Household medicine: sickness, salves and skillets

While costly silverware and books have an obvious place on any list of the “best things” in one’s household, the inclusion of quarts and pints of medicinal cordial waters and syrups is, perhaps, surprising to modern readers. In fact, Elizabeth’s stockpile of drugs is reflective of the central place which health care and medicine played within the lives of householders and the wide range of medical activities going on in homes of the early modern period (c1500–1800).

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Maintaining health

During this period, men and women were attuned to their bodies and bodily changes, constantly searching for indications of health and of possible illness. Following ancient medical theories, most saw their bodies to be constructed from four humours: blood, phlegm, black bile and yellow bile. Sickness was seen as an imbalance of these humours. Any bodily ailments from internal pains to surface boils and bumps could be an indication that something was not quite in sync. Remedies to rebalance one’s body came in a wide variety of forms including exercise, diet and changing one’s environment by, for example, exchanging the polluted air of the city for the fresh air of the countryside. Medicines and drugs were simply one of the ways to address the imbalance of bodily humours.

When it came to health care options, there was a wide array of choices in both commercial and non-commercial spheres. If people were willing to open their purses, they could seek help, advice and services from a variety of practitioners, ranging from the university-trained physicians to the itinerant mountebank touting his nostrums on the market square. For those who preferred to save their pennies, family and friends and neighbours, including the local vicar, were often willing to recommend tried and tested remedies.

The decision of whom to ask for help was as much dependent on the kind of ailment suffered as on economic, geographic and social factors. In cases of female health issues and childbirth, women would have sought out the local midwife. For particular ailments such as cataracts or venereal disease, people might well seek out specialists of good repute. These specialists, of whom some were itinerant practitioners, were more likely to have earned their reputation through their experience with helping patients than from their fancy medical degrees.

Early modern men and women tended to self-diagnose and call in the appropriate practitioner based on their own judgment. For example, on 10 August 1708, Elizabeth Freke, suffering from a head ailment and “tissick”, decided to call the local vicar, Edward Smith of Winch, to let her blood and to cut her hair. Both of these measures were designed to readdress the humoural balance in her body.

Preparing for ill health

Despite the assortment of available practitioners vying for their custom, many householders elected to first deal with sicknesses themselves before venturing out to seek help. As many domestic manuals attest, housewives and housekeepers were expected to possess basic medical skills and knowledge of the human body. Contemporary gardening books such as Leonard Meager's The New Art of Gardening with the Gardener's Almanack advised on the different types of medicinal herbs suitable for the physic garden. In addition, householders were also able to buy basic medical guides and compendia of recipes with instructions to make a range of medical remedies.

Bottles of general medicines and the information to make more specialised drugs were kept on hand, just in case they may be called to use. Elizabeth Freke's five locked cupboards of medicines is an example, perhaps more enthusiastic than some, of the householder's preparation for the possible onslaught of ailments and illnesses. Her collection of syrups and cordial waters dealt with a variety of bodily complaints and many of these such as the elixir salutatis or aqua mirabilis were common panaceas or cure-alls. For more specific ailments such as agues, fevers, diseases such as the small pox or maladies of particular body areas, Freke kept a selection of information in the form of medical recipes and would no doubt have made up these medicines as needed.

When taken together, the cupboards of actual medicines and the ‘virtual’ medicine chest in the form of her recipe notebook were designed to deal with most common ailments occurring during the period.

Producing medicines

The home was the site for a range of medical activities. Householders were not only adept at caring and nursing the sick but also accustomed to monitoring their own and their family’s bodies and making health-related decisions. One of the main medical activities which occupied many householders was the making up of medicinal waters, syrups, juleps and salves. Many of these substances had a relatively simple production process, involving easily obtainable herbs and spices and made using the pots and pans of the early modern kitchen.

Medicinal waters could be made either by boiling and seeping the ingredients in a large pot with water or alcohol or by distillation. The latter was a more time-consuming process and would have required specialist equipment such as a limbeck or a glass still. The producer usually had to pound the herbs and infuse them overnight in the liquid before distilling the next day. A number of the medicines listed in Elizabeth’s inventory were made using this process. Such medicines were often sweetened with honey or sugar.

Salves and plasters were made by dissolving the ingredients in a skillet with fat. These were either applied directly onto the affected part or spread onto a cloth which was then bound to the body part as required. Elizabeth’s list indicates that she owned brass and metal skillets, frying pans, chaffing dishes and kettles, pestles and mortars and distillation equipment including a copper and a pewter limbeck, all of which could be used to produce medicines.

Many of the substances used in the early modern pharmacopoeia are common herbs and spices still in use, such as rose, rosemary, angelica, senna, cinnamon and nutmeg. Elizabeth Freke had syrups made with the familiar damsons, elderberries, purslane and turnips, as well as the less familiar buckthorn and bullace. Her cupboards also housedrosemary water, lemon water and brandy, tincture of lavender, syrup of saffron and tincture of nutmegs.

The different types of ingredients used highlight the importance of international trade networks during the period. English households were reliant on foreign imports for spices such as pepper, nutmeg, cloves and cinnamon from south-east Asia and substances such as sugar from the Caribbean.

A peer into any early modern medicine chest is likely to reveal a mixture of homemade tinctures lying alongside bottles of ready-made remedies and packets of single spices obtained from apothecaries, grocers, spicers and travelling drug-sellers. As with other aspects of health care, householders were content to mix what was commercially available with what they could produce themselves in their search to alleviate their aches and pains.

In many ways, Elizabeth Freke’s five locked cupboards of medicines served not a dissimilar function in her household as modern-day medicinal cupboards. Both contain drugs designed to deal with a range of everyday ailments and both were prepared and gathered together for those moments when a cough, a cold or a headache hits a family member.

Then, as now, it pays to be prepared. While readiness in today’s Britain may involve a walk to the local chemists, for householders such as Elizabeth Freke it meant a great deal more work. This investment in time, resources and energy makes the medicines ideal candidates for Elizabeth’s list of “best things”.

Medical know-how

Early modern men and women could turn to a number of avenues to satisfy their thirst for medical knowledge. The blossoming London print trade offered a wide range of vernacular medical books priced to suit (almost) every pocket. With titles like The Surgions Mate, The Queens Closet Opened and The Castel of Helth, these contemporary printed books provided early modern readers with an assortment of medical information from the theoretical to the practical. Many of these volumes that survive in libraries bear the marks and annotations of former readers revealing their interests and information selection.

In addition to the offerings of the book producers, householders also seized other opportunities to enlarge their own repertoire. Studies of manuscript recipe collections suggest that family, friends and ‘professional’ medical practitioners provided the more enthusiastic collectors with an array of information. Archdale Palmer, a 17th-century gentleman living in Leicestershire, had a tendency to badger his dinner guests and visitors for medical information. The advantage of information gained through these channels is that often the cures have been tried and tested through personal experience and one could always ply the donor for further explanation or for ingredient substitutions later on if so needed.

This wealth of information available to householders in early modern England not only shaped health care within the household but also had an impact on patients’ interactions with commercial medical practitioners. Armed with an arsenal of medical know-how, many of them were smart consumers who often dictated the course of care provided by practitioners. Contracts, whether oral or written, delineating the course of treatment and payments due, were frequently drawn up between patients and practitioners to ensure that both parties were satisfied with the possible outcome.

Elaine Leong is a Leverhulme early career research fellow, University of Warwick. She is working on a book titled: Treasuries of Health: Medical Knowledge and Practice in the Early Modern Household

This article was first published in the January 2010 edition of BBC History Magazine