Thomas Phaer (c. 1510-1560) was something of a Renaissance polymath (Bowers, 1999, p.11). He was a physician, a legal theorist, a classicist, a man of letters, and an MP who served a few constituencies in Wales. In 1544 he published The Boke of Chyldren. It came to be a medical bestseller of its day, going into 27 editions between first publication and 1656.
Importantly, by publishing a book specifically dealing with children’s health, Phaer made a statement that children were deserving of special consideration as younger human beings. He saw children as especially vulnerable. Indeed, in his introduction he says: ‘My purpose here is to do them good that have moost need, that is to say chyldren’ (Phaer, 1544, p. 27). The Boke of Chyldren is generally regarded as the first book on paediatrics written in English.
By writing in vernacular English, we can see that Phaer was trying to reach a wide readership. He felt medical knowledge should be demystified and shared - it should not be purely the preserve of physicians. Writing in English rather than Latin also showed he felt it could be the language of ‘learned consciousness’ (Bowers, 1999, p. 11). We should remember that this was a time when the Bible was translated into English, and a time of the Protestant Reformation and upsurge in English nationalism under Henry VIII.
Phaer’s ideas were based on an amalgam of ideas, such as Galen’s work on the humours (see another of our posts), prayers, and folk medicine (using charms and herbs etc…). He wrote at a time when infant mortality was high, and disease was rife. It was also a period in which female influence over childbirth and infant care was beginning to erode.
Breastmilk
Wherever possible, Phaer argued that a child’s birth mother should breastfeed her infant as it was ‘agreing to nature’ (Phaer, 1544, p. 32). But he conceded that this was not always possible, so he provided detailed advice on what to look for in a wet nurse. His advice said the wet nurse should be: ‘sober, honest and chaste, well fourmed, amiable and cheerful’, not a ‘drunkard, vicious nor sluttish for such corrupteth the nature of the child’ (p. 33). There was a long-standing belief at this time that the milk an infant received was imbued with the personality traits of the nurse. Whilst this rather magical transference of objectionable traits to the infant might seem ridiculous to us, we suspect few today would want to entrust the care of their infant to a drunk, vicious, or slovenly caregiver. Sexual relations during the period when an infant was breastfeeding from its caregiver was generally frowned upon as it would result in the souring of breastmilk – hence Phaer recommends that a wet nurse should be chaste (i.e. avoid sex whatever their marital status). Whilst this might seem a tall order to our sensibilities today, sobriety, honesty and cheerfulness do not seem too much to ask of someone assigned to care for an infant.
The breastmilk of potential wet nurses was inspected for quality and Phaer offered detailed advice on what to look for. Their milk should not be: ‘thicke and gros, or to much thinne and watry, blackishe or blewe, or enclining to redress of yellow, and for all such are unnaturall and evill.’ He argued that a potential wet nurse’s milk should be tasted to check it was not bitter or sour as this would not be good for the child. The ‘ideal’ milk was ‘white and sweet, and when ye drop it on your naile, and do move your finger, neither fleeteth abrode at every stering [stirring], not will hange laste upon your naile, when ye turne it downward, but that which is between is best’ (Phaer, 1544, p.33).
Phaer was concerned about suckling directly from animals too. This was a practice that was not unknown when human breastmilk was unavailable. Drawing on the ‘wisdom’ of a Roman philosopher - Favorinus (c.80 – c.160 CE) – Phaer argued:
‘If lambes be nourished with the mylke of gootes, they shall have course wolle like the heere [hair]of gootes, and yf kyddes in lyke maner sucke upon shepe, the heere of them shal softe lyke woll. Wherby it doth appeare that the mylke and nouryshyng hath a marveylous effecte in chaungyng the complexion, as we see lykewyse in herbe and in plantes, for let the seede or ympes [cuttings] be never so good and pure, yet yf they be put into unkynde earth or watred with a noughty and unwholesome humour, eyther they come not up at all, or els they wyll degenerate and turne out of theyre kynde’ (Phaer, p. 32).
In effect, by suckling on an animal, Phaer cautioned that the bestial qualities of the animal might somehow transfer themselves to the infant – just as one would not suckle a kid goat on a sheep. No less than degeneration of humankind was at stake! Clearly, however, there must have been occasions when families had to resort to practices like this, desperate to ensure an infant would survive.
Food and medicine
The boundaries between food and medicine in the 16th century were far more blurred than is often thought today, so cures for common ailments often include advice on diet in The Boke of Chyldren. Phaer talks about children having ‘terryble dreames and feare in the sleape’ (nightmares), which he thought emerged from ‘stinking vapours’ from the stomach which find their way into the ‘senses’ of the brain. The cure for this, he felt, was to give the child a little honey, a little powder from the seeds of a peony and a little treacle mixed with their milk. This should be taken not on a full stomach, and sensibly, he advised the child should not be overly rocked afterwards as it might make them vomit (see Phaer, 1544, pp. 40-42).
A child suffering from shaking or a palsy of its arms or legs might be treated – if an infant – by attending to their nurse’s diet. A ‘hot and dry’ diet of spices such as nutmeg, ginger and mace and roasted meats was recommended (a clear linkage to the humours can be seen here). And the nurse should avoid foods such as fish and milk (as not hot and dry). Phaer’s book includes numerous recipes for ointments and potions which demonstrate that households made many of their own medicines – it was an essential part of the repertoire of the Tudor housewife. Cows’ dung seeped in cows’ milk laid upon a child’s swollen leg is a remedy long consigned to history.
Legacy
Thomas Phaer certainly put children on the map as deserving of special interest medically, owing to his belief they were particularly vulnerable and because he saw them as a different category of patient. He was evidently a man of compassion and had a strong sense of social responsibility, keen to share what he knew (albeit not all had access to printed books in the 16th century).
Such is the importance placed on his work, there is a memorial to him at the Church of St Llawddog, Cilgerran. The quoted text on his monument comes directly from The Boke of Chyldren.
References
Rick Bowers (ed) Thomas Phaer and the Boke of Chyldren, (Arizona: Arizona Center for Medieval and Renaissance Studies, 1999).
John Riddington Young 'The Father of Paediatric ENT', IXth Meeting of the International Society for the History of Otolaryngology at Heidelberg University on 11th September 2015. https://www.historiaorl.com/wp-content/uploads/2017/08/John-Riddington-Phaer.pdf (image of memorial from this source)
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