Of course there was another side to the question, patients then as now being more ready with promises when ill than with fees when well. There was William Robinson, for instance, a haberdasher of Lombard Street, who fell ill with pestilence and sent for William Paronus, promising that if he would only save him ‘he would reward him as well as ever he was rewarded for any cure’; but when, after a month’s attendance, he was well again, he declined even to pay the doctor’s out-of-pocket expenses incurred for drugs. And sometimes there were cases in which it was difficult to decide who was in the right. One such case came into court in 1292. Mauger le Vavassour, a member of a leading Yorkshire family, fell ill; his wife, Agnes, and other friends, including his uncle, Henry le Chapeleyn, sent for Master Otto of Germany, evidently a doctor of repute, promising him one mark to come and see the invalid, and further six marks if he would undertake his treatment. So Master Otto paid his visit and then went off to York to the apothecary’s and compounded various medicines and healing drinks, which he gave to Mauger, with excellent effect. When the patient was convalescent Master Otto put him on a very strict diet, so strict that Mauger grew restive, and his wife, who sympathised with his feelings, gave him various forbidden foods. The doctor, finding his orders disobeyed, declined to accept responsibility, washed his hands of the case and withdrew. The question then arose whether he was entitled to his fees or whether he had shown neglect by leaving his patient before he was fully cured. The jury decided that Master Otto ordered the strict diet for Mauger’s good, and not, as had been suggested, with the object of keeping him weak, and so increasing the bill for attendance, but they also found that as a matter of fact the extra food did the patient good and not harm. The verdict being thus for both parties the judges were puzzled and reserved their decision.
Another rather curious point cropped up about the middle of the fifteenth century. Eryk de Vedica, one of the brethren of the Grey Friars of London, was a physician of skill and reputation, and was sent for by Alice, wife of William Stede, a vintner. She seems to have been in a very bad way, and when Brother Eryk saw her and understood her ‘grete age and jubertous sikeness’ he was with difficulty persuaded to attempt her cure. However, after five weeks’ attention he ‘had soo doon hys parte vnto her that she thought herself wele amended in her body, she cowde hym grete thancke and gave hym 20s. for his labour.’ And then her curmudgeon of a husband, who was possibly not particularly pleased at her recovery, sued Brother Eryk for taking the money, and technically the unfortunate friar had no defence, as ‘the common law supposeth every receiving of the husband’s goods or money by the hands of his wife without his licence or command to be a wrongful taking away of the same from him.’ We will hope that the Court of Chancery, whose assistance was invoked, over-ruled the Common Law and did the friar justice.
It was not unusual for friars to have a knowledge of science and medicine, but a statement that I read the other day in a book recently published, that most (I believe my author said ‘all’) mediæval doctors ‘were, of course, monks’ is singularly wide of the truth. On the contrary, in even the largest monasteries it was customary to call in a doctor from outside in any case of serious illness, and the greater houses frequently retained the services of a secular physician. The cathedral monastery of Winchester, for instance, in the fourteenth century, made an agreement with Master Thomas of Shaftesbury that he should attend the convent in return for his board and lodging, the board, it may be noticed, including a daily allowance of one and a half gallons of the best ale and a gallon of a smaller brew. It is probable also that Master Adam of St. Albans, surgeon, who came from the priory of Ely to attend King Edward I. in his last illness at Lanercost, was the cathedral doctor. There were, of course, medical attendants attached to the court; their salaries were not large, the surgeons of the first two Edwards being paid only from one to two pounds a year, but there were perquisites in the shape of furred robes, gifts of money, or silver goblets from grateful patients, and substantial pickings in the shape of ecclesiastical benefices—the favourite way of pensioning a court physician being to give him one or more prebends or rectories. Occasionally the pension took the form of landed estate, as when Edward III. gave land in Kildare to his surgeon, John Leche, a grant which proved rather a white elephant, for early in the next reign Parliament, seeing the evils of absenteeism, ordered that all owners of estates in Ireland should reside on them in person or else pay for an able-bodied man to assist in policing the country, two alternatives equally trying to the old surgeon’s feelings. With such slender and precarious remuneration it was excusable that the royal doctors should sometimes have an eye to the main chance, and Fabyan tells a story against one Master Dominic, physician (very much) in waiting to Elizabeth, Queen of Edward IV. Before the birth of her first child (the Princess Elizabeth) Master Dominic had been very positive that it would be a boy, and so, when the time came, he stood outside the queen’s room ‘that he myght be the firste that shulde brynge tydynges to the kynge of the byrth of the prynce to the entent to have greate thanke and rewarde of the kynge; and lastly when he harde the childe crye, he knockyd or called secretly at the chamber dore, and frayned what the quene had. To whom it was answeryd by one of the ladyes, “what so ever the quenes grace hath here wythin, suer it is that a fole standithe there withoute.” And so confused with thys answere, he deperted wythoute seynge of the kynge for that tyme.’
‘... called secretly at the chamber dore.’
The position of the medical man who was not attached to the court or to some nobleman’s suite is rather obscure. In London during the fourteenth and fifteenth centuries the surgeons of the city were under the control of two or more master surgeons who acted as universal consultants; any surgeon undertaking a case involving risk to life or limb being obliged to call in one of the masters to see that his treatment was correct. In the same way the veterinary surgeons were at liberty to call in the advice of a master farrier, and if through conceit or negligence they did not do so and the horse they were treating died, then they would be responsible to the owner for its value. As to the country practitioner, it is not quite clear who licensed him to take the title of ‘leech’ or whether he merely assumed it. There were, no doubt, a certain number of men of learning in the provinces, and in 1478 Sir John Savage was able to find a ‘connyng fisission’ for Robert Pilkington in Macclesfield. He certainly required such a one, for, as a result of eating a mess of ‘grene potage’ containing poison he was ‘swolne so grete that he was gyrd abowte his bodye in iij places with towells and gyrdylls’ to prevent him bursting. When a man is in such a state it is ‘a thousand to one if he lives the age of a little fish,’ as Nicholas Culpeper would say, but the physician ‘dyd grete cures to hym’ and he recovered. As a rule, however, it is probable that the country leech had little more knowledge of the healing art than many of his patients. It must be remembered that a knowledge of simple herbal remedies was pretty widely diffused, and an acquaintance with more elaborate preparations formed part of the education of the upper classes. Did not the lady of the manor almost to our own days dispense home-made medicines with moral stimulants to her tenants, whose simple minds and dura ilia received therefrom much benefit? Yea, ‘kynges and kynges sones and other noble men hath ben eximious phisicions,’ and there is in the British Museum a book full of recipes for plasters and ointments, composed by Henry VIII. Half a century before that bluff but gouty monarch ‘the gude Erl of Herforth was holden a gud surgen,’ though he seems to have had a tendency towards extravagant multiplication of ingredients in his prescriptions. In humbler ranks of life every monastery had an Infirmarian who, though dependent on outside assistance in serious cases, was expected to treat the ordinary illnesses of his brethren, and at least to see that there was always ginger, cinnamon, and peony (this last most effectual for the incubus or nightmare) in his cupboard. It is noteworthy that in all the hundreds of hospitals founded prior to the Reformation, from St. Leonard’s at York with its two hundred beds downwards, there appears to have been no provision for medical attendance. The wardens were rarely medical men; Master Thomas Goldington, one of the surgeons of Edward III. was made warden of two hospitals, at Derby and Carlisle, but the only result was that he attended to his private practice and neglected the hospitals. Clearly the rudiments of nursing were assumed to be known to the resident chaplain or some of the inmates—more particularly the women. Wise women have doctored the country-side time out of mind, and in the reign of Elizabeth we even find one, Isabel Warick, practising surgery in York and requiring protection from her male rivals. A century earlier Alice Shevington, servant to William Gregory of London, ‘pretendyng hirself to have had connyng in helyng of sore ighen,’ spent much of her time attending to her neighbours’ eyes instead of her master’s house, wherefore he docked her of part of her munificent wages of 16s. a year.
‘... gyrd abowte his bodye in iij places with towells and gyrdylls.’
But, of course, this lay knowledge of herbs and so forth was not enough, for, as Andrew Borde, that man of wit and sound learning, said, quoting Galen, ‘“If Phisicions had nothing to do with Astronomy, Geomatry, Logycke and other sciences, coblers, curryars of lether, carpenters and smythes and al such manner of people wolde leave theyr craftes and be Phisicions,” as it apereth nowe a dayes that many coblers be; fye on such ones!’ Without a knowledge of astronomy how could Culpeper have discovered that a certain French quack was ‘as like Mars in Capricorne as a Pomewater is an Apple,’ and that therefore he was a fool? It was important also to comprehend the mystical properties of gems, many of which exercised as healing an influence as any herb. So well was this recognised that in 1217, when Alice Lunsford, a member of an old East Sussex family (whose later descendants endeavoured to extend its antiquity by forging Saxon ancestors with the delightfully improbable Christian names of David and Joseph), fell ill, she sent to Philip Daubigny and borrowed three rings from him, and when he asked for them back begged him, for the love of God, not to take them away, as without them she could not recover. Unfortunately the troops of Louis the Dauphin plundered her house shortly afterwards, and although she did recover Philip lost his rings, one of them being a sapphire for which he would not have taken 50 marks.