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Hertfordshire lecturer’s new book explores terrifying early medical treatments

PUBLISHED: 11:01 15 January 2018 | UPDATED: 17:18 15 January 2018

A patient lies still as trepanning is performed on his skull. Another apprehensive looking man sits beside him being prepared to undergo the same operation, 1594 (Wellcome Library, London)

A patient lies still as trepanning is performed on his skull. Another apprehensive looking man sits beside him being prepared to undergo the same operation, 1594 (Wellcome Library, London)

Wellcome Library, London

It’s a world exotic and often terrifying, Louise McEvoy explores a fascinating new book on early medicine by the University of Hertfordshire’s Jennifer Evans

When you consider that medics 300 years ago cut open a live trout on the stomach to treat jaundice and drilled the skull to release evil spirits, it makes you wonder how today’s medicine will be perceived in three centuries time.

Someone with a deep insight into the changing nature of medicine is Dr Jennifer Evans, a senior lecturer in history at the University of Hertfordshire. She is co-author of Maladies and Medicine: Exploring Health and Healing 1540-1740, a new book which evokes fascination and repulsion in equal measure and as such is difficult to put down.

Jennifer’s love of history and biology was sparked at school. She went on to study history at the University of Exeter and it was here that her two favourite subjects converged.

‘That was the start of my entire life, as far as I am concerned,’ the 33-year-old says. ‘It hadn’t dawned on me before then that I could combine both of my key interests, and the final year of university is where it all started.’

Fever, represented as a frenzied beast, stands racked in the centre of a room, while a blue monster, representing ague, ensnares his victim by the fireside; a doctor writes prescriptions to the right, 1788 (Wellcome Library, London)Fever, represented as a frenzied beast, stands racked in the centre of a room, while a blue monster, representing ague, ensnares his victim by the fireside; a doctor writes prescriptions to the right, 1788 (Wellcome Library, London)

With a thirst for knowledge in her chosen field, Jennifer went on to do a Masters in history and a PhD in medical history, lecturing at Exeter before going on to join the history department at University of Hertfordshire.

When she left Exeter in 2013, she was awarded a postdoctoral research fellowship from the Society for Renaissance Studies and this brought about a fortuitous meeting with Sara Read, who had also been awarded a fellowship and is an English literature lecturer at Loughborough University, specialising in early modern literature and medicine.

Jennifer, who lives in Hertford, says of the meeting: ‘The moment we started talking about the kinds of things we were interested in it was like finding our other half in intellectual and academic terms. Our interests complemented each other and we were both particularly interested in reproductive health in the early modern era,’ Jennifer says.

After spending time separately carrying out research and writing various papers, and Jennifer blogging at, Sara suggested in late 2015 that they write a book together. The result is gripping, even for those without a burning interest in either history or medicine, and explores the often stomach-turning symptoms and surprising treatments for conditions such as smallpox, gout, palsy and dropsy during the early modern period.

Charles II touching a patient with the kings evil (scrofula) surrounded by courtiers, clergy and public (Wellcome Library, London)Charles II touching a patient with the kings evil (scrofula) surrounded by courtiers, clergy and public (Wellcome Library, London)

Jennifer says of the book ‘it seems to be grabbing people’s attention in the way that we wanted, and we would both like to write another book because there’s a lot more to be said about early modern medicine.’

In this era, health was thought to be determined by four main liquids – or humours – in the body, and that these were connected to the elements and seasons of nature. Blood was related to air and spring; yellow bile (choler) to fire and summer; black bile (melancholy) to the earth and autumn, and phlegm to water and winter. If the humours fell out of balance, you became ill. Physicians and others sought to rebalance the humours of the sick by many means, such as controlling diet, so patients suffering from too much phlegm might be prescribed a ‘drying’ diet. More extreme but routine interventions included administering emetics to induce vomiting, and suction cups and scarification to draw malign humours out through the skin. Blood letting by making a small incision or with the use of leeches was also popular. Too many humours gathering in the head were thought to cause headaches and leeches were applied to the temples to draw excess blood away in an effort to ease the pain. The leech patients had it easy compared to those with mental health issues for which drilling a hole in the head using a trepan was believed to allow evil spirits to escape. Drilling was however principally conducted in cases of skull fractures.

Toothache was a perennial problem. Some medical practitioners thought worms bred on debris in the cavaties and gnawed the insides of the teeth causing shooting pain. For this, the root of henbane (stinking nightshade) was used to draw them out.

‘I had a lot of work done on my teeth when I was younger so I can feel people’s pain in this area,’ Jennifer says. ‘This makes my skin crawl a little bit.’

The Gout, James Gillray, 1799 (Wellcome Library, London)The Gout, James Gillray, 1799 (Wellcome Library, London)

More shockingly, the teeth of people who had recently died were often whipped out and used to replace rotten teeth in the living.

Remedies recommended for adults suffering from jaundice included foul mixtures such as the fresh dung of a goose dried on the white part of hen’s dung and made into a powder, or rooks’ livers powdered and drunk in wine. Not all remedies for jaundice had to be consumed, with a recommendation to cut open a live trout and lay it on the stomach to cure the affliction.

There were some gruesome treatments offered for gout - a condition used to describe a range of arthritic conditions - such as taking the skin from the heels of a vulture and laying it on your feet, or using a plaster soaked in the fat of a puppy.

The unsightly skin condition scrofula, commonly known as the King’s Evil, was believed to be melancholic and phlegmatic humours forming hard swellings in the neck, and the collective sins of the nation were blamed for the manifestation of the disease. From the time of Edward the Confessor in the 11th century, it was widely believed the monarch had special powers to heal this condition. The king or queen (it continued on until Queen Anne) would ‘cure’ victims at grand ceremonies. The disease is known to go into remission naturally and sufferers received special golden coins called touchpieces during the ceremony - so there was an upside to giant lymph nodes.

Illustration showing the position of two cupping glasses on the buttocks of a gentleman, 1694 (Wellcome Library, London)Illustration showing the position of two cupping glasses on the buttocks of a gentleman, 1694 (Wellcome Library, London)

The hands of hanged men were used to try to cure a variety of bodily swellings. Medics waited at gallows and asked the executioner to stroke the bodies of patients with the dead hand.

On this belief in the transformative power of touch - either royal or dead - Jennifer says, ‘One of the fascinating things is that the body was much more mysterious and powerful in ways we don’t necessarily think about anymore.’

Dropsy, now known as oedema, is an excess of watery fluid in the cavities or tissues of the body. A patient’s swollen body limits mobility and leaves them short of breath. In many respects, those who died from dropsy really drowned. A ‘tapping’ operation was thought to alleviate the condition and involved puncturing the navel or abdomen with a curved needle to drain the excess fluid. Of all the illnesses researched, Jennifer finds dropsy the most terrifying.

‘It must have been absolutely terrible to be slowly compressed by the weight of water and there was little they could do about it.’

Jennifer EvansJennifer Evans

Despite what looks to us as alien and often terrifying, early modern people took maintaining their health very seriously and actually made great strides in understanding many conditions, including scurvy.

‘They were already discussing fruits and citrus and starting to get to the modern understanding of the condition,’ Jennifer explains. ‘They clearly knew a varied diet was necessary to cure scurvy, but it took a long time to reach a consensus.’

How would physicians of the period perceive the huge advances in modern medicine?

‘I think they would be absolutely amazed at the length of life people have and that things like smallpox are no longer a worry for many people in many countries around the world.’

With such a long view of medicine, Jennifer’s attitude to treatment is that we are still on a journey with an unclear destination.

‘We tend to have an assumption that science has reached a peak and that we know everything, but we don’t. It’s changing all the time. It’s inevitable that in 300 years time someone will be writing a book about what we know now. The most radical advances will be to do with the brain. That’s the organ we still know the least about. I can also imagine that an awful lot more will come out about genetic medicine, which will be radically different to our understanding now.’

Maladies and Medicine: Exploring Health and Healing 1540 -1740 is available from Amazon, priced £12.38.

Jennifer will give a talk on early modern surgery at Hertfordshire Archives and Local Studies at County Hall, Hertford at 6.30pm on January 23. For more information, visit


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