A POLITICS OF THE SENSES: THE POLITICAL ROLE OF THE KING’S-EVIL IN RICHARD WISEMAN’S SEVERALL CHIRURGICALL TREATISES
Introduction
For many centuries, English monarchs maintained the ability to cure their subjects of the King’s-Evil, a disfiguring illness caused by Mycobacterium tuberculosis resulting in painless neck masses which would grow until ulceration. The healing of this affliction was an important royal practice, maintained in order to legitimise the English monarch’s right to rule.1 Using Richard Wiseman’s 1676 text Severall Chirurgicall Treatises (hereinafter ‘SCT’) as a counterpoint, this article aims to examine this practice within the context of Restoration England. Close reading of the text highlights the contemporary evolution of the curative act away from royal prerogative towards the primacy of medical care, bringing to the fore the increasing sufficiency of the medical praxis.
As Sergeant-Surgeon to the King, Richard Wiseman represents a unique figure: he is meant to assess and treat those presenting to his surgery with the King’s-Evil, but also to refer them on to the King for a miraculous cure should they be refractory to treatment. Given the growing shift in attitude away from the monarch’s primacy in curing scrofula, Wiseman’s source-text provides an interesting lens into how he navigated this evolving dual role.
A disease by many names: the King’s-Evil, Present and Past
The King’s-Evil is but one name for a disease affecting the lymph nodes of the neck: it has historically also been known as strumae or scrofula.1 Known to physicians today as tuberculous lymphadenitis, the King’s-Evil is now understood to be a sequela of infection by bacteria of the genus Mycobacterium.2 Often, but not always, this occurs due to the reactivation of M. tuberculosis, the causative agent of tuberculosis; however, clinical disease may manifest itself after primary infection from bovine tubercle bacilli subsequent to ingestion of contaminated milk, as well as infection with nontuberculous mycobacteria.2,3 Infected lymph nodes form painless granulomas which undergo a form of necrosis, predisposing them to ulceration if left untreated. This ulceration accounts for the disfiguring dermatologic manifestations of the King’s-Evil (Figure 1). Recent literature has shown that spontaneous resolution of untreated infection with nontuberculous mycobacteria occurs in approximately 90 percent of paediatric cases4, a finding which may underlie the historically high rate of ‘miraculous’ cures.1
In Restoration England, the aetiology of the King’s-Evil was more equivocal in nature. Richard Wiseman’s contemporary, the noted surgeon-in-ordinary to Charles II and plagiarist5 John Browne, espoused an explanation based in humoral theory which acknowledged a disequilibrium of the diet – insofar as it was too cold, moist, and plentiful – as the causative factor of the King’s-Evil.1,6 Browne treated his patients with "purging potions, diuretick decoctions, and specifique alterant drinks”6, aiming to balance the ‘cold, moist’ cause of the King’s-Evil with a “hot and dry”6 cure. Earlier evidence of this manner of approach to treatment of the King’s-Evil can be noted during the Elizabethan era, in William Clowes’s 1602 publication on the same. In his treatise, Clowes offers phlegmatic purgatives and blood-letting, inter alia, as forms of treatment.7
Les Rois Thaumaturges in England
[…] strangely-visited people,
All sworn and ulcerous, pitiful to the eye,
The mere despair of surgery, lie cures,
Hanging a golden stamp about their necks,
Put on with holy prayers : and 'tis spoken,
To the succeeding royalty he leaves
The healing benediction. (Macbeth, IV, iii)8
Despite the increasing role of medicine in the treatment of the King’s-Evil, healing by virtue of the miraculous touch of the King remained perhaps the best-known ‘cure’. William of Malmesbury recounts the first-recorded use of this thaumaturgic (from the Greek θαῦμα “miracle” and ἒργον “work”) touch in De Gestis Regum Anglorum by King Edward the Confessor (1003-66 CE), which was corroborated by later biographies.9,10 In this account, a woman supplicates King Edward to heal her swollen neck glands. The king moistens his fingers with water, signing the cross on the affected portions of her neck, which immediately causes sanies to be discharged from her wound; within a week, the woman is healed.9 Thus began a controversy as to the source of the king’s power to heal what would become known as the King’s-Evil: was it by virtue of his saintliness proper, or was this quality afforded to him by virtue of his royal blood? This controversy was a politically salient one: individually-linked miraculous powers were of little political use, whereas dynastically-linked healing could be harnessed as a political tool. William of Malmesbury himself addresses this debate, endorsing the view that the king’s saintliness as its source:
unde nostro tempore quidam falsam insumunt operam, qui asseverant istius morbi curationem non ex sanctitate, sed ex regalis prosapiae hereditate fluxisse (p.273).9
This can be rendered as:
Whence in our time, some falsely bestow upon these works the assertion that [the] disease is not cured out of [Edward the Confessor’s] holiness, but flows instead out of the [graces of the] royal hereditary lineage (author’s translation).
By the 14th century CE, however, the debate was all but settled in favour of linking the thaumaturgic touch to the dynastic lineage. In his treatise Octo Quaestiones de Potestate Papae, William of Ockham (1285-1347 CE) links the dynastic power of the English monarch's ability to heal the King’s-Evil to the act of unction during the coronation ceremony (p.164).11
Unction is a central act of the English coronation service, during which the monarch’s body is anointed with holy oils of the Catholic tradition.1 This English custom was likely borrowed by way of the Franks. Charlemagne (742-814 CE) was the first Frankish monarch to be consecrated emperor through the imposition of the crown and anointing with holy oils10 by a member of the catholic apostolic succession. In Charlemagne’s case, this was by Pope Leo III, but it was more commonly performed by a bishop. By the ninth century CE, this practice had spread to England (p.7-8),1 where monarchs were anointed with the oil of catechumens and chrism, most notably on the hands (p.59).12 The anointing of the hands is a unique aspect of the coronation service, insofar as it is the only Christian liturgy other than the ordination to the priesthood that anoints the hands. By the coronations of James I (1566-1625 CE) and Charles I (1600-1649 CE), the prayers and hymnody drew explicit attention to this fact (p.7).6 As Marc Bloch describes, anointing made the coronation an “acte sanctificateur par excellence” (p.93)10 by placing the monarch in the same topographic space as priests. There is a substantial discourse demonstrating the parallel being drawn between the priestly miracle of transubstantiation, the liminal moment in Christian worship whereby bread and wine are believed to be transformed into the flesh and blood of Christ, and what the monarch accomplished with their hands namely, healing those afflicted with the King’s-Evil.13,14
It would be tempting to assume that the rhetorical link between transubstantiation and the thaumaturgic touch – and thus, the primacy of this ritual act – suffered irrevocable damage during the period of the Protestant Reformation. This assumption may have been particularly salient after the Act of Supremacy of 1534 – which separated the governance of the Church of England from the Pope – and the general Protestant distaste for the doctrine of transubstantiation. However, the reality is slightly more opaque: as Simon Werrett shows, the political expediency of the healing act is arguably the reason why the thaumaturgic touch was retained while other paraliturgical practices fell into disuse in Protestant England.1,13,14 Elizabeth I’s thaumaturgic touch, for example, was used as evidence that the papal bull Regnans in excelsis, which excommunicated her from the Catholic Church, did not withdraw the English monarch from a state of Divine grace (p.9).1 Given its status as a political tool, the thaumaturgic touch was also liable to imitation by folk healers and claimants to the throne (p.12-16)1, and it was thus guarded very closely by the ruling dynasty.
In order to examine the role of ‘King’s-Evil as politics’, it is necessary to mention the overall conception of the body politic in mid-17th century CE England. As Simon Werrett asserts, society was conceived in corporeal terms, with the people as the body and “the King as their head” (p.380).14 A politics of representation is thus established under which the ritual of the thaumaturgic touch is subsumed: the head – the monarch – maintains its autonomy over the body – the people – through the curative act.13,14 When Charles I was beheaded in front of the Banqueting House at Whitehall, it presented a unique problem for the dominant hermeneutic of the time: in the beheading act, society was left both literally and figuratively without its head, and thus without its ability to heal (p.381).14
By the time the monarchy was restored in 1660 and Charles II (1630-1685 CE) occupied the throne, “the discourse of divine kingship became one amongst many languages of power, no longer a natural or revealed mythology, but an ideology designed to persuade” (p.382).14 The medicalised language of healing was a natural fit for Charles II, who used it as a materia medica of sorts for reconciliation in a post-Cromwellian England.14 In the Declaration of Breda (1660), Charles II wrote of wounds which “kept bleeding” and needed to be “bound up” (p.57).15 Playing on the perception that a dismembered body politic was just as immune to the salvific grace of God as a dismembered body, the performative act of the thaumaturgic touch flowed naturally from this need to staunch a “bleeding” England. With a plurality of syntaxes of power, it was necessary to fashion the thaumaturgic touch into a theatrical and impeccably choreographed ritual. Assessment by the King’s Sergeant-Surgeon and written proof from the ill person’s parish of residence assenting that they had not heretofore been touched by the monarch – lest a prior (failed) thaumaturgic touch be seen as a threat to the integrity of this ritual syntax of power – were soon prerequisites for any afflicted subject wishing to be touched for the King’s-Evil (p.383).14 Lending itself to the theatrical nature of the cure was an increasingly common attempt to describe the thaumaturgic touch as an instantaneous cure (p.387).14 This put the ritual yet again on tenuous grounds, as the charge was levelled that Charles II was a Catholic sympathiser, practicing a ritual which, like the disavowed practice of transubstantiation, was an instantaneous miracle. In 1673, Charles II quashed these accusations forthright with the adoption of the Test Act, which mandated an oath affirming allegiance to the Church of England and a disavowal of the doctrine of transubstantiation for all officials in public office (p.388).14 Given this forceful assertion of licit nature of the thaumaturgic touch within the Protestant context, the thaumaturgic touch was allowed to thrive for the remainder of Charles II’s reign.
“…that they being healed of their infirmities” – the Paraliturgy of the Scrofulous
The historical evolution of the political discourse of thaumaturgic healing and the paraliturgical rite that accompanied it are interdependent, and will be necessary to understand in order to properly contextualise Richard Wiseman’s work. Much like the political discourse undergirding the monarch’s ability to heal, the paraliturgical ceremonial which accompanied the thaumaturgic act underwent myriad changes over the centuries. While William of Malmesbury and other biographers have accounted for the use of the thaumaturgic touch by Edward the Confessor, it is unclear to what extent monarchs used the thaumaturgic touch or whether it was formalised as a rite until the late 14th-early 15th century CE, corresponding with the reign of Henry VII (1457-1509 CE, r.1485-1509). In the codification of this rite, the grace that the anointing acte sanctificateur par excellence bestowed upon the monarch at coronation became self-evident: by receiving two ritual absolutions over the course of the rite, it became clear that the monarch functioned as priest when they healed their subjects of the King’s-Evil. The rite attributed, likely erroneously (p.24)1 to Henry VII, was modelled after the Use of Salisbury (Sarum Rite), the prevalent form of Anglo-Catholic religious practice prior to the Reformation.
The Sarum-influenced rite, presented in primary sources in English but likely performed in Latin, began with a confiteor and the aforementioned absolutions of the monarch. A reading from the sixteenth chapter of the Gospel of Mark followed:
Afterward he appeared unto the eleven as they sat at meat, and upbraided them with their unbelief and hardness of heart, because they believed not them which had seen him after he was risen.
And he said unto them, Go ye into all the world, and preach the gospel to every creature.
He that believeth and is baptized shall be saved; but he that believeth not shall be damned.
And these signs shall follow them that believe; In my name shall they cast out devils; they shall speak with new tongues;
They shall take up serpents; and if they drink any deadly thing, it shall not hurt them; they shall lay hands on the sick, and they shall recover.16
At the Gospel’s direction to “lay hands on the sick”, the monarch touched the neck of the afflicted person, making the sign of the cross on the wounds. This was followed by reading the first chapter of John, at which time a gold coin suspended on a ribbon was placed around the neck of the healed person. Subsequent to this, a versicle, response, collect, and secretum were prayed, the latter being said inaudibly by the monarch at the conclusion of the rite.1,17
By the Elizabethan era, the form of the rite evolved in order to be better suited to the formulae of Protestant worship found in the Book of Common Prayer (BCP). While primary sources reproduce the Elizabethan rite in Latin, the rite was likely performed in English, given its similarity in form to Protestant rites (p.25).1 In keeping with the Protestant ethos, the confiteor and absolutions of the monarch were removed. The concluding prayers – kyrie, Lord’s Prayer, and preces – were adapted from the BCP, whereas a concluding collect was retained from the Sarum rite:
Omnipotens Deus, Æterna salus omnium in te sperantium exaudi nos, te precamur nomine famulorum tuorum hic praesentium, pro quibus misericors auxilium tuum imploramus, ut salute accepta tibi gratias agant in sancta ecclesia tua per Iesum Christum Dominum nostrum. Amen. (p.97)18
This was later rendered in English in the Prayer Book of Queen Anne (1665-1714 CE) as:
O Almighty God, who art the Giver of all health, and the aid of them that seek to thee for succour, we call upon thee for thy help and goodness mercifully to be showed upon these thy servants, that they being healed of their infirmities may give thanks unto thee in thy holy Church, through Jesus Christ our Lord. Amen. (p.253-4)19
By the reign of Charles II – who added a concluding “grace” – the only other changes to the Elizabethan rite were the removal of the sign of the cross over the wounds by James I and the addition of a blessing by Charles I (p.27,30).1 Charles II, as we previously mentioned, used this rite to great effect: according to incomplete (and, perhaps, politically-inflated) records in John Browne’s Adenochoiradelogia, he touched 92107 subjects for the King’s-Evil throughout his reign (Figure 2)(vol. 3, appendix).6
Richard Wiseman, Sergeant-Surgeon to the King
Having explored the syntax of power inherent in the English thaumaturgic touch and how the liturgical form used to practice this rite upheld that same syntax, we will now briefly comment on the life of Richard Wiseman, the author of the SCT. Baptised on 31 December 1620, little is known of Wiseman’s early life.20 He entered into his surgical apprenticeship under Richard Smith at age sixteen. By 1644, Wiseman entered into surgical service in the royalist army under the command of the future Charles II. As evidenced by his case reports within SCT, Wiseman was present at the sieges of Weymouth and Taunton, and later retreated with the Prince of Wales to continental Europe after the royalist defeat in 1646, whence he was the Prince of Wales’s surgeon.21 In the Battle of Worcester (1651), after now-King Charles II’s army had returned to England, Wiseman was taken prisoner. By 1652, he was released and travelled to London, where he obtained a per servicium freedom of the Barber-Surgeons’ Company.21 He briefly set up a private practice in London before being re-arrested and imprisoned in Lambeth House on charges of aiding one of his patients – a fellow royalist – to escape the Tower. Wiseman biographer J.R. Kirkup states that Wiseman likely spent the years 1654 to 1657 in service of the Spanish navy during the Cromwellian Protectorate, on active duty in the Spanish Netherlands and Caribbean (p.274).20 Within ten days of the Restoration in 1660, Wiseman began a meteoric ascent in the King’s court: he was appointed surgeon-in-ordinary (1660); Master of the Barber-Surgeons’ Company (1665); and finally, Sergeant-Surgeon (1672).21
Treatises Various and Sundry – A primer on SCT
Having gained an insight into Wiseman’s life, the SCT writ large may now be briefly considered. SCT was originally much more narrow in its surgical scope: a singular treatise, published in 1672 as an octavo volume entitled A Treatise of Wounds, dealt solely with Wiseman’s experience as a battlefield surgeon.21 By 1676 – the year of Wiseman’s death – this singular treatise had been repackaged and augmented into his magnum opus, a folio volume entitled SCT (p.275).20 SCT is unique in its breadth and form, insofar as it eschewed regurgitation (or, as Kirkup notes,21 “plagiarism”) of the classic medical texts in favour of the practical experience espoused by hundreds of case histories. In reality, a Wiseman treatise is akin to a proto-case series: it introduces a medical problem; discusses its significance; and lists the presenting complaint, examinations and interventions undertaken, and the medicines prescribed to the numerous patients which make up the case-series. Wiseman’s motivations for writing SCT in this manner were clear: “in the writing of [these Treatises] I was more conformed to my own Judgment and Experience, than other Men’s Authority” (ii, ‘Epistle to the Reader’).22 In a particularly poetic passage, Wiseman clearly sets out a constructivist view of clinical practice, noting that if one relied solely on theory over practice, one is “only rolling Sisyphus his Stone” (iv, ‘Epistle’)22. Instead, Wiseman posits that practical experience is the sine qua non of surgical practice:
increasing knowledge in our Profession, and leaving Sea-marks for the discovery of such Rocks as they themselves have split upon before […] there being more of instructiveness often in an unfortunate case than in a fortunate one (iv, ‘Epistle’).22
Keeping with this goal, SCT is composed of eight treatises: of Tumours; of Ulcers; of the Diseases of the Anus; of the King’s-Evil; of Wounds; of Gunshot-Wounds; of Fractures and Luxations; and of Lues Venerea (pox and gonorrhoeal infections). McVaugh (p.126, footnote 1)23 and Kirkup (p.275)20 assert that the content of SCT remained free of editorial emendation between published editions. We therefore remain unconcerned that editorial content is a confounding factor in our close-reading of the chapter on the King’s-Evil that follows. It is, therefore, Wiseman’s original words that we analyze in the passage that follows.
The importance of the thaumaturgic touch as ritual: a discursive on semiotics and somatic expression
The continuity of the thaumaturgic touch throughout the historical narrative, as well as its dynamic flux in terms of form and function over the centuries, underlies an important theoretical point. The interrelation of causal, temporal, and spatial elements underscores the importance of ritual insofar as its ability to define the divine and the political agency to heal. In theoretical terms, there is an indexical element (here, we refer to Stasch’s definition of indexicality as “a felt quality of causal, spatiotemporal contiguity between one element and what it additionally makes present”, p.161)24 to the thaumaturgic touch and Wiseman’s exegesis of the same, which stood in accordance with the growing biomedical praxis of his time. We therefore approach the healing of the King’s-Evil through the framework of ritual, which examines the event as an emblematic orchestration of layered semiotics and indexical connections. These layered semiotics and indexical connections ultimately feed into the relations of space-time relevant to that specific healing event. Accordingly, we note that the thaumaturgic touch functions, within the context of the King’s-Evil, in two compositional indexes: liturgy and soma.
The paraliturgical codification of the thaumaturgic touch into a ritual intensifies the element of divinity contained therein. The socio-cultural context of the ritual act is thus brought to the fore by the somatic expression of metaphor and the privileged healing touch. The laying of the hands – and the indexical act of touch in the ritual act – exemplifies and reifies the asymmetric yet reciprocal relationship between the monarch and the afflicted. The ritual act produces metasemiotic binaries that signify the political organisation of both the individual and society: these are inherent in the binaries of monarch-subject, healer-healed, and head-body. Privileged in rite and liturgy, the thaumaturgic touch represents a complementary schismogenesis that creates the political economy of the very role each agent upholds: the monarch reigns and heals, while the afflicted is the subject and is healed (p.167)24. The metasemiotic binary of head-body can be extrapolated within the overall conception of the body politic in mid-17th century CE England: as Simon Werrett asserts, society was conceived in corporeal terms, with the people as the body and “the King as their head” (p.380).14 A politics of representation is thus established: the head – the monarch – maintains its autonomy over the body – the people – through the curative act.13,14 Thus, when Charles I was beheaded in front of Whitehall, it presented a unique problem for the dominant hermeneutic of the time. In the beheading act, society was left both literally and figuratively without its head, and thus without its ability to heal (p.381).14
We believe this frame is vital in order to contextualise Richard Wiseman’s examination of the King’s-Evil within an evolving medical praxis. The thaumaturgic touch should be considered as an event that formulates representational asymmetrical relations across defining indexes of soma and liturgy for forms of political expediency and macrocosmic socio-cultural organisation. We posit that Wiseman adheres to the significance of the ritual action and, within a biomedical and political paradigm, re-defines the value of the action in the indexes of the soma.
The Privilege of Sight
Keeping in mind the history of les rois thaumaturges, the spatiotemporal evolution of the paraliturgical rite of touching for the King’s-Evil, and the production of politically-salient binaries for a larger socio-economic order in mind, a close reading of Wiseman’s treatise on the King’s-Evil can be undertaken. Previous scholars21 have noted that the opening of Wiseman’s treatise on the King’s-Evil is an adulatory defence of the monarch’s ability to heal the disease, yet Wiseman concludes his first chapter as follows: “[w]ithal, as feeble as our Art is, this Treatise will shew you that it is not altogether ineffectual; and though the difficulty of Cure will sufficiently appear, yet the possibility will also be made out in many remarkable instances” (p.235-6).22 Wiseman therefore asserted a contrasting biomedical probability to the thaumaturgic touch. The position inherent in Wiseman’s simultaneous defence of the thaumaturgic touch and his support of the biomedical has been signposted by others; however it is analysed as ipso facto vis-à-vis his occupation as Sergeant-Surgeon. While there is likely an element of truth to this, we believe that position fails to provide a more detailed analysis through an appropriate semiotic and sociopolitical lens. The duality of Wiseman’s views provides an interesting locus for analysis in a period of history during which an extensive fluidity existed with regards to the understanding of the body, illness, and health.
Wiseman’s treatise is predominantly a work about his own successes in treating the King’s-Evil within the biomedical paradigm: “I could give you more instances…I never failed in the Cure of the worst of them” (p.313).22 Meanwhile, the monarch’s thaumaturgic touch functioned, as previously discussed, within a ritual dependent on the indexes of soma and liturgy to derive political and socio-cultural meaning. In the Declaration of Breda (1660), Charles II wrote of wounds which “kept bleeding” and needed to be “bound up” (p.57).15 Playing on the perception that a dismembered body politic was just as immune to the salvific grace of God as a dismembered body, the performative act of the thaumaturgic touch flowed naturally from this need to staunch a “bleeding” England. With a plurality of syntaxes of power, it was necessary to fashion the thaumaturgic touch into a theatrical and impeccably choreographed ritual. Charles II thus attempted to re-signify the ritual act in Restoration England by co-opting the biomedical paradigm such that he could regain the political economy of the healer, monarch, and head. For Wiseman to prove the utility of his “Art”, it thus became necessary to co-opt the monarchical paradigm of healer and head. By examining the form of the treatise on the King’s-Evil, we can appreciate the re-signification Wiseman was aiming for.
Wiseman is perceived to be unable to heal as well as others in the socio-economic order during many instances throughout the presented cases. His language connotes a palpable impatience with this fact, particularly in cases where other professionals were first called, only to “at last [him]self” (p.281)22 be consulted on a case which he then successfully treated. Wiseman’s confidence in his abilities makes it all the more absurd that his adulation of the monarch should be accepted at face value and not probed further. Of the ninety-one cases presented in his treatise on the King’s-Evil, twenty-one of them deal specifically with ocular manifestations of the King’s-Evil. We believe that, having emphasized ocular manifestations of the King’s-Evil (ophthalmia, lippitudo, and aegilops were given their own chapters within the treatise), Wiseman attempted to co-opt for biomedicine the monarch’s role as healer and head. For Wiseman, the binaries have shifted from monarch-subject to chirurgeon-patient. His exegesis thus functions to extrapolate the index of somatic expression through the sense of sight. The monarch’s increased dependence on the theatricality of ritual in the context of Restoration England allowed a privileging of the sense of sight. The receipt of a miraculous cure for the King’s-Evil was just as dependent on the sight of the healed as it was the touch of the healer: sight reified the healing act and the theatre of the ritual, proving the veracity of the healing act (as the healed beheld it), as well reaffirming the centrality of somatic touch. In structuring his treatise in this manner, Wiseman is situating himself as the healer within the political economy: the form of his biomedical narrative suggests a new binary: touch-sight. Subsequent to a litany of purgatives, specificks, and surgeries by others, Wiseman’s patients became readily aware of the fact that he could staunch their bleeds and those of England through the biomedical touch.
Conclusion
With the ascendancy of biomedicine in Restoration England, the monarch’s position as the unique healer of the King’s-Evil was no longer unopposed. Having explored the political nature of the thaumaturgic touch in the context of the King’s-Evil, it is easy to see why the political economy afforded to the healer in this healer-healed metasemiotic binary was sought after. The unique political and socio-economic order of the time allowed the chirurgeon Richard Wiseman to co-opt the traditionally monarchical role of healer as his own by drawing attention to a medical ritual of healing that was as reliant on a touch-sight binary as the theatrical ritual of the thaumaturgy. It is through drawing our attention to the touch-sight binary that we simultaneously become aware of our own presence within the indexes of soma and liturgy. By seeing Wiseman’s words on a page, we have become convinced of the ability of both Wiseman and biomedicine to heal the King’s-Evil.