The Common Lot: Sickness, Medical Occupations and the Urban Poor in Early Modern England (review)

Margaret Pelling. The Common Lot: Sickness, Medical Occupations and the Urban Poor in Early Modern England. London: Longman, 1998. xiv + 270 pp. Ill. $30.00.

Twenty years ago, in a symposium organized to celebrate the fiftieth anniversary of the Johns Hopkins Institute of the History of Medicine, Charles Webster called for a new social history of medicine. Urging his colleagues to heed the advice offered some four decades earlier by Henry Sigerist, Institute director from 1932 to 1947, he challenged historians of medicine to widen the scope of their studies to include all forms and contexts of medical provision and all dimensions of the patient's experience.¹ By the time Webster issued his call he had already contributed to an impressive example of the new social history, a comprehensive examination of the broad spectrum of medical practice in sixteenth-century England coauthored with his former student Margaret Pelling.² Since that critical moment, Pelling has established her own reputation as a leading figure in the new social history of medicine, as she has plunged more and more deeply and with increasingly penetrating insight into the complexities of medical practice, sickness, and disability in early modern England.

The volume under review collects ten of Pelling's studies undertaken in the eighties and nineties. Seven of them were previously published as journal articles or book chapters; three are published here for the first time. All ten essays have been updated and revised in the light of increasingly sophisticated recent scholarship. Pelling also provides a wonderfully written introduction that sets out her basic approach to the social history of medicine and the themes of the present volume.

Many of Pelling's findings are stunning. She tells us, for example, that in the late sixteenth and early seventeenth centuries municipalities and parishes in various parts of England provided considerable medical service, regarding such expenditures as "legitimate an object of charity as losses by fire, or shipwreck" (p. 241). In Norwich, at least thirty-four of the city's numerous practitioners were employed at some time by the city, and more than one-third of these were women. Pelling also tells us that in the same period a system evolved for taking care of the infirm elderly by the "sharing out" of children. According to this system, the elderly lived in their own households apart from their married children, while "the alertness, mobility, and dexterity of children of pre-apprentice age . . . added greatly to the viability of . . . an elderly household with disabled members" (p. 149).

More speculatively but very persuasively, Pelling connects the rise of voluntary hospitals in the early eighteenth century with the decline of apprenticeship in the later seventeenth. Since masters were responsible for their apprentices in "sickness and in health" (p. 124), when the system of indenture with its attendant obligations began to change, other institutions may well have evolved to take over this shifting societal function. Most dramatically, Pelling connects the close association of late-sixteenth-century barber-surgeons with tradesmen concerned with dress and adornment, the selling of tobacco and alcoholic beverages, and the provision of musical entertainment, to the role of the barber-surgeon's shop as a public "place of resort" (p. 223). As social and economic crisis deepened, the demand increased for "such consolations as alcohol, gambling--and medicine. . . . the barber's shop, like the alehouse, may have emerged more strongly as another of the fragmented, commercialised alternatives to the parish church as a centre of communal activity" (p. 229).

These few samplings from its many riches should make clear why The Common Lot is so welcome an addition to the literature on the social history of medicine, and there is much more of solidity, subtlety, and depth. On the other hand, the book has its flaws and frustrations, most of which derive from its origin...