Heal Thyself: Nicholas Culpeper and the Seventeenth-Century Struggle to Bring Medicine to the People (review)

Although seventeenth-century English herbalist Nicholas Culpeper (1616–54) has been dismissed by many historians of botany as a quack and astrologer, he is convincingly established as a reformer of medical information and practice in Benjamin Woolley's lively account of his life and times. The work is particularly valuable as an analysis of the development of the medical professions during this period of political and social tumult, an epidemic of the plague, civil war, and regicide. The long digression on the contemporary career of anatomist William Harvey (1578–1657) gives Woolley the opportunity to contrast Culpeper's populist approach to medicine and treatment to that of the royalist Harvey, who was physician to King Charles. Woolley presents Culpeper as an outsider in many domestic, social, and professional circles, although this status did not appear to limit his accomplishments. When he received only forty shillings at his father's death and was unable to pay the fees to complete his apprenticeship and thus gain his freedom as an apothecary, Culpeper moved beyond the city walls of London and set up an unlicensed medical practice with the support of a wealthy, albeit strong-willed wife. Here he pursued his childhood interest in the common English herbs, believing them to be both efficacious and appropriate, following the doctrine of signatures. As Culpeper noted on the title page of his popular herbal, the native English plants were "most fit for English Bodies."

Woolley's work also provides a wealth of specific detail about the training and certification processes of physicians and apothecaries and the strained relationships between these two interlocked groups of practitioners. The intellectual environment of the time was one in which empirical knowledge was ridiculed because it challenged the a priori reasoning of such ancients as Galen. Under royal charter, the members of the College of Physicians were permitted to prescribe but not dispense medicine. Compounding and dispensing medicines was the responsibility of the Guild of Apothecaries (separately chartered from the Society of Grocers in 1617), although the physicians gained control over the apothecaries by overseeing their stock and specifying the composition of those medicines. The primary reference tool, produced by the College of Physicians, was the Pharmacopoeia Londinensis. First published in 1618, it included many elaborate preparations involving precious metals and unobtainable ingredients, and it was written in Latin, largely unintelligible to many apothecaries. Due to a combination of the expense of these ingredients and the limited number of doctors, formal medical treatment was beyond the reach of the poor.

Culpeper's unauthorized English translation of the Pharmacopoeia, first published in 1649 as A Physical Directory or a Translation of the London Dispensatory, enraged the College of Physicians. Not only did it note and correct the absurdities and inconsistencies in the list of ingredients and give practical information on the mixing of those ingredients, but it also provided information on what the medicines were for, which the original work had specifically omitted. Although medical information written in English was certainly uncommon, Culpeper's herbals were not the first and were preceded at least by the 1551 herbal of English herbalist William Turner. Turner defended the use of the vernacular, noting that when the ancients Dioscorides and Galen wrote in their native tongue, they did not give occasion for every old wife to take on the practice of medicine. The translation of the London Dispensatory continued to be popular, appearing in seventeen English editions between 1649 and 1718, with the Boston 1720 edition being the second medical book published in North America. The first was a 1708 publication of Culpeper's herbal.

With the encouragement of his printer, Peter Cole, Culpeper produced a number of other medical works, including a guide to midwifery, but he is best remembered for his 1652 herbal, originally published under the title of The English Physitian. Woolley begins each chapter with a lengthy...