[Ed. Note: Happy New Year! Our first post of 2013 is from Dianne Mitchell, a Ph.D. student in the English Department at Penn]

Today, we’re going on a field trip.  It’s a trip that will take us beyond the hallowed walls of Van Pelt Library and into the nation’s first hospital: the Pennsylvania Hospital, founded by Ben Franklin and Dr. Thomas Bond in 1751.[1]  More specifically, we will be going to the Clinical Library of the hospital, a trip which involves a Hogwartsian journey up three flights of stairs to the Old Pine Building and then down another flight to the office of the Clinical Librarian.  Once arrived, we will be confronted with a mysterious item: R710 Ar5 a two-volume collection of twenty printed texts that can only be described with the qualifier “mostly”: mostly printed in London in the 1730s and 40s, mostly medical in character.

How this nonce collection – a book made unique by its particular selection and compilation of various published materials – ended up in Philadelphia in the library of the Pennsylvania Hospital is still something of a mystery.  The library’s catalogues reveal that the two volumes, along with two further volumes which couldn’t be located at the time of writing, were acquired by the library sometime between 1794 and 1806. The individual items in the volumes could have been compiled and bound by a librarian, but a glance through the minutes of the board of the Pennsylvania Hospital shows that large-scale efforts were being made to expand the library during this period; it seems likely that the nonce collection existed in private hands prior to its acquisition, and can be classed with other untitled volumes described in the minutes as being purchased at an estate sale, or willed to the hospital by a well-off local with a library.[2]


Pastedown and flyleaf of R710 Ar5 v.1 with manuscript table of contents.

What make the two volumes of this collection truly fascinating, however, are the hodge-podge of materials they contain.  We can begin to get a sense of this from the handwritten tables of contents in each volume , which include such titles as “Armstrong’s Art of Health a Poem” (the 1745 second edition of physician and poet John Armstrong’s The Art of Preserving Health: A Poem. In Four Books, printed for A. Millar [ESTC T22477]), and “Denoue’s Cat. of several curious of Human Anatomy in Wax” (A Catalogue Of Several Curious Figures of Human Anatomy in Wax, Taken from the Life [ESTC T149019] which accompanied an exhibition on view in London).

But to really understand the diversity of genres and subject matters contained within this strange collection, we need to turn to a few of the texts themselves.

The End of the Earl

Six items between the two volumes are connected with the man who would go down in history as England’s first prime minister: Robert Walpole, first Earl of Orford (1676-1745).[3]  While there is not any clear principle for the ordering of the texts within the two volumes (neither genre nor chronology govern the order, and pamphlet responses often precede the texts that prompted them), the compiler of the collection clearly wanted to create a subsection of the two volumes that brings together texts dealing, not with the life of the Earl of Orford, but with his death.

The first of these is John Ranby’s A Narrative of the Last Illness of the Right Honourable Earl of Orford (1745) [ESTC T28449]. Ranby (1703-1773), sergeant-surgeon to King George II,[4] attended the Earl in his final weeks, and claims at the opening of the narrative that his patient wished his sufferings to be made public (presumably) for the benefit of scientific knowledge.  The result reads, at least to someone who spends more time with self-consciously literary texts, like a parody of an epistolary novel:  we find Ranby supplementing his narrative with diary entries, a transcribed autopsy report, a copy of a letter from the Earl’s country physician to his physicians in town, and even an engraving of the Earl’s kidney stones, “the stone” being an ailment which recurs in various texts throughout the collection and which can be said to have contributed to the Earl’s death even if it was not the immediate cause.


Illustration of Kidney Stones from John Ranby’s A Narrative of the Last Illness of the Right Honourable Earl of Orford

What kind of responses did this intimate narrative, which dwells unflinchingly on the Earl’s tendency to urinate blood and his desire to be treated, like many of his time, with a seemingly endless series of “clysters” (enemas), generate?  In this collection, Ranby’s Narrative is followed by two anonymous and disgruntled publications, one titled An Epistle to John Ranby [ESTC T32848] and the other Advice to John Ranby [ESTC T21059].  The author of the first objects in no uncertain terms to what he reads as insinuations by Ranby that the Earl’s death could have been avoided if he had not taken advice and medicine from other surgeons present throughout his illness: “an unwary Reader,” he complains, “would be apt to conclude, that the bloody Urine my Lord so frequently made, after Dr. Jurin had visited him, was altogether occasioned by this Lixivious Medicine” (24).  Interestingly, the author of the second publication is less interested in defending a particular surgeon than in showing, via a kind of textual exegesis, that Ranby’s language throughout the Narrative is inherently impartial, despite the surgeon’s claims to the contrary.  He also reads Ranby’s detailed discussion of the Earl’s symptoms as an invitation to diagnose the Earl himself (the solution, he claims, would have been easy had the surgeons remembered a lengthy passage in Greek which he helpfully includes in his Advice).  These attacks prompted a cranky rebuttal by Ranby which forms the last item in the sequence of six “Orford” texts, the pithily titled An Appendix to the Narrative of the Last Illness of the Right Honourable the Earl of Orford [ESTC N30315].

The other two publications in the sequence have a less obvious connection to PaHospital2medicine.  Following the anonymous Advice to John Ranby we find An Authentick Copy of the Last Will and Testament of the R—t H—-ble E—l of O—-. With Remarks, [ESTC N43281?].  Anyone interested in the legal safeguards aristocrats construct for ensuring succession of property, or interested, for that matter, in how one might subtly leave large sums of money to a former mistress and her offspring, would enjoy reading this document, although it might seem a bit dry after all the gory details of the Earl of Orford’s painful last weeks in Ranby’s Narrative.  Meanwhile, the other publication, The Character of Pericles: A Funeral Oration [ESTC T108922], honors the late Earl through an allegorical comparison to the famous orator; naturally, his quality of voice is singled out for praise.  Perhaps we might read the oration (if this is the right term for a printed document) as a different kind of diagnosis of the Earl of Orford: one that seeks to come to a conclusion about the Earl based on evidence from his political life rather than from his medical complaints.

Preserving Health?

The variety of genres generated by the Earl of Orford’s death – narrative, will, oration, letter, and the like – begs the question: what is the best genre of writing for giving health advice?  The answer of the Pennsylvania Hospital library volumes would seem to be: all of them.

One interesting item in the second volume of the collection combines a kind of lab report with a well-researched but very heterogeneous “supplement” in order to present evidence about the efficacy of a nostrum for curing kidney stones (perhaps the remedy the Earl of Orford needed!).  An Account of Some Experiments and Observations on Mrs. Stephens’s Medicines for dissolving the Stone . . . To which is added, a Supplement to a Pamphlet, intitled, A View of the present Evidence for and against Mrs. Stephens’s Medicines, &c. [ESTC T18903] offers two very different approaches to “testing” whether or not this miracle cure is as miraculous as Mrs. Stephens claims.  Here is an excerpt from Part I, rector Stephen Hales’s account of his home experiments to determine whether it is the soap or the calcified shells or something else altogether that causes Mrs. Stephens’s medicine to dissolve stones (an undertaking which required Hales to acquires some real kidney stones from a friendly physician):

I cut twenty-seven pieces out of the above mentioned Stone A, which weighed severally from 3 to 14 Grains, and having put them into so many two Ounce Vials, which were mark’d with Labels pasted on them; I put into each Vial an Ounce of cold Urine, and then dropped into each Vial, from one to twenty-six drops of capital Soap-lees, according to the Number of each Vial respectively;and this was repeated every Morning with fresh Urine of the Night past (16).

It is to be hoped that none of Rector Hales’s parishioners walked in on his rigorously recorded experiments.

David Hartley, the author of the second part of the publication, moves beyond the world of test tubes, beginning his Supplement with an account of Mrs. Stephens’s background and transcribing a certificate produced by parliament providing her with a reward of £5,000 for her medical ingenuity.  Alongside case studies of real people cured by her medicines, Hartley describes his efforts to determine whether the medicine could be produced in a fashion that reduces unpleasant side effects for the patients.  This leads him to ask important questions such as, what is the best kind of soap to include in a medical recipe that calls for large quantities of soap?  Fortunately, he has an answer:

As to the Soap, Mrs. Stephens assures us from long Experience that Allicant[5] is preferable to any other of the foreign Soaps commonly sold in London, as CastileVenice, Naples, Joppa, both as to its dissolving Virtue and Agreeableness to the  Stomach. But I believe any of the above-mentioned foreign Soaps will answer, as they are all made of the same Materials with Allicant Soap, viz. Lime, fixed alcaline Salt, and Oil of Olives . . . ” (57).

If the idea of swallowing soap particles sounds unpleasant, it’s important to remember that another key ingredient of Mrs. Stephens’s medicine was snails cooked in a crucible.

We should be careful, however, not to read the collection as purely a compilation of prose accounts; after all, the first volume opens with John Armstrong’s The Art of Preserving Health, a poem so popular it was republished in Philadelphia by Ben Franklin the year after its first printing in England in 1744.[6]


John Armstrong (1708/9-1779) was a physician as well as a poet; indeed, it is said that his practice may have suffered following the publication of what the Oxford Dictionary of National Biography Online calls “a glowingly explicit sex manual in blank verse,” Oeconomy of Love, in 1736.[7]  The Art of Preserving Health, however, offers a more holistic and less controversial guide to wellness through four verse sections on “Air,” “Diet,” “Exercise,” and “The Passions,” each of which mingle didacticism with eloquent descriptions of how the body functions.  For instance, in Book IV (“The Passions”), Armstrong offers the following assessment of the body’s natural process of decay:

By its own toil the gross corporeal frame
Fatigues, extenuates, or destroys itself:
Nor less the labours of the mind corrode
The solid fabric. For by subtle parts,
And viewless atoms, secret Nature moves
The mighty wheels of this stupendous world.
By subtle fluids pour’d thro’ subtle tubes
The natural, vital functions are performed.
By these the stubborn aliments are tam’d;
The toiling heart distributes life and strength;
These the still-crumbling frame rebuild; and these
Are lost in thinking, and dissolve in air (105).

If we take a poem seriously as a form of medical advice, as I think the collection invites us to do, we might read this Augustan poetic body as a kind of stand-in for our physical bodies.  Armstrong seems to suggest that if we treat our bodies with the successful combination of evenness and variety that this poem offers even in its descriptions of weakness and vulnerability, we would all be able to preserve health.

Much more could be said about the twelve other items I haven’t discussed, which include a history of the mandrake, a defense of “tar-water” as a form of medication, a record of legal proceedings against a physician in Bath, and a treatise on diseases of the eye.  We could engage in endless speculation about what exactly compelled the original compiler to draw these diverse materials together – but sadly, it’s time to end our field trip.

[1] “About Pennsylvania Hospital.” http://www.pennmedicine.org/pahosp/about/

[2] My research suggests that they were NOT included in the famous Byrd bequest of 1800: see http://www.uphs.upenn.edu/paharc/timeline/1751/tline4.html for more details.

[3] Taylor, Stephen. “Walpole, Robert, first earl of Orford (1676–1745).” Oxford Dictionary of National Biography. Ed. H. C. G. Matthew and Brian Harrison. Oxford: OUP, 2004. Online ed. Ed. Lawrence Goldman. Jan. 2008. <http://www.oxforddnb.com/view/article/28601&gt;.

[4] Power, D’A. “Ranby, John (1703–1773).” Rev. Michael Bevan. Oxford Dictionary of National Biography. Ed. H. C. G. Matthew and Brian Harrison. Oxford: OUP, 2004. Online ed. Ed. Lawrence Goldman. <http://www.oxforddnb.com/view/article/23106&gt;.

[5] Soap from Alicante in Spain.

[7] Sambrook, James. “Armstrong, John (1708/9–1779).” Oxford Dictionary of National Biography. Online ed. Ed. Lawrence Goldman. Oxford: OUP, 2004. <http://www.oxforddnb.com/view/article/660&gt;