Kill or cure? Consulting an Elizabethan physician could often be that much of a gamble. Almost everything sixteenth century doctors believed they knew was wrong. They had inherited a view of disease and the human body steeped in the writings of the Greek, Roman and Arabic physicians of antiquity. The unquestioning belief of medical men – like Dr Nicholas Shelby, the lead character in The Jackdaw Mysteries, my series of novels set around the Jackdaw tavern on London’s Bankside – was that the body was influenced by four humours. These more or less corresponded to the four elements which were thought to make up all matter: earth, water, air and fire. They could be made to account not only for illness, but also for ageing and temperament. They mirrored the world as people experienced it in its most basic states: hot, cold, dry and wet. Illness was a result of the humours becoming unbalanced. And one of the ways a physician could restore that balance was by draining blood from an appropriate area of the body. This approach only died out in the mid nineteenth century.

Elizabethan doctors thought they were being rational. What could seem more obvious in a time of superstition than preparing for a course of treatment by casting a horoscope? What caused disease if not invisible vapours and malignant spirits? And yet they didn’t know that the heart was a pump or how the circulation of the blood functioned. Physicians rarely got their hands bloody. Their task was to diagnose. The cutting, stitching and splinting was done by barber-surgeons.

Ambroise Paré

Even so, the first real signs of a modern approach to healing were emerging. The illustrations in the anatomy books by Andreas Vesalius, born in Brussels in 1514, are astounding. Some of the interventions practised by his contemporary, the Frenchman Ambroise Paré, were still used to treat the wounds of soldiers injured in the First World War. Yet for every Vesalius and Paré there were any number of tricksters and charlatans preying on the desperate. And even Paré himself was convinced that if a pregnant woman sat too long on a stool, it could damage her unborn child.

Nicholas Shelby, however, has a second occupation: as an intelligencer for Sir Robert Cecil, Elizabeth’s Principal Secretary of State. In the recently published latest book in the series, The Rebel’s Mark, Nicholas and his apothecary wife Bianca are caught up in the Earl of Essex’s disastrous campaign in Ireland. Nicholas is attached to the earl’s retinue as a physician, but his prime task is to spy on Essex and report back to Cecil.

One of the more starling discoveries I made in researching Rebel was that it was not uncommon for both the Irish and the English to cut of the heads of their enemies as trophies. Some things are beyond the curing capabilities of even the best physicians.

S.W.Perry is the author of The Rebel’s Mark, out now.

Note: The Rebel’s Mark is the fifth in the series of The Jackdaw Mysteries, published by Corvus. The sixth, The Sinner’s Mark, is due in 2023.

Aspects of History Issue 9 is out now.