By Reilly Gambelli

In the 17th and 18th centuries, England's medical markets appeared to have changed. These changes center around physicks. Physicks was the act of attending to and prescribing cures to patients.^[1] Under Henry VIII's proclamation, physicians were the only medical professionals who could prescribe treatment to patients. In comparison, apothecaries were the only men who could concoct medicine to cure patients.^[2] In actuality, physicians and apothecaries blurred these professional lines. Apothecaries often prescribed treatments to patients, and in 1698 physicians opened a dispensary of their own.^[3] Parliament, the Crown, and the College of Physicians, an organization of physicians, reinforced Henry VIII's proclamation regarding who could and could not practice physicks through legislation and court cases. Despite institutional attempts to reinforce physicians as the only medical practitioners who could administer physicks, medical recipe books demonstrate how families administered physicks in the home. Institutional reinforcement had little effect on medicine's actual practice, revealing gaps in knowledge and communication between institutional and domestic medicine.

Harold J. Cook's analysis of the Rose case (1704) demonstrates gaps in knowledge and communication between institutions and domestic spheres. The Rose case consisted of the College of Physicians suing William Rose, an apothecary, for practicing physicks. The court ultimately ruled that Rose did not practice physicks, but they reinforced that only physicians could practice physicks. Cook concludes that the Rose case did not restrict apothecaries from attending to and treating patients in practice, despite establishing that physicians could only practice physicks.^[4]Illuminating this court case and the conflict between physicians and apothecaries helps demonstrate the larger argument around the changing concept of physicks. To add to the broader scholarship centered around physicks, I argue that there is evidence that a gap exists between what intuitions decided and how families practiced medicine at home during the 17th and 18th century. One type of evidence that can illuminate this gap is medical recipe books kept by families. This paper illuminates gaps between institutionalized medical practice and the actual consumption of medicine in England by analyzing household medical recipes and published medical recipe pamphlets.

In Elaine Leong's chapter "Making Recipe Books in Early Modern England: Material Practices and Social Production of Knowledge" in her book Recipes and Everyday Knowledge: Medicine, Science, and the Household in Early Modern England, she illuminated how medical recipe books shared knowledge within and outside of the domestic sphere. Leong argues that the accumulation of medical recipes from family members, friends, and other recipe books developed knowledge networks. Even more, Leong describes how medical recipes highlight what the individual needs of the family were. She does this by explaining the physical construction of recipe books. Sometimes, recipe books would come with starter recipes and blank spaces where families could add recipes that fit their individual needs. Other times recipe books would be blank, and families could fill in space as they acquired new recipes. Either way, recipe books were often passed down from generation to generation as families accumulated knowledge. The construction of recipe books often underlined what medicines the family needed or thought they would need and served as a medical history of family ailments.^[5] An interesting point that Leong makes in her argument is that specific patterns of recipes may indicate when the household believed they needed outside help. She writes about a family whose daughter was ill in August 1713. In response, the family acquired two medical recipes to treat her symptoms. The first recipe came from a cousin and the second recipe was from Dr. Rowland Cottom. "This pattern suggests that when Katherine was ill, the family first looked within itself for a remedy and, when that did not perform as desired, they paid a medical practitioner."^[6] Here historians can see that households were also practicing physicks and looked to physicians for medical knowledge outside their sphere of knowledge. Could this suggest that physicians should have examined the needs of the people at a deeper level? Should they have looked to expand their roles to meet the different needs of families? I have found another recipe book that includes a physician's advice and may spark similar research questions.

In The English Medical Notebook, 17th century, a recipe called "The virtues of pouder of Earth wormes by Doctor Bonham" the author took notes on what Dr. Bonham believed earthworm powder could cure. "It helpeth the dropsie, the jaundis…as also the stone & vlcers in the remes of bladder…"^[7] The notes continued and seemed a cure-all to all different ailments. Following these notes were recipes that cured jaundice and stones. Though this pattern does not indicate that families tried to cure jaundice and stones before reaching out to a physician, it could indicate that families sought more knowledge than they had. In analysis with Leong's study, the incorporation of physician's medical advice, followed or preceded by familial cures, in medical recipe books indicates a gap in how institutionalized medicine understood the consumption of medicine in England.

Leong's additional work points to evidence that the domestic sphere of medicine and institutional medicine were connected.^[8] In her article "Making Medicines in the Early Modern Household," Leong analyzes the Freke family's different medical notebooks and account books. One of her main conclusions is that "Freke's papers demonstrate that when seeking a cure, households were comfortable in mixing the domestic and commercial…".^[9] Despite using robust evidence to support her conclusion, some of Leong's research illuminates where gaps in knowledge and communication exist between the domestic and institutional medical spheres.

During the late 17th century, physicians began to argue over which type of medicine, galenic or chymical, was most effective. Galenic medicine stated that "treatment [was] determined…after careful analysis of [the patient's] unique humoral balance."^[10] On the other hand, chymical medicine "accounted…for the primal structures of all physical bodies, the so-called tria prima (i.e., three principles) of sulfur, salt, and mercury". The actual debate around each practice's merits is not relative to this paper, but the components of the cure are. Leong succinctly describes galenic medicine as using herbs such as "thistle, baume, sage, angelica seed, anise seed…", and chemical medicines as "coral…vitoriol…[and] mercury", usually harder to find and more expensive products.^[11] Chymical medicine's eventual rise to prominence as the more effective cure among physicians did not automatically diffuse into households. Medical recipe books in the late 17th and early 18th century still used galenic recipes. Leong suggests that the accessibility of products, the equipment, and the time needed to make chymical medicines aided this lack of use. This paper suggests the continuation of galenic cures in medical recipe books demonstrates the gaps between institutionalized medical practice and the actual consumption of medicine in England. While institutionalized medicine looked for further advancement, domestic medicine needed immediate cures and the most cost-effective way to take care of families.^[12]

Historians may see this gap in "The Queens closet opened". A medical recipe book (1683), containing galenic recipes that included gilly flower, coriander, and parsley. The introduction of this book states, "To The Ingenious & Courteous Reader. Reader, it being at firft the general good which caufed us to publifh this ufeful and coompleat piece, we could not choofe but for the fame end give it a new birth…".^[13] The introduction tells historians that print houses were publishing popular pieces. The reprint of this medical recipe book indicates that households are still consuming the same galenic cures. Additionally, this introduction underlines that the book is being marketed to the general people to serve a 'general good'. Marketing these recipes as something the Queen uses indicates a gap between institutionalized medicine and domestic medicine. Print houses have recognized that the general public trusts the Crown. Equating galenic recipes to an authoritative voice allows the typical person to equate their medicine to the best medicine available. In actuality, what the Queen is consuming as medicine is unknown to the general public. It appears that chymical medicine's advancements may also be unknown, creating a gap in institutional and domestic medical knowledge. Approximately fifteen years later, in 1698, Sir John Floyer, an English physician, published "A treatise of the athma divided into four parts". Floyer writes that "the Chymists unjustly reject the Galenic Cacochymias, and explain as well as cure all Diseases by their Mineral Principles, which seems very absurd." He continues to declare that "all pure Chymical Authors know little of Anatomy…".^[14] Interestingly, although this treatise is public-facing and praising galenic cures, it seems to defend galenic medicine. This piece seems to be less available to the general audience than "the Queens closet opened." Advanced rhetoric, an explanation of why the cure works (something most recipe books lack), and a defensive tone leads me to believe that this document was trying to convince other physicians to endorse galenic medicine. There is a lack of effort to educate the general public about the medicine they are consuming, and a highlighted effort to unit all physicians under one practice, galenic—this document hints at a gap between institutionalized medical practice and the actual consumption of medicine in England.

My analysis of familial medical recipe books and preprinted medical recipe books leads me to conclude that there are knowledge and communication gaps within the medical market. Institutionalized medical practice centered around arguments between who can practice physicks and which cures are most effective. The actual consumption of medicine in England focused on relieving symptoms and restoring health as quickly and efficiently as possible. Knowledge and communication between spheres lacked unity. At this point, I cannot confidently suggest why these gaps existed, but I can suggest causes. As Elaine Leong mentioned, accessibility of ingredients and tools to convert to chymical medicine may have a larger implication than this paper allowed. Accessibility to medical pamphlets and educations may have widened these gaps. Additionally, economic gain and competition in various markets, including printing and trade, may have widened the gap between institutional and domestic medicine.