Elizabeth Isham and Medicine
Michelle DiMeo and Rebecca Laroche
Cultural and social historians have well established that women practiced medicine in early modern England. There is evidence not only of women performing the expected ‘housewifely’ duty of watching over and tending to the health of the household, but also extensive proof that women performed tasks in midwifery, surgery and physic, both charitably and for money.[i] Even though early modern institutional medicine in London and its environs was largely male as controlled by the bodies of the College of Physicians and the Barber-Surgeons’ Company, women’s roles in medicine were fluid and necessary components of the maintenance of health in seventeenth-century England.
In many ways, Elizabeth Isham’s autobiography—in its representation of a great grandmother ‘who was…very skillful in surgery’ (fol. 27r), an Aunt Isham who cared for Elizabeth’s mother in ‘her mind and body’, and a neighbour woman whose help was efficacious in Elizabeth’s own caretaking of her ill sister—provides more evidence of women’s widespread contributions to the health of a nation.[ii] The Constructing Elizabeth Isham project team has discovered new manuscripts that indicate that Isham studied and very likely practiced medicine well into the decade after the Remembrances were written, and the autobiography itself shows the early seeds of this study and practice.[iii] More specifically, Isham’s autobiography belongs to a subset of evidence for women’s medicine, that of gentlewomen’s life-writings that give testimony to their practice. Grace Mildmay, Margaret Hoby, Anne Halkett, and Lucy Hutchinson all record moments in which they tended to the health of not only their family members but also neighbours and poor individuals in other townships, sometimes caring for those with the ague, other times mending wounds from farming accidents or even from Civil War battle.[iv] Surrounding evidence shows us that these women were exceptional only in the fact that they thought to write down their experience as practitioners, thus leaving testimonies to historical women’s practice.
Women’s medical practice demanded study, as demonstrated by books printed in the period marketed directly to female readers. Elizabeth Isham’s Remembrances, along with her book list, the Northamptonshire diary, and her draft recipe book, demonstrate that Isham substantiated her practice with her reading. Many contemporary print texts provided advice in the healing arts at the same time as they targeted a female audience. Item number thirty in Isham’s inventory shows that she did indeed own one such text, John Partridge’s The Treasurie of hidden secrets. Commonlie called, The Good-huswiues Closet of prouision, for the health of her Houshold, first published in 1600 with that title.[v] Such texts circumscribed women’s practice within ‘the household’, but this did not mean that their readers could not carry knowledge thus gained beyond those boundaries. Research also has shown that female practitioners owned texts not primarily directed at them, and Isham’s writings show us another such instance. At one point in the narrative she resolves ‘to read of the virtue of…hearbs and flowers’ so that she may better help her ‘sister and others’ (fol. 28r). The Northamptonshire diary reveals that in 1633 Isham ‘read of the ve\r/tue of hearbs’, and her book inventory suggests that she owned texts which would have allowed her to elaborate on the knowledge she acquired in Partridge’s text, including ‘An Herball’ (a treatise on herbs and their medicinal uses) and ‘A Book of Gardening’ (which also would have such knowledge in it).[vi] While vernacular herbal authors did define their main audience as physicians, surgeons, and apothecaries, later texts in the tradition often referred to the charitable practice of gentlewomen. Evidence seems to suggest that in her mid-twenties, Isham set out to pursue such a practice.
Early seventeenth-century England was a place of competing medical systems, ranging from ancient authorities to new experimental alternatives. Isham and her family studied and practiced a form of Galenic medicine, a traditional philosophy prevalent in England from the middle ages to the seventeenth century. At the core of the philosophy is humoural theory, which can be found in the works of many ancient authorities who preceded Galen (120-200), including Hippocrates and Aristotle. Humoural theory was the belief that the four elements of nature corresponded with four bodily fluids: fire with yellow bile, air with blood, earth with black bile, and water with phlegm. Galen contributed to humoural theory by expanding the qualities associated with these humours from four to eight, and by placing emphasis on them: fire is hot and dry, air is hot and moist, earth is cold and dry, and water is cold and moist. Certain personalities were associated with each humour: choleric (fire), sanguine (air), melancholic (earth), and phlegmatic (water). Individuals were thought to have a natural mixture of humours which must be kept in balance to retain health, and an individual may have a dominant humour causing his or her tendency toward a particular disposition. For example, if an individual has an excess of black bile this could lead to melancholia, a running narrative in the autobiography about Isham’s sister and mother.[vii] The medical treatments used by and proscribed for the Isham family often involved a comprehensive regimen, or ‘diet’ (a term which denoted food intake as well as exercise, sleep patterns and bowel movements) based on Galenic doctrine.[viii] The family does not appear to have made use of newly available chemical remedies, and Elizabeth Isham and other members of the family clearly rejected magical medicine. Astrological influences, an element of Galenic medicine that became contentious in the early modern period, were discussed by Isham only in relation to planetary influences at the time of her birth.[ix]
While some seventeenth-century families were forced into becoming medically self-reliant because geographical and social circumstances prohibited them from accessing professional medical care, Isham’s Remembrances show that her family had the knowledge, money, and personal connections to choose whom they would like to treat an illness and how they would like the treatment performed. Isham’s detailed records of visits by physicians and surgeons show that she fully understood remedies proscribed by medical professionals. She, her sister and her mother often critiqued the remedies these men employed, further demonstrating the Isham women’s active participation in their healthcare, even when being treated by professionals. Seventeenth-century manuscript recipe books compiled by women and men include medical recipes that originated with both female lay-practitioners and accredited male physicians with little or no distinction between the two, suggesting that medical knowledge travelled across social and gendered boundaries;[x] Isham’s autobiography provides contextual evidence that complements such documents. As a whole, Isham’s Remembrances affords modern readers an intimate and extensive view into an early-seventeenth-century Englishwoman’s knowledge of medicine and her medical network.
[ii] For more on women and surgery, see Charles Webster and Margaret Pelling, ‘Medical Practitioners’, Health, Medicine and Mortality in the Sixteenth Century (Cambridge: Cambridge University Press, 1979) p. 165-235 and A.L. Wyman, ‘The Surgeoness: The Female Practitioner of Surgery 1400-1800’ in Medical History, 28 (1984), p. 22-41.
[iii] Northamptonshire Record Office, IC 4831. Also see essays and abstracts from the Princeton Symposium ‘Constructing Elizabeth Isham (1608-1654)’, held 7-8 September 2008 at Princeton University: http://www2.warwick.ac.uk/fac/arts/ren/projects/isham/workshop/
[iv] Linda Pollock, With Faith and Physic: The Life of a Tudor Gentlewoman, Lady Grace Mildmay, 1552-1620 (New York: St. Martin’s Press, 1993); Margaret Hoby, The Private Life of an Elizabethan Lady: The Diary of Lady Margaret Hoby 1599-160, ed. Joanna Moody (Stroud, Gloucestershire: Sutton Publishing, 1998); Lucy Hutchinson, Memoirs of the life of Colonel Hutchinson, ed. James Sutherland (London: Oxford University Press, 1973); Anne Halkett, The Memoirs of Anne, Lady Halkett and Ann, Lady Fanshawe, ed. John Loftis (Oxford: Clarendon Press, 1979).
[v] An earlier version of Partridge’s text appeared in 1573 and 1584 as The Treasurie of Commodius Conceites & Hidden Secrets. For a discussion of Partridge’s texts and others like them, see Wendy Wall, Staging domesticity: household work and English identity in early modern drama (Cambridge: Cambridge University Press, 2002).
[ix] For an overview of astrological medicine, see Bernard Capp, Astrology and the Popular Press: English Almanacs 1550-1800 (London: Farber and Farber, 1979), p. 204-214. On the debate around Galenic medicine and astrology, see Andrew Wear, ‘Galen in the Renaissance’, Galen: Problems and Prospects, ed. Vivian Nutton (London: Wellcome Institute, 1981) p. 229-262.
[x] Elaine Leong and Sara Pennell, ‘Recipe Collections and the Currency of Medical Knowledge in the Early Modern “Medical Marketplace”’, Medicine and the Marketplace in England and Its Colonies c. 1450-c 1850, eds. Mark Jenner and Patrick Wallis (Basingstoke: Palgrave Macmillian, 2007), p. 133-152; Sara Pennell, ‘Perfecting Practice? Women, Manuscipt Recipes and Knowledge in Early Modern England’, Early Modern Women’s Manuscript Writing: Selected Papers from the Trinity/Trent Colloquium, eds. Victoria Burke and Jonathan Gibson (Aldershot: Ashgate, 2004), p. 237-58; Jennifer Stine, ‘Opening Closets: The Discovery of Household Medicine in Early Modern England’, unpublished Ph.D. thesis, Stanford University, 1996.