Having only focused on the administering of medicine, we decided to search for other examples of refined medical expertise. Interestingly, several of the receipts included by female compilers Sarah Jackson and Anne Battam focus on preventative techniques. It is hard to define a category under which this form of medical expertise falls. However, it is likely that mid-eighteenth century women and/or their readers participated in some form of experimentation surrounding preventative medicine. This might appear insignificant when compared with later discoveries of causation. Yet, the continuing use of preventative medicine shows us the prevailing desire to refine medical expertise.
In these instances, receipts containing statements of efficacy (displaying the success of the remedy) are the key identifier of female medical expertise. It is likely that these female compilers chose their receipts based on a number of factors, one being the likelihood of success. Due to these statements of efficacy being our main focus, this relates closest to the category of experimentation. Despite not knowing if these women wrote their own receipts, a statement of efficacy means someone has had to test the receipt and display its results. Perhaps the decision to include receipts containing preventative techniques within their efficacy statements shows their conscious decisions to engage with Galenic principles and move away from relieving symptoms.
In the seventeenth and eighteenth-century, discoveries of the cause of an illness was scarce. Diagnosis was unintended and, instead, a desire to be cured of the symptoms was sought. The analysis of symptoms predominated the field of medicine. Historian N. D. Jewson elaborates on this, explaining how ‘symptoms were not regarded as the secondary signs of internal pathological events, but rather as the disease itself’ (1). It is unsurprising, then, that when contemporary physicians such as Dr Sydenham instructed others to ‘cure the disease, and do naught else’, the obligation of the doctor was to simply cure the symptoms (2). This means that we are unlikely to find many examples of treatments which cure the ailment rather than relieve the symptoms or even attempt to prevent them.
Sarah Jackson includes a receipt that engages with the prevention of symptoms as opposed to relieving them. Despite including receipts by eminent physicians such as Sydenham, Jackson’s The director: or, Young woman’s best companion contains statements of efficacy in which certain symptoms are prevented prior to their occurrence. One example of this Galenic principle is the inclusion of Howe’s Water for the Stone. Under the circumstances in which there is a ‘Fit of the Stone’, the receipt claims that the medicine ‘will prevent the Fits’ (3). Similarly, The Yellow Salve claims to be efficacious in that it will ‘prevent proud Flesh’ (4). In both instances, the analysis of symptoms and preventative techniques are employed by the writer. Nonetheless, it does not yet treat the cause of the ailment (nor identify the cause of discomfort). Therefore, this is an example of Jackson’s involvement in female medical expertise. The likelihood of her having any involvement in the authorship of these receipts is slim. Despite this, she has actively chosen to include receipts that feature efficacy statements (a strong indication of previous experimentation). They are also examples of the successful prevention of symptoms, something which Jackson might have chosen to focus on when displaying receipts with effective results.
Notably, Jackson’s 1755 edition of receipts features one in which the title reads To prevent vomiting after Meat. The purpose of the receipt is clearly to focus upon the reader’s symptoms (as a result of eating meat). Noticeably, preventing the symptoms is not the most significant step away from orthodox medicine (particularly when compared to developments surrounding aetiology). Instead, Jackson perhaps included a receipt which conformed to symptom-based treatment because identifying a cause was (and still is) intensely complex and significantly costly.
Nevertheless, the receipt uses assertive language in its conclusion, which is a shorter version of an efficacy statement. By including yet another receipt proven to be successful at preventing illness, Jackson again becomes involved in medical expertise through experimentation. Not knowing whether she claimed authorship to this receipt does not take away the fact that Jackson has read and identified a receipt that outwardly displays its success as a result of experimenting.
There is a sense of disparity between both Sarah Jackson and Anne Battam in their approach to preventative medicine. Battam’s The lady’s assistant in the oeconomy of the table contains receipts with a more complex and refined approach to preventative medicine. In Battam’s inclusion of Locatelli’s balsam (in the 1750 edition), the efficacy statement maintains that the medicine is ‘good for inward bleeding’ (5). Initially, it can be observed that this receipt is conforming to orthodox medicine by relieving symptoms and following Galenic principles involving preventative medicine.
Additionally, by treating inward bleeding, the balsam treats the cause of further symptoms. The discomfort associated with internal blood loss is being prevented. While this is not identifying the cause of inward bleeding, it is preventing the cause of further illness. This is very similar to Sarah Jackson, in that both women appear to be actively choosing receipts that have been experimented on and their results displayed. Both women engage with female medical expertise not only through distant experimentation, but also through their focus on the medical treatment that was desired at the time. The symptoms associated with each ailment are relieved and prevented, proving that both Jackson and Battam resolved to find receipts that were desirable to their readers.
Furthermore, the inclusion of the receipt To make and use the antiscorbutick juices is the most noteworthy illustration of Battam’s engagement with preventative medicine. The title itself informs us of the purpose of the receipt, antiscorbutic being the adjective for ‘preventing scurvy’. During the 1730s and 1740s, developments were made towards identifying the cause of scurvy. Though it was not yet labelled as a Vitamin-C deficiency, it was argued that the illness was caused by a lack of fresh fruit and vegetables. Consequently, Battam (or her predecessor post-death in 1755) might have chosen to include this receipt in her 1759 edition because of the use of ingredients such as ‘sea-scurvy grass’, ‘horse-radish roots’, and ‘Seville oranges’, all of which conformed to contemporary ideas of the prevention (and aetiology) of scurvy (6). There is no efficacy statement accompanying this receipt, meaning we might doubt whether Battam (or her predecessor) chose a receipt that had previously been experimented on. Having said this, adjectives such as ‘antiscorbutick’ would advertise to the reader that this female compiler might have consciously decided to include a receipt whereby the experimentation is evident in the title.
Overall, both Sarah Jackson and Anne Battam convey female medical expertise through experimentation. The use of efficacy statements requires trialling in order to publish results. It is likely that these women acknowledged the experimentation involved in producing efficacy statements. This means that the receipts would have been perceived as highly reliable and effective in their preventing of symptoms. Circulating the importance of relieving and preventing symptoms was a well-grounded theory by the mid-eighteenth-century. Therefore, these women engaged with medical expertise by both highlighting the importance of experimentation and the outcomes of this, namely preventative medicine.
(1) N. D. Jewson, Medical Knowledge and the Patronage System in 18th Century England, Sociology (1974)
(2) Jewson (1974)
(3) Sarah Jackson, The director: or, Young woman’s best companion (1755)
(4) Jackson (1755)
(5) Anne Battam, The lady’s assistant in the oeconomy of the table: a collection of scarce and valuable receipts (1750/59)
(6) Battam (1750/59)