How did the older gentlewomen healers and caregivers of early modern England feel about providing hands on care when suffering illness and infirmity themselves? Amie Bolissian provides a historical perspective on being an ageing and infirm carer. [Content Warning: injury detail]

Image: Wikimedia Commons

Despite being disparaged as ‘quacksalvers’, or marginalised, witch-like ‘crones’ by qualified doctors, ‘old women’ played a crucial role in the care of patients at every level in Tudor and Stuart cities, towns, and villages. Most of these women were also usually suffering from some sort of illness or infirmity themselves. Why did these ailing women continue to care for the sick into their old age? Some, of course, may have needed the income for everyday subsistence. Parish records have shown that poor women with ‘nursekeeping’ experience might be pressured into caring for patients by the authorities, on pain of losing their own poor relief of money and food.[1] But what of wealthier older women, who cared for patients in their families and communities while also suffering from disease or disability? These women were entirely capable of paying for others to provide care, but they chose to persist, working on through feelings of fear, ‘grief’, pain, and discomfort. Why might this have been? Affection for an ailing relative may have played a part, and a feeling of duty towards kin and friends, but my research into diaries and letters has also revealed the particular importance of feeling ‘useful’.

An example of this can be found in the extensive writings of English gentlewoman Lady Anne Halkett (1623-1699), who suffered from extremely painful kidney stones, a chronic cough, and breathing problems but continued to care for the sick up until months before her death aged seventy-six. Former courtier and staunch royalist, Halkett was schooled in medicine and surgery by her mother – Jane Drummond Murray, previous governess to King Charles I’s children – and treated patients for most of her life. This included stints during the civil war, and within her community in Fife, Scotland, where she lived with her husband until he died at age sixty, then as a widow for a further 29 years.

Wax figure of Lady Anne Halkett at her desk in Abbots House, Dunfermline, Wikimedia Commons

Halkett made and distributed remedies, but her ‘meditations’ reveal that she also provided in-person care, day and night. Descriptions of her attending patients, including her own son, as she entered her seventies, show the toll that could take on her health – causing neck pain, cramps and worse. In 1696, at the age of seventy-three, she described a charitable care visit one evening but explained that, while she had little ‘paine or sickness’ at the time, after supper her painful ‘fitt of the stone… grew so much worse as I could get noe rest’. She eventually passed the stone, described as ‘a Pea & sharpe att one end’, and felt much better, but she directly linked her relapse with her caring labours.[2]

Directly after her ‘fit of the stone’, she wrote that she had declined to take in a sickly child for care because, as she put it, ‘I absolutely refused […] in the reason of my old Age & unfittnese to undertake new trouble of others when I had so mych of my owne’, referring also to her substantial debts. But then she had a change of heart. The pious Protestant wrote that she began to interpret the petition to help the child as a sign from God. ‘Perhaps’, she wrote, ‘the Lord in his Providence had sent this occation to lett mee see hee would have mee still continue to bee usefull to others.’ The word useful appears twice in this passage, and she also refers to her practice as doing God’s work.[3]

An old woman wearing a black veil; head and shoulders. Etching by or after Rembrandt van Rijn, 1631. Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

While the term ‘useful’ does not (curiously) appear in the King James Bible, the notion of being of use and in service to God was commonly expressed. ‘Useful’ as applied to a person appeared with greater and greater frequency in Protestant religious commentary over the seventeenth century. The theologian Richard Steele’s 1688 Discourse on Old Age suggested that before decrepitude set in, old age might even be considered the ‘best parcel of our Life’, because ‘our impetuous Passions being already spent, we are furnished by great experience to be very useful’.[4] Halkett may have felt that, as long as she maintained her ‘usefulness’ in her medical care-work, she might avoid entering the culturally dreaded decrepitude of extreme old age – what a contemporary diarist of hers, Lady Sarah Cowper, called the bitter ‘dreggs’ of life and what is now often referred to as ‘the fourth age’.[5]

Early English Books Online, Burke Library, Union Theological Seminary

Yet there were other routes to feeling useful for ageing women in early modern devout Protestant culture. Printed religious discourse, following the teachings of Cicero, assured the aged that, despite being infirm and unable to work as they formerly had, they could turn to studious, religious contemplation, edifying reading and writing, and a pious preparation for death – thereby avoiding ‘idleness’ which was considered a gateway shrug to sin. When describing the ideal old man, Steele recommended that ‘Aged men be sober, grave, temperate, sound in Faith, in Charity, in Patience’, but added, ‘The aged Women likewise, &c.’[6] As customarily found in published works, ‘old women’ were an addendum, an afterthought, a postscript, inhabiting the &c. This also occurred in texts on women’s health, where postmenopausal women past childbearing were found relegated to parentheses and consigned to caveats. On the rare occasions that old women were addressed in spiritual literature, they were urged to be exemplars for younger women. The cleric and author Thomas Becon, used the image of a mirror, claiming the ‘dutie of olde women’ was to ‘shew themselves … naturall myrrours of all godlines and honestie’.[7] To be useful, they could erase their own decrepit, post-menopausal, post-protagonist body by becoming a reflective surface representing a purely spiritual ideal for the reproductive-age women who mattered.

Page from Lady Anne Halkett’s ‘Meditations’, Image: Public Domain, https://www.bl.uk/collection-items/autobiography-of-lady-anne-halkett

As a devout, literate woman with visibility, and some means (despite her debts) Anne Halkett had access to these forms of cultural identity and validation in old age. Nonetheless, despite her prodigious efforts in spiritual writing and religious practices, something about her medical ministry still called to Halkett, and made her feel that she was truly the ‘worke’ of God’s ‘owne hands’.[8] It appears her characterisation of ‘usefulness’ was far more active and embodied than that recommended by religious doctrine.

My research has shown me that there is no doubt ageing women like Halkett, and others, believed their medical care-work was hazardous to their health and emotions, but the desire to be ‘useful’ to God, those they loved, and the wider community seems to have compelled them to continue. In a cultural context which largely ignored, vilified, or ridiculed older women, unless you were the actual Queen of England (and even then… ), they may well have gained a valued identity and sense of continuing relevance from their medical roles.

Amie Bolissian is a Wellcome-funded PhD Candidate researching ageing patients in early modern England, examining medical understandings of old age and the experiences of sick older people from c.1570-1730.

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1. See: Harkness, Deborah E., ‘A View from the Streets : Women and Medical Work in Elizabethan London: Women, Health, and Healing in Early Modern Europe’, Bulletin of the history of medicine, 82/1 (2008), 52-85, 66; Munkhoff, Richelle, ‘Poor women and parish public health in sixteenth-century London’, Renaissance studies, 28/4 (2014), 579-96, 587; Wear, Andrew, ‘Caring for the sick poor in St Bartholomew’s Exchange, 1580-1679’, Medical History; Supplement, 11 (1991), 41-60, 46. Also: Pelling, Margaret (ed.), The Common Lot : Sickness, Medical Occupations and the Urban Poor in Early Modern England (London: Longman, 1998), Ch.8: 179-202.
2. National Library of Scotland, Halkett, Lady Anne, ‘Meditations’ NLS MSS.6489-6502 (Mid seventeenth century), MS 6501, fol.246.
3. Halkett, Lady Anne, ‘Meditations’, MS 6501, fol.249.
4. Steele, Richard, A discourse concerning old-age tending to the instruction…of aged persons (London, 1688), 11.
5. Kugler, Anne, The Diary of Sarah, Lady Cowper, eds Lynn Botelho and Susannah R. Ottaway, 8 vols. (The History of Old Age in England, 1600-1800, 7; London, 2009), 87; Gilleard, Chris and Higgs, P., ‘Aging without agency: Theorizing the fourth age’, Aging & Mental Health, 14/2 (2010/03/01 2010), 121-28..
6. Steele, Richard, A discourse, title page.
7. Becon, Thomas, The sycke mans salve, (London: 1561), unpaginated.
8. Halkett, Lady Anne, ‘Meditations’, MS 6501, fol.246.