A Brief History of the Tudor Age (28 page)

Henry, who was always afraid of catching infectious diseases, went to great trouble in 1528 to avoid the sweating sickness; leaving the immediate vicinity of London, he retreated to a tower at
Hunsdon in Hertfordshire with only one servant in attendance. One of his secretaries, Brian Tuke, caught the sweat, but, unlike most of the other victims, he did not panic. He was convinced that
psychological factors played an important part in catching the disease, for the sweating sickness was known throughout Europe as ‘the King of England’s disease’, and only
Englishmen caught it; while it was raging among the English population of Calais,
¹⁰
not a single case was reported a few miles away at Gravelines, although
merchants were continually travelling between the two towns. But when someone with the sweat came from Sussex to London, and this became known, a thousand people in London fell ill that same night,
though children never caught it, unless their parents had told them about it. Tuke duly recovered quickly from the sweat; and the French ambassador in London, Jean du Bellay, noticed that, despite
all that people said about the sweating sickness, only 2,000 people had died of it in London, although 40,000 people had caught it.

Although the English in the Tudor Age spoke so much about the sweating sickness, the plague claimed many more victims. There were several outbreaks of plague in Henry VIII’s reign; but the
worst visitation was in 1563, when it was brought back to England by the English troops who returned from the disastrous expedition to Le Havre in support of the French Protestants. Between June
1563 and June 1564, 17,046 people died in London, which was about one in six of the inhabitants, as the population was probably about 100,000. The plague returned
on several
occasions during Elizabeth’s reign, though nothing on the same scale recurred until the summer of 1603, a few months after Elizabeth’s death, when 38,000 people died in London –
about the same proportion as in 1563–4, for by 1603 the population of London had increased to about 200,000.

There was no cure for the plague except to allow the people to die and to take strict measures to segregate those who had caught it or had come into contact with it. During the outbreak of 1563,
the houses where cases occurred were required by law to be marked by blue crosses on white paper and the words ‘Lord, have mercy upon us’, and all the doors and windows of the house
were to remain closed for forty days. When Henry VIII visited Calais in 1532, orders were given that all sufferers were to be taken out of their houses and carried to a field outside the town and
left to die there, so that there should be no risk of them infecting the King. This was sometimes done in other towns, even when the King was not coming.

There were other new diseases which suddenly appeared in Europe during the Tudor Age. The first cases of syphilis occurred when the French army occupied Naples in 1494, though there were
national disagreements about its origin; the French called it ‘the Italian disease’, and the Italians called it ‘the French disease’. It had become very prevalent in every
country in Europe by the middle of the sixteenth century, particularly among the upper classes; many people at the French court were infected, including King Francis I. No one suggested until the
nineteenth century that Henry VIII’s ulcers were a symptom of syphilis. It is very unlikely that he caught it, because, apart from his wives, he had only two mistresses who could have
infected him; if any of them did, it was probably Anne Boleyn’s sister Mary, who, according to Francis I, had been the most immoral woman at his court when she spent some years there before
she returned to England to become the mistress of Henry VIII.

Smallpox and measles were new diseases, and both were very serious. Elizabeth I nearly died of smallpox in 1562. Mary Queen of Scots’ husband, Darnley, fell ill with measles in 1567;
but he was well on his way to recovery when he was assassinated as he fled from his sick bed at Kirk-o’-Field after the house had been blown up by gunpowder.

The emphasis of the Tudor physicians was on diet. Elyot distinguished between persons with hot stomachs, who have little appetite and like warm food, and those with cold stomachs, who have big
appetites and enjoy eating large quantities of cold foods. He prescribed the right sort of vegetables and other dishes which should be eaten during the four seasons of the year – in winter,
which lasts from 8 November to 8 February; in spring, from 8 February to 8 May; in summer, from 8 May to 8 August; and in autumn, from 8 August to 8 November.
¹¹
He advises his readers to avoid excessive eating and drinking at all times.

The disease of scrofula – tuberculosis of the lymph nodes at the side of the neck with ulceration of the overlying skin – was known as ‘the King’s evil’, because
both physicians and the people believed that it could be cured if the sufferer was touched by the King, who was supposed to have acquired this healing power through the holy oil with which he was
anointed at his coronation. All the Tudor sovereigns touched thousands of people to cure them from scrofula, and the practice continued after the Reformation and throughout the seventeenth century
until the days of Queen Anne.

The most common cure for many diseases was blood-letting, which was adopted on religious as well as on medical grounds. Not only did physicians believe that diseases could be cured by getting
rid of bad blood – a doctrine which had been duly approved by Galen – but monks believed that a man could rid himself of his sins by ejecting the evil ingredients in his blood. This was
probably the origin of the occupation of barber-surgeon.
It seems strange in the twentieth century to combine the professions of a surgeon and a hairdresser; but barbers were
regularly employed in monasteries to cut the hair and shave the heads of the monks in order to give them a clerical tonsure, and on these occasions the monks would often ask the barber to bleed
them so as to get rid of their sins with the bad blood. Bleeding was carried out either by venupuncture, from a vein, or by placing leeches on the naked body of the patient.

The distinction between physicians and barber-surgeons, which in a very different form still exists today between physicians and surgeons, derived front the intellectual approach of the
physicians of the Tudor Age. The physicians did, of course, take personal care of their patients; but as almost the only cures which they could suggest were virtuous living and good diet, their
approach was largely theoretical. They therefore spent much more time writing books than attending to patients, when they were not studying Greek, or performing the ecclesiastical and diplomatic
duties which they so often combined with their medical practice. The barber-surgeons were not intellectuals, but practical men, who, without knowing Greek, or ever writing, or even reading, a book,
set fractures and healed wounds in the traditional way which they had been taught by their predecessors and had picked up by practical experience. Their services were highly valued, particularly by
the army in wartime, but they were not considered to be the social equals of the physicians.

The barber-surgeons were forced to carry out their surgical operations with methods which horrify those of us who are fortunate enough to live in the twentieth century. They pulled out teeth
with tongs, straightened fractures by sheer physical strength, and amputated legs and arms, in all cases without any kind of anaesthetic, while the patient was given a good dose of alcohol and was
held down by the surgeon’s assistants. Wounds were cauterized by applying a burning iron or boiling oil to the wound. English surgeons in the Tudor Age continued to apply this method to the
wounds of soldiers, or to criminals who had had a hand or an ear cut off as a judicial punishment, for more
than fifty years after the great French surgeon, Amboise Paré
– who wrote his books on surgery in French because he could not speak Latin – had discovered, to his surprise, during the French campaign in Italy in 1536, that the wounded soldiers
recovered more quickly when he had no instruments available with which to cauterize their wounds, and therefore merely washed and bandaged them.

Child delivery was carried out by midwives, who were trained and supervised by surgeons. Babies were sometimes delivered by Caesarean operations. This was widely believed to have occurred when
Jane Seymour gave birth to Edward VI. The popular ballad ‘The Death of Queen Jane’ was probably being sung very soon afterwards, though the earliest written record of it dates from the
seventeenth century. In the song, Jane says to the surgeon: ‘Rip open my two sides, and save my baby’; but in fact Edward VI was almost certainly born by natural process, and Jane died
twelve days later from septicaemia, like so many other mothers during the Tudor Age.

In the reign of Henry VIII, steps were taken to control the practice of medicine by both physicians and surgeons. Thanks to Linacre’s influence with the King, an Act of Parliament was
passed in 1512 which forbade anyone to practise as either a physician or a surgeon within seven miles of the city of London without a licence from the Bishop of London or the Dean of St
Paul’s, which was only to be granted after the applicant had been examined by four doctors of physic. It was also forbidden to practise as a physician or surgeon outside the London area
without a licence from the diocesan bishop, but this did not apply to graduates of Oxford or Cambridge Universities. In 1540 the authority of the College of Physicians was extended over
apothecaries; no apothecary was permitted to sell any drug which had not been approved by four members of the Fellowship of Physicians, on pain of a fine of a hundred shillings for each
offence.

It was also in 1540 that an apparently contradictory statute was passed which on the one hand united the Company of
Barbers and the Company of Surgeons in the Company of
Barber-Surgeons, but also for the first time separated the two occupations. Parliament was worried because barber-surgeons sometimes caught ‘pestilence, great pox [syphilis] and such other
contagious infections’ from their patients, and then passed on the infection to their customers when they shaved them and washed their hair. So the statute enacted that no barber could
practise as a surgeon, and no surgeon could practise as a barber. All surgeons practising within a mile of the city of London were required to display a sign in the street outside their surgeries
so that the public should know where to find them. Surgeons were to be exempt from the obligation to wear armour when serving in the army in wartime. The Company of Barber-Surgeons was to be
allowed to have four bodies of executed criminals every year for them to dissect for the study of anatomy, which had been revived at the beginning of the sixteenth century under the inspiration of
Leonardo da Vinci. The Act was to be enforced by four Masters or Governors of the Company of Barber-Surgeons, of whom two were to be surgeons and two were to be barbers.

But, as so often with Tudor legislation, there were lobbies and counter-lobbies at work to influence Parliament, and a statute which proclaimed the need to prevent unskilled practitioners from
taking advantage of the public and lowering professional standards was often followed by another statute which denounced the governing body of a profession for furthering its professional interests
to the detriment of the public welfare. The Acts of 1512 and 1540 were followed by a statute of 1545, which accused the Company of Barber-Surgeons of ‘minding only their own lucres and not
having the profit or ease of the diseased or patient’ in mind. The surgeons had ‘sued, troubled and vexed divers honest persons, as well men as women, whom God hath endued with the
knowledge of the nature, kind and operation of certain herbs, roots and waters’, and who had used these herbs to cure sore breasts in women, a pin or web in the eye, corns on the hands,
burns, sore mouths, stone, or other ailments, although these herbalists had taken no remuneration
for their efforts and had helped poor people ‘only for neighbourhood and
God’s sake of pity and charity’. This was contrasted with the attitude of the surgeons, for ‘it is now well known that surgeons admitted will do no cure to any person but where
they shall know to be rewarded with a greater sum or reward than the cure extendeth unto; for in case they would minister their cunning to sore people unrewarded, there should not so many rot and
perish to death for lack of help of surgery as daily do’. After more denunciations of the iniquity and incompetence of surgeons, the Act authorized all persons with experience of herbal
cures, or of drinks which would remedy the stone, to administer them to the poor without being harassed by the surgeons.

It was fortunate for the inhabitants of London that the Act of 1545 made it possible for these herbalists to help them, for they were indeed suffering and dying from neglect; but Parliament, in
blaming the greed of the surgeons, had not dared to mention the true cause. The suppression of the monasteries and religious establishments had harmed hospitals as much as grammar schools. In 1545
Henry VIII suppressed chantries, hospitals and mental institutions which had been founded by charitable benefactors; he did this ostensibly for religious reasons, but really as an excuse to raise
money to pay for his war against France. The sick and the mentally ill were turned out of the hospitals and left to roam the streets, unless they were conscripted into the army, or helped by the
charity of philanthropists. As in the case of schools, the harm was slightly mitigated by the more public-spirited members of the Privy Council and the leading bishops, especially after
Henry’s death, though the seizure of religious property continued in the reign of Edward VI.

In November 1552 Nicholas Ridley, the Bishop of London, wrote to Sir William Cecil, the Secretary of State, about the plight of the homeless in London.