The Greatest Benefit to Mankind. Roy Porter

(1633 – 1703), who later became president of the Royal Society of London, surveyed his health and found himself in exceptionally good condition, he was unsure of the cause. On 31 December 1664, he balanced his books for the year:

      So ends the old year, I bless God with great joy to me; not only from my having made so good a year of profit, as having spent £420. and laid up £540 and upward.

      But I bless God, I never have been in so good plight as to my health in so very cold weather as this is, nor indeed in any hot weather these ten years, as I am at this day and have been these four or five months. But I am at a great loss to know whether it be my Hare’s fote, or taking every morning a pill of Turpentine, or my having left off the wearing of a gowne.

      As this suggests, for Pepys as for others, religion, magic and medicine coalesced for therapeutic ends. Bread baked on Good Friday would never go mouldy; if stored, it would treat all manner of disease; rings made out of silver collected at the Eucharist would cure convulsions; the sacrament of confirmation would ward off sickness. Such beliefs had been encouraged within the proliferating healing rites of medieval Catholicism. In Protestant countries, with the anathematizing of pilgrimages, relics, holy waters, invocation of saints and the like at the Reformation, similar rituals continued, though essentially without express ecclesiastical authorization.

      Medical magic was accepted by the unlettered and the elite alike until at least the seventeenth century, and was thought to operate in many ways. Disease could be transferred, transplanted or transformed. A sick person should boil eggs in his own urine and then bury them; as the ants ate them, the disease would also be eaten up. To heal a swollen neck, one was to draw a snake along it, put the snake in a tightly corked bottle and bury it; as the snake decayed, the swelling would go. Similarly, whooping cough sufferers should stand on the beach at high tide; when the tide went out, it carried the cough with it. Warts might be treated by touching them with a pebble; the pebbles were placed in a bag which was ‘lost’ as the sufferer went to church. Whoever found the bag acquired the warts too.

      It was also widely believed that disease could be transferred to the dead. The sick person should clutch a limb of someone awaiting burial; the disease would then leave his or her body and enter the corpse. This mode of magic explains why mothers crowded around a scaffold, struggling to get their sickly infants into contact with an executed felon’s body.

      The doctrine of signatures linking humans and nature, microcosm and macrocosm, was of course interwoven with astrology – a learned science as well as a popular belief. Understanding of the heavens was seen as providing the key to the particular properties of herbs and minerals. Plants governed by Venus, herbalists explained, were aids to fertility and childbirth; those under Mars provided strength, and the moon played a crucial part.

      Above all, magic functioned with religion in popular healing. Christianity endorsed an articulate symbolic cosmology which asserted the supreme potency of non-material forces. Roman Catholicism etched onto believers’ minds the notion of miracle cures and the healing powers of sacraments, relics, Latin incantations, invocation of saints and holy waters. Popular therapeutic magic and religious healing could be interchangeable. Rejecting Catholic ‘superstition’, Protestants fought such ‘contamination’ of religion with magic; but the Reformation’s iconoclasm towards magic within the Church encouraged it to flourish in a kind of ‘black market’ outside. Modernizing forces – literacy, the availability of commercial medicines, the rise of the medical profession – gradually peripheralized such beliefs. But the finger of God might continue to be seen in visitations of illness and injury. ‘Last Wednesday night while carrying a bucket of water from the well,’ noted the Revd Francis Kilvert (1840–79) in his journal on 26 December 1874, ‘Hannah Williams slipped upon the icy path and fell heavily upon her back. We fear her spine was injured for though she suffers acute pain in her legs she cannot move them. The poor wild beautiful girl is stopped in her wildness at last, and perhaps by the finger of God.’

      What must be stressed is the ceaseless dialectic of popular and educated medicine, and everything between. Superficially at least, the distinctive medical systems seem to have nothing in common but animosity. The medical missionary and explorer, David Livingstone (1813 – 73), recorded an exchange between representatives of quite different medical systems:

       MEDICAL DOCTOR: Hail, friend! How very many medicines you have about you this morning! Why, you have every medicine in the country here.

       RAIN DOCTOR: Very true, my friend; and I ought; for the whole country needs the rain which I am making.

       M.D: So you really believe that you can command the clouds? I think that can be done by God alone.

       R.D: We both believe the very same thing. It is God that makes the rain, but I pray to him by means of these medicines, and, the rain coming, of course it is then mine.

      As the Rain Doctor recognized, they had more in common than met the eye. And the similarities yet differences between diverse medical systems and practices have always been evident to the sick themselves. In modern Taiwan, for instance, the sick use modern western doctors for certain ailments, traditional Chinese medicine for others, Japanese medicine and local herbal medicine and healers.

      This sense of difference in commonness should help focus our attention to what is special to modern western scientific medicine: it is one healing system among many, yet it has, formally at least, in large measure broken with the traditional wisdom of the body. Herein lie its strengths and weaknesses. A distinguished historian of medicine, Jean Starobinski, writes,

      The historian who hopes to make sense out of the development of medicine cannot simply list the discoveries in the field, adding them up as if one grew spontaneously out of the other. These conquests have been made possible only by a never-ending struggle against entrenched error, and by an unflagging recognition that the accepted methods and philosophical principles underlying basic research must be constantly revised.… Disease is as old as life, but the science of medicine is still young.

      Contained within those remarks are the ideology of western medicine and some genuine historical insights. The following pages explore these ambiguities.

* Smallpox, the largest of all viruses, is the product of a long evolutionary adaptation of cowpox to humans – something clearly perceived two hundred years ago by Edward Jenner. His An Inquiry into the Causes and Effects … of the Cow Pox (1798) noted that:

      The deviation of man from the state in which he was originally placed by nature seems to have proved to him a prolific source of diseases. From the love of splendour, from the indulgence of luxury, and from his fondness for amusement he has familiarized himself with a great number of animals, which may not originally have been intended for his associates.

      Jenner thus perceived the dangers animals posed to human health. Now, in the late 1990s, the transmission chain between the cattle disease, bovine spongiform encephalopathy (BSE), and the human Creutzfeldt-Jakob Disease (CJD), is a hot epidemiological and political issue in Europe.

CHAPTER III ANTIQUITY

      AT THE END OF THE LAST ICE AGE about ten thousand years ago, a revolution began which decisively changed the symbiosis of society and disease. As we saw in the previous chapter, communities learned to master animals, to herd them for food, yoke them for traction, and spur them to war. Familiarity with soils, seeds and seasons made it possible to harvest crops regularly. Settlements grew, and with them arts and crafts. Story-telling and public memory were cultivated and the gods propitiated through priestly rituals. With the Bronze Age (from about 4000 BC), metal-working was improved, the wheel exploited, the reckoning of time and space rationalized and the calendar invented. Learning was encouraged, cities administered, tributes extracted, treasure hoarded, laws promulgated, empires enlarged. All such developments – the ABC of civilization – brought new approaches to healing and, for the first time, the writing down of medical practice. Medicine entered history.

      MESOPOTAMIA