian, people might not know this. You have a PhD in virology. I do, for my sins. I have a PhD in herpes. That's my specialty. The classic route into comedy. It just doesn't come up much, especially on a first day. So if you are a trained scientist, modern medicine, presumably you're pretty comfortable. Do you know about the history of medicine? I know bits and pieces. I did the evolution of herpes. That was sort of my, well, not the evolution of it, like from what it looked like at the beginning to what it looks like now.

3:16I mean, it was pretty much the same. Well, it wasn't, but you know what I mean? Like, I know bits and pieces, but when you study virus evolution, it actually doesn't come up in terms of human medicine as frequently as you would have thought, even though you can kind of look back and go, oh, that was a virus. Oh, that was a virus. So I'm excited. Good, good. Especially 16th century. I've been sitting here for five minutes going, is that the 1500s or the 1700s? Because it's always one number out, isn't it? It's the 1500s. It's the 1500s. Well, I was going to ask you, actually, you know, does the phrase Renaissance era England mean anything to you?

3:54See, when you say Renaissance, great. I'm thinking Italians. I'm thinking French. I'm thinking some wonderful progression in science. Then you said England and I went, oh, that's a very different thing. You know, that could be as big as we don't poo outdoors anymore. Do you know what I mean? Like, progress for the English, especially back then, wasn't quite the same as progress for the rest of Europe. So, what do you know?

4:23This is where I have a go at guessing what you, our lovely listener, might know about today's subject. And thanks to Shakespeare's plays and the many weird and wonderful adaptations you've seen, plus all the pop culture about Tudors and Stuarts, you've probably got some sense of what life was like in Renaissance-era England. But what about disease and healthcare specifically? Well, maybe, like me, you're just thinking of the classic scene in Blackadder where the cure for everything is leeches. But what was visiting the doctor in Renaissance England really like? Was there more to it than plague masks?

4:52Did they use plague masks? And what about those leeches? Were they true? Oh, and who on earth was the stroker? Let's find out. Ria, when we say Renaissance England, you're thinking post-Italy and France. In your head, you've got a lovely image of Michelangelo sort of doing art. All of the turtles doing their thing. Definitely. We're talking about a renaissance that arrives in England later than in Italy and in France. So it's the Tudor and Stuart eras, the 16th, 17th centuries. Is there a kind of commonality between European medicine and English medicine in this period? There really is. There's a lot of overlap.

5:27In fact, it's not very different from each other. The Catholic Church losing its power in England and so stuff starts to be more in English. But that's kind of happening all over the continent because we often think that the church has really been like stamping down on medicine before this and that they didn't let people do anatomies and stuff. Actually, it's not true. The church never stopped people from doing anatomies. There weren't enough people being hanged, basically, to provide enough dead bodies that nobody would mind you anatomising. Once you have cities, you've got more crime, you get more people being hanged.

5:58You also get universities, more people wanting to see the anatomies. Alana, what does anatomise mean? It means cutting up somebody's dead body to have a look inside. Fair enough. And the English doctors are going all over the continent and they're going to these new anatomy theatres in Leiden and Padua and Paris and stuff. And they're going to the hospitals as well. Paris is meant to be like the best place in Europe for hospitals. And they bring that all back. There's also loads of migrants coming into England and a lot of those are doctors. So a lot of people coming from Huguenot, France, over here and bringing their skills with them.

6:34And that's the chamber of family. How dare they arrive on boats with skills? I know. I'm outraged. The absolute temerity of it. We're talking here about a time where the theory of medicine hasn't changed in over a thousand years. Is that fair, Alana? Broadly, yeah. So the main thing that they believe is Galenism. It's the idea of the four humours. And there's these four humours that go around in your body and they're on this spectrum of hot, cold, wet, dry. So you have black bile, which is cold and dry. Blood, which is hot and wet. Yellow bile, which is hot and dry. And then phlegm, the most appealing humour, which is cold and wet.

7:12But it does kind of make sense. If you don't know about microorganisms and stuff, this is quite an intuitive way of viewing your body. And we still talk about like being in a good or bad humour or whatever. Ria, which of the humoral profiles do you think you would be? Especially after that conversation, yellow bile. So we've honed our sense of humours, lol. Now let's look at the various medical professions in Renaissance England, because there's not just one type of healthcare worker. As today, there are multiple professions. So, Alana, can we start with, I suppose, the obvious ones, what we would call physicians, which I assume means doctor, but maybe it doesn't?

7:45It pretty much does. So the physicians are doctors, but not all doctors are physicians. Oh, OK. Yeah, it's history. It's got to be complicated. I mean, you are Venn diagramming my mind. Yeah. And in the Venn diagram, like the bit of overlap is really small because the physicians are quite a small group because it's really difficult to be a physician. You have to train for about seven years. You need a university degree and then you have to get licensed by the College of Physicians. So they get this college in 1518. They managed to get Henry VIII to say, yeah, you can be a college. This is a brand new guild, a body to regulate and to administer and say that you've been, you're legit.

8:22You've done the training. Yeah. And then if you're in the College of Physicians, they have a bit of control over you. If you do something bad, they can bring you in and say, like, why did you give that lady seven ounces of hemlock or something? that's a lot of hemlock that's too much hemlock i mean yeah how much does it time does it take to get that much hemlock anyway yeah the physicians are really expensive so they're only seeing like really quite wealthy people it's about 10 shillings to get a physician to come out to you and then as you go on you get different groups like there's always been different groups but they start to be more and more formalized because they have to be because otherwise the physicians are just going to take them all over so if i'm a rich person spending my 10 shillings to get the doctor in, the physician comes around.

9:04How are they diagnosing me? What are they looking for in terms of symptoms, things they can read? So the physicians are really proud of their diagnostic skills. It's kind of the main thing they have that's different from everybody else. They'll take a really detailed history, what your symptoms are, but also what you've been eating, what your relationship's like, how you sleep, how often you have sex. They also will take your pulse and I've never quite worked out why they're doing this. They're really proud of their ability to take the pulse and read it. But they never seem to actually diagnose anybody from it.

9:37The thing that they use, and it's more useful to them, is reading urine. Uroscopy. And you'll get a flask of your urine, and the physician will have a look at it, and he'll give it a sniff, and he might drink some of it. Whoa! Yeah. Oh, that's normal. The fastest way to tell if someone's diabetic is to taste their pain. Exactly. You seem very unperturbed about drinking urine. We shouldn't be grossed out by urine. I mean, people were washing their clothes in it way back when. It's a fair point. I suppose in the 16th century, urine is a lot more utilitarian. I mean, urine's probably cleaner than a lot of the water sources.

10:11Sure. You wash your hair in urine, you put urine in your makeup. But listener, please, don't go around drinking your own weed just because we said so. Yeah. Stick with chamomile. It looks very similar. Similar temperature. Okay. So Alana, so the doctor has diagnosed, has quaffed the urine. What are they going to recommend? They've gargled it. What a lovely vintage. I need sauvignon. What are they going to recommend? Is it diet, exercise, you know, the classic stuff? Yeah, so about probably 80, 85 % of what they recommend is going to be regimen, as they call it. So diet and what you do, but mostly diet.

10:49So you want to rebalance whatever humour is out of whack. Let's say you've got a disease and it's being caused by melancholy, so black bile, which is cold and dry. you're going to want to eat things that are hot and wet. So the foods that are hot, it kind of makes sense. It's the things you think are hot. So red meat, salty foods, cheese, red wine. I mean, it sounds great. More often they're telling people that they have to give up all that stuff, which they don't always like very much. And the physician's always complaining about people not taking their advice. Okay. And then presumably there's also things like purging.

11:25Yeah, they love a purge. So the three great remedies, as they call them, of the College of Physicians are bleeding, vomiting and diarrhoea. Those aren't remedies. Those are symptoms. Yeah, very fast and loose with the word great there. The other thing I suppose we need to talk about, as well as purging, the bloodletting with leeches. Blackadder was correct? Yeah. They don't use leeches all the time. Sometimes they just cut you and let you bleed into a bowl. It just depends. And we have this idea that physicians love letting blood out of people and they want to do it all the time. Actually, it's kind of driven by the patients.

12:02Patients want to get their blood let because they have the idea that if you let out some of the blood, all the bad stuff's going to go with it and then you'll make new blood, which is good. We do have scientific progress. You talked about anatomy, which is where someone is opening up the body to look for evidence of disease. We do have a very famous anatomist, William Harvey, who does some proper science. Yes, he is a clever chap. Before this point, you talked about Galen and blood. And the Galenic theory of blood is that you make blood mostly in your liver. And then the heart like adds oxygen into the blood.

12:37And then it kind of goes around the body, but it sort of just sloshes around the body. William Harvey, he measured how much blood you could pump out of the heart. And he worked out for that to be true, you'd have to be making enormous quantities of blood from your liver every day, like multiples of what you weigh. So he's like, OK, that can't be true. So he gets ligatures and he puts them around people's arms. So he ties off their arms. Yeah. And then he looks at what happens to the arm. And if you have the ligature really tight, the arm will go cold. Yeah. But if you have the ligature a bit looser, the arm will go hot and fat.

13:12because the arteries are further down in the body than the veins. So from there, and using various weird experiments on animals, he works out that the blood does in fact go round and round the body. So this is the circulatory system. He figures out that the heart pumps blood around the body. It's not completely like we would understand it now, but he's pretty close. Sure, he gets the principle of it. And this is a major revolution in the history of medicine, which is important. And to a certain extent, he's doing that because he's got a lot of bodies around because of the English Civil War, right?

13:42There's violence, there's wars, there's battles, there's dead bodies everywhere. So he's sort of going, all right, I've seen some bodies. So are we post-1665 now? Just before. Yeah, just before, I think, a little bit before. Yeah, I think it was 1640s and 50s, I think. We're going to talk about the barber surgeons. Ria, care to guess what a barber surgeon was and the clues in the name? Basically, I remember that you needed to have big hands. And I don't know why barbers had to have big hands, but I knew that to be a surgeon you had to have big hands because you wanted to be able to grip. Like later in the 1800s, you wanted big hands to play Rachmaninoff.

14:14But in this time, you wanted big hands to be able to grip the arteries on both sides of the thigh with one hand so that you could stem the bleeding while you sawed off the leg. Was hair particularly coarse back then? Yeah, it's a good question. I've had expensive haircuts, but this could cost you an arm and a leg, literally, right? It starts off with the barbers. and for ages they're called the Company of Barber Surgeons because the barbers back in medieval times... They sung lovely songs, didn't they? Can you imagine? Four-part harmonies. While sawing away. While screaming. So the barbers, they are pretty handy with a razor and the monks that were doing most of the medicine back in the medieval period are not actually supposed to spill blood.

14:58So they get the barbers in to do... Oh, but beer was okay. Wow, the standards, the double standards. And then eventually some of the barbers, they're pretty much just working as surgeons and they decide, OK, we should formalise this. And they get the company of barber surgeons in 1534. So there's this picture of Henry VIII handing over a charter to this company while the physicians stand on his other side looking like they've swallowed a bee. And then they decide, OK, now we've kind of divvied it up. The surgeons are going to do the surgery and the barbers are going to cut their hair and never the twain shall meet.

15:35And obviously the 16th and 17th century in England is a time of war, of battles, of civil wars in the 17th century, of course. So you've got loads and loads of people going to war and horrible injuries. So this is also a time of prosthesis, of false legs, of false eyes, of false noses, ears stitched to hats, which I love. Yes, it's brilliant. So you put the hat down and suddenly you've got ears attached, which is amazing. We should bring those back. Look, I'm an elf. But we need to move on to a different discipline, which is the apothecary. I mean, I don't know if I pronounced that correctly, but these are pharmacists?

16:06Yeah, basically. So they come from the pepperers and the spices who are medieval. OK. Did you say those two words again? Pepperers and spices. I'd love to be pepperers. They import pepper and spices. Oh, wow. Yeah. Pepperers and spices. Yeah. And they basically are pharmacists. What they're supposed to do is fill the prescriptions that the physicians write. What they actually do is they do that, but they also sell their own medicines and they do a bit of their own medical practice. So they diagnose, they sell, they've got their own little shops maybe. Yeah, there's loads of them. Yeah, and there's loads of them in London, isn't there?

16:37We know it's like one for every 2 ,000 people. And this is a big city. Yeah. So there's a lot of apothecaries. How are we pronouncing it? Apothecary. Apothecary, it's quite hard to say. And the most famous one, I suppose, would be Nicholas Culpepper, who is amazing, does work with the poor, often does incredibly sort of, you know, really generous work, and also writes one of the most popular medicine books of all time. Yeah, it's still in print. It's had more editions than Grey's Anatomy. Wow Wait what's it called I'm buying Culpepper Turbo Culpepper Turbo Culpepper Turbo Yeah

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18:10That's why road safety is so important to me. I know that I must slow down and be extra careful when I make a wide turn. Buses need more room than cars. Everyone can help keep our roads safe. Next time you're driving, remember to give buses plenty of time and space to finish turning before driving ahead. Let's all plan to share the road safely. Learn how at www.sharetheroadsafely.gov. So we've discussed legit medical professionals. We've got physicians, apothecaries. We've got barber surgeons. But we've also got some slightly dodgier quacks. I'm going to use the word quack. Ria, what do you think the stroker did as a service?

18:51Okay, this is a family show, so not that. The stroker. I think the stroker, I keep thinking too far forward into the 1800s, and there were a lot of things that doctors did for women that could come under the stroking umbrella, but we're not there yet. Okay. So does the stroker do some kind of, something that calms the nervous system, like literally stroking, they don't realise that that's what they're doing by calming people down? That's a good guess and very, very elegantly put. Well done for Radio 4. Alana, who is the stroker and what does he do? So the stroker is a guy called Valentine Great Rakes.

19:33What a name. I know. I mean, you start with a good name and then you get an even better nickname. He is Irish. He's essentially a faith healer and he comes over from Ireland in 1665 and the way he treats people is that, say you've got a headache, he'll start, he'll kind of stroke your head and then he'll stroke like maybe down to your fingertips and the headache comes out at your fingertips. Oh. Yeah, he's incredibly popular. He calms your nervous system. Yeah. Oh my gosh. So it's sort of massage or is it just sort of, it's more like feathery stroking. Feathery stroking. It's Irish Reiki. Does he also speak in his Irish accent?

20:08Because I'll be honest, If I had a migraine and someone just talked to me in that beautiful lilt, I think it would go as well. Yeah, maybe. I mean, presumably. He is Irish, so. And we would call him a quack. What does quack mean in a historical term? The word quack comes from the word quacksalver, which is a Dutch word for somebody who sells ointments by boasting about their medical credentials. Right, OK. So someone with a bit of kind of a little bit of showmanship, rathematous. Buy my stuff, it'll cure you. What was the Dutch word? Quacksalver. So we've got male surgeons, male physicians, male quacks.

20:39And I think, Alana, we need to talk about the fact that women were hugely involved in health care. I suspect they were hugely involved in Culpeper's herbal. Maybe. Yeah, I mean, a lot of what Culpeper puts in the herbal, he's just cribbed from women. OK. Yeah. We always talk about the physicians and the surgeons and stuff because they're the ones that left a lot of writings. but the vast majority of medical treatment is being administered by women, kind of noble women or women of the kind of middling class who give medicines to their servants and their families and their neighbours. And they do extraordinary medicine.

21:14They do all the kind of basically giving you a hot toddy type medicine. But they also, some of them will do bits of surgery, like treat quite serious illnesses. The noble women will do this. That's fascinating. not like in my picture in my head i picture the noble woman living in a manor but then it's going to be like the village herbalist that comes in and does all the midwifery but you're saying the noble women they've got money and they're bored witless and they're clever and they're quite well educated so they yeah okay amazing so the so actually you know in a local village you've got your squire who's got some land and everything else and it might be his wife that that is the nurse of the town.

21:55Yeah. Wow. And one of the most famous women of this era would be Hannah Woolley. Yeah. Hannah Woolley is kind of like Martha Stewart or someone like that. So she's not noble. She pulls herself up basically by her bootstraps. Her husband dies and she needs to make some money. So she does one of the first commercial remedy books. Yeah. And it's really, really popular and she ends up publishing loads of these. So it's her and Culpepper, they're kind of best-selling medical books of the time, I suppose. Yeah, and a lot of... There's not really copyright in this period. There's not copyright now, is there?

22:29AI companies, boo! Anyway, sorry. A lot of the medicines appear across numerous textbooks. Sure, gotcha. Okay. Ria, important question. What was cock water? Okay, because this is a family-friendly radio show, I'm going to assume you're spelling cock, C-A-U-L-K. Oh, beautiful. And it's mineral water or something chalky. No, it's spelled C-O-C-K. It's spelled cock water. I tried to lift this programme up out of the gutter and you keep bringing it back down. You're a classy lady and I've dragged it down again. Alana, what is cock water? Cock water is a cure-all medicine for fevers and things. You make it by mashing up a cock roll and then you distill the water from the cock roll with raisins, the milk of a red cow and ambergris.

23:20And ambergris is whale phlegm, right? It is. Yeah, hyper expensive, incredibly expensive. Hard to find. Hard to find because you need a whale to literally wash up on the beach. Sometimes just the ambergris will wash up on the beach. Oh, beautiful. Yeah, and it's for fevers and things. OK. Oh, so it's like cow poll. Kind of. It sounds like chicken soup. It's cream of chicken soup. The other cures, of course, would be oil of frog. Oil of frog. Oil of frog. Oil of frog. And puppy water, I don't want to ask. Puppy water can either be puppy wee or water in which you've boiled a puppy. Oh, come on. No.