RLG100Y1 Lecture Notes - Henry Iv, Part 1, Prince Octavius Of Great Britain, Shandy

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School
Department
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22 June 2011
Tudor Health Reform
Introduction
Professor Tim Connell
Welcome to today’s Symposium on Tudor Hospitals, a fascinating subject which, oddly
enough, has certain resonances with NHS reforms today. Let’s begin with an overview of
public health in the Tudor period:
It is actually quite a popular subject these days, taught at both Key Stage 2 and GCSE. The
common view is one of dirt, disease and death, bound down by superstition, quack remedies
and bizarre medicines, all of which contains an element of truth, although there are more
positive points and good news stories than might at first meet the eye.
Childbirth and infancy
If we focus on the human condition, a key experience (for all concerned) was childbirth and
infancy. The population of The British Isles grows in this period, and nowhere more so than in
London, which between the birth of Henry VIII in 1509 and the death of Elizabeth in 1603
grows from 90,000 to a quarter of a million. Inheritance and succession are of critical
importance from titles and great estates to even quite ordinary trades. There are few greater
examples of this than the redoubtable Elizabeth Pickering Jackson Redman Cholmeley – who
in the 1530s and 40s married no fewer than three members of the Stationers’ Company
(though not at the same time, of course) and who went on to become a successful printer in
her own right – the first woman in fact known to be a printer.i Families were large, though
mortality rates were high, even amongst the great families. No fewer than three queens died
giving birth to future kings (Henry V, Henry VIII and Edward VI).ii The service for the
Churching of Women in the Book of Common Prayer refers to the “great pain and peril of
childbirth” which is reflected in the high death rates to be seen in the lying-in hospitals of the
next century and beyond. Even 150 years later in Tristram Shandy, (most of which revolves
around the author’s birth) his father Mr Walter Shandy is prone to philosophising, whereas My
Uncle Toby (surely one of the kindest figures in English literature) takes a rather more
practical view:
Of all the riddles of a married life, said my father, crossing the
landing in order to set his back against the wall, whilst he propounded it
to my uncle Toby—of all the puzzling riddles, said he, in a marriage
state,—of which you may trust me, brother Toby, there are more asses
loads than all Job's stock of asses could have carried—there is not one
that has more intricacies in it than this—that from the very moment the
mistress of the house is brought to bed, every female in it, from my
lady's gentlewoman down to the cinder-wench, becomes an inch taller
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for it; and give themselves more airs upon that single inch, than all
their other inches put together.
I think rather, replied my uncle Toby, that 'tis we who sink an inch
lower.—If I meet but a woman with child—I do it.—'Tis a heavy tax upon
that half of our fellow-creatures, brother Shandy, said my uncle Toby
—'Tis a piteous burden upon 'em, continued he, shaking his head—Yes,
yes, 'tis a painful thing—said my father, shaking his head too—but
certainly since shaking of heads came into fashion, never did two heads
shake together, in concert, from two such different springs.iii
In real life, Parson Woodforde’s remarkable diary of Eighteenth century life in Norfolk recounts
in some detail the case of the Squire’s lady Mrs Custance. She had eleven children in twelve
years, and was left virtually crippled by the last confinement. Three of the children died in
infancy, although three lived into their eighties, and two into their nineties, an interesting
reflection on the increase in longevity into the Nineteenth century.iv
The death rate among women of childbearing age seems to have been near epidemic levels,
which must have led to other issues such as care of surviving children and disruption to the
home economy and indeed whole families. I find it hard to believe that people faced such
levels of human tragedy with nothing more than fatal resignation and, pious though people
undoubtedly were, the comfort of religion must have been bleak in the face of it. The burial
service reminds us that in the midst of life we are in death and people in Tudor times must
have been acutely aware of that. If we take the example of Henry VII, he had lost his son and
heir Prince Arthur who died in April 1502, his wife died in childbirth less than a year later in
February 1503, and the baby did not survive either. Apart from any personal feelings, there
were dynastic issues to take into account, although Henry in the end did not re-marry. But if
this was the experience of the monarch, how must his subjects have fared, from the lady’s
gentlewoman down to the cinder wench? At the other end of the Tudor-Stuart spectrum
almost one hundred years later, there is Queen Anne: she went through eighteen
pregnancies, of which thirteen were miscarriages or stillbirths; four children died before the
age of two, and one died at the age of eleven.v Again there were dynastic implications, with
the Crown passing subsequently to the German Georges and the Hanoverians, but the
constant suffering of the poor Queen can hardly be over-stated.
Disease
With regard to disease specifically in Tudor times, there was no lack of choice when it came to
things to die of, ranging from dysentery and typhoid to malaria, smallpox and leprosy – and
that was just the fate of the kings of England.vi
There were all sorts of epidemics, not least of which was the sweating sickness, which has
never been precisely identified, but which had a devastating effect on the population. It also
killed Prince Arthur, heir to Henry VII, and nearly killed his young wife Catherine of Aragon. To
quote the Bard:
Let us sit upon the ground
And tell sad stories of the death of kings;
How some have been deposed; some slain in war,
Some haunted by the ghosts they have deposed;
Some poison'd by their wives: some sleeping kill'd;
All murder'd: for within the hollow crown
That rounds the mortal temples of a king
Keeps Death his court.vii
Or to put it more prosaically, two English monarchs died of dysentery (Edward I and Henry V)
and two of TB (Edward VI and possibly James I); Henry IV Part I may have had leprosy (though
some people think that Henry IV Part II had psoriasis and actually died of something else);
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Edward III had a stroke; Mary died of ovarian cancer, and only Henry VII and Elizabeth appear
to have died from natural causes and old age. And curiously enough, relatively few princes
succeeded their father to the throne: the Black Prince may have had multiple sclerosis; Henry
VIII’s illegitimate son Henry Fitzroy had TB; and Prince Henry, the highly promising son of
James I, died of typhoid.viii The course of history would undoubtedly have been different had
any of these survived to take the crown.
Leprosy, as we shall hear, was a sufficient threat for dedicated hospitals to be set up. And it
had a high enough profile for some lazar hospitals to achieve notoriety, such as the one at
Harbledown that pilgrims to Canterbury had to pass – and run the gauntlet of the inmates who
wanted them to kiss a relic of St Thomas à Becket. (Erasmus himself commented on this
practice with some disgust.)ix
Then there was the plague, which hit London in 1563, 1593, 1597 and 1603, killing tens of
thousands of people in the process.x It affected all levels of society (Shakespeare actually lost
three sisters and a brother to the disease)xi and caused a great deal of upheaval as people
left London for lengthy periods of time if they could (or were allowed to). For ordinary people
and lesser afflictions, there were the folk remedies, the wise woman with her knowledge of
herbs, and housewives would have had their own remedies for family ailments. Many houses
would have had a physic garden of the sort that the Barber Surgeons’ Company has today at
their hall just near here.xii
Accidents and infirmity
Transport and travel were hazardous (Sir Thomas Gresham broke a leg by falling off a horse,
and his only son, a promising youth aged 20, died in a similar way.)xiii Industrial accidents, not
to mention occupational hazards, must have been common, with risks ranging from tetanus to
septicaemia. There was only the vaguest notion of hygiene and public health was
rudimentary, even though the City authorities did take the matter seriously.xiv
A great deal of human suffering lies behind all of the above. I am something of a renegade in
all this. Did people really tolerate such apparent helplessness in the run-up to the Age of
Reason? When Prince Octavius died in 1783 at the age of 4, King George III was so affected
that he cried, “There will be no heaven for me if Octavius is not there”,xv echoing perhaps the
great lament of King David, “would God I had died for thee, O Absalom, my son, my son!” And
Absalom was far from being the perfect son…xvi
The elderly wealthy would not have been prepared to accept infirmity – and plenty of medical
men (and especially the quacks and mountebanks) would not have wanted them to! There is
ample evidence of bequests, legacies and endowments for hospitals or for the relief of
suffering to show that people cared as much then as we do today with our donations to
cancer or heart charities. Some of these early bequests have survived to this day, such as
Trinity Hospital, which was founded by the Earl of Northampton in 1614, and is still managed
by the Mercers Company.xvii
I would prefer to think that two key human characteristics came to the fore in the face of
constant ongoing pain and personal tragedy: one is human compassion; the other is human
ingenuity.
Not all at sea
I would like to take Medicine at Sea as an example. In the introduction to some symposia
previously, I have unwittingly stolen the speakers’ thunder by inadvertently using the
examples they were already going to draw on, so I hope that this topic will widen our
perspectives without treading on anyone’s toes! Ships’ logs, memoirs and reports and the
needs of a growing navy provide us with a fair amount of data;xviii there is an interesting
literature as growing literacy leads to an increasing number of manuals and textbooks; and
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Document Summary

Welcome to today"s symposium on tudor hospitals, a fascinating subject which, oddly enough, has certain resonances with nhs reforms today. Let"s begin with an overview of public health in the tudor period: It is actually quite a popular subject these days, taught at both key stage 2 and gcse. If we focus on the human condition, a key experience (for all concerned) was childbirth and infancy. The population of the british isles grows in this period, and nowhere more so than in. London, which between the birth of henry viii in 1509 and the death of elizabeth in 1603 grows from 90,000 to a quarter of a million. Inheritance and succession are of critical importance from titles and great estates to even quite ordinary trades. No fewer than three queens died giving birth to future kings (henry v, henry viii and edward vi). ii the service for the.

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