In the course of the eighteenth century, traditional healers remained active, drawing on centuries of folk knowledge about the curative properties of roots, herbs, and other plants. Faith healing also remained popular, especially in the countryside. Faith healers and their patients believed that evil spirits caused illness by lodging in people and that the proper treatment was to exorcise, or drive out, the offending devil. Religious and secular officials did their best to stamp out such practices, but with little success.

In the larger towns and cities, apothecaries sold a vast number of herbs, drugs, and patent medicines for every conceivable “temperament and distemper.” By the eighteenth century many of these medicines were derived from imported plants. The Asian spices prized since medieval times often had medicinal uses; from the sixteenth century onward, the Portuguese and then the Dutch dominated the Indian Ocean trade in these spices (see Chapter 14). As Europeans expanded to the New World, they brought a keen interest in potentially effective and highly profitable medicinal plants. Botanists accompanied European administrators and explorers to the Americas, where they profited from the healing traditions of indigenous peoples and, in the plantation societies of the Caribbean, enslaved Africans. They returned to Europe with a host of medicinal plants such as ipecacuanha, sarsaparilla, opium, and cinchona, the first effective treatment for fever. Over the course of the seventeenth century, imports of medicinal plants boomed. By the late eighteenth century, England was importing annually £100,000 worth of drugs, compared to only £1,000 or £2,000 in 1600.30

Like all varieties of medical practitioners, apothecaries advertised their wares, their high-class customers, and their miraculous cures in newspapers and commercial circulars. Medicine, like food and fashionable clothing, thus joined the era’s new and loosely regulated commercial culture.

Physicians, who were invariably men, were apprenticed in their teens to practicing physicians for several years of on-the-job training. This training was then rounded out with hospital work or some university courses. Seen as gentlemen who did not labor with their hands, many physicians diagnosed and treated patients by correspondence or through oral dialogue, without conducting a physical examination. Because their training was expensive, physicians came mainly from prosperous families and they usually concentrated on urban patients from similar social backgrounds. Nevertheless, even poor people spent hard-won resources to seek treatment for their loved ones.

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Physicians in the eighteenth century were increasingly willing to experiment with new methods, but time-honored practices lay heavily on them. They laid great stress on purging, and bloodletting was still considered a medical cure-all. It was the way “bad blood,” the cause of illness, was removed and the balance of humors necessary for good health was restored.