Women wrote about health, healing and the body in a variety of spaces in early modern England. When we look from the top down, that is from the perspective of a physician, we see few women healers, and even fewer women writers. However, if we start at the bedside, we see women involved in a wide range of healing activities, many of which they preserved in one form of writing or another. In order to understand the kinds of women's writings that have survived, we need to frame those texts in two larger contexts, that of medical work, and that of women's speech. Historians used to think that medical work in early modern England was organized the way that physicians imagined that it should be: with themselves at the top, overseeing their inferiors. We now recognize that vision for the fantasy that it was. There were many kinds of health care providers in early modern England. The basic four clearly identified occupational groups were midwives, apothecaries, surgeons and physicians. Of these, women were eligible for entry only into the ranks of midwives. They were barred from universities and thus from becoming physicians, and they were not apprenticed to surgeons or apothecaries. However, these groups represented only a portion of England's female healers. Many, many others practised in part-time or occasional fashion. Equally if not more important, many women were responsible for the health of their household, diagnosing, prescribing and preparing medicines at home. We will never know the full extent of women's health care practice, but women were a substantial portion of practitioners.

INTRODUCTION

From the Renaissance well into the nineteenth century, no ethics particular to medicine governed the patient–practitioner relationship in Europe and North America (see also Chapters 1 and 28). Although elite university-trained practitioners wrote treatises on topics that we now consider under the rubric of medical ethics, the day-to-day relationships between healers and the sick were shaped by two sets of more general social norms. First, the structure of early modern health care provision has been likened to a medical marketplace. In such a marketplace, medicine was a commodity like any other, and so medical interactions were largely structured by the rules of commercial interchange. Second, as in other social relations of the period, both patients and practitioners appreciated the mutual obligations of patronage and deference between people of different social groups. At times, the patient was the patron, and the practitioner a client, whereas at others these roles were reversed. From the seventeenth century, patients were sometimes understood as a group deserving of special protection due to their temporary or permanent disability.

THE MEDICAL MARKETPLACE

Over the past two decades, historians have become interested in the rank-and-file of medical practitioners and in the experiences of patients rather than just the elite of medicine. As a result of this broader canvas, they have come to describe health care provision in early modern Europe and North America as a medical marketplace (see also Chapter 27). Three key features characterize this model.

Today, science is something we think we recognize when we see it; it is a part of our cultural landscape. Regarded as easily distinguished from religion, it involves the production of new knowledge rather than the reproduction of faith. Science’s stated mission is to tell truths about the natural world – truths produced by trained scientists working in specific fields. There is much argument about details, but a single method is held to lie at the heart of its production.

The processes by which new scientific knowledge is diffused or reformulated for different audiences are also generally regarded as unproblematic. First elaborated and validated in specialist journals, scientific ideas are usually thought to make their way into undergraduate textbooks and subsequently, or simultaneously, undergo popularization or reframing for a wide audience. Newspapers, magazines, television, and radio help perform the task. Ultimately, a few scientific ideas become so widespread that they can be referred to in the shorthand of jokes or cartoons.

This commonsense model of the production and diffusion of scientific knowledge is something like a fried egg, sunny-side up. At the center, the self-contained yolk represents new knowledge generated by scientists. Surrounding this is a penumbra of ever-thinning white, representing diffusion. Finally, the crackly bits at the outer edge of the white – those jokes and catchphrases – barely resemble the self-contained yolk. As another historian has described it, the transfer of scientific knowledge is often seen simplistically as moving from areas of high truth concentration to those of low truth concentration.