100 • ConfusionSurgeons and College of Physicians both were “well entrenched oligarchies
dominated by self-perpetuating cliques,” but surgeons had skills doctors
didn’t possess. They could cut for stones in bladders and kidneys, remove tu-
mors, and fix dislocations and fractures. They were noted for their fine in-
struments—which no physician used, believing surgery to be beneath his
calling. The outcome of a surgeon’s treatment was easy to judge, unlike that
of a doctor’s fine-tuning of humors. Surgeons could be found around the
hospitals for the poor—Saint Bartholomew’s and Saint Thomas across Lon-
don Bridge—and near many apothecaries. Their company hall was near the
western wall and drew medical professionals as well as the interested public,
such as Samuel Pepys, to their anatomy demonstrations and lectures.^4
An estimate can be made of how many surgeons, apothecaries, and doc-
tors offered medical care in London. Licensed practitioners connected to the
three professional organizations numbered around 250 , all of them men; an
additional 250 persons, including 60 women, may have offered similar thera-
pies without a license. The normal ratio was roughly one caregiver for every
six hundred persons inside the old city, according to Andrew Wear, a special-
ist of early modern medical care in England.^5 Since most of the members of
the College of Physicians had fled from the city and far fewer licensed care-
givers practiced in the poor suburbs, the ratio in this sickly time was hardly
encouraging. A merchant who had stayed on was unlikely to find his family
doctor still in town. At any time working-class families in the suburbs were
far less likely to see a male caregiver because there were fewer around than in
the city and their fees were beyond reach. Parishes provided emergency med-
ical services to their poorest residents, and during plague epidemics a few
suburban parishes paid a doctor, apothecary, or surgeon to treat some of the
infected poor with medicines or lancing of buboes.
Women caregivers were widely sought after for their special skills and nur-
turing ways. Furthermore, midwives and many nurses were believed to be im-
mune to the plague, having already been in the thick of the epidemic and not
touched. These female medics often knew as much as if not more than the
theoretically oriented men when it came to practical health care. Some
people high and low were skeptical of London’s nurses, accusing them of
thievery or even murder, but nurses were the major source of medical care for
poor families on parish relief. At Saint Margaret Westminster, they were paid
two shillings a week to care for a child and five shillings a week to nurse an
adult. Once a family was shut up with the plague, a live-in nurse was likely to
be its only caregiver.