SOURCE: “Mirrors of Health and Treasures of Poor Men: The Uses of the Vernacular Medical Literature of Tudor England,” in Health, Medicine and Mortality in the Sixteenth Century, edited by Charles Webster, New York: Cambridge University Press, 1979, pp. 237-61.

[In the following essay, Slack examines the nature and influence of vernacular medical literature in England from the sixteenth and early seventeenth centuries, arguing that it was the social elite and not the poor who would have read them.]

It was the ‘compassion that I have of the poor people’ which moved the author of the most popular medical work of the sixteenth century to put pen to paper, so that ‘every man, woman and child’ might ‘be their own physician in time of need’. So wrote Thomas Moulton, whose Mirror or Glass of Health went through at least seventeen editions between 1530 and 1580.¹ Other writers followed what seemed to be a sure recipe for success. Claims to popular utility became as commonplace in the prefaces of the English medical works of the Tudor period as appeals to the ‘general reader’ on the dustjackets of academic books today.

Like their modern equivalents, however, these were pious hopes or calculated advertisements rather than statements of fact. Such works can scarcely have reached the illiterate poor, and the extent of their diffusion even among the literate may well be questioned. Neither can they be taken without qualification as reflections of ‘popular’ attitudes towards disease, still less of popular treatment of it.² They were one small and specialized part of a medical world in which there were several alternative sources of knowledge and advice, from the educated practitioners to the more numerous ‘cunning’ men and women who represented a well-worn and well-known tradition of magical and folk medicine.³ Nevertheless, the literature existed, found a market and grew in volume, and it is important to ask what, in an already well-peopled medical universe, its function was. How great was the contribution of the printed book to medical attitudes and medical care, and how much can it tell us about them?

I

The answers to these questions depend upon some initial assessment of the quantity and quality of the literature itself. We need to determine its volume and its subject-matter. This is no easy task since the works involved were so various. The vernacular literature of the sixteenth century is readily identified and already pre-packaged for us (if the occasional Latin work is excluded) in the Short-Title Catalogue;⁴ but the term ‘medical’ does not have such a sharp definition. As one would expect in a society in which the care of the sick was not yet a specialized professional activity, and in which astrologers and priests practised medicine, there were several works which straddled the borders between medicine and other subjects. Compiling a list of ‘medical’ books for the early modern period is therefore an even more subjective and arbitrary exercise than most bibliographical classifications. For the purposes of calculating the figures which follow, ‘medical literature’ has been taken to cover all books and pamphlets deliberately and largely devoted to the description, analysis or treatment of human health and disease. Herbals and works on anatomy have been included but not books on the care of animals.⁵ Books of ‘secrets’ almost wholly concerned with disease have been counted, but not a more general encyclopaedia like that of Bartholomaeus Anglicus,⁶ or works on astrology which may refer to medical matters among others.⁷ More questionably, perhaps, almanacs and most religious tracts on epidemics and other diseases have been excluded from the figures, although they will necessarily be referred to at a later point in the discussion. Of the religious tracts, only those few works which included some relatively technical enquiry into the natural remedies for or protections against disease have been counted.⁸

Using this definition, it has been possible to identify 153 medical titles published before 1605. The first was the Little Book, a plague tract attributed to Canutus, published about 1486;⁹ one of the last was another work concerned with plague, Francis Herring's A Modest Defence, published in 1604.¹⁰ Between them came a variety of books covering many other aspects of health and disease. The number of recorded titles tells us little in itself, however. In one sense it is a minimal estimate, for it comprises only works listed in the Short-Title Catalogue, that is works which are known to survive.¹¹ Several others must have been lost, especially no doubt the smaller more popular tracts which were probably never bound. In another sense it may be too large a figure. Quite apart from the amount of borrowing by one author from another, some titles are in fact only slightly different versions of earlier books.¹² Duplicates of this kind have been excluded where possible, but it is likely that not all have been spotted. In any case the number of titles is less indicative of the quantity of medical literature available than the number of editions. Several of the 153 titles were reprinted again and again. If we count all known editions (but not variants) as well as originals, there were 392 editions of medical works between 1486 and 1604 inclusive.

In order to calculate at all reliably the total book-stock implied by this number, we should need to know the size of each edition, a subject on which we have no accurate information. In the early part of the sixteenth century editions may well have been quite small, but a not unrealistic estimate of the average for the whole period might be 1,000 copies.¹³ That would give a total of nearly 400,000 copies printed between 1486 and 1604. The number of volumes in use at any one time was, of course, much smaller. Even at the end of the sixteenth century, when the number of publications was increasing, it cannot have been very large. If we allow each book a life of around thirty years—probably a generous estimate—there may have been some 166,000 medical books still in use in 1604, one for every twenty people or so, had they been equally distributed. Despite some contemporary fears that the market was being flooded, these are quite modest figures. Medical works represent only a small proportion of English publishing, probably some 3 per cent of the total output of books.¹⁴ We can scarcely attribute any major social or medical impact to a volume of literature of this size. Having said that, however, rather less than half a million books is not a negligible number. If medical books did not force themselves on the attention of the literate by their numbers, they probably existed in sufficient quantity by the end of the period to be accessible to most of the readers who positively wanted them.

The output of these books was unevenly spread over time. Fig. 1 shows both the total number of editions and the number of new titles printed in each quinquennium after 1520 (before that date the number of publications was very small).¹⁵ The gradual growth in the volume of medical publishing is evident, from an average of one or two editions a year to an average of four or five. So too is the heavy dependence during the middle decades of the century on reprints rather than new texts. This reinforced the second- or third-hand quality of medical writing, which was already well established by authors borrowing from foreign texts or fifteenth-century collections. Only after 1575 did the number of new works slightly exceed the number of reissues, and even then there was no period like the 1650s when the number of new publications rose dramatically.¹⁶

Output was, however, more prolific in some years than in others, and there were clusters of productive years, some of which are masked by the quinquennial divisions in Fig. 1. Two such were in 1539-41 and 1546-8, when the genre of medical works intended for laymen, pioneered by Moulton, Sir Thomas Elyot, Andrew Boorde and Thomas Paynel, achieved instant success and gave rise to several new editions.¹⁷ Another prolific period occurred between 1560 and 1562, partly owing to reprints of Elyot and Moulton after a hiatus in Mary's reign, partly perhaps because of the epidemic fevers of the later 1550s which must have boosted sales and editions of relevant works.¹⁸ Later in the century epidemics of plague certainly inspired authors to seize the main chance. Outbreaks of the disease across the country, together with the government's interest in encouraging public health measures against it, may have helped to produce a cluster of publications between 1578 and 1580, for example;¹⁹ and it was literature on plague which pushed up the total number of new publications to a record height in 1603.²⁰

The very high productivity of the years 1585-7, on the other hand, was much more varied in its make-up and cannot be attributed to any single cause. Rather it illustrates the range of ‘medical’ literature with which we are dealing. It included Bostocke's defence of Paracelsian medical theory,²¹ and treatises by an Oxford professor, on eye diseases and medicinal springs in Warwickshire.²² There was a translation of a foreign work on surgery, as well as an edition of a book on the French pox by the English surgeon, William Clowes.²³ There were three small tracts trumpeting the virtues of particular medicines,²⁴ a treatise on melancholy,²⁵ a handbook of medical receipts intended for household use,²⁶ and—inevitably—reprints of Elyot's Castle of Health and of Boorde's Breviary of Health. And there were other works besides.

It is time, therefore, that we tried to define the content of this varied literature. Perhaps its most striking feature, apart from the large number of reprints, is the number of translations of foreign works. Exactly one third of the titles, fifty-one, were explicitly translations. Some of them were versions of prestigious authorities, of Galen or modern writers such as Gesner.²⁷ Of wider appeal, however, were books billed as revelations of the ‘secrets’ of some foreign sage, such as Fioravanti, or Alexis of Piedmont whose collection of remedies appeared in four parts and several editions between 1558 and 1614.²⁸ In addition there were works which, while claiming to be by English authors, were borrowed from continental sources. Thomas Lodge's Treatise of the Plague (1603), which historians have sometimes supposed to refer to English conditions, has been shown to be such a case,²⁹ and detailed comparison of texts would no doubt reveal others.³⁰ For English medical literature was very often derivative in the sixteenth century. Translations, and works ostensibly by English authors, covered much the same variety of themes, and they must be grouped together when considering the literature's subject-matter.

Accordingly, Table 1 divides the totals of 153 titles and 392 editions into eight distinct categories.³¹ Although determined by the content of the books themselves, these are not rigid thematic groups. They represent an attempt to impose strict subject divisions on works which often ranged across several themes. Hence the vagueness of some of their headings. There were inevitable difficulties in pigeon-holing several publications, and nice distinctions have had to be drawn. The categories ‘Anatomy and surgery’ (1) and ‘Herbals’ (3) are self-explanatory and their contents readily recognizable. Works on these subjects were relatively well defined and specialized in their subject-matter in the sixteenth century.³² Our other groups are more artificial. ‘Reflections on theory and practice’ (2) comprises works, some of them controversial, on medical practice in general. It includes, for example, Timothie Bright's A Treatise wherein is declared the Sufficiency of English Medicines (1580), R. Bostocke's Difference between the Ancient Physic … and the Latter Physic (1585), and other books criticizing or defending the medical profession and its current treatments. It is perhaps the loosest of our eight categories, determined largely by exclusion from the others. Works solely concerned with ‘Plague’ (4) are numerous enough to justify a group of their own.³³ Several further publications have long sections concerned with this disease, but if they consider other matters besides they have been allocated to groups (7) or (8). ‘Other specific diseases’ (5) takes in books concentrating on such complaints as syphilis, the sweating sickness, pleurisy, melancholy and diseases of the eye.³⁴ ‘Single or specialized remedies’ (6) is a similarly mixed bag. It includes works on English medicinal springs and spas, as well as on such ancient remedies as mithridatium; but all are publications on a single theme.³⁵

The works in categories (7) and (8) range over a wider field, and the line between these two groups was the most difficult of all to draw. Each of them contains books giving advice on how to combat a great variety of diseases, and claiming to be popular handbooks for the use of the layman. A distinction can be made, however, between those which simply list remedies for named complaints, and those which attempt also to explain the origins and symptoms of disease or to show how health can be preserved; between simple practical manuals on the one hand, and more discursive works of literature on the other. Examples of the latter, from the category ‘Textbooks and regimens’ (7), are Elyot's Castle of Health and Thomas Cogan's Haven of Health (1584); and of the former, from ‘Collections of remedies’ (8), Moulton's Mirror or Glass of Health and T.C., An Hospital for the Diseased (1578).³⁶ Some works bridged the gap between the two, like Thomas Phaer's edition of Jehan Goeurot's The Regimen of Life [1543?]. This has been classed here as a regimen since the French original was based on the Regimen sanitatis Salerni, but the English version is largely devoted to the provision of specified remedies for specific complaints. There are, however, evident differences of style and purpose between the works at the two extremes.

Which were the most popular of these categories? The first column in Table 1 shows that the largest in terms of titles are textbooks and regimens (7), books on anatomy and surgery (1), and plague tracts (4). If we look at the number of editions in each category, however, a different picture emerges. Textbooks and regimens retain their prominence, even increasing their share of the total output; but they are joined now by the simple collections of remedies (8) whose few titles went into many editions, five each on average. All the others except herbals (3) lose ground by comparison. Between them, textbooks and regimens and collections of remedies supplied half the medical books published during the period.

Much of this unequal distribution of editions is readily explained. Works on single or specialized remedies (6) were clearly advertisements, of short life. Most of the reflections on theory and practice (2) were tracts for the times of little continuing importance, as were some of the works on specific diseases (5). Plague tracts (4), though still the third-largest category, were published during or shortly after epidemics and not reprinted until the next outbreak. They also concerned a subject, the most intractable of all diseases, on which no single author could hope to make himself the obvious authority. On the other hand, collections of remedies, like herbals and to some degree regimens, belonged to an established ‘genre’ in which little variety but much reprinting might be called for.

The difference between the distribution of new titles and that of all editions was also in part a function of chronological changes in the pattern of publishing. The older the book, the more opportunity there was for it to be reprinted before our closing date of 1604. It is significant therefore that works in some of the more specialized areas appeared in large quantity only after 1575. Before then the literature was more heavily dominated by collections of remedies and by textbooks and regimens: 39 per cent of pre-1575 titles were in categories (7) and (8), compared with 29 per cent in the later period. The literature was much more varied in content at the end of the sixteenth century than it had been thirty or forty years before.

The need for new editions might depend also on the physical durability of the work in question. Large bound volumes lasted longer than small pamphlets of twenty or thirty pages and were reprinted less often. The format of a book has its own story to tell, however, since it reflects the author's and publisher's view of the purpose and audience for it. The larger the volume, the less likely it was to be put to everyday household use, the more likely to be designed for the study or library. Table 1 shows that the distribution of books of smaller format—octavo, duodecimo and sexto-decimo—was even more unequal than that of editions. Very few works on anatomy and surgery were printed in less than quarto size. Even octavo plague tracts were few in number, though they were much shorter than the surgical folios and quartos and can rarely have been bound. More than half the textbooks and regimens were in small format, however, and nearly three quarters of the collections of remedies. These were clearly the most popular categories of medical work. The particular hold which the collections exercised on such ‘mass’ market for medical literature as existed in Tudor England is indicated by the fact that they comprised only an eighth of titles, but a quarter of all editions and nearly a third of works of ‘pocket’ size.

The limited information available about the price of books is consistent with the evidence of popularity given by editions and format. Prices depended in part on whether or not a work was bound, and they also varied between different works in each category. On average, however, publications in categories (7) and (8) were much the cheapest. Whereas the surgical works of Vigo cost 4s, and Dodoens's herbal 6s (Gerard's herbal cost as much as 48s), textbooks and regimens could be got for as little as 1s (Regimen sanitatis Salerni, 1575) or 6d (Elyot's Castle), and collections of remedies for 6d (T.C., An Hospital for the Diseased, 1578) or 2d and 3d (Moulton's Mirror). These copies of Moulton were as cheap as any publication on the market in the later sixteenth century.³⁷

Consequently it is not surprising that regimens, textbooks and collections of remedies dominated the list of medical best-sellers between 1485 and 1604. Table 2 shows the thirteen titles which achieved more than six editions before 1604. No less than eleven of these works are in categories (7) and (8). Three of them are rather more specialized than the others and should be mentioned first. The Seeing of Urines was a popular version of larger works which, ‘considering that it is expedient for every man to know the operation and qualities of his body’, expounded the techniques by which disease could be identified by simple inspection of the urine.³⁸ Roesslin's Birth of Mankind was the standard work, translated by Richard Jonas from the Latin, on childbirth. The Antidotharius covered the making of ointments and plasters. All were relatively narrow in scope, but all referred to several different diseases and complaints and can thus be counted with more general textbooks and collections.

The two exceptions noted from Table 2 were further removed in character from the other best-selling titles. The first is the herbal, published by Banckes and once attributed to Cary, which, like similar works, was based on medieval manuscripts listing various plants and their medicinal uses. It was swept from the market after 1560 by the more extensive volumes of Turner, Dodoens and finally Gerard.³⁹ The plague tract attributed to a fifteenth-century Swedish bishop, Canutus,⁴⁰ was similarly descended from manuscript tractates of the later Middle Ages, and it was overtaken by an even larger volume of literature on plague in the second half of the sixteenth century. Essays on the precautions to be adopted to prevent infection and on treatments for the disease were appended to other works, like Moulton's Mirror and Goeurot's Regimen. There were also several separate publications, one of the first a tract translated by Thomas Paynel,⁴¹ and one of the most popular, Thomas Brasbridge's The Poor Man's Jewel, that is to say a Treatise of the Pestilence (1578). Although they continued to be written from a traditionally Galenic standpoint, stressing the miasmic origins of epidemic infections, these later works introduced into the literature both variety and a new note of controversy, with disputes about the nature of contagion and about the virtues of various treatments.⁴² The variety of the literature on plague was further increased at the end of the period by a succession of devotional works, prescribing prayers and meditations as defences against the disease.⁴³ Although Canutus alone occurs in Table 2, therefore, his work is a reminder of the very large number of publications, twenty-three ‘medical’ titles and thirteen ‘religious’ works, devoted to this single disease between 1486 and 1604.

The character of textbooks and regimens, and of collections of remedies, the main titles in Table 2, changed much less in the course of the period. Of the textbooks and regimens, Elyot's Castle was reprinted throughout the century, and so too was the work on which it was partly based, the Regimen sanitatis Salerni. It was not until 1607 that Sir John Harington's verse translation of the latter⁴⁴ partially replaced Paynel's version; and works like Boorde's Dietary (1542), Bullein's Government of Health (1558) and Cogan's Haven of Health (1584), though popular, did not dethrone the Castle. Some of them indeed gave the game away by copying Elyot verbatim.⁴⁵ Sir Thomas Elyot could have claimed therefore to be both the originator and chief representative of this genre of publication, the main characteristic of which was the provision of simple rules for a healthy diet and course of life. As he made clear in his book, Elyot had earlier models whose work he adapted. Salernitan writings on these themes, like the ‘Isagoge’ of Johannitius, had been widely available before the invention of printing, and the Regimen itself was accessible in Latin even before Paynel's translation.⁴⁶ There was also Erasmus's version of Plutarch, De tuenda sanitate (1513), which had a similar subject-matter.⁴⁷ But it was Elyot who built on Galenic, Salernitan and humanist foundations a didactic and beguiling essay incorporating humoral theory, dietary advice and a few practical remedies, a work, as the author said, combining moral philosophy with physic.⁴⁸ Elyot established a model which was influential for at least a century, and which produced echoes even in medical textbooks concerned more narrowly with ‘physic’.

The collections of remedies, which occupy even more space in Table 2, had no single influential hand behind them, and were hence very different in quality. Where the regimens discussed humoral theory, explained the origins of disease and advised on how to maintain health, the collections simply listed illnesses, sometimes in alphabetical order, more often according to the part of the body affected, and added one or more remedies. They had direct roots in the vernacular literature of the Middle Ages. Moulton's Mirror and The Treasure of Poor Men prescribed remedies, most of them purgative or soothing concoctions of herbs, in as direct a way as the manuscript collections of receipts of the fifteenth century.⁴⁹ There were close similarities between the remedies in manuscript and printed works, and there was a minimum of explanation in both.⁵⁰ Although one reader of The Treasure felt moved to scribble against a prescription a note of the humoral theory behind it,⁵¹ few can have expected such information in a book of this kind. One or two collections, like Humphrey Lloyd's translation of The Treasury of Health attributed to Pope John XXI, contained rather more comment on symptoms than others, but their origin and purpose was the same. Unlike the regimens, they were handbooks apparently intended for everyday use.

As Table 2 suggests, there were some changes in this literature in the later sixteenth century. There was no reprint of The Treasure of Poor Men after 1575, of Moulton after 1580, or of The Treasury of Health after 1585. In their place came works which incorporated more up-to-date information without changing the established format. A very few chemical remedies and practices such as distillation made their appearance.⁵² There were new drugs like guaiacum to be mentioned.⁵³ John Partridge's Treasury of Commodious Conceits also appealed because it had recipes for quinces, marmalades and perfumes alongside medicines. But the basic formula in Partridge, in T.C.'s An Hospital for the Diseased, in A Book of Sovereign Approved Medicines and Remedies (1577), and in A.T.'s A Rich Store-house or Treasury for the Diseased (1596) was the same as before. Old remedies by far outnumbered new, and the lists of complaints had changed scarcely at all.

The largest sectors of medical publishing in the sixteenth century were thus the most conservative in quality. The many works on plague may have increased in variety and scope at the very end of the sixteenth century, but they were never in such great demand as the textbooks and regimens based on Elyot's model and the collections of remedies which had roots even further back in time. The most popular medical works covered familiar ground and were no doubt successful for that reason. For one must assume that, in this as in other areas of publishing, authors were well attuned to the requirements of their readers. Having considered the quantity and content of the literature, we must examine the authors and the audience who between them determined both.

II

The authors were a miscellaneous group, not all of whom deserved the title.⁵⁴ We have noted the extent to which publications drew on the past and on each other. As the similarity of their titles suggests, they were scarcely original works, and it is significant that the most hackneyed of them, the collections of remedies, often had anonymous authors. Few of their compilers can be identified and it is scarcely profitable to make the attempt. The ‘T.C.’ who according to its title page ‘gathered’ the remedies in An Hospital for the Diseased, for example, has sometimes been identified as the Puritan divine, Thomas Cartwright. Even if he was, he was the author of no more than the Preface describing God's gift of medicines; and he may equally well have been Thomas Cooper, who before becoming a bishop had studied medicine at Oxford.⁵⁵ His exact identity is of little more than bibliographical importance. The question does, however, illustrate one important feature of the literature with which we are concerned: the small role which the medical establishment played in it. Only a third of the textbooks, regimens and collections of remedies with identifiable authors came from the pens of established physicians; and the latter can have provided few of the several authors who are unidentified.

This is not to say that the medical elite as a whole disdained to write vernacular works. Dr John Caius's apologia to his English work on the sweating sickness suggests some initial reluctance to adopt the habit.⁵⁶ There may equally be some significance in the fact that Christopher Langton, who had published two general works on physic, was expelled from the College of Physicians in 1558 for his arrogant and immoral behaviour: his publishing record may have been one symptom of a personality ill suited to the conservative confines of the College.⁵⁷ By the end of the century, however, established physicians were publishing works in English, though normally on rather specialized subjects. Francis Herring, and Peter Turner, physician at St Bartholomew's Hospital, wrote on plague; Walter Bayley, Regius Professor of Physic at Oxford, produced works on eye diseases and medicinal waters; Edward Jorden published a book on hysteria.⁵⁸ Works on surgery were also the province of the specialists: Thomas Gale, William Clowes, John Banister and Peter Lowe were all surgeons with military or naval experience on which they drew in their works.⁵⁹

Yet the majority of the more popular medical works of the period, the textbooks, collections of remedies and even the plague tracts, were not written by professional medical men in the modern sense. Their authors made their living in other ways. They were lawyers and civil servants, clergymen, or, by the end of the century, professional writers, most of whom would have regarded themselves as socially and intellectually superior to mechanic surgeons. Many of them had studied medicine at one or other of the universities; a few went abroad to further their medical education; and some of the clergy certainly practised physic. As their other activities show, however, they belonged to an age in which divisions between the learned professions were not yet clearly drawn, and in which humanist teachings positively encouraged the blurring of such distinctions.

Sir Thomas Elyot is the most eminent example of a lawyer, civil servant, diplomat and humanist who wrote on subjects outside medicine. A somewhat similar figure at the end of the century was William Vaughan, author of Natural and Artificial Directions for Health (1600), who was also a lawyer, colonial pioneer, poet and writer of devotional tracts. Two more professional authors were John Partridge, who produced poems and translations as well as The Treasury of Commodious Conceits, and Thomas Lodge, who turned to the study of medicine and wrote on plague only after a successful literary career in other fields had been disrupted by suspicions of his Roman Catholicism.⁶⁰ The translators, who were of first importance in determining the character of the literature in the first half of the century, were similarly involved in non-medical projects. Humphrey Lloyd, who was responsible for The Treasury of Health, was an M.P. and author of antiquarian works. Thomas Paynel was an almost full-time translator of Latin works in the years after 1528, a plague treatise and the Regimen sanitatis Salerni being only two of his renditions.⁶¹ Thomas Phaer, a lawyer and Doctor of Medicine, published legal handbooks and a translation of Virgil besides the ‘Book of children’ which he added to his edition of Goeurot's Regimen.

The clergy's contribution to the literature was particularly large. The study of medicine had flourished among members of religious orders in the Middle Ages, and it is not surprising to find among the most successful authors of the early sixteenth century, Thomas Moulton, a Dominican, Andrew Boorde, once a Carthusian,⁶² and Paynel, once an Austin friar. Schoolmasters like Thomas Brasbridge of Banbury and Thomas Cogan of Manchester also practised and wrote about medicine. Cogan, who was also a Fellow of Oriel College, Oxford, directed his work particularly to students.⁶³ William Turner, a convinced Protestant and Dean of Wells, used his periods of religious exile on the continent to develop his contacts with foreign medical scholars, and published herbals and a book on medicinal springs as well as A New Book of Spiritual Physic (Emden, 1555).⁶⁴ Thomas Newton of Cheshire, rector of Little Ilford, was another clergyman who wrote on other subjects besides medicine.⁶⁵ If William Bullein found it easy to move from a career as a country parson to the study of medicine, Timothie Bright, writer on melancholy, could make the opposite transition from St Bartholomew's Hospital to a country rectory.⁶⁶

The authors of the medical literature were thus men of diverse accomplishments and interests, not professional scientists working within the conventions of an established discipline. This did much to determine the range of their output, and it also explains the blurred boundaries between ‘medical’ and other types of publication in the sixteenth century. There was, for example, considerable overlap with religious literature. Although physicians like Caius disclaimed any intention to trespass on the territory of ‘divines’,⁶⁷ and devotional tracts on sickness showed by their titles that their authors were aware of the same distinction, there was in practice a marked identity of interest. There were at least twenty-seven devotional works for the sick, prescribing prayers and meditations as aids to health, published before 1605. The most popular was Thomas Becon's The Sick Man's Salve, which ran to twenty editions between 1560 and 1604. There were also books of ‘ghostly medicines’, ‘godly gardens’ of herbs, and ‘pomanders of prayer’.⁶⁸ The authors of these normally confined their attention to spiritual remedies for disease, but the shared vocabulary demonstrates the basic similarity between their concerns and those of medical writers, and the two sets of publications cannot always be distinguished. This was especially the case with tracts describing the actions to be taken during epidemics of plague. Pamphlets by the London preachers James Balmford and Henoch Clapham on the plague of 1603, for example, contained a good deal of medical as well as theological argument.⁶⁹

The medical literature was equally close to the world of astrology and particularly to the world of the almanac. Andrew Boorde, author of the Breviary and Dietary, was also the first English author of almanacs. John Securis, a Salisbury practitioner, published almanacs as well as a criticism of current medical practice.⁷⁰ Although not included in our quantitative survey of the literature, almanacs themselves contained, along with other matter, much medical information: advice on bloodletting, indications of the days favourable or unfavourable for medical treatment, and prognostications of the sicknesses most likely to prevail at particular seasons of the year. They were also much more popular publications than any so far considered. More than 600 almanacs were published before 1600, far exceeding in number all the literature classed as medical here.⁷¹ If religious works on the one hand and almanacs on the other show the loose boundaries to ‘medical’ literature, they also point by way of contrast to its limited quantity and hence to its relatively small audience.

The composition of that audience is much less easy to assess than its probable size. The limited evidence available suggests, however, that the readers of medical works, though larger in numbers, were probably not very different in character from their authors. Works of anatomy and surgery were obviously aimed at and perhaps reached a group of specialized practitioners. Vicary, for example, wrote for new members of the surgeons' gild; and like other surgeons he added recommended remedies to his work in recognition of the fact that—however much the College of Physicians might wish otherwise—physic and surgery were in practice not often distinguished.⁷² More remarkably, however, apparently ‘popular’ medical works were also intended in part for practitioners. One or two, like Boorde's Breviary, gave the names of herbs and medicines in Latin, while A.T.'s A Rich Store-house, although ostensibly designed for ‘the poorer sort of people … that are not of ability to go to the physician’, included a section of ‘divers and sundry good instructions and rules for all such as are the true practisers of physic and surgery’.⁷³ It is possible that one of the purposes of the literature was the instruction of less well-educated popular practitioners, of men like the shoemaker in Elizabethan Chelmsford who also acted as a surgeon,⁷⁴ or of clergymen practising medicine far from the learned worlds of the universities and London.

The defensive tone adopted by the prefaces to medical books scarcely suggests so respectable a purpose, but it need not be taken at face value. If writers seem to have felt the need to justify opening the secrets of the ‘noble science’ of physic to the multitude,⁷⁵ a large part of this was a calculated appeal for readers. There is little evidence that physicians as a whole disapproved of these works, and more that it was empirics and astrologers who wished to keep their practices confidential.⁷⁶ Most of the medical works reinforced the establishment view of physic as a complex art demanding learning and judgment, and attacked the amateur tamperings of untrained and illiterate practitioners. As the translator of one work remarked, vernacular books might serve to increase respect for physicians and to instruct their less prestigious colleagues such as apothecaries.⁷⁷

Yet it would be difficult to argue that printed literature of this kind was as important an instrument for the instruction of medical practitioners as its authors hoped. It probably helped to keep them familiar with the vocabulary of their trade, with the language of the humours and the nomenclature of diseases, but it seems not to have materially affected their treatments. Doctors' casebooks suggest that the remedies prescribed by them were in general much simpler than those in the printed collections. They might include plague waters of the kind authors recommended, but simple purges were the great standby. Doctors were also as likely to borrow remedies from other physicians, from well-known cunning women, and especially from their more eminent patients, as from printed works.⁷⁸ Though they possessed books and must occasionally have used them, they were clearly working in a society in which personal recommendation and oral communication were more important than the printed word.

If medical practitioners were one part of the audience for medical literature, who were the rest? They clearly were not the ‘poorer sort’, the ‘ignorant’ and the wholly ‘unlearned’ referred to in authors' prefaces.⁷⁹ Neither is it likely that they included many of the ‘middle sort’, the increasingly literate tradesmen and yeomen of the later sixteenth century. Only almanacs were available in large enough quantity to reach the lowest ranks of the literate, and even they contained medical advice which demanded a knowledge of dates and times, and assumed a choice of diet and exercise (tennis, for example) which must have been foreign to many of their readers. Some almanacs explicitly referred to a narrower audience when they included medical rules ‘worthy the observation amongst all practitioners’.⁸⁰ The less voluminous literature considered here necessarily had a smaller readership, and it was probably a more select one. The content of the textbooks and regimens certainly presupposed a choice of activities which can have had little meaning outside the leisured elite, and although the simpler collections of remedies ought to have had wider appeal, it is difficult to show that they reached a wider audience before the end of the sixteenth century.

Hard evidence of possession or purchase, the real test of readership, is scanty. Regimens and collections of remedies are not mentioned in the library catalogues and probate inventories of the period, but this may simply be because these sources tended to concentrate on more valuable and less ephemeral books.⁸¹ There ought to be more evidence of them in the few surviving lists of booksellers' stock, but there is none before the reign of Elizabeth, which suggests that their circulation may well have been very narrow indeed in the early sixteenth century, perhaps even confined to London. In 1585, however, a Shrewsbury bookseller was selling some of the more reputable, that is less anonymous, items in the vernacular literature. He experienced some demand for the works of Bullein, Gesner, Fioravanti and Recorde, as well as for Beza's tract on plague, although we should note that he needed more copies of Becon's Sick Man's Salve and of the latest almanacs than of any of these.⁸² His customers are not recorded. They may have been local clergy and doctors; but one piece of evidence from the same year suggests that they probably also included country gentlemen. In 1585 a Huntingdonshire gentleman, Edward Wingfield, ordered from his London bookseller an interesting range of medical works, all of them from our categories (7) and (8): they were Bullein's Bulwark, Boorde's Dietary and Breviary, Barrough's Method of Physic, and, at the cheaper end of the market, Thomas Newton's Approved Medicines and T.C.'s Hospital for the Diseased, each of which cost him 6d.⁸³

This reference to the Hospital is not the only evidence for the appeal of collections of remedies, as well as of the more sophisticated textbooks and regimens, to an upper-class audience. The collections were the source of many of the prescriptions copied into the commonplace books kept by the gentry, by scholars, and by the richer inhabitants of towns in the later sixteenth and early seventeenth centuries. There are examples of such borrowings in the books begun shortly after 1610 by a northern gentry family and by a Norwich citizen,⁸⁴ and the annotations in them, like the manuscript additions to some of the printed volumes,⁸⁵ show that the remedies were occasionally used.

The elite nature of a large part of the readership suggests conclusions about the circumstances in which the medical literature might be drawn upon. One was no doubt the consultation between the gentleman or woman and the doctor. The prefaces to the regimens and textbooks often insist on their usefulness in patient-physician relationships. Elyot, for example, saw his task as the provision of background knowledge so that the patient might ‘instruct his physician whereunto he may adopt his counsel and remedies’.⁸⁶ The upper classes found some basic acquaintance with medical theory essential if they were to judge the expertise of the doctor, to shop around between different practitioners, and to engage in a relatively equal exchange of information with a medical man who was their employee rather than their master.⁸⁷ Collections of remedies on the other hand were helpful tools for the literate in the absence of the physician. They were perhaps used especially by women and they were employed initially, as Partridge noted, by the housewife ‘amongst her own family’.⁸⁸ Their influence might extend further than this, however. They could assist women in the social elite in giving advice to others. The preface to an early edition of Goeurot's Regimen referred to one such lady who ‘according to her custom’ advised the ‘poor’ who came to her; and several other works claimed to be of use, not so much to the sick themselves, as to those who visited or cared for them, their ‘friends’ and ‘neighbours’.⁸⁹ The vernacular literature thus contributed something to the exchange of information between doctor and patient and perhaps between neighbour and neighbour. Far from challenging, let alone overturning, the oral culture of a ‘face-to-face’ society, printed medical books simply gave a few people more to talk about.

The evidence for the readership of medical books, though slight and inconclusive, points therefore in the direction of the social elite: members of the professions, gentlemen, no doubt some merchants, and their wives. The collections of remedies were cheap enough and available in sufficient quantity to be rather more accessible. They may have reached apothecaries and others at the lower levels of medical practice. They may have been bought also by a few yeomen and tradesmen, especially perhaps in London, of whose purchases no trace remains; but we cannot be sure that this occurred and it is perhaps unlikely to have happened before the very end of our period, or outside the capital. It would hence be impossible to argue that the literature had any major social effects. That does not mean that it has no historical utility, however. Much of it, the collections of remedies in particular, can be thought of as analogous to modern cookery-books. They were bought both by professionals and by laymen, but not heavily used by either in their everyday activities. They may have been bought by people who could not afford the recipes they contained, as well as by those rich enough to experiment. The ordinary practice of the craft with which they dealt cannot be deduced from them. But they formed part of the background knowledge to the craft, they reflected some of its techniques and assumptions as well as its ambitions, and they helped to some degree to form attitudes towards it. Thus the textbooks and regimens and collections of remedies helped to mould or to confirm the attitudes of the social establishment towards disease and health, and these subjects are of interest in themselves.

Moreover, in one important respect the analogy with cookery-books does not hold. The collections of remedies and many of the regimens made no attempt to change attitudes or practices; they did not try to introduce new fashions or to innovate. They were conventional and conservative, reinforcing rather than conflicting with other sources of medical knowledge, and they may thus tell us something about the medical problems of a wider section of the population than that which read them. A brief examination of the content of the more ‘popular’ medical works might be expected to reveal some of the common assumptions and anxieties surrounding sickness in sixteenth-century England. …

Notes

1. Thomas Moulton, This is the myrour or glasse of helthe [before 1531], chapter 1.

2. There is a useful general account of these works in H. S. Bennett, English Books and Readers 1475-1557, 2nd edn (Cambridge, 1970), pp. 97-109, and idem, English Books and Readers 1558-1603 (Cambridge, 1965), pp. 179-89.

3. On popular and magical medicine, see K. Thomas, Religion and the Decline of Magic (London, 1971), especially chapters 7 and 8.

4. STC A; STC B, vol. 11.

5. An example of the latter is anon., Remedies for diseases in horses (1576, and later edns).

6. Bartholomaeus Anglicus, De proprietatibus rerum. transl. John Trevisa (1495).

7. E.g., Claude Dariot, A breefe introduction to the astrologicall judgement of the starres (1583), though the 1598 edition, which has the addition of a treatise on ‘mathematical physic’, has been included.

8. E.g., Henoch Clapham, An epistle discoursing upon the pestilence (1603) and idem, H. Clapham, his demaundes and answeres touching the pestilence (1604) have been included.

9. [Canutus], Here begynneth a litil boke the whiche traytied and rehersed many gode things necessarie for the pestilence [c. 1486].

10. Francis Herring. A modest defence of the caveat given to the wearers of amulets (1604).

11. The figures in this and the following paragraphs have been calculated from STC A, revised as far as possible with reference to STC B, vol. 11, and to the information on the revision of letters A to H available in the Bodleian Library, Oxford. STC B adds few new titles (two works on baths by John Jones are examples: STC B 14724a.3, 14724a.7), but many editions not known to the original compilers of the work.

12. Conrad Gesner, The newe jewell of health (1576) and idem, The practise of the new and old phisicke (1599), both translated by Thomas Hill and George Baker, are examples.

13. Bennett, English Books and Readers 1475-1557, p. 228; English Books and Readers 1558-1603, p. 298; L. Febvre and H.-J. Martin, The Coming of the Book, English edn (London, 1976), p. 262.

14. Bennett, English Books and Readers 1475-1557, p. 20; English Books and Readers 1558-1603, p. 269. John Jones thought there were so many medical books ‘that books may seem rather to want readers than readers books’: A diall for all agues (1566), sig.Aviiir.

15. Fig. 1 is based on information in STC B, vol. 11, and on the information so far available on vol. 1 in the Bodleian Library. The dates of several works published between 1520 and 1570 are only approximate, being the suggestions of the revisers of STC. They are often significantly different from those of STC A. Where the revisers suggest no date (saying, for example, ‘before 1546’), the edition has not been included in the figure.

16. See C. Webster, The Great Instauration: Science, Medicine and Reform 1626-1660 (London, 1975), p. 489. My total for 1600-4 is slightly larger than Dr Webster's, no doubt because of our different definitions of ‘medical’ literature.

17. Moulton, Mirror [edns in 1540?, 1541?, 1545?, 1548?]; Sir Thomas Elyot, The castel of helth [first edn, c.1536; probably six further editions before 1549]; Andrew Boorde, Here foloweth a compendyous regyment or a dyetary of helth (3 edns, 1542-7); idem, The breviary of healthe (1547); Regimen sanitatis Salerni, trans. Thomas Paynel (first edn, 1528; another, 1541).

18. E.g., William Bullein, Bulleins bulwarke of defence againste all sicknes (1562), and the reprints [John XXI], The treasury of healthe [c.1560], and Jehan Goeurot, The regiment of life (1560).

19. E.g., Pierre Drouet, A new counsell against the pestilence (1578); Thomas Brasbridge, The poore mans jewell, that is to say, a treatise of the pestilence (4 edns, 1578-80).

20. E.g., Thomas Thayre, A treatise of the pestilence (1603); Thomas Lodge, A treatise of the plague (1603); James Balmford, A short dialogue concerning the plagues infection (1603); S. H., A new treatise of the pestilence (1603); Francis Herring, Certaine rules, directions or advertisements for this time of pestilentiall contagion (1603).

21. R. B[ostocke], The difference betwene the auncient phisicke … and the latter phisicke (1585).

22. Walter Bayley, A briefe treatise touching the preservation of the eiesight (1586); idem, A briefe discours of certain bathes or medicinall waters in the counties of Warwicke (1587).

23. Hans Jacob Wecker, A compendious chyrurgerie, trans. John Banister (1585); William Clowes, A briefe and necessarie treatise touching the cure of the disease called Morbus Gallicus (1585).

24. Anon., A briefe and short discourse of the vertue of balsame (1585); anon., A discourse of the medicine called mithridatium (1585); Andreas Bertholdus, The wonderfull and strange effect of a new terra sigillata found in Germania (1587).

25. Timothie Bright, A treatise of melancholie, containing the causes thereof (1586).

26. John Partridge, The treasurie of commodious conceits, and hidden secrets, and may be called, the huswives closet, of healthfull provision (1586 edn). Cf. the same author's The widowes treasure, plentifully furnished with secretes in phisicke (1585).

27. Certaine workes of Galens called methodus medendi, trans. Thomas Gale (1567); Gesner, New Jewel of Health, and idem, The treasure of Euonymus: conteyninge the wonderfull hid secretes of nature, trans. P. Morwyng (1559). On Gesner, see A. G. Debus, The English Paracelsians (London, 1965), pp. 52-7 passim.

28. Leonardo Fioravanti, A compendium of the rationall secretes, trans. John Hester (1582); [Alessio], The secretes of Alexis of Piemont containing remedies against diseases, trans. William Warde (1558 onwards). On the latter, see J. Ferguson, ‘The secrets of Alexis. A sixteenth-century collection of medical and technical receipts’, Proceedings of the Royal Society of Medicine, XXIV (1930-1), 225-46.

29. E. Cuvelier, ‘“A treatise of the plague” de Thomas Lodge (1603)’, Etudes Anglaises, XXI (1968), 395-403.

30. Compare, for example, T.C., A godly and learned sermon, upon the 91. Psalme (1603), with Andreas Osiander, How and whither a christen man ought to flye the horrible plage of the pestilence, trans. Miles Coverdale (1537).

31. Some 13 per cent of the works (20 titles) have not been seen by the present author in any edition; and their themes have had to be judged from their titles or from secondary literature. This may have introduced some slight inaccuracy in the table.

32. See F. N. L. Poynter (ed.), Selected Writings of William Clowes 1544-1604 (London, 1948), pp. 13-17; A. Arber, Herbals. Their Origin and Evolution … 1470-1670, 2nd edn (Cambridge, 1938).

33. For examples, see the works mentioned in note 20 above.

34. E.g., Clowes, A Brief and Necessary Treatise Touching … Morbus Gallicus; Phillippus Hermanius, An excellent treatise teaching howe to cure the French-pockes, trans. John Hester (1590); John Caius, A boke, or counseill against the disease commonly called the sweate, or sweatyng sicknesse (1552); William Bullein, A comfortable regiment against pleurisi (1562); Bright, A Treatise of Melancholy; André Du Laurens, A discourse of the preservation of the sight (1599).

35. See the works cited in notes 22 and 24.

36. Other examples of these two categories will be referred to later in this essay.

37. Information on prices from H. R. Plomer, ‘Some Elizabethan book sales’, The Library, 3rd ser., VII (1916), 328; F. R. Johnson, ‘Notes on English retail book-prices 1550-1640’, ibid., 5th ser., V (1950), 83-112.

38. Anon., The judycyall of uryns [1527?], title page. Cf. anon., Hereafter foloweth the judgment of all urynes [1555?]

39. Anon., Here begynnyth a newe mater: the which is called an herball (publ. R. Banckes, 1525); Bennett, English Books and Readers 1475-1557, pp. 98-9; William Turner, A new herball (1551); Rembert Dodoens, A niewe herball or historie of plantes (1578); John Gerard, The herball or generall historie of plantes (1597). If works similar to Banckes's, e.g. anon., A newe herball of Macer [1535], are counted as editions of the same work, there were in fact nineteen, not eleven, editions before 1561.

40. For an edition of this tract, see A litil boke, ed. G. Vine, John Rylands Library Facsimiles, no. 3 (Manchester, 1910).

41. A moche profitable treatise against the pestilence (1534).

42. See, for example, Clapham, An Epistle; Herring, A Modest Defence; Peter Turner, The opinion of … concerning amulets or plague cakes (1603); Balmford, A Short Dialogue.

43. Examples are, Anthony Anderson, An approved medicine against the plague (1593); William Cupper, Certaine sermons concerning Gods late visitation (1592); Henry Holland, Spirituall preservatives against the pestilence (1593); John Sanford, Gods arrowe of the pestilence (1604).

44. The Englishmans docter. Or, the Schoole of Salerne, trans. John Harington (1607).

45. For an example compare Henry Wingfield, A compendious or shorte treatise, conteynynge preceptes necessary to the preservation of healthe [1551?], sig. Avv, with Elyot, Castle of Helthe [1541], ed. S. A. Tannenbaum, Scholars' Facsimiles (New York, 1937), fol. 43r; and see S. E. Lehmberg, Sir Thomas Elyot, Tudor Humanist (Austin, Texas, 1960), p.147.

46. For brief accounts of early Salernitan writings, see C. H. Talbot, Medicine in Medieval England (London, 1967), chapter 3, and H. E. Sigerist, Landmarks in the History of Hygiene (Oxford, 1956), chapter 2.

47. Translated into English as, The gouernaunce of good helthe, by the moste excellent phylosopher Plutarche, the most eloquent Erasmus beynge interpretoure [1549?].

48. Elyot, Castel, ed. Tannenbaum, fol. 65 [recte 67]; see also Lehmberg, Sir Thomas Elyot, pp. 132-47.

49. For examples of the latter, see The ‘Liber de diversis medicinis’, ed. M. S. Ogden, Early English Text Society, original ser., CCVII (London, 1938); A Leechbook or Collection of Medical Recipes of the Fifteenth Century, ed. W. R. Dawson (London, 1934).

50. Compare the remedies for headaches in Liber de diversis medicinis, p. 1; Leechbook, p. 19; Moulton, Mirror, cap. vii; anon., Here begynneth a newe boke of medecynes intytulyd or callyd the treasure of pore men (1540 edn), fol. xv; for fevers in Leechbook, pp. 129-31 and The Treasure of Poor Men, fol. xxxvv; and for flux in Leechbook, p. 47, and Moulton, Mirror, cap. lxx.

51. The Treasure of Poor Men (1540), Bodleian Library, Oxford, Crynes 873, fol. xxviiir.

52. See the simple account of distilling in Partridge, Treasury of Commodious Conceits (1591 edn), sigs C4v-C5; and cf. C. C. Mambretti, ‘William Bullein and the “lively fashions” in Tudor medical literature’, Clio Medica, IX (1974), 290-1. For other new remedies and medicines see R. Multhauf, ‘Medical chemistry and the Paracelsians’, Bulletin of the History of Medicine, XXVIII (1954), 101-26; O. Temkin, ‘Therapeutic trends and the treatment of syphilis before 1700’, ibid., XXIX (1955), 309-16.

53. The growth in imports of foreign drugs is criticized in William Harrison, The Description of England, ed. G. Edelen (Ithaca, N. Y., 1968), pp. 266-8; and described in R. S. Roberts, ‘The early history of the import of drugs into Britain’, in F. N. L. Poynter (ed.), The Evolution of Pharmacy in Britain (London, 1965), pp. 168-70.

54. In what follows, information on authors is taken from DNB unless otherwise stated.

55. Cartwrightiana, ed. A. Peel and L. H. Carlson (London, 1951), pp. 9, 14-15.

56. Caius, A Book or Counsel, in Works, ed. E. S. Roberts (Cambridge, 1912), pp. 4-8.

57. Christopher Langton, An introduction into phisycke [1545?]; idem, A very brefe treatise, ordrely declaring the principal partes of phisick (1547); Sir George Clark, A History of the Royal College of Physicians of London (2 vols., Oxford, 1964-6), 1, pp. 108-9.

58. Herring, Certain Rules, idem, A Modest Defence; Turner, The Opinion of … Amulets; Bayley, A Brief Treatise of Eyesight, idem, A Brief Discourse of Baths; L. G. H. Horton-Smith, Dr Walter Baily (or Bayley) c.1529-1592 (St Albans, 1952), pp. 30-1; Edward Jorden, A briefe discourse of a disease called the suffocation of the mother (1603); Clark, History of the Royal College, 1, p. 165.

59. See STC for their works, and, on some of their lives: Poynter (ed.), Selected Writings of William Clowes, pp. 17-18; T. Finlayson, Account of the Life and Works of Maister Peter Lowe (Glasgow, 1889). The quality of some surgical writings is discussed in P. H. Kocher, ‘Paracelsan medicine in England (c. 1570-1600)', Journal of the History of Medicine, 11 (1947), 466-80; S. V. Larkey and O. Temkin. ‘John Banister and the pulmonary circulation’, in Essays in Biology in Honor of Herbert M. Evans by His Friends (Berkeley, Calif., 1943), pp. 287-92.

60. On Elyot, see Lehmberg, Sir Thomas Elyot, and J. M. Major, Sir Thomas Elyot and Renaissance Humanism (Lincoln, Nebraska, 1964); and on Lodge, W. D. Rae, Thomas Lodge (New York, 1967), p. 101, and E. A. Tenney, Thomas Lodge (New York, 1935), pp. 160-77.

61. Bennett, English Books and Readers 1475-1557, pp. 153, 165; J. K. McConica, English Humanists and Reformation Politics (Oxford, 1965), pp. 138-9.

62. On Boorde, see the introduction to The Fyrst Boke of the Introduction of Knowledge made by Andrew Borde … ed. F. J. Furnivall, Early English Text Society, extra ser., x (1870).

63. Brasbridge, The Poor Man's Jewel; Thomas Cogan, The haven of health (5 edns, 1584-1605); Clark, History of the Royal College, 1, p. 167. John Stockwood, translator of two works on plague, was also a schoolmaster (DNB). Other works partially directed towards students were Philip Moore, The hope of health (1564), see sig. Ai; Gulielmus Gratarolus, A direction for the health of magistrates and studentes, trans. Thomas Newton (1574).

64. Arber, Herbals, pp. 120-3.

65. Thomas Newton, Approoved medicines and cordiall receiptes (1591); idem, The old mans dietarie (1586).

66. W. S. Mitchell, ‘William Bullein, Elizabethan physician and author’, Medical History, III (1959), 188-200; Mambretti, ‘William Bullein and the “lively fashions”’, p. 285; G. Keynes, Dr Timothie Bright 1550-1615. A Survey of his Life with a Bibliography of his Writings (London, 1962), pp. 1-20.

67. Caius, A Book or Counsel, in Works, p. 36; there is a full account of this theme in the literature in P. H. Kocher, Science and Religion in Elizabethan England (San Marino, Calif., 1953), especially pp. 265-79.

68. E.g., Paul Bushe, Certayne gostly medycynes to be used to eschew the plage of pestilence (n.d.); anon., A godly garden out of the which most comfortable herbs may be gathered (1574); Thomas Becon, The pomander of prayer (1558); William Perkins, A salve for a sicke man (Cambridge, 1595).

69. Balmford, A Short Dialogue; Clapham, An Epistle, and idem, Demands and Answers.

70. Thomas, Religion and the Decline of Magic, p. 294; John Securis, A detection and querimonie of the daily enormities and abuses committed in physick (1566). Securis was following the example of the French astrologer Nostradamus, whose works, including An excellent tretise, shewing suche perillous, and contagious infirmities, as shall insue. 1559. and 1560 (1559), had recently been translated.

71. Bennett, English Books and Readers 1558-1603, pp. 204-5; E. F. Bosanquet, English Printed Almanacks and Prognostications: A Bibliographical History to the Year 1600 (London, 1917), provides an extensive list. Two examples containing the sort of medical information mentioned are the almanacs and prognostications for 1589 by John Dade, ‘gentleman, practitioner in physic’, and John Harvey, ‘M.A. and practitioner in physic’.

72. Thomas Vicary, The Englishemans treasure (1596 edn), sig. Bi; Joannes de Vigo, The whole worke (1586), fols. 363 et seq.; Thomas Gale, Certaine workes of chirurgerie (1586), ‘Instit. of a surgeon’, sig. Aii v.

73. A.T., A rich store-house or treasury for the diseased (1596), sigs. A2v, B1-C4; cf. anon., The antidotharius, in the whiche thou mayst lerne how thow shalt make playsters, salves, etc. [1535?], sig. Biii r.

74. Essex Record Office, Q/SR 41/31, 10 July 1572.

75. Examples in Bennett, English Books and Readers 1558-1603, pp. 180-1.

76. Compare the attitude of the Elizabethan astrologer, Forman: A. L. Rowse, Simon Forman: Sex and Society in Shakespeare's Age (London, 1974), p. 89. Archbishop Cranmer, however, thought that physicians as well as alchemists deliberately used ‘strange languages’ to ‘hide their sciences from the knowledge of others’: Writings and Disputations of Thomas Cranmer, Parker Society (Cambridge, 1844), pp. 310-11.

77. Joseph Du Chesne, The practise of chymicall and hermeticall physicke, trans. Thomas Tymme (1605), ‘To Reader’. Cf. William Bullein, A newe booke entituled the governement of healthe (1558), fols. vi-vii; William Clever, The flower of phisicke (1590), ‘To the Reader’; Bullein, Bulwark, ‘Book of the use of sick men’, fol. lii v; Jones, Dial for All Agues, sig. Ciii v.

78. F. N. L. Poynter and W. J. Bishop (eds.), A Seventeenth-Century Doctor and his Patients: John Symcotts, 1592?-1662, Bedfordshire Historical Record Society, XXXI (Streatley, 1951), pp. xix-xxi, 97; W. R. Le Fanu, ‘A North-Riding doctor in 1609’, Medical History, v (1961), 179. Compare the similar practices recorded in British Library, MS. Sloane 1529 (commonplace book of an Essex practitioner 1644-5), e.g. fol. 239r; MS. Egerton 2065, Case Book of John Hall 1622-36; Bodleian Library, Oxford, MS. Rawlinson A.369, Case Book of an Oxford doctor 1589-1614.

79. A.T., A Rich Store-house, title page; Bullein, Bulwark, ‘Epistle dedicatory’; Boorde, Breviary, bk 11, fol. l v.

80. Gabriel Frende, A new almanacke and prognostication for the yeere … MDLXXXIX (1589), sigs. Cvv, Aii v.

81. S. Jayne, Library Catalogues of the English Renaissance (Berkeley, Calif., 1956), p. 54; P. Clark, ‘The ownership of books in England, 1560-1640: the example of some Kentish townsfolk’, in L. Stone (ed.), Schooling and Society (Baltimore, 1976), p. 103. Only herbals commonly occur in booklists: e.g. The Lumley Library: the Catalogue of 1609, ed. S. Jayne and F. R. Johnson (London, 1956), p. 273; John Caius, The Annals of Gonville and Caius College, ed. J. Venn, Cambridge Antiquarian Society Publications, XL (1904), p. 213. But the celebrated collector of ballads, Captain Cox of Coventry, had a copy of Boorde's Breviary in 1575: Robert Laneham's Letter, ed. F. J. Furnivall, New Shakspere Society, VI, pt 14 (1890), p. xiii.

82. A. Rodger, ‘Roger Ward's Shrewsbury stock: an inventory of 1585’, The Library, 5th ser., XIII (1958), 250-61 passim. There is no sign of the earliest publications in F. Madan (ed.), ‘Day-book of John Dorne 1520’, in Collectanea I, Oxford Historical Society (Oxford, 1885), pp. 71-178; or in D. M. Palliser and D. G. Selwyn, ‘The stock of a York stationer, 1538’, The Library, 5th ser., XXVII (1972), 207-19.

83. Plomer, ‘Some Elizabethan book sales’, p. 328. Herbals were even more clearly destined for gentry and professional men: for examples of purchase and use, see Trevelyan Papers, pt II, ed. J. P. Collier, Camden Society, old ser., LXXXIV (1863), p. 98; M. M. Knappen (ed.), Two Puritan Diaries (Chicago, 1933), pp. 103-4.

84. Arcana Fairfaxiana Manuscripta. A Manuscript Volume of Apothecaries' Lore and Housewifery nearly Three Centuries Old, Used, and partly Written by the Fairfax Family, intro. by G. Weddell (Newcastle-on-Tyne, 1890), pp. xlii-xliii, 10 and passim; Bodleian Library, Oxford, MS. Tanner 397, fol. 4 et seq. (from rear). Other examples are in Bodleian Library, Oxford, MS. Tanner 169, fols. 78 et seq.; MS. Rawlinson C.506, fols. 122v-123.

85. E.g., the Bodleian Library copy (Douce P. 90) of [John XXI], The Treasury of Health [1550?], sigs. Qii-Qiv; and the Wellcome Historical Medical Library, London, copy of Moulton, Mirror (1546), in which plague remedies are underlined.

86. Elyot, Castel, ed. Tannenbaum, p.v; cf. [John XXI], The Treasury of Health, sig. Aiii r.

87. For examples of doctor-patient relationships, see F. N. L. Poynter, ‘Patients and their ills in Vicary's time’, Annals of the Royal College of Surgeons, LVI (1975), 145-9, and the letters in Letters and Papers, Foreign and Domestic, of the Reign of Henry VIII, ed. J. S. Brewer and others (38 vols., 1862-1932), XIII, pt 1, nos. 431, 538, 1491; The Official Papers of Sir Nathaniel Bacon of Stiffkey, ed. H. W. Saunders, Camden Society, 3rd ser., XXVI (London, 1915), pp. 221-2.

88. Partridge, Treasury of Commodious Conceits, title page.

89. Goeurot, Regimen [1543?: STC B 11966.5], prologue; anon., The key to unknowne knowledge (1599), ‘Judgment of urines’, sig. Aii; Bullein, Bulwark, ‘Dialogue’, fol. 6r; Nicholas Gyer, The English phlebotomy (1592), sig. A6. The correspondence of the early seventeenth century contains many examples of ladies giving medical advice to their friends and relations: e.g. The Oxinden Letters 1607-42, ed. D. Gardiner (London, 1933), pp. 179, 191-2.