and perfumes it provided an antidote to the aroma of the sickroom. Perhaps all too many physicians resembled Molie`re’s caricature of the physician, whose prescription for any illness was always ‘‘clyster, bleed, purge,’’ or ‘‘purge, bleed, clyster.’’ (Clyster is an archaic term for enema.) In Molie`re’s play Love’s the Best Doctor, we learn that ‘‘we should never say, such a one is dead of a fever,’’ because, to tell the truth, the patient died of ‘‘four doctors and two apothecaries.’’
Nevertheless, physicians were mastering the art of using new drugs, such as quinine and ipecac, while the introduction of New World foods, especially potatoes and corn, had a remarkable effect on health and population growth. The potato became the staple food of the poor in northern Europe, the British Isles, and Ireland. A one-acre plot of potatoes could feed a family of six all year. Over-dependence on a single crop has always been one of the risks of agricultural societies, as demon- strated by the Irish potato famine of 1845. (In 2001, scientists were able to use PCR ampliﬁcation of samples taken from historic specimens to identify the speciﬁc strain of the plant pathogen, Phytophthora infestans, that was responsible for the devastating potato blight.) Corn, which was usually called maize, or Turkish wheat, provided much needed calories, but also made pellagra (a nutritional disease caused by insufﬁcient niacin and protein in the diet) an endemic disease in many areas. Some New World plants, such as tobacco, were simultaneously credited with medicinal virtues and condemned as poisons.
Although mortality rates for this period are generally crude esti- mates, interest in the accurate measurement of births and deaths was growing. John Graunt (1620–1674), author of Observations upon the Bills of Mortality (1662), the ﬁrst book on vital statistics, attempted to derive general trends from the local Bills of Mortality (weekly lists of burials) and the records of marriages and baptisms kept by parish clerks. Graunt called attention to the fact that the urban death rate was greater than that of rural areas. Infant mortality, a good index of general health and sanitation, was very high: probably 40 percent of all infants died before reaching their second birthday. Renowned astronomer Edmond Halley (1656–1742), who was interested in the theory of annuities and mortality rates, noted that those who reached maturity should not complain about the shortness of their lives, because half of all those born were dead within 17 years. Nevertheless, the physical sciences had been transformed and it seemed reasonable to expect a similar revolution in medicine. To this end, physicians devoted to scientiﬁc research developed elaborate theories, which had little to do with the practical details of patient care. Thomas Sydenham, who has been honored as the English champion of clinical, or bedside medicine, provides an instructive example of a physician who recognized the growing tension between medicine as science and medicine as the care of the sick.