The Greatest Benefit to Mankind. Roy Porter

towards folk or religious medicine within Europe itself. The sixteenth-century French physician Laurent Joubert (1529–83) wrote a huge tome exposing ‘common fallacies’. Erreurs populaires [1578] systematically denounced the ‘vulgar errors’ and erroneous sayings of popular medicine regarding pregnancy, childbirth, lying-in, infant care, children’s diseases and so forth, insisting that ‘such errors can be most harmful to man’s health and even his life’. ‘Sometimes babies, boys as well as girls, are born with red marks on their faces, necks, shoulders or other parts of the body,’ Joubert noted. ‘It is said that this is because they were conceived while their mother had her period … But I believe that it is impossible that a woman should conceive during her menstrual flow.’ Another superstition was that whatever was imprinted upon the imagination of the mother at the time of conception would leave a mark on the body of her baby.

      Elite medicine sought to discredit health folklore, but popular medicine has by no means always been misguided or erroneous. Recent pharmacological investigations have demonstrated the efficacy of many traditional cures. It is now known, for instance, that numerous herbal decoctions – involving rue, savin, wormwood, pennyroyal and juniper – traditionally used by women to regulate fertility have some efficacy. Today’s ‘green pharmacy’ aims at the recovery of ancient popular medical lore, putting it to the scientific test.

      Once popular medicine had effectively been defeated and no longer posed a threat, scholarly interest in it grew, and great collections of ‘medical folklore’ and ‘medical magic’, stressing their quaintness, were published in the nineteenth century. But it is a gross mistake to view folk medicine as a sack of bizarre beliefs and weird and wonderful remedies. Popular medicine is based upon coherent conceptions of the body and of nature, rooted in rural society. Different body parts are generally represented as linked to the cosmos; health is conceived as a state of precarious equilibrium among components in a fluid system of relations; and healing mainly consists of re-establishing this balance when lost. Such medical beliefs depend on notions of opposites and similars. For example, to stop a headache judged to emanate from excessive heat, cold baths to the feet might be recommended; or to cure sciatica, an incision to the ear might be made on the side opposite to the pain.

      Traditional medicine views the body as the centre or the epitome of the universe, with manifold sympathies linking mankind and the natural environment. Analogy and signatures are recurrent organizing principles in popular medicine. By their properties (colour, form, smell, heat, humidity, and so on) the elements of nature signal their meaningful associations with the human body, well and sick. For instance, in most traditional medicine systems, red is used to cure disorders connected with blood; geranium or oil of St John’s wort are used against cuts. Yellow plants such as saffron crocus (Crocus sativus) were chosen for jaundice, or the white spots on the leaves of lungwort (Pulmonaria officinalis) showed that the plant was good for lung disease, and so on. Sometimes it was argued that remedies had been put in places convenient for people to use. So, in England, the bark of the white willow (Salix alba) was valued for agues, because the tree grows in moist or wet soil, where agues chiefly abound, as the Revd Edmund Stone, of Chipping Norton in Oxfordshire, observed in his report to the Royal Society of London in 1763:

      the general maxim, that many natural maladies carry their cures along with them, or that their remedies lie not far from their causes, was so very apposite to this particular case, that I could not help applying it; and that this might be the intention of Providence here, I must own had some little weight with me.

      Maintaining health required understanding one’s body. This was both a simple matter (pain was directly experienced) and appallingly difficult, for the body’s interior was hidden. Unable to peer inside, popular wisdom relied upon analogy, drawing inferences from the natural world. Domestic life gave clues for body processes – food simmering on the hob became a natural symbol for its processing in the stomach – while magic, folksong and fable explained how conception and birth, growth, decay and death mirrored the seedtime and the harvest. The landscape contained natural signs: thus peasant women made fertility shrines out of springs. To fathom abnormalities and heal ailments, countryfolk drew upon the suggestive qualities of strange creatures like toads and snakes (their distinctive habits like hibernation or shedding skins implied a special command over life and death), and also the evocative profiles of landscape features like valleys and caves, while the phases of the moon so obviously correlated with the menstrual cycle.

      Nature prompted the idea that the healthy body had to flow. In an agrarian society preoccupied with the weather and with the changes of the seasons, the systems operating beneath the skin were intuitively understood as fluid: digestion, fertilization, growth, expulsion. Not structures but processes counted. In vernacular and learned medicine alike, maladies were thought to migrate round the body, probing weak spots and, like marauding bands, most perilous when they targeted central zones. Therapeutics, it was argued, should counter-attack by forcing or luring ailments to the extremities, like the feet, where they might be expelled as blood, pus or scabs. In such a way of seeing, a gouty foot might even be a sign of health, since the big toe typically afflicted was an extremity far distant from the vital organs: a foe in the toe was trouble made to keep its distance.

      In traditional medicine, as I have said, health is a state of precarious balance – being threatened, toppled and restored – between the body, the universe and society. More important than curing is the aim of preventing imbalance from occurring in the first place. Equilibrium is to be achieved by avoiding excess and pursuing moderation. Prevention lies in living in accord with nature, in harmony with the seasons and elements and the supernatural powers that haunt the landscape: purge the body in spring to clean it of corrupt humours, in summer avoid activities or foods which are too heating. Another preventative is good diet – an idea encapsulated in the later advice, ‘an apple a day keeps the doctor away’. Foods should be consumed which give strength and assimilate natural products which, resembling the body, are beneficial to it, such as wine and red meat: ‘meat makes flesh and wine makes blood’, runs a French proverb. The idea that life is in the blood is an old one. ‘Epileptic patients are in the habit of drinking the blood even of gladiators,’ noted the Roman author Pliny (AD C. 23–79): ‘these persons, forsooth, consider it a most effectual cure for their disease, to quaff the warm, breathing, blood from man himself, and, as they apply their mouth to the wound, to draw forth his very life.’

      Clear-cut distinctions have frequently been drawn between ‘science’ and ‘superstition’ but, as historians of popular culture today insist, in societies with both a popular and an elite tradition (high and low, or learned and oral cultures), there has always been complex two-way cultural traffic in knowledge, or more properly a continuum. While often aloof and dismissive, professional medicine has borrowed extensively from the folk tradition.

      Take, for instance, smallpox inoculation. There had long been some folk awareness in Europe of the immunizing properties of a dose of smallpox, but it was not until around 1700 that this knowledge was turned to use. The first account of artificial inoculation was published in the Philosophical Transactions of the Royal Society of London in 1714, and widespread publicity was achieved thanks to the observations of Lady Mary Wortley Montagu (1689–1762), wife of the British consul in Constantinople, that Turkish peasant women routinely performed inoculations. One English country doctor who practised inoculation was Edward Jenner. In his native Gloucestershire it was also known in the farming community that there was a disease of cattle – cowpox – which was occasionally contracted by human beings, particularly dairy-maids who milked the cows. This led Jenner to the idea behind vaccination; elite medicine clearly had much to learn from folk tradition.

      We must thus avoid taking for granted the antagonistic presence of two distinct traditions: the scientific and the superstitious, the right and the wrong. In all complex societies there have been various ways of thinking about the body, health and disease. In early modern Europe there was nothing mutually exclusive about different types of therapeutics or styles of healing. The English parson-physician, Richard Napier (1559–1634), was a graduate of Oxford University and a learned scholar. Yet he was also an exponent of religious healing: he would pray for the recovery of his patients, and to protect them ‘against evil spirits, fairies, witcheries’ he would also give them protective sigils and amulets to