BONFIRES OF MEDICAL VANITIES
Bonfires of Medical Vanities?
Benjamin
Woolley, The Herbalist: Nicholas Culpeper and the Fight for
Medical Freedom, London: Harper Collins, Feb 2004
After attracting many deservedly favourable reviews in
the UK, this is undoubtedly a well-written and researched study, and a
fine example of social history. Woolley depicts the famous plebeian
herbalist, Nicholas Culpeper [1616-1654], as a tortured, tobacco-addicted
outsider, from a troubled family, against the highly charged political
canvas of the English Civil War, when King Charles I was deposed and
beheaded [1649]. Thus dramatically commenced the only brief Republican
period in Shakespeare’s “sceptred isle…this precious stone set
in the silver sea…this teeming womb of royal kings,” [Richard
II, Act II, scene I] and which very probably was the most turbulent
episode in British history after the Norman Conquest.
In a very absorbing read, he attracts our sympathy for
Culpeper as a David figure, an anti-hero, struggling with a powerful
Goliath, one William Harvey and the College of Physicians. These
convenient and deftly-used contrast devices make for exciting reading, but
to what extent they accurately establish the main themes and tensions of
the period, each reader must be the judge.
Woolley vividly portrays a period of open rebellions,
bold defiance, deviance and experimentation, in politics and in medicine,
when rule books were torn up, villains hung and large bonfires built—such
as the Gunpowder Plot of 1605 to blow up Parliament and King James I, only
eleven years before Culpeper was born. A certain stage is therefore set,
upon which the events occurred and the book tumbles along at an agreeable
pace. Building on the work of bold pioneers [heretics?] like Copernicus,
Paracelsus, Bacon, Vesalius, great luminaries flood the same century—such
as Galileo, Newton, Hobbes, Boyle, Locke and Sydenham—and unfurl a
glorious new science and a Royal Society, whose path-breaking work was to
straddle and dominate an entire century. Though the demolition of Church
dogma, Aristotle and Galen were not their expressed intentions, they
certainly became the definite results of their labours.
Some
themes of Woolley’s previous book [The Queen’s Conjuror] about
Queen Elizabeth’s astrologer royal, alchemist and magician, John Dee
[1527-1608], become briefly reignited in his description of Culpeper’s
astrological and magical leanings—such as a chilling prediction of the
King’s death—but it is Culpeper’s battles with the College of
Physicians, the book’s main focus, that Woolley dissects in
unprecedented detail. The Inquisitorial machinations of a draconian
institution vigorously engaged in preserving an established medical
monopoly, is what Nicholas, a young apprentice of the Society of
Apothecaries, detested.
Along the way, some important developments in
seventeenth century medicine might have been located in a wider frame,
spanning say 1450-1750, but the book rightly anchors at centre-stage the
passionate energy with which our Parliamentarian hero tenaciously pursues
his libertarian cause of providing jargon-free medicine to the poor. His
touchstone was a timeless medical truism: the monopoly and power of
privileged physicians was contained in their Latin herbal secrets. As a
plain-speaking and cantankerous crusader against the private language of
abstruse medical terminology that excludes and belittles the uneducated
and maintains the prestige of an elite class, his book declares the simple
virtues of English herbs in the vulgar tongue to facilitate medical
self-help for the poor: a radical move quite breathtaking in its
conception.
It would be churlish to deny that an already gripping
biography and profoundly insightful social history has spilled over into a
pretty impressive medical history too. For example, Woolley’s central
thesis that a revolutionary period in politics is often associated with a
revolutionary period in medicine can be provisionally elevated into a
general principle that medicine and politics—somehow always entwined—often
mirror each other. In searching for some parallel examples, an obvious one
is 1860s America and the Civil War that coincided with a grand flowering
of Thomsonian Botanic medicine and homeopathy; such is already well
documented, not that they were truly causally linked. The French
Revolution may provide another example, associated with a zealous form of
‘Enlightenment’ hospital-based medicine, initially employing
nature-trusting methods and large-scale pathological studies—Quetelet’s
‘l’homme moyen’—but soon employing strong chemical drugs. Following
Woolley’s example, it is tempting to link these events in a causal
fashion.
Comparative studies following the same theme might then
probe medicine in the Russian Revolution, or the Chinese Cultural
Revolution, Asian medicine during and after the Vietnam War, or changes in
post-war Japanese medicine. By adhering to Woolley’s principle, ‘cultural
change’ in the broader sense, should be shadowed by the tearing up of
old rule books in other fields, and concomitant major shifts in medicine
too. Given that the whiff of political upheaval can even infect medical
practice, then change is often on the cards; during quieter times, the
status quo is preserved along with an assertion of prevailing medical
dogma.
Examination of such periods in this way, might well
prove the general validity of Woolley’s notion that medical revolutions
coincide with or succeed radical political upheavals. On this basis, one
might even conclude that the emerging medical pluralism in Europe—with
the rise of complementary therapies—is riding piggy-back on an alleged
‘crisis of post-modernism,’ which can be interpreted as a revolution
of sorts. In another sense, it is a clear plebeian movement driven solely
by patient demand. Woolley’s compelling thesis proves both fertile and
timely either way.
Regarding
Culpeper’s herbal practice in London, Woolley makes a superbly valid
point: that—typical then, atypical now—he adopted a holistic approach
by individualising each case. Culpeper “emphasised the need for
education, to encourage healthy living,” [166] by his patients.
His further aims “to infuse hope, induce confidence and peace of
mind,” [166] and of “salving the soul as well as the
body,” [166] echo many a wise physician of any epoch. However,
even before 1800, the rote-prescribing of drugs for ‘disease entities’
had rudely displaced that wider approach, and as Woolley says, patients’
needs often translate into a dilemma of “self-help versus expert
consultation, education versus advice, community values versus commercial
interest, simple natural remedies versus complex artificial compounds.”
[352] When Woolley questions a medicine that portrays “every
personal problem…as a medical condition,” [352] and that “increasingly
scientific complexity makes secrets of every medical advance,” [352]
he virtually asks what progress has four centuries delivered? Wryly, he
then concludes, “the struggles of Harvey and Culpeper…are as
relevant [today] as ever.” [352]
[1042 words]
Acknowledgement
I acknowledge my
grateful thanks to Gregory Vlamis of Chicago for supplying some
invaluable source material without which writing this essay would have
been rendered much more difficult.