A manuscript preserved in the British Museum, written in beautiful Tudor script, records a royal collection of 114 favourite recipes for "plastres" and "cataplasmes", for "balmes . . . waters, lotions and decoctions". Thirty-two of these are noted as being of "the Kinges Maties devise", and there seems no reason to doubt that they were composed by the King himself, sending his servants scurrying for two ounces of finely powdered red coral or another pint of rose-water, and consulting his personal apothecary Thomas Babham on a fine professional point from time to time, while he pored over his herbals and his antidotaries.
Many of the medicaments devised by Henry must have been for his personal use. His leg with its obstinate ulcerous sore began to bother him fairly early in his reign, and he experimented with a plaster which, the manuscript note claims, "resolves humoures which there is swellynge in the legges", and another one intended "to ease the payne and swelling abowt the ankles". There were other remedies designed perhaps for the same trouble: "a grane oyntement devised by the Kinges highnes to take awaye heat and Indurations", and still more "to resolve and ease Payne", "to heal ulcers without pain", and "to cool inflammation".(3)
His strenuous sexual life appears to have brought its own problems: the "King's Grace's oyntement" was invented at St James's, "to coole and dry and comfort the Member", and another soothing ointment "to dry excoriations and comforte the membre" was devised at Cawood. ("Was not that an episcopal palace? How devoutly was the Head of the Church employed!" commented Horace Walpole waspishly, two centuries later.)(4)
The ingredients Henry used probably reflect fairly accurately the standard medical practice of his time. Most of them were herbal -- plants and flowers known since Dioscorides for their soothing, cooling, healing, and softening properties, such as plantain (Plantago major), linseed (Linum usitatissimum), fenugreek, (Trigonella foenum-graecum), and marguerite (Chrysanthemum leucanthemum). He used marshmallow (Althaea officinalis), highly thought of by the Arab pharmacists as a poultice for inflammations, and the leaves of the sweet-scented violet (Viola odorata) which, as Gerard noted later, were commonly "used in cooling plasters, oyles and comfortable cataplasms or poultices".(5)
Henry also used the sweet yellow flowers of the tall weed melilot (Melilotus officinalis), which the country people called King's clover. Tudor farmers hated it because it took over their pasturelands and ruined their corn, but country herbalists found it very useful: a poultice of melilot: "boiled in sweet wine" with "the yollk of a rosted egge, linseed, marshmallow and hog's greece" was the very thing. said Gerard, for assuaging inflammation.(6) Appropriately for a Tudor monarch, Henry also used plenty of "oyle of roses" and rose-water, probably as much for its, sweet smell -- perhaps concealing others less pleasant -- as for its medicinal value.
As well as plants, he used lead and turpentine for his plasters: more exotic ingredients such as silver or powdered red coral in which he seems to have had great faith; positively fabulous articles such as unicorn horn; and the occasional repellent animal substance -- but carefully prepared for him -- such as "the pouldre of long wormes well washed and dryed". All of these were heated, stirred, and pounded together, and given the necessary body by contribution from the royal kitchens such as manchet or fine wheat bread, freshly laid eggs, capon fat, or veal suet.
There was nothing uncommon in this herbal expertise. Henry VIII was merely doing for fun, and in grand kingly style, what every housewife in his kingdom did from necessity. Shakespeare's plays are stuffed with knowledgeable allusions to herbs: "give me mandragora and let me sleep". It was part of every gentleman's breeding to be familiar with them. Every good library in the kingdom possessed one of the fine new Latin herbals then in print, and in 1526 -- the year that Henry's eye first strayed to Anne Boleyn -- the Grete Herbal, the first English one, was published with the object, like the French work from which it was translated, of "enformyng how men may be holpen with grene herbs of the gardyn and wedys of the feldys as well as by costly receptes of the potycaryes prepared".(7)
Not all the herbals published in this and the following century were intended for home consumption, however. On the contrary, the vast majority were the work of physicians, surgeons, or apothecaries -- men professionally involved with medicinal plants, and anxious to have available in clear concise form all the most important information to be found in the works of Greek, Latin or Arab authors.
Authoritative and complete texts of Dioscorides -- as opposed to the scrappy and unreliable extracts the medieval doctor had had to rely on -- were considered essential, and Latin translations of the West's first herbal, often running alongside the Greek original, were among the earliest works on medicinal herbs to be printed. Other standard classic and Arab authors followed, white a French physician. John Ruellius, produced early in the sixteenth century the complete reference work De natura stirpium, in three fat volumes, "wherein he hath accurately gathered all things out of sundrie writers, especially the Greekes and Latines".(8)
But as time went by, it became clear that the great task of clarifying and collating, so far from being nearly complete, was hardly begun; that confusion was, if anything, being made worse by so many different attempts to impose some kind of order; and that the world was full of plants which Dioscorides had never seen and about which he had not a word to say -- a situation that at least one writer. Petrus Andreas Matthiolus, found so unnerving that he actually falsified the figures of some of these alien growths "to make them agree with Dioscori".(9)
We may suspect, too, that many of the physicians who wrote so happily and knowledgeably about medicinal plants were pursuing an academic hobby rather than adding to the general knowledge of their profession. Conrad Gesner (1516-1566), whose leisure for years was absorbed by "the great and general worke of plants" he planned, wats professionally far more fascinated by the exciting possibilities of the new chemical medicine, and wrote a book strenuously advocating it as early as 1552.
Another well-known writer on plants, the youthful prodigy Valerius Cordus (1515-1544), spent much of his brief life collecting and improving pharmaceutical formulae. When the physicians of Nuremberg enquired if they might see the result of all his researches, they were so impressed that the Senate ordered a collection of his Aromatics and Opiates, Confections anti Conserves, Cerates, Syrups and Electuaries to be printed as the first official pharmacopoeia, and it caused a stir in medical circles throughout Europe. "Disgusting polypharmacal messes", comments a modern pharmacist. "If the physicians and Senate were so favorably impressed with the superiority of this work, one cannot but wonder what must have been the character of the formulae that had previously been used."(10)
As for master surgeon John Gerard (1545- 1607), whose very name is almost synonymous with herbal in England -- who can doubt that if he had lived today, he would no more have thought of going in for medicine than of apprenticing himself to a plumber? He would have been a landscape gardener, a Peter Coats, a Harry Wheatcroft. Every line of his enchanting Herbal or General Historie Plantes, published in 1597, betrays the keen eye, the skill, the patience, and the enthusiasm of the born gardener. "Talke of perfect happinesse or pleasure, and what place was so fit for that as the garden place where Adam was set to be the Herbarist?"(11)
The fact was that apart from a few botanizing enthusiasts, most physicians in the sixteenth and seventeenth centuries were not interested in pursuing the study of medicinal plants other than on paper, in elegant herbals, and within the straitjacket confines of the humoral approach with its endless categories and subdivisions. It seems to have occurred to few of them to investigate for themselves the action of the abundant home-grown medicinal plants that were available in fresh, reliable form, test them singly on patients instead of in the combinations of dozens of herbs that doctors usually prescribed, and to make notes of the results.
Both indifference to and ignorance about their native medicinal plants seems to have been almost universal, confirming Paracelsus's angry conviction that physicians and apothecaries were only impressed by exotic imported herbs, while scorning those in the local hedgerow. In the preface to his 1542 work on medicinal plants, the German physician Leonhart Fuchs (1501-1566) took his colleagues severely to task:
"by immortal God, is it to be wondered at that kings and princes do not at all regard the . . . investigation of plants, when even the physicians of our time so shrink from it that it is scarcely possible to find one among a hundred who has an accurate knowledge of even . . . a few plants?"(12)
William Turner (1520-1568), himself a physician and a distinguished graduate of Cambridge, made the same point in his preface to the Herbal he published in 1551: in his student days, he said, he had found it impossible to learn the names -- Greek, Latin, or English -- "amongst the Phisicions of any herb or tre, suche wits the ignorance in simples at that tyme".(13)
Professional snobbery is the most likely explanation of this attitude. Perhaps at no time in history had the physician's training been so completely theoretical, with its emphasis on classical studies. The full degree course at Oxford or Cambridge lasted up to fourteen years (Thomas Linacre, Henry VIII"s personal physician, was thirty-two by the time he graduated), and included a solid grounding in the classics. Many of the wealthy young men who took up medicine went abroad to take their degrees, rounding off their education in the widest possible sense at Paris, Montpellier, Salerno, or Basel. Linacre himself was a Padua man, and a meticulous classical scholar, who had delved in Italian libraries for obscure early Greek medical texts to add to the canons of received knowledge, and published his own recension and translation of them.
The sheer length of his training must have convinced the sixteenth-century physician that all available medical knowledge was now at his fingertips. To men like these -- a well-bred and exclusively educated elite -- it was unthinkable that anyone less well-trained than themselves should dare to describe himself as a doctor. It was even more unthinkable that the homegrown herbs used by amateurs and by vast numbers of illiterate quacks might possibly be more effective than the grand compounds taken from Avicenna or Mesue which they prescribed for their wealthy patients.
And in the reign of Henry VIII these quacks and amateurs represented real competition to the physicians. It was bad enough that, as a result of the flood of herbals, doctoring with simples had become a fashionable amateur pastime:
"for now [say they] every man without any study of necessary artes unto the knowledge of Phisick: will become a Phisician . . . every man nay every old wyfe will presume, not without the mordre of many, to practyse Phisick."(14)
But as well as these presumptuous amateurs, England -- and London in particular -- was running over with self-styled medical practitioners of every kind.
There were, first, the surgeons, who had been making rapid strides professionally, since the invention of printing began adding to their knowledge and resources. Theoretically, surgeons were supposed to stick to surgery and leave internal medicine to the physicians, but many of them had quietly been developing into general practitioners under the very noses of the physicians. The brand-new scourge of syphilis had brought them plenty of profitable business, as well as a new class of customer, since syphilis cases were commonly referred to them: "upon the cure of Venereal disease . . . alone", it was reckoned, "the subsistence of three parts in four of all Surgeons in town depended".(15)
Hard on the heels of the surgeons proper, who had neither Guild nor Charter, came the barber-surgeons, a proud and independent City company who had obtained a Royal Charter in 1462; but they, in turn, were expected to confine themselves only to the lower reaches of surgery -- cupping, bleeding and tooth extraction, activities advertised to this day by the bloodred stripes of the barber's pole.
Next in actual importance came the apothecaries, who learned their craft as apprentices. The English apothecaries fancied that they knew quite as much about simple and compound medicines as any grand physician. Many of them probably did, but in hard fact, they were a mere cog in the wheel of the great and powerful Grocers' Company, who had received their Royal Charter even earlier than the barber-surgeons.
The apothecaries were expected to keep on hand stocks of all the drugs commonly used in medicine, from agrimony to unicorn's horn. But since their most profitable lines -- the sugar confections, spices, syrups and electuaries which kept for months -- were always being creamed off their business by the grocers, leaving them with deteriorating supplies of costly perishable drugs, many had no choice financially but to do a little prescribing on the side, and drum up extra business in that way.
Below these ranks of skilled or semiskilled practitioners there swarmed, according to the preamble in the Letters Patent which gave Linacre his College of Physicians,
"a great multitude of ignorant persons, of whom the greater part had no insight into physic, nor in any other kind of learning; some could not even read the letter on the book, so far forth, that common artificers, smiths, weavers and women, boldly and accustomably took upon them great cures, to the high displeasure of God, great infamy of the faculty and the grievous hurt, damage and destruction of many of the King's liege people."(16)
It was, one suspects, those illiterate smiths and weavers who particularly stuck in the physicians' gullet. But all the same, there was an obvious need for some form of supervision or control over this seething mass of practitioners, many of them foreigners. And although everyone could see it was unrealistic to insist on over-rigid lines of distinction in the country at large -- where people simply tended to call on whatever form of medical aid happened to be available -- London was another matter altogether, and its exploding population, which climbed from 30,000 to 200,000 during this century, made it particularly vulnerable to exploitation by quacks.
So it was with the full backing of both Henry and his minister Wolsey that the physicians pressed for legislation which would give them authority to deal with these abuses, and in 1512 Parliament passed the first of a series of acts designed to regulate the practice of medicine in London and the provinces. This Act dealt chiefly with London, restricting the practice of medicine within a seven-mile radius of London in the future to graduates of either Oxford or Cambridge, unless they had been licensed by the Bishop of London on tile recommendation of four physicians.
Six years later, in 1518, the College of Physicians was set up by Letters Patent, as the formal regulatory body which such legislation obviously called for; and in 1523 the existence and authority of the College were not merely confirmed by Parliament but actually extended -- at least in theory -- over the whole country.
Neither Wolsey nor Linacre can have supposed for a moment that this system of control, however sweeping in theory, could be made effective in practice. What it did, however, was set up administrative and legal machinery, lacking until then, by which the worst abuses mentioned in the first Act -- those practitioners threatening "grievous hurt, damage and destruction" to their victims -- could be dealt with. And this appears to have been the intention of Parliament.
It was not, however, the first object of the physicians, who following the very first Act of 1512 had almost immediately set in motion the first of a series of demarcation disputed which eventually touched off a sort of domino effect throughout the medical hierarchy: the physicians suing the surgeons for practising medicine. the surgeons rounding on the barbers for practising surgery, and both of them occasionally falling on the apothecary.
In another attempt to straighten out medical matters. Parliament passed two more acts in the early 1540s, the first of which reconfirmed the authority of the physicians, and gave them control over both surgeons and apothecaries; and the second of which formally united the Surgeons and Barber-Surgeons into one grand new Company, and gave them control over surgical matters in an area extending one mile around the City. As a sop to the surgeons, however, the barbers were now strictly forbidden to practice surgery.
These Acts, far from keeping everybody happy, simply produced a fresh crop of victims, since the surgeons, smarting under their new subjection to the physicians, but at least secure in their own rights, fell mercilessly upon some of the simple, unlicensed practitioners they felt were poaching in their preserves -- women who had been giving medicine "for helyng of womens papes" or "giving water to young children to heal cankers in their mouths", and a brewer named Margetson "for giving water to cleanse men's eyes [eyes]".(17) But it turned out that far from being the docile victims the surgeons had imagined, at least one of them -- the brewer -- had friends in high places, and the retribution of Parliament was swift and severe.
In an Act worded with biblical eloquence, it castigated the surgeons who "minding onely their own lucre, and nothing the profit or ease of the diseased or Patient, have sued, troubled, and vexed divers honest persons, as well men as women, whom God hath endued with the knowledge of nature, kind and operation of certain Herbs, Roots and Waters, and the using and ministring of them, to such as has been pained with customable diseases, as Womens Breasts being sore, a Pin and the Web in the Eye, Uncomes of hands, Scaldings, Burnings, Sore mouths, the Stone, Strangury, Saucelim and Morphew, and such other like diseases: and yet the said persons have not taken anything for their pains or cunning, but have ministered the same to poor people onely for neighbourhood and God's sake, and pity and charity.
This behaviour, the Act continued, wats in contrast to that of the surgeons who allowed many to "rot and perish to death for lack of help" because they could not pay; furthermore, "the most part of the persons of the said Craft of Surgery have small cunning, yet they will take great sums of money and do little therefore, and by reason thereof they do oftentimes impair and hurt their patients".
Since the greed and ignorance of the surgeons left a void in medical care for the poor, therefore, the Act proceeded to legalize an entirely new class of practitioners:
"it shall be lawfull to every person being the King's subject, having knowledge and experience of the nature of Herbs, Roots and Waters, or of the operation of same, by speculation or practice within any part . . . of the King's dominions, to practise, use and minister in and to any outward sore, uncome, wound, apostemations, outward swelling or disease, any herb or herbs, oyntments, baths, pultes and amplaisters, according to their cunning, experience and knowledge in any of the diseases, sores and maladies before said, and all other like to the same, or drinks for the Stone and Strangury, or Agues, without suit, vexauon, trouble penalty, or loss of their goods".(1)
The final words of the Act were a warning to the physicians, in turn, that they could not invoke any powers granted to them under previous legislation to meddle with the newly legalized herbalists: "the foresaid Statute in the foresaid third year of the King's most gracious Reign, or any other Act, Ordinance or Statute to the contrary hereof made in any wise notwithstanding".(18)
To schoolboys and doctors this Act has been known ever since as the Quacks' Charter. Modern herbalists, however, have called it the herbalists' charter, since the insolent greed of a handful of Tudor surgeons not only ensured the survival of their profession, but provided a flimsy legal roof under which it has sheltered and flourished to this day in Britain.
Three things are immediately remarkable about this Act. The first is its plain implication that outside the ranks of professional physicians, traditional medicine still flourished, and there were numbers of honest people -- women as well as men -- who were skilled and knowledgeable about herbs, and perfectly capable of providing a much-needed medical service for the poor.
The second is the quite astonishing range of diseases which these practitioners were to be allowed to treat -- a range far wider than that of the surgeon, in fact, since not only could they supply dressings, plasters, and ointments for "outward sores" and other disagreeable skin afflictions, but they could also give drinks -- which was internal medicine, the physician's province -- for three diseases. Any one of these three ailments would be serious enough in our time, and two of them were in Tudor days life-threatening: the stone, strangury (or pain and difficulty in urinating), and agues. Few remedies suggested by sixteenth-century physicians were effective against the agonies of the stone (literally, small calculi trapped in the kidney or bladder); patients who had been treated to no avail could choose either to continue suffering, or to undergo the surgical operation of lithotomy, or being cut for the stone -- all ordeal which even two centuries later, when it had been devel oped into a highly skilled, swift anti routine operation, the diarist Evelyn's brother died rather than undergo. There are, however, highly effective plant remedies for the stone -- an insignificant creeping plant called pellitory-of-the-wall (Parietana officinalis) being one of them -- and some of the City practitioners may have built a reputation for cures of the stone by using them.
Several herbs, usually with a marked diuretic action, have been found useful in urinary problems: the herbalists probably prescribed butcher's broom (Ruscus aculeatus), recommended by Dioscorides for such cases; horsetail (Equisetum arvense): or the tiny creeping scarlet pimpernel (Anagallis arvensis).
Ague in Tudor times was almost synonymous with malaria, which was then endemic in northern Europe. Although it was the milder of the two forms of malaria, caused by the parasite Plasmodium vivax, it was a debilitating disease, characterized by bouts of tertian, or recurrent, fever, which often led to chronic anaemia, and none of the classic treatments for it were very effective in the days before quinine. Plenty of country wise women claimed to have a cure for it, though; the nineteenth-century Dr. Thornton in his herbal tells the story of an old man who performed wonderful cures of ague and other diseases with the herb tormentil (Potentilla erecta), and became so celebrated for them locally that Lord William Russell gave him a piece of land on which to cultivate his miracle herb.(9)
The third point, and perhaps the most striking, to be made about this Act is that it makes plain that however contemptuous physicians and surgeons may have been of the herbalists with their simples, they had powerful friends in high places (Henry VIII included) who had a very considerable opinion of their skills, and thought that they deserved protection and encouragement -- and possibly patronage too.
The offhand way in which Parliament, by this Act, legalized the practice of scores of illiterate nobodies shook the College to its foundations, and although the Act had seemed to be directed entirely against the surgeons, many of them actually took advantage of its deplorably vague phrasing to extend their practice.
What was threatened by the Act, moreover -- as the doctors could see only too well -- was the authority of the proud physicians: how could it be otherwise if any old woman with a glimmering of knowledge or skill should be allowed to take on diseases by which distinguished scholars and gentlemen, with years of training behind them, were defeated?
More than a century later Dr. Charles Goodall (1642-1712), a Fellow of what had by then been raised to the dignity of Royal College of Physicians, wrote a long account of its gallant struggles against "Empiricks and unlicensed Practisers". Largely an exercise in public relations, Goodall's book was intended to prove that the College had been devoting its energies for decades to the extermination of unscrupulous and restless quacks, even when these were protected by the highest in the land, as an extraordinary number of them in fact appear to have been; and some fairly horrific accounts of mercurial excesses and backstreet abortion rackets emerge from it.
What is also clear is how seriously the College took the challenge to their professional status represented by the Quacks' Charter, and how savagely they hounded down the modest practitioners of traditional herbal medicine.
In 1581, for instance, the College pounced on "one Margaret Kennix, an outlandish, ignorant, sorry woman", whose practice in ministering to her neighbours and charging for her services too was stopped by the College.(20) It turned out they had caught a tartar: this sorry woman boldly complained to no less a person than the Queen. Now Elizabeth, as it happened, was just as much interested in medicine as her father Henry VIII, and just as much given to dabbling in pharmacy, having once composed a tonic for heart and brain containing amber, musk, and civet dissolved in spirit of roses, which she sent to the Emperor Rudolf II.
Elizabeth may have felt an amateur's sympathy for another amateur, she may have suspected that the physicians were needlessly tiresome and overbearing, or she may simply have had a flicker of fellow feeling for another woman struggling to keep her end up in a man's world. Whatever the reason, Elizabeth took a personal interest in this case, inquired carefully into the circumstances, and being satisfied that Margaret Kennix was no threat to her subjects' lives, directed her Secretary of State, Walsingham, to write to the physicians. It was, he duly wrote:
"her Majesty's pleasure that the poore woman shoold be permitted by you quietly to practice and mynister to the curing of diseases and wounds, by the meanes of certain Simples, in the application whereof it seemeth God hath gieven her an especiall knowledge."
There followed a courteous threat:
"I shall therefore desire you . . . to take order amongst yourselves for the readmitting of her into the quiet exercise of her small talents least by the renewing of her complaint to her Majesty through your hard dealing towards her, you procure further inconvenience thereby to your selfe."
The College was not inclined to take this lying down: they could not possibly reconcile it with their conscience, they wrote firmly back, to "allow either her [or any other person not qualified accordingly] to intrude themselves into so great and daungerous a Vocation . . . to the evident daunger of the life and health of such her Majesties most loving subjects, as shall be abused by their notorious and wilful ignorance".(21)
The College had their revenge on Walsingham for meddling when five years later, in 1586, he wrote again on behalf of an Empirick, asking them to have released from prison a man named Not, "forasmuch as both my self have heretofore used him, and divers other Gentlemen have also received good by him". In their reply, the College mentioned tongue in cheek that Not "protesteth openly (and that most infamously as we think and offensively to the credit and good name of such as admit him to their persons) that he dealeth with none but onely for the Pocks".(22)
By the end of the sixteenth century, however, the question of the unlicensed practitioner, though still a nagging preoccupation, was no longer foremost in the minds of the College physicians. The burning issue of the day -- an issue which split the College itself into two violently opposed factions -- was whether or not they could bring themselves to approve the new chemical medicine, which was rapidly making converts among professional physicians all over Europe.
[Reprinted with permission from Green Pharmacy by Barbara Griggs, published by Healing Arts Press, an imprint of Inner Traditions International, Rochester, VT, U.S.A. Copyright 1981, 1997 Barbara Griggs]
(1.) Sloane ms 1047 (BM), cited Blaxland Stubbs, "Henry VIII and Pharmacy: Part I", The Chemist and Druggist, 27 June 1931, p. 794.
(2.) LaWall, p 210.
(3.) Sloane ms 1047, op. cit.
(4.) Walpole, Correspondence with the Rev. William Cole (ed. Lewis and Wallace), p. 332.
(5.) Gerard, Herbal, cited Grieve, p. 828.
(6.) Ibid, pp. 525-6.
(7.) Preface to the Grete Herball, printed Peter Treveris 1526, cited Rohde, pp. 68-9.
(8.) Gerard, Herbal, "To the Reader".
(9.) Ibid, pp. 525-6.
(10.) La Wall, pp. 227-230.
(11.) Gerard, Herbal, "To the Reader".
(12.) Fuchs, De Historia Stirpium, preface, cited Arber, Herbals, p. 67.
(13.) Turner, A New Herball, preface.
(15.) Rosebury, Misrobes and Morals, p. 171.
(16.) Letters and Papers of the Reign of Henry VIII, 2, pt. 11, 4450.
(17.) Letters and Papers of the Reign of Henry VIII, 2nd Ed. xvii, 1255, cited Roberts, "The Personnel and Practice of Medicine in Tudor and Stuart England: Part II, London" MH, 1962, VI, p. 223.
(18.) Statutes of the Realm, 34-35, Henry VIII, c 8.
(19.) Grieve, p. 820.
(20.) Goodall, An Historical Account, etc. p. 316. ff.21.. ibid. pp. 317-8.
(22.) Ibid, pp. 320-1.
Article copyright American Botanical Council.