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date: 14 December 2017

Sickness and Writing in Early Modern England

Abstract and Keywords

This article explores the ways in which experiences of illness are conveyed in early modern English writing through the examples of three texts of autobiography: Isaac Casaubon’s Ephemerides, Lady Anne Clifford’s diaries, and Elizabeth Freke’s memoirs, the Remembrances. Drawing comparisons between these texts also emphasizes the challenges of seeing writing on sickness during this period as a cohesive category. While patient narratives have become widespread in recent decades and have even evolved into recognizable subgenres, early modern personal texts on illness cannot all be approached in the same way, and their records can be limited and fragmentary. A devotional impetus can be found in many diaries, but a memoir such as Freke’s also reveals the practicalities of illness and pain in the seventeenth and eighteenth centuries and the financial burden that treatment could entail.

Keywords: sickness, pain, illness, Isaac Casaubon, Anne Clifford, Elizabeth Freke, autobiography, diaries, memoirs

In the early summer of 1614, the classical scholar and ecclesiastical historian Isaac Casaubon was at work on an extended confutation of Cardinal Caesar Baronius’s 12-volume Annales Ecclesiastici (1588–1607). Casaubon was nearly as experienced in religious controversy as he was in philology, church history, and textual commentary. He had produced one volume already, published that year as De Rebus Sacris et Ecclesiasticis Exercitationes and dedicated to James I. Casaubon would leave the work, and many other projects, unfinished. Since the previous year, he had been suffering from an agonizing condition that his physicians, James’s own doctor Theodore de Mayerne and Raphael Thorius, struggled to diagnose. It presented with symptoms similar to those caused by calculi, stones formed by mineral accretions in the kidneys or bladder that gave the victim horrific pains, particularly when attempting to urinate (one famous sufferer later in the century, Samuel Pepys, held an anniversary dinner to celebrate the surgical removal of a stone). Casaubon did not respond to treatment, and his condition became more and more painful. He passed blood, mucus, and stones in his urine and developed a fever. One year after his symptoms began, he died (on July 1, 1614).1

The details of Casaubon’s final torments come to us from two main sources. One is his physician Mayerne’s manuscript account, posthumously published in a collection of his consilia (medical advice notes), letters, and observationes (case histories). The “Historia Morbi & Mortis D. Isaaci Casauboni” (History of the Illness and Death of Dr. Isaac Casaubon) gives a full account of his condition and also includes a report of the postmortem, in which Mayerne discovered that, next to his bladder, a second bladder had formed, six times the size of the first and full of stones and mucus; a picture of the diseased organ was printed at the end of the history.2 Throughout his account, Mayerne juxtaposes the physical observations and symptoms with the character of this “singularis eruditionis Vir” (man of singular erudition). The discomforts of Casaubon’s body increasingly interrupted his studies, but these in their turn had played their part in his sickness: “necessariorum naturæ immemor” (forgetful of the necessary calls of nature) while at his books, he aggravated his bladder condition.3 The connection Mayerne makes between Casaubon’s dedication to his scholarship and his neglect of his body is, as Nancy Siraisi has shown, an old topos.4 It would also be an effective and enduring one: In 1853, Mark Pattison’s pen-portrait of the scholar who had “pored over books till to desist was to make his existence a blank to everything except irritating longings after the forbidden fruit” and whose final illness was one “which no skill could have arrested, but which studious habits had doubtless developed with accelerated rapidity,” would influence the creation of George Eliot’s Mr. Casaubon in Middlemarch.5 Although Mayerne’s account shows Casaubon to be partly responsible for his suffering, it also memorializes his fortitude in the face of extreme pain.

The other source on Casaubon’s last illness is his own Latin diary, the Ephemerides, which he kept daily from 1597 until June 1614. It is remarkable among early modern diaries, not only for its unbroken coverage of such an extensive period but also for the fact that Casaubon continued to write in it during serious illness. On June 15, 1614, for instance, he notes that “Crescit vis morbi” (the strength of the illness grows) and, with the doctors prognosticating the worst, repeats a petition from the Lord’s Prayer: “Fiat, Domine, tua voluntas” (may your will be done, Lord).6 The last entry in his own hand makes for even more painful reading. Although he has been bled,

et nox præterita et totus dies per summos cruciatus sunt acti. Æquum est, justum est, Domine, quia ea est tua voluntas. Da patientiam, et leva cruciatus, si ita placet. Cæterum de studiis meis actum esse video, nisi aliter statuerit Dominus Jesus. Fiat hic quoque tua, O Deus, voluntas. Amen. [both last night and the whole day were gone through with the utmost torments. It is fair, it is just, Lord, because it is your will. Give patience, and relieve torments, if it so pleases you. I see that the rest of my studies are finished, unless the Lord Jesus were to determine it otherwise. May this your will also be done, O God. Amen.]7

Casaubon’s model for suffering is Christ in the Garden of Gethsemane: “Pater si vis, transfer calicem istum à me. Veruntamen non mea voluntas, sed tua fiat” (Father, if thou be willing, remoove this cup from me: neverthelesse, not my will, but thine be done).8 Christ’s example sanctions a simultaneous acceptance that his pain is part of divine providence and a petition for its relief (“si ita placet”). Casaubon’s choice of word for his pain, “cruciatus” (torments), is widely used in classical Latin, but, as he would have well known, in patristic and medieval Christian texts it takes on an association with the pains of martyrs or of hell, the former seeming the more appropriate resonance here (bearing in mind, too, the etymological link to crux, the cross).9 Even when in violent pain, Casaubon’s expression of it is mediated through the precedents provided by his faith and his reading. In the manuscript of the Ephemerides, bequeathed to Canterbury Cathedral library by his son, the scholar and divine Meric, Casaubon’s agonies are writ large on the page. In this entry, his normally compact handwriting has deteriorated to a spidery scrawl.10 Two more entries (for June 17 and 18, 1614) in another hand show that he was, for the first time, forced to dictate his words, while his silence in the last two weeks suggests the even worse suffering of a man who had previously not allowed illness to interrupt his many labors.

Casaubon’s diaries are some of the fullest autobiographical writings we have by a learned man in the seventeenth century, and the fact that they were still being composed during serious illness makes them particularly unusual: Casaubon continued writing until he was no longer able to do so. The Ephemerides are also distinctive in that they can be read alongside the remarkably detailed case history of Theodore de Mayerne. The accounts of a learned physician and an even more learned patient give a unique, comparable set of perspectives on how the experience of sickness was handled by a sufferer and his healer. Yet, as an exemplary case, the death of Isaac Casaubon also shows us the difficulties and challenges of approaching early modern writing on illness. Casaubon’s very distinctiveness as a diarist and as a scholar—a highly educated, multilingual virtuoso whose output was prodigious—means that one must be cautious about drawing wider conclusions about writing from his case. The urge to write about one’s sickness while one was experiencing it was not, if surviving texts give a fair picture, something that many of his contemporaries felt, and the records of it are sparse.

This article aims to construct a picture of the varied textual responses to ill health by comparing Casaubon’s case with two further examples of autobiographical writing from across the early modern period: Lady Anne Clifford’s diaries and Elizabeth Freke’s Remembrances. While, as journals and memoirs, they have something in common, their examples also highlight the problems of treating early modern writing on sickness as a category. While the recent growth of writing from a patient’s perspective has helped to highlight aspects of earlier texts that have been overlooked, and to provoke scholarly inquiry into them, modern illness writing has developed recognizable genres and subgenres (e.g., the American website Navigating Cancer’s directory of cancer blogs has thirty categories, organized by type) that early modern writing never had.11 To explore how the sick expressed and shaped their experiences on the page, one must turn to a diverse collection of sources—diaries, memoirs, letters, poetry, religious treatises, sermons, and essays—each of which brings its own conventions and expectations. Moreover, one must acknowledge their limitations: Most surviving personal accounts were produced by people of the middling and upper classes and hence give only a fragmented sense of what it was like to be ill in the early modern period; there is little evidence on poorer people’s experiences.

Given that much of this writing is in manuscript, accessibility has proven another significant determining factor in modern criticism. The frame of reference has been defined to a certain extent by modern publication and the efforts of individual scholars. For instance, Alan Macfarlane’s seminal work on the clergyman Ralph Josselin (1616–1683) and the subsequent edition of Josselin’s diary have provided the materials for a detailed study of the Josselin family’s experiences of sickness and health.12 Likewise, Raymond Anselment’s writing on and edition of Elizabeth Freke’s Remembrances have brought to prominence a figure whose poor health, intertwined with financial concerns and a troubled family life, came to dominate her self-perception.13 While women as sufferers and healers have received some recent attention—in particular Lady Margaret Hoby (1571–1633), Alice Thornton, and most recently Dionys Fitzherbert—male writers as patients have been less well served.14 In the case of Isaac Casaubon’s Ephemerides, the paucity of research reflects the difficulties of an untranslated Latin text, which has only been printed in one nineteenth-century edition. Another reason is the special role of women within healing settings. Although licensed physicians in England were all male, women were, as Lucinda McCray Beier has put it, “intimately involved with all the health incidents of humanity—illness, injury, childbearing, old age and death,” whether as paid or amateur medical practitioners; “within the domestic sphere, women were the medical authorities of seventeenth-century England.”15 Their treatment of the sickbed has thus become an important focus for understanding female roles in the household and the community. In the most recent scholarship, new avenues of exploration have been opened up through study of the humoral body and the generation of emotions, an area that offers many rich possibilities for an understanding of how illness is felt.16 The differentiating category of age in illness has been highlighted through the study of an important but neglected group of sufferers—children—also revealing how the voices of the ill can be transmitted through accounts of sickness recorded by others.17

The one English text to receive major scholarly attention from a literary and medical perspective is John Donne’s Devotions Upon Emergent Occasions, and Severall Steps in My Sicknes (1624).18 Donne, like Casaubon a patient of Mayerne, shaped his experience of illness (probably typhus) into twenty-three meditations, expostulations, and prayers, a devotional design that is ultimately Augustinian but is, at the same time, markedly original. While the exceptional nature of Donne’s text makes it a fine subject for substantial individual analysis, it also renders it less conducive to comparison with other works. Its composition alone is a startling feat: The entire 50,000-word text was written within a month and printed within two months of Donne’s illness. As with Casaubon, physical incapacity did not prevent him from writing, but the extent of his productivity and indeed the direct link between it and illness has no parallel in the period. For Donne, his body is a text on which God writes a commentary: “I know that in the state of my body, which is more discernible, than that of my soule, thou dost effigiate my Soule to me.”19 The preacher who cannot turn to his library of scriptural commentators must instead interpret each developing symptom as a cipher for sinfulness and the divine will. Although unique in its approach, Donne’s text does highlight the devotional intent that is at the heart of much illness writing. As we have seen, Casaubon’s expression of pain implicitly evokes the afflictions of Christians before him and of Christ himself as exemplary sufferer (a figure that Donne is reluctant to compare with his own pain). The bouts of ill health recorded in accounts such as Margaret Hoby and Ralph Josselin are likewise related to divine providence, although their theological complexion may differ significantly. The verse from Hebrews—“For whome the Lord loueth hee chasteneth, and scourgeth euery sonne whom he receiueth” (Heb. 12: 6)—was a motto of treatises on sickness as well as sufferers’ accounts. This frame of reference controls not only the way that information is conveyed but also the extent to which information is recorded. Lucinda McCray Beier’s remark about Hoby’s diary can be more broadly applicable to other writing about illness:

Illness, as an obstacle to spiritual exercise, was to be either ignored or dealt with as quickly as possible. Intrinsically it was not of sufficient importance to warrant detailed description. Only as a sign of God’s displeasure was it significant. [ … ] Illness was one of God’s tools for educating and chastising humans. Only in this context was it truly worth mentioning in a spiritual diary.20

The sometime frustratingly brief (for the modern scholar) accounts of illness should be seen in the context of why a writer is recording daily events and to what they are related. Nonetheless, accounts such as Casaubon’s and (as we shall see) Lady Anne Clifford’s show that devotional aims may be mixed with other motives for memorializing and record-keeping.

One further context necessary to an understanding of how illness and pain were articulated is the medical framework of approaches to suffering, still in the seventeenth century reliant on Hippocratic and Galenic theory. In the Corpus Hippocraticum—the collection of ancient Greek medical texts once ascribed to the founding father of Western medicine, Hippocrates—there is no sophisticated theorizing about pain, nor does it feature as a subject in its own right.21 For the first-century Roman physician Galen, pain was associated with the sense of touch and treated as an essential diagnostic tool, indicating an invisible internal disorder or the interruption of continuity through an injury such as a fracture, cut, or burn.22 The Persian Avicenna (Ibn Sina, died 1037), whose Canon was a standard textbook in medical faculties across Europe during the Middle Ages and Renaissance, classified fifteen types of pain including “compressing pain,” produced “by fluid or gas when it is confined in too small a space in a member and so compressed or squeezes the tissues,” “heavy pain,” caused by “an inflammatory process in an insensitive member such as the lung, the kidney or the spleen,” itching pain, pricking pain, and throbbing pain.23 While it gives qualitative descriptors for pain as a means of identifying a cause, Avicenna’s terminology does not reflect a wider investigation into the varied nature of physical affliction. There is very little discussion in the Hippocratic and Galenic tradition of the effects of pain on a patient, apart from its interferences with bodily functions. Vocabulary for pain thus provides an aid for diagnosis but has no intrinsic value as a means of expressing it. This attitude on the part of medical authorities may be another explanation for the relatively undetailed accounts that Beier describes.

Lady Anne Clifford

The inexpressibility and unsharability of physical pain is, as Elaine Scarry’s classic account argues, one of its essential attributes: It is fundamentally resistant to language.24 Yet the intellectual resources, theoretical and cultural models, and prevailing modes of thought available in a given period also shape the ways in which suffering and illness are conceived and described, as an analysis of the writing of Lady Anne Clifford (1590–1676) can show. In her final months, Clifford continued her accustomed habit of keeping a diary, dictating it to scribes, including her private secretary and steward Edward Hasell.25 One of her most frequently repeated entries is:

I went not out of the house nor out of my chamber today.

                          Ps. 121.26

We know that the previously active Clifford became immobile at some point between the end of the previous volume, late November 1675, and the beginning of this one on January 1, 1676. This typically terse statement says nothing of bodily symptoms, but the Bible reference is suggestive. According to the King James Version, this psalm expresses “the great safety of the godly, who put their trust in Gods protection”; it begins “I will lift up mine eyes into the hilles: from whence commeth my helpe” (Psalm 121: 1). The scriptural citation expresses faith and confidence in God and at the same time the need for divine help and protection. Interestingly, a reading of this psalm forms a major part of the Churching of Women (a thanksgiving after childbirth) in the Book of Common Prayer and thus may have had special associations with female preservation for Clifford, whose diaries show great pride in her two daughters and many grandchildren and greatgrandchildren.

Another frequently repeated entry is more explicit about physical illness:

I had a very ill fitt of the wind today, and yet nevertheless I slept well in ye night notwithstanding, I thank God.

                          Ps. 23. 4, 5.27

The Bible verses cited in this case are familiar ones for suffering and mortality:

Yea though I walke through the valley of the shadowe of death, I will feare no euill: for thou art with me, thy rod and thy staffe, they comfort me. Thou preparest a table before me, in the presence of mine enemies: thou anointest my head with oyle, my cuppe runneth ouer.

Although not part of the 1662 Book of Common Prayer burial service, the psalm has a strong association with preparation for death. Clifford uses scriptural citation to express her confidence in God and to register the seriousness of her physical condition. Her awareness of her proximity to death is shown in the psalm verses rather than her own words. It is noteworthy that her habit of coupling diary entries with references to scripture is much more frequent in this final diary of 1676 than in the earlier volumes of what she called her “Great Books.” An increase in piety with age and sickness may partly explain this. At the same time, the psalms provide a form of emotionally expressive language that is at once familiar and sanctifying. A frequent scriptural recourse for the sick in early modern England, the psalms give words for experiences of, and responses to, affliction—not only pain but penitence, fear, faith, thanksgiving, petition, and comfort. In Donne’s case, the beginning of Psalm 22—“My God, My God”—is heard repeatedly, but Donne resolutely uses it in the voice of the sinful David, not the crucified Christ (Matthew 27: 46); Psalmic language (“Why dost thou melt me, scatter me, powre me out like water upon the ground so instantly?”) allows him to reach the conclusion that “I am fallen into the handes of God with David, and with David I see that his Mercies are great.”28 The preacher at Clifford’s funeral, the Bishop of Carlisle, remarked that the Psalms held particular significance for her: “when Age had deprived her of the benefit of her Limbs; her hearing also being much decayed, her Chamber [ … ] was her Oratory,” and she had the daily Psalms from the Book of Common Prayer read to her: “she much delighted in that holy Book [the Psalms], it was her Companion, and when persons, or their affections, cannot so well be known by themselves, they may be guessed at by their Companions.”29 The citations from the psalms perform such a function in her diaries, making known and authorising her ‘affections’.

What was the nature of Clifford’s final illness? The “ill fitt of the wind” described by her does not simply mean flatulence. The term could denote a variety of conditions, many of them serious. The translator of a work on the subject by the Antwerp physician Jean Feyens claims that “there is no disease more usual and vexatious, chiefly in the North, and less understood by Physitians, though indifferently learned, then those of Wind” (interestingly, Clifford spent much of her life in, and strongly identified herself with, northern England, in her final months living at Brougham Castle near Penrith).30 The name indicates the perceived cause—excess wind within the body—of a variety of illnesses, which could affect not only the abdomen but also the head and other regions. The symptoms could include vertigo, ear pain, toothache, headache, and heart palpitations, as well as abdominal pains, flatulence, and diarrhea.31 Certainly, it could be fatal (it is likely, for example, that appendicitis and bowel cancer were diagnosed as wind). In Clifford’s case, we do not know whether she considered herself to be ill throughout the time of the last volume of her diaries nor whether the various fits of wind she records constitute part of the same condition or separate attacks.32 On January 6, she notes that “this morning after I was out of my Bed I had 7 or 8 great loose stooles downwards, which I thought did me much good, but withall weakened my Body so much that it cast me into a Swoning fitt.”33 This belief that the body’s purging of itself through evacuation is health-giving reflects a medical outlook still dominated by humoral theory. Indeed, this was the purpose of many remedies: As Beier remarks, the patient “expected a preparation to show its strength by producing an immediate result—usually in the form of multiple bowel movements or vomits.”34

The diary does not record in any great detail the circumstances of her physical condition, nor her reaction to it beyond thankfulness to God, faith, and (implicit) relief when her fits are over. She does not mention treatment by a physician. A local doctor, Thomas Ewbank, did visit her and dined with the household, but this may have been merely a social call; she notes that “I had him into my chamber and took him by the hand” (as she did with all male visitors), then paid him six shillings to see her Under Butler, Arthur Swindin, who was himself in his final illness.35 If she did consult him, she does not record it. However, one other entry for February that is not at first glance obviously medical does describe treatment:

And this 22nd day in ye morning, before I was out of my Bed, did I pare off ye topps of ye nails of all my fingers & toes, and when I was upp out of bed I burnt them in ye fire in ye chimney in my chamber.

And a little after in that same chamber of mine did George Goodgion clipp off all ye haires of my head, which I likewise burnt in the fire. And after supper I washed and bathed my feet and leggs in warm water, wherin beef had been boiled and some Brann. And I had done none of this for myself, nor had George Goodgion cutt my haire for mee since the 18th of December last that he did the like in this chamber of mine at Brougham Castle.

God grant that good may betide mee & mine after it.

                          Ps. 23. 4, 5.36

The near-ritualistic procedures are partly cosmetic, partly a process of the cleansing of the sick person and the sickbed: Clifford, perhaps here seeing death close at hand, prepares her body and destroys its excrescences. These treatments are also therapeutic, however, being in the class of “alteratives” (remedies that alter the body’s internal temperament and thereby strengthen it), a gentler category of treatments than purgatives (remedies that promote evacuation). Cutting off the hair cools the head, thereby encouraging the vapors produced by corrupt or burnt humors away from brain, where they can do the most damage, and also allows the application of ointments (e.g., for head melancholy Robert Burton recommends “Irrigations of the head shaven, of the flowres of water lillies, Lettuce, Violets, Camomile, wild Mallowes, wethers head, &c.”).37 Baths had a sound Galenic pedigree as a treatment, especially when the water had been boiled with something appropriate for the condition: “Some beside hearbs, prescribe a rammes head and other things to be boyled.”38 In Clifford’s case, the combination of bathing her feet and legs with cutting her hair suggests that she was attempting to move noxious vapors and excess heat from her head to the other end of the body, where they were less capable of threatening life. Her named assistant, George Goodgion, was not a medical professional but one of her household staff.

It is likely then that Clifford self-prescribed, no doubt while receiving medical advice from others. She was as well informed about illness and remedies as one would expect of a noblewoman of her day. Sixty years earlier, when Clifford received a letter informing her that her mother, Margaret Russell, was “exceeding ill, & as they thought, in some danger of Death,” her response was to send letter “& certain Cordials and Conserves,” probably prepared from her own collection of recipes.39 Her mother was herself learned in alchemy, and Anne would have inherited family receipts.40 In the triptych painting Clifford commissioned around 1646 to mark her final inheritance of the family estates in Craven and Westmorland, known as the “Great Picture,” the left-hand panel depicts her younger self, age fifteen, standing in front of shelves of books, among them The Epitome of Gerards Herball. This could be an alternative title for one of the printed short versions of John Gerard’s work, or possibly, as Rebecca Laroche suggests, Clifford’s own manuscript collection from Gerard.41 Yet, although medical knowledge forms part of her pictorial self-presentation, it is not displayed prominently in her own writing.

While Clifford keeps remarks on her own physical condition brief, she narrates another story of illness during her last diary entries. The anniversaries of all kinds of family events are commemorated in her writing—not only births, marriages, and deaths but also the hearing of news, journeys, visits to houses, and even rows (of which there were many) with her late husbands (of which there were two). The first months of 1676 saw a particularly careful cataloguing of past events, with the longest sequence starting in January:

The 12th Day. I remembered how this day was 59 years (since) my first and then only child the Lady Margaret, after shee had been in the garden of Knowl house in Kent, did in the night fall desperatly sick of her long Ague of which shee was in great danger of death, she then lying in a chamber in the tower there, which was underneath my chamber.42

In further entries, she repeatedly reminisces about the progression of this illness, usually in the same words: “the Lady Margaret was desperately sick and of a fitt of her long Ague.”43 The time of this illness (1617) was an anxious one for Clifford, in which her two-year-old daughter’s ague coincided with a crisis point in the long-running Clifford inheritance dispute as James I intervened to dissuade Anne from pursuing her case (not, it should be said, with any success).44 In revisiting this distressing experience in memory fifty-nine years later, Anne’s reflections contrast with the present evidence of a happy conclusion: Margaret completely recovered and in 1676 was herself a grandmother and a frequent correspondent, while Anne finally secured her inheritance in 1643 and was living in one of the castles she had acquired. Reminiscence also seems to have taken the place of activities she could no longer perform. Although she was still involved in the management of her estates, negotiating with local tradesmen and receiving guests, the formal nature of her remembrances indicates an occupation that she could carry out from her bedside. That said, the dates in 1676 said to mark fifty-nine years since Margaret’s fits of ague do not correspond exactly with the entries in the so-called Knole Diary of 1617; either she was consulting another source or her remembering was a purely internal process, in which individual dates were less important than a marking of the daily experiences of her past. That she chose to revisit her daughter’s infant sickness while confined to her bedchamber at the age of eighty-six might suggest parallels (Margaret stayed in her bedchamber for nearly four months, with the curtain drawn for at least three weeks) but could just as well mark a contrast to her own now-peaceful, contented life.45 One of the Bible references that she added to entries about her daughter’s illness is Ecclesiastes 3, which begins “To every thing there is a season, and a time to every purpose under the heaven. A time to be borne, and a time to die” (vv. 1–2).

Clifford was aware that her condition was serious. On February 20, noting that she had “one or 2 ill fits of the Wind,” she adds, “I thank God, but that wind put me in great danger of Death” and cites both Psalm 23: 4–5 and Psalm 121.46 Likewise, on March 19, four days before her death, she notes that she had “a very violent fitt of the wind, so that it caused me to fall into a Swouning Fit for about halfe an hour together, so as I thought I should have dyed, but it pleased God I recovered and was better afterward.”47 Like Casaubon, she continued to make entries. Casaubon’s physician Raphael Thorius added an account of his death, while in Clifford’s diary, a last entry for March 22 was made by a member of her household, perhaps Hasell: “after she had endured all her pains with a most Christian fortitude, always answering those that asked her how she did with—‘I thank God I am very well’—which were her last words directed to mortals, she, with much cheerfulness [ … ] yielded up her precious soul into the hands of her merciful Redeemer.”48 Her fortitude is characteristic, and so too, perhaps, is the contrast between what she is reported to feel and the attitude expressed in her final words.

Elizabeth Freke

The restrained accounts of illness in Clifford’s diary could not be further from the obsessive cataloguing of complaints that goes on in the Remembrances of Elizabeth Freke (1642–1714). A widow from 1706 and the owner of an estate in West Bilney, Norfolk, Freke was of less elevated status than Clifford and had nothing resembling the supportive network of extended family and household that Clifford had established; her relationships with relatives and servants were characterized by conflict and distrust. She was a long-term invalid who suffered from various chronic complaints including “tissick” (phthisic) and asthma, and later on rheumatism, pleurisy, and colic, and was for some years disabled. All of these were charted in two sets of manuscript Remembrances, now in the British Library, which cover approximately the same period but vary subtly; the later, revised version is kinder to the memory of her deceased husband, for instance.49 The textual conditions of these two accounts are in themselves important. The first (Add. MS 45718) is part of a commonplace book that also contains a compendium of remedies from Gerard and Culpeper, as well as unpublished medical sources, acquaintances, and family. Like Clifford, then, she took responsibility for treating herself and others: During an outbreak of smallpox in 1712, she records that “my cook maid dyed of itt stark madd in aboutt ten days time by the doctoers giveing her a vomitt when they [the spots] were coming out [ … ] But my own maid Martha recovered itt by Gods blesing on my endeavours.”50 The second account (Add. MS 45719) is alongside numerous financial lists; as Raymond Anselment aptly puts it, “medicine, money, and misery are inseparably woven into the life Elizabeth Freke constructs and reconstructs in the telling and retelling that characterize her remembrances.”51 As the account of smallpox suggests, she was suspicious of professional medical care even though she had periodic recourse to it. Her own activities as healer function, not in complement, but in opposition to the costly attentions of official doctors, and there is some pride in her success where they have failed. On one occasion, when her servant Henry Crutland “shott off his hand with killing of a pigion,” she records that

He lay under the hand of a surgion fowre months in a most sad condition; and then by his importunity and the parishes I took itt to cure, which I humbly thank my God I did—I effecttually did itt. He was the patients [patientest] creture ever I saw. He held his own hatt before his face whilst his fingers and wrist was sawed off and never cryded, oh, or shed one teare.52

Despite her graphic description, it is highly unlikely that the amputation happened under her care; more probably, she was present while the surgeon performed this and took over treatment when the wound failed to heal. Her position as Crutland’s employer and her reputation in the community give her the authority to act as healer at a time when medicine was become an increasingly professionalized. It is a sign of changing attitudes to medicine that the servant was treated by a surgeon for a full four months, rather than for the amputation alone.

A typical entry from late in Freke’s life (February 14 and 15, 1712) shows her attitudes to her own ill health, as she recounts how she was taken with “a violentt plurisy in my left side.” The next day she

sentt to Mr Smith to bloud me for itt att night in my bed; where before I could have any ease, I lost above threescore ounces of bloud att the age of above seventy years and have labouered ever since under soe violentt a cough and weakness as to bee unculpable of any business or comfortt. And with the violence of my cough for fowre monthes want of rest and soe much bleeding, I am allmost tottally deprived of my eye sightt, an insuportable griefe to me. And no friend neer me, tho I have this fowre monthes every day expectted my last summons, which with most humble patience I doe attend till my God shall release his miserable servant out of all my miseryes or raise me as he shall see good and best for Eliza Freke.53

By contrast to Clifford, Freke’s account is highly specific about her symptoms and the treatments she receives (at the hands of Edward Smith, a rural vicar who was also licensed to practice medicine and surgery).54 Despite her choice of professional medical care, her disapproval of Smith’s method is evident. For Freke, suffering accumulates, with the latest bout of her recurrent condition adding to preexisting bodily and emotional “griefs” in a breathless sequence of clauses. In documenting them, it is as if Freke is providing the full medical picture of predispositions, individual circumstances (such as age), and chronic ailments that the good early modern physician should take into account when treating any specific complaint, clearly not something that she thought Smith had done. In her friendlessness, too, writing provides an outlet for complaint and one suspects creates a chronicle and testament to vindicate her own position in the face of misfortune and mistreatment, even if it is posthumously. Many of the entries are initialled or signed, as if they were legal documents. One set of entries from August 1708 in the first version of the Remembrances tells how she came back to Bilney “weary and very ill” and “sent to Mr Smith of Winch to lett me bloude and to cutt off all my haire, both for my head and tissick” (as in the previous quotation, Smith is sent for to perform a specific medical procedure, not to give his opinion). Later in the month, Freke is summoned to court about a legal dispute and also notes that she has lost five coach horses “soe thatt now nesesitty will oblige me to stay att home since I cannott walke a foot.” She adds, “This is my hard ffate of Eliz Frek.”55

Freke’s response to her many adversities is to tell and retell them. They provide the impetus for her narrative as a whole, as her title indicates: “Some few remembrances of my misfortunes which have atended me since I were maryed (in my unhappy life), which was i4 of November i67i.”56 The worst experiences feature multiple times even within one version of the Remembrances. In the second version, her account of two years in which her grandson John was accidentally shot dead and her husband Percy died after a long illness is followed by a recap of the worst events: “And now give me leave to recon up the misfortunes I have undergone for this year past, i705 and six.”57 This is a rare moment where Freke acknowledges a potential reader. This might suggest that the act of memorializing has, for Freke, a more external outlook than Clifford, whose habit of marking anniversaries in her final months would seem to emphasize a personal exercise of recollection. Freke’s repetition of the years 1705–1706 is a process of “rec[k]on[ing] up,” a form of account-keeping. There is perhaps a greater unifying purpose to Freke’s writing too, in that it explicitly seeks to record misfortunes. The editor of her Remembrances, Raymond Anselment, suggests that she began to write the first version in 1702, perhaps relying on earlier notes, and that later entries were written soon after the entry dates, with the second version being started about ten years later.58 Volumes of Clifford’s writings exist for different periods, each of which has its own personal characteristics and emphases. Yet she too had an eye for external record-keeping, having three copies of her “Great Books” made; unlike Freke and Casaubon, who both wrote in their own hands, she dictated to various scribes.59 Modern categories such as diary, memoir, and even autobiography can be unhelpful descriptors for texts composed in the way Clifford and Freke operated, writing on some occasions soon after the event, at others days, months, or even years later.

Freke’s Remembrances recount the events of her marriage and widowhood through dated narrative entries, but there is a further way in which she records illness. Among the various financial accounts, inventories, and statements about personal property in her manuscript books there is “An account of what I laid outt on the sickness, death, and buriall of my deer husband, Percy Frek, Esqr.”60 This is a highly unusual form of illness writing, although one suited to Freke’s purpose of “reckoning up” misfortune, in which financial and medical concerns are interwoven. It gives us a detailed picture of how much serious illness could cost (for those who could afford it) and of the resources that a rural gentry household might use. Each entry includes the date, a brief narrative, and, in the right-hand column, its cost in pounds, shillings, and pence. Thus Percy’s first treatment after suffering shortness of breath on Christmas Day, 1705, was to be bled twice at ten shillings a time, which totalled one pound. There are payments for professional visits, for servants employed as “watchers,” for treatments in the form of food and drink (white Lisbon wine, old hock, and twelve shillings for “3 dosen of oranges and lemons”), as well as coals for the sick chamber and furniture.61 The frustrations in the practical arrangements for managing long-term sickness come through in entries for the new wicker chair and easy chair bought on March 30, 1706, “Neiter of which could my deer husband sitt in; they both were too strait [narrow] for him,” and for which Freke paid £5 10s.62 Freke’s own voice is heard strongly in this idiosyncratic account, most prominently in her responses to the medical professionals she engages. After a series of consultations by doctors, on February 22, 1706,

itt was agreed and consented to by my deer husbantt thatt I should send againe presently to Doctter Thomas Shortt of Bery a man and a horse and to Doctter Barker and Shelldrick of Sawfum; which I did. When itt was unanimously agreed thatt my deer husband should goe the nextt day to Saffum to be there murdered, as he was. For which I payd them all for this fattall consulltation  7-7-663

Despite the fact that the next day, when he is removed to Swaffham “to dye by artt,” he is given “soe strong a purge before I gott to him forced all the humours into his right legg” (a treatment that clearly alarms her), she continues to consult the same doctors in subsequent weeks. The bitterness is the accumulation of years of hindsight: This account of expenses was made in 1712, six years after Percy’s death, when—as we have seen—she reviewed this period repeatedly (an earlier version was completed in 1709).

The conflict between her suspicion of medical practitioners and her limited sources of help is expressed in the discontentment of her financial account of her husband’s illness and death. The early modern period has been characterized as a medical marketplace in which the sick and their families had recourse to a wide range of healers, professional and nonprofessional. Yet it must be remembered that in rural areas, opportunities were restricted by the personnel available. During Percy’s illness, Elizabeth sent for physicians in King’s Lynn, Swaffham, Norwich, and Bury St. Edmunds. The first two are within eight miles of Bilney, while the others are both about forty miles distant: two days’ ride, and hence a more significant cost. Joint consultation was a particularly expensive practice, open only to the elite sick, and Freke’s physicians were reputable; Barker, for instance, trained in Cambridge and the major Dutch medical university, Leiden.64 She was prepared to spend money, although resentful of doing so given the doctors’ perceived ill judgments, but did not have the resources to seek aid further afield, in London. In all, she calculated her expenses for his illness at £210 6s. 6d. With his funeral, the final account came to £1185 18s. Freke’s financial output, the tomb she commissioned, and the records she kept act as public evidence of her devotion, to match the sleepless nights spent at her husband’s bedside. Her expressions of grievance are also vindications of her own role.

If Freke’s list of expenses for oranges and easy chairs seems far from Casaubon’s anguished journal of his own dying a century earlier, this may remind us of the diverse ways in which sickness narratives were made in the period. Without the established forms of modern patient memoirs and blogs, the shared means of expression they have enabled, and the generic expectations they have created, earlier writing may appear crude or narrow in its approach to the experience of being ill, yet it also reveals a capacity for experimentation. We may point to major literary achievements such as Donne’s Devotions, or perhaps George Herbert’s “affliction” poems, as examples of this. Yet Freke’s compulsive telling and retelling of her misfortunes, Clifford’s recourse to scripture, and the textures of Casaubon’s Latin vocabulary form alternative and distinctive rhetorical methods of emotional expression, while narrative forms beyond their own control—the final diary entry after death by another, the physician’s historia—further enrich and counterpoint the testimony of their own writing.


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(1) Theodore Turquet de Mayerne, Opera Medica: In Quibus Continetur Consilia, Epistolæ, Observationes, Pharmacopeia, Variæque Medicamentorum Formulæ (London, 1703), 146–147.

(2) Mayerne, Opera Medica, 144, 154. Thorius also wrote an account, appended to Casaubon’s diary; see Isaac Casaubon, Ephemerides, ed. John Russell, 2 vols. (Oxford, 1850), 2: 1242–1249.

(3) Mayerne, Opera Medica, 144, 145. The tendency not to urinate for extended periods of time while working is now known as “nurses’ bladder.”

(4) Nancy G. Siraisi, History, Medicine, and the Traditions of Renaissance Learning (Ann Arbor: University of Michigan Press, 2007), 72.

(5) Mark Pattison, “Diary of Casaubon,” The Quarterly Review, 93 (1853), 499–500; see further Isaac Casaubon, 1559–1614 (London, 1875).

(6) Isaac Casaubon, Ephemerides, ed. John Russell, 2 vols (Oxford, 1850), 2: 1064.

(8) Bibliorum Sacrorum Glossa Ordinaria … cum Postilla Nicolai Lyrani, 6 vols (Venice, 1601–1603), Luke 22:42; translation from the King James Bible, in The Bible in English database (Chadwyck-Healey, 1997), All further Bible quotations are taken from this translation in this database.

(9) See, e.g., Augustine, De Civitate Dei Contra Paganos, 18.50: “varios cruciatus ac funera martyrum” (Patrologiæ Cursus Completus … Series Latina, ed. J.-P. Migne et al., 221 vols. (Paris, 1844–1903), 41: 612; “the many tortures and deaths of the martyrs”).

(10) Canterbury Cathedral Library, CCA-LitMs/D/1, fol. 271v.

(12) Alan Macfarlane, The Family Life of Ralph Josselin, A Seventeenth-Century Clergyman: An Essay in Historical Anthropology (London: Cambridge University Press, 1970); The Diary of Ralph Josselin, 1616–1683, ed. Alan Macfarlane, Records of Social and Economic History, n.s. 3 (Oxford: Oxford University Press for the British Academy, 1976); Lucinda McCray Beier, Sufferers and Healers: The Experience of Illness in Seventeenth-Century England (London: Routledge & Kegan Paul, 1987), 182–210.

(13) Raymond A. Anselment, “‘The Wantt of Health’: An Early Eighteenth-Century Self-Portrait of Illness,” Literature and Medicine 15 (1996): 225–243; The Remembrances of Elizabeth Freke, 1671–1714, ed. by Raymond A. Anselment, Camden Fifth Series, Vol. 18 (Cambridge: Cambridge University Press, 2001). The Remembrances were published in selected and altered version as Mrs. Elizabeth Freke Her Diary, 1671 to 1714, ed. Mary Carbery (Cork: Guy and Co. Ltd., 1913).

(14) See Beier, Sufferers and Healers, 211–241; Rebecca Laroche, Medical Authority and Englishwomen’s Herbal Texts: 1550–1650 (Farnham: Ashgate, 2009); Women, Madness and Sin in Early Modern England: The Autobiographical Writings of Dionys Fitzherbert, ed. Katharine Hodgkin (Farnham: Ashgate, 2010).

(16) See, e.g., Emotions and Health, 1200–1700, ed. Elena Carrera (Leiden: Brill, 2013).

(17) Hannah Newton, The Sick Child in Early Modern England, 1580–1720 (Oxford: Oxford University Press, 2012).

(18) See, e.g., Stephen Pender, “Essaying the Body: Donne, Affliction, and Medicine,” in John Donne’s Professional Lives, ed. David Colclough (Cambridge: D. S. Brewer, 2003), 215–248; Mary Ann Lund, “Experiencing Pain in John Donne’s Devotions upon Emergent Occasions (1624),” in The Sense of Suffering: Constructions of Physical Pain in Early Modern Culture, ed. by Jan Frans van Dijkhuizen and Karl Enenkel (Leiden: Brill, 2009), 323–345.

(19) John Donne, Devotions upon Emergent Occasions, ed. by Anthony Raspa (New York: Oxford University Press, 1987), 119.

(21) Peregrine Horden, “Pain in Hippocratic Medicine,” in Religion, Health and Suffering, ed. John R. Hinnells and Roy Porter (London: Kegan Paul International, 1999), 296–297.

(22) Roselyne Rey, The History of Pain, trans. Louise Elliott Wallace, J. A. Cadden, and S. W. Cadden (Cambridge, MA: Harvard University Press, 1995), 31–36.

(23) Avicenna, The Canon of Medicine, ed. Laleh Bakhtiar, trans. O. Cameron Gruner and Mazar H. Shah (Chicago: Great Books of the Islamic World, 1999),, 249–250.

(24) Elaine Scarry, The Body in Pain: The Making and Unmaking of the World (New York: Oxford University Press, 1985), 4.

(25) The Diaries of Lady Anne Clifford, ed. D. J. H. Clifford (Stroud: The History Press, 2011), 237 (hereafter, Diaries). The manuscript is on display in the home of Hasell’s descendants at Dalemain, Cumbria.

(26) Diaries, 239.

(27) Diaries, 272.

(28) Donne, Devotions, 12–13.

(29) Edward Rainbowe, A Sermon Preached at the Funeral of the Right Honorable Anne, Countess of Pembroke, Dorset, and Montgomery (London, 1677), 61.

(30) Jean Feyens, A New and Needful Treatise of Spirits and Wind Offending Mans Body, trans. William Rowland (London, 1668), sig. A4r. The original is De flatibus humanum corpus molestantibus (Heidelberg, 1589).

(32) Diaries, xi.

(33) Diaries, 241.

(34) Beier, Sufferers, 169–170; cf. Andrew Wear, Knowledge and Practice in English Medicine, 1550–1680 (Cambridge: Cambridge University Press, 2000), 39, 90.

(35) Diaries, 268–269.

(36) Diaries, 267.

(37) Robert Burton, The Anatomy of Melancholy, ed. by Nicolas K. Kiessling, Thomas C. Faulkner, and Rhonda L. Blair, with commentary by J. B. Bamborough and Martin Dodsworth, 6 vols. (Oxford: Clarendon Press, 1989–2000), 2: 253 (

(38) Burton, Anatomy, 2: 29 (

(39) On women as collectors and preparers of medical recipes, see Wear, Knowledge and Practice, 49–55.

(40) Penny Bayer, “Lady Margaret Clifford’s Alchemical Receipt Book and the John Dee Circle,” AMBIX 52 (2005): 271–284.

(42) Diaries, 244.

(43) Diaries, 264.

(44) This account is preserved only in a late eighteenth-century transcript; Diaries, ix.

(45) Diaries, 52 n. 36, 56.

(46) Diaries, 265.

(47) Diaries, 280.

(48) Diaries, 281.

(49) Remembrances, 20–23.

(50) Remembrances, 286–287.

(51) Remembrances, 1.

(52) Remembrances, 227–228 (July 1, 1691).

(53) Remembrances, 280.

(54) See Remembrances, 93 n. 154.

(55) Remembrances, 97–98 (August 10, 14, 22, 1708).

(56) Remembrances, 211.

(57) Remembrances, 252.

(58) Remembrances, 2.

(59) Diaries, xi–xii.

(60) Remembrances, 289.

(61) Remembrances, 289–304.

(62) Remembrances, 294.

(63) Remembrances, 291.

(64) Remembrances, 84 n. 134.