Director, McMicken Health Research Center
Institution: University of Cincinnati
Email: meloncon at tek-ritr dot com
Description of Work:
When working in the discourses of health and medicine, my primary focus is on ensuring patients and others involved in their care understand the information they are given and therefore, they can act on it. I’ve started to call what I do patient experience design since it merges together the rhetorical aspects of language with a true focus on the patient, as well as combining the theoretical and practical aspects of my research and education (rhetoric, technical communication, user experience). Much of my work is geared toward improving patient engagement and outcomes through education and communication that is focused on patient experiences and knowledge in conjunction with the usability of information and technology. Patient experience design incorporates an adaptive collaborative model between patients and other participants in the design of patient education materials (such as doctors, researchers, technical communicators, nurses, clinicians, and others), and at its center it focuses on the quality of life and perceptions of the patients.
The impact of technology on information development and dissemination is one of my primary concerns as the technology is often representative of the spaces that enhance or impede the delivery of health information. Much of my theoretical thinking around this topic is currently in process in the project Tracing Medicine: Geographic Histories of Medical Discourse.You can learn more about my work in progress on my website.
Vernacular Health Healing: Making Medicine Through Rhetoric, 1540-1575
Why is it people believe in the “scientific” home remedy? What is the power of everyday medicine in the lives of people who are suffering or who are sick? What motivates people to believe in what, on the surface, appears to be an unbelievable home remedy? Where are the lines when it comes to what is considered medicine? In what ways are everyday medicines authenticated and codified in different cultural milieus? Here I hope to answer these questions, and others, by going back to England, ca. 1375-1575. I use early modern England in more liberal terms than current scholars. Rather than staying securely in the early modern era, after 1550, or confining my study to the medieval era, I instead bridge the gap,[i] which is vital to extend the existing histories of both medieval and early modern medicine.[ii] The dates I’ve chosen are important in the history of medicine from an English perspective. Around 1379 in a somewhat unusual move, Henry Daniel wrote an influential uroscopy in English rather than the more common Latin, and at the other end of the spectrum, with the publication of Philip Barrough’s Physic in 1583,[iii] the vernacular medical text was undergoing an important change as medicine was starting to become more scientific. This liberal interpretation of the early modern era provides a context for a key period in the development of medicine, and for a key period in the history of vernacular medicine. While no monumental discoveries were made (unless one considers Paracelsianism), medicine was distinctly practiced and interpreted. Thus, this transitional period helps to shed light on the appropriation of medieval medicine in early modern medicine while also pointing to, anticipating in some ways, the direction medicine would go in the seventeenth century.
To talk of early modern medicine is to illuminate much about the cultural and material history of sixteenth century England. To talk about early modern medicine means to understand constant metaphorical allusions found in the great literature that would follow in the late sixteenth century and through the Restoration. To talk of early modern medicine is to understand the epigrams by William Bullein and Susan Sontag written almost 400 years apart. The continuity in their perspectives illustrates key concepts and concerns of this study. Illness belongs to everyone in every time in every era in every place. We all hold it and it holds us. We are either ill or waiting to be ill. Yet, simultaneously, we experience an inherent hope for the promise of health and healing, and embedded in that hope is a belief in remedies and regimens and yes, even in old wives’ tales.
Medicine is everywhere in early modern England: in the literature, the history, letters, commonplace books and diaries and the records of the earliest books to roll off the presses. Take for example the large numbers of letters left behind by the Paston family. In their correspondence, mostly between the years 1422-1509, issues of health and healing are interspersed with discussions of family business and news of days. On September 28, 1443, Margaret writes to her sick husband John that she wishes she was with him so she could care for him during his illness. The letter’s postscript offers John medical advice: “be wel dyetyd of mete and dryngke, for that is ye grettest helpe that ye may have now to your helthe ward.”[iv] John Lydgate, the medieval poet and contemporary of Geoffrey Chaucer, wrote Dietary, which survives in some fifty-seven manuscripts and was printed by William Caxton as early as 1489. The poem, written in the first half of the fifteenth century, discusses food and nutrition, but it also includes references to the medical theory of the day. Illustrating the importance of diet in maintaining health and wellness, Lydgate writes, “Moderate fode gyveth to man his helthe/ and all surfetes doth from hym remeve.”[v] Of course, Chaucer could not be left out of the cultural obsession with health and healing so he includes a “doctor of physik” in his band of travelers to Canterbury. Chaucer’s physician was a “perfect practioner” because “He knew the cause of everich maladye, / Were it of hoot, or coold, or moyste, or drye, / And where they engendred, and of what humour” (ll.419-421).[vi]
Not even the King was immune from health concerns. As Derek Wilson claims, Henry VIII constantly worried about his health, even moving court when he heard rumors of disease.[vii] And Henry had good reason for his kingly paranoia having come to power because young Prince Arthur contracted the “sweating sickness” and died. The “sweating sickness” was feared in England, and in a letter dated August 19, 1517, Thomas More writes to Erasmus about a recent outbreak:
If ever we were in trouble before, our distress and danger are at their
greatest now, with many deaths on all sides and almost everyone in Oxford
and Cambridge and London taking to their beds within a few days and
the loss of many of my best and most honourable friends; among them
(which I am sorry to think will bring you sorrow too) our dear Andrea
Ammonio, … For this sweating-sickness is fatal only on the ﬁrst day.
I and my wife and children are still untouched, and the rest of my house-
hold have entirely recovered. But of this I can assure you: one is safer on
the battleﬁeld than in the city.[viii]
What all of these examples illustrate is that medicine, health and healing were part of early modern society just as they are today. In published literature and personal correspondence, health and healing are continuously on the minds of early moderns. In addition to extant discussions of medicine, we have at our disposal thousands of manuscripts and texts scattered in libraries around the world.[ix] What we will see as medical discourse is traced from manuscripts into print, that most medical discourse is a poly-vocal text, containing several texts on different subjects with related interpretations and commentaries. The resulting manuscripts are eclectic amalgamations in various hands and resulting “voices.” All of these texts help us to understand the magnitude of medicine and the pervasiveness of medical discourse into every facet of culture. Vernacular medical texts will us “in comprehending the ways in which culture shapes our sense of self in sickness and in health”[x]
[i] For other moves toward bringing the medieval into conversations with the early modern, see the Journal of Medieval and Early Modern Studies 37, no. 3 (2007), and also Gordon McCullan and David Matthews, eds., Reading the Medieval in Early Modern England (Cambridge: Cambrdige University Press, 2007).
[ii] See Nancy Siraisi, Medieval and Early Renaissance Medicine: An Introduction to Knowledge and Practice (Chicago: University of Chicago Press, 1990) and Faye Getz, Medicine in the English Middle Ages (Princeton: Princeton University Press, 1998).
[iii] Philip Barrough, The methode of phisicke conteyning the causes, signes, and cures of invvard diseases in mans body from the head to the foote. VVhereunto is added, the forme and rule of making remedies and medicines, which our phisitians commonly vse at this day, with the proportion, quantitie, & names of ech [sic] medicine. By Philip Barrough. (Imprinted at London : By Thomas Vautroullier dwelling in the Blacke-friars by Lud-gate, 1583). STC 1508.
[iv] Paston family. Paston letters and papers of the fifteenth century, Part I, Electronic Text Center, University of Virginia Library. Letter 126. http://etext.lib.virginia.edu/toc/modeng/public/PasLett.html
[v] In this tretyse that is cleped Gouernayle of helthe what is to be sayd wyth crystis helpe of some thynges that longen to bodily helthe, (Westminster : William Caxton, 1490?), Lines 75-76. STC 12138.
[vi] Geoffrey Chaucer, Canterbury Tales, trans. David Wright (Oxford: Oxford World Classics, 2008).
[vii] Derek A. Wilson, In the lion’s court: power, ambition, and sudden death in the reign of Henry VIII (New York: St. Martin’s Press, 2002).
[viii] Erasmus, The Correspondence of Erasmus Letters 594-841 (1517-1518), vol. 5, trans. R. A. B. Mynors and D. F. S. Thompson (Toronto: Toronto University Press, 1979), letter 623.
[ix] The Harley and Sloane collections at the British library are the largest collection of medical literature from this era. The Wellcome Library also houses numerous manuscripts. See the magisterial electronic resource by Linda Ehrsam Voigts and Patricia Deery Kurtz, Scientific and Medical Writings in Old and Middle English: An Electronic Reference. CD (Ann Arbor: University of Michigan Press, 2000), which has been updated and is available electronically at http://cctr1.umkc.edu/cgi-bin/search.
[x] Frank Husiman and John Harley Warner, eds. Locating Medical History: Their Stories and Their Meanings, (Baltimore: Johns Hopkins University Press, 2004), 1.