7. Advances (c.1610–c.1625): ‘Good endeavours bring forth much good frute’

THE WEALTHY CITY merchant Sir William Smith had been suffering for months from a large stone in his bladder. Although the pain was excruciating he was loath to be ‘cut for the stone’, an extremely dangerous and painful operation, during which the surgeon made an incision near the base of the penis, then groped around inside the bladder with a tool called a ducks bill. ‘If the stone be greater than may be drawne forth at the hole’, a diarist wrote, ‘the partie dyes for it.’ Desperate with fear, Sir William summoned Harvey to his London home.

During the initial consultation, the physician inserted his finger into his patient’s rectum in order to feel for the stone. What Harvey discovered gave him hope. The stone was so tiny that an operation would not be necessary. ‘Have patience for a month’, he counselled, ‘for I have a secret [medicine] which no man in England has but me, and I will make trial of it and do not doubt that it will do you much good and even dissolve the stone.’ ‘Good doctor,’ an ecstatic Sir William replied, ‘let me have the medicine and let my apothecary make it because he knoweth the state of my body best.’ ‘No’, Harvey, responded, ‘I shall make it up myself; for I am desirous that no man but myself learn the ingredients.’ Jubilant at the prospect of a painless cure, Smith offered Harvey an annuity of £50, to be paid in quarterly amounts of £12.10s., for as long as he did not have to be cut for the stone.

If Harvey was wary of calling upon Sir William’s surgeon to perform an operation, and suspicious of his apothecary, he was openly hostile to the merchant’s resident doctor, the empiric John Emerson, a vicar from Shoreham. On encountering the unqualified physician in Sir William’s bedchamber, the choleric doctor ordered the ‘horse leech’ to return to his provincial parish; invoking the authority of the College of Physicians he ‘did also threaten to lay him in prison for his meddling in what therein he had no skill’. Emerson countered by boasting of his success in curing countless ‘knights and ladies’; Sir William also rallied to his defence. ‘If you imprison any man that shall want to do me good Doctor Harvey, I will quickly find means to enlarge him again.’ Knowing that it would be foolish to challenge a knight of the realm, the physician was forced to retreat.

Harvey administered to Sir William the miracle medicine, recommending a ‘very stict and sparing diet’ for the duration of the cure. He visited Sir William regularly, and was sanguine in his prognosis. ‘Your water is better than it was’, he would announce cheerfully, ‘I can keep you at this stage [dosage]’. Yet the patient perceived no improvement in his condition; indeed his agony only intensified with every passing day.

During one visit Sir William announced ‘I tell you plainly that (when all is done) I must be cut for, because I am not able to be so tortured as I am; my pains are so great as that they will distract me from my senses.’ Harvey counselled patience, but Sir William feared his suffering would cause him to lose his mind: ‘it is not possible for me to live in this manner as I do, so by God’s grace I will adventure it [the operation]’. Harvey reluctantly agreed to call for the surgeon. ‘If you be cut’, he added, making reference to their financial arrangement. ‘I do not intend to demand [further payment] of you.’ – though he still wished to be paid for the time he had tended upon Sir William up to the operation.

Sir William’s surgeon successfully removed a huge stone from his bladder. But a urinary infection ensued soon afterwards, contaminating his kidneys. Within two months, Sir William was dead. On his deathbed he mustered up the energy to curse his physician, and expressly commanded his son ‘not to pay Harvey’ the £12 10s still owed on his annuity. Harvey was determined, however, to obtain the outstanding fee, and brought a common law action against the family.

This was not an isolated instance of unsound judgement on Harvey’s part. Surgeons often accused him of erroneously (and self-interestedly) prescribing medicine in cases where external treatment was necessary, thus causing patients to die ‘by ill practice’. A fellow doctor claimed that one of Harvey’s medicines sent a patient instantaneously to ‘the Close Stool’ and from thence almost as rapidly to ‘the other world’. A friend of Harvey’s confirmed that he ‘never heard of any [physician] that admired [Harvey’s] Therapeutique way. I knew several practitioners that would not have given 3d for one of his Bills; and [who said] that a man could hardly tell by one of his Bills what he did aime at.’

In the highly competitive and litigious world of medicine, accusations of malpractice were common. Yet even some of Harvey’s patients complained that his diagnoses were fanciful and inaccurate. One characterized him as an indifferent and uncaring doctor ‘(yet he pretends very much to study and lay my case to heart)’.

Despite his mixed reputation as a physician, Harvey’s private practice flourished. Through his contacts at the College of Physicians he had access to noble men and women willing to pay dearly for his services. Poor lame Sir Davy Gam sought his advice; Sir Thomas Hardes consulted him about his urethral stricture. Such patients dwelt in the penumbra of King James I’s presence, on the outer circles of the court, and they may have afforded Harvey partial access to it. It was perhaps on their recommendation that the Lord Treasurer consulted Harvey during an attack of urinary calculus.

William’s brother John, the second of the seven Harvey boys, and some four years his younger, also offered him an entrée to the court. Settling in London, presumably soon after his older brother, John had ingratiated himself at court, eventually becoming ‘one of his majesty’s footmen’. When or how John secured the position is unknown, but his good fortune was not unusual; the Scots king often favoured men of lowly backgrounds, much to the chagrin of men of aristocratic status who complained of a court crammed full of ‘scum such as … sheep-reeves, yeomen’s sons, pedlar’s sons’. From the lowly position of footman John rose to the rank of ‘yeoman of the bedchamber’, performing his duties in a magnificent livery of ruff and doublet embellished with the Tudor rose. John had the unenviable task of dressing the notoriously slovenly king, yet he was rewarded with wages of around £50 a year, and by the influence he could now exert on behalf of friends and family. It is just possible that it was through John that William had obtained the letters of recommendation from the king, with which he secured his post at St Bartholomew’s.

Court was the epicentre of power and influence. The grants, pensions, monopolies and positions on offer there made it a magnet for the ambitious. James was infamous for auctioning off titles and sinecures in return for much-needed cash, having failed to secure an income through either Parliament, taxation, or forced loans from his subjects. The court was a motley gaggle of 1,500 members, comprised of preachers and players, physicians and musicians, who followed the king’s wandering progress between his London residences at the Tower, Whitehall, Bridewell Palace and Hampton Court. Days passed in a round of gossiping, diplomacy, scheming and feasting; meals and entertainments were lavish.

Having entered this labyrinth of potential patients and contacts, Harvey now had to navigate his way successfully. It is difficult, perhaps, to imagine the lowly and intensely intellectual country boy mastering, in the full glare of the court, the art of plucking off his napkin gracefully, footing it with dancing, warbling along when a general song was carolled up, or chatting away chivalrously to the ladies. Despite his Italian sojourn he may have lacked the elegance, poise and sprezzatura for such refined capering and carousing. Harvey would probably have had little natural inclination, either, to keep up with all the court news – ‘who loses and who wins, who’s in, who’s out’.

Yet if Harvey’s first steps at court were hesitant and awkward, soon enough he was sauntering, if not exactly swaggering, his way through it. He seems to have learned quickly enough how to ‘flatter and look fair’. In the portrait painted of him in the 1620s, he wears a fashionable puce-coloured fustian doublet and a velvet mantle and ruff.

There is something aloof and detached about Harvey’s expression in this 1620s portrait: while he seems proud of being a courtier, it is as though he is merely posing as one.

Harvey’s everyday attire was elegant too, consisting of a rich black cloak, full doublet, ribbed stocking of black silk, and long high-heeled boots fringed at the top. When visiting patients Harvey decked himself out in his purple robe; on his journey to their homes he always ‘rode on horseback with a footcloath … his man following on foote’, which was reckoned very decent, and the height of fashion.

The yeoman’s son also developed great fluency in polite discourse. ‘My sweete Lord,’ he would write in letters to gentlemen, ‘yf ever I have done and may be able to doe service to you ther is nothing wilbe more comfort and joy unto me, wheare all good endeavours bring forth much good frute and all service is soe plentifully acknowledged.’

With the right contacts, and the appropriate doublet and conversation, Harvey eventually came to the notice of King James himself, being appointed one of his ‘physicians extraordinary’ in 1618. The king, who was regarded by many as ineffectual, wilful and overly fond of his own coarse jokes, would nevertheless have been interesting to Harvey from a medical point of view, his constitution being extremely susceptible to disturbances.

The King’s mind is moved suddenly. He is very wrathful, but the fit soon passes off. Sometimes he is melancholy from the spleen [which] … easily heaps up melancholic juice … Urine generally normal. Impatient of sweat as of all things … After [a] great sadness [he experiences] diarrhoea for eight days … fainting, sighing, dread, intermittent pulse … there [has been] a descent of humours into his right arm whence arose swollen glands.

King James would have been a difficult patient for Harvey, owing to these manifold complaints, which were compounded by his volatility and lack of fortitude. ‘He is of extreme sensitiveness, impatient of pains’, wrote one of Harvey’s colleagues, ‘and while they torture him with most violent movements, his mind is tossed and bile flows.’ To make matters worse, James, like so many of his contemporaries, had no confidence whatsoever in the opinion of his physicians. ‘The King laughs at medicine and holds it so cheap that he declares physicians to be hardly necessary. He asserts the art to be supported by mere conjectures and useless because uncertain.’

In 1625 Harvey followed a melancholy king to Theobalds, his Hertfordshire retreat. First crippled by an ague, then felled by a sudden stroke, the king was finally overwhelmed by a violent attack of dysentery ‘dangerous unto death’, and took to his bed. Harvey administered to his needs tirelessly but to little effect. He could see that the ‘former Vigour of Nature’ was ‘low and spent’ in his master. Knowing that his end was approaching, James asked his chaplain to ‘make me ready to go away to Christ’. After prayers were intoned over him, James raised his hands up to his face and shut his own eyes.

Soon after James’ son Charles ascended the throne he awarded Harvey the sum of £100 ‘as of His Majesty’s free gift, for his pains and attendance about the person of His Majesty’s late dear father, of happy memory, in time of his sickness’. Charles I also retained Harvey as a physician extraordinary, in time promoting him to physician in ordinary – a far more important position, which carried with it an annual salary of £300, a pension of £400 per annum, and a daily ‘diet of three dishes of meat a meal, with all incidents thereunto belonging’.

Harvey’s official duties included prescribing medicine for the royal household, tending upon its members during bouts of illness, and accompanying them, or their favourites, on their travels abroad. This left him little time for his commitments to either the College of Physicians or St Bartholomew’s Hospital, but he was excused from these, the king having the precedent claim.

The fastidious and forbidding Charles was far less approachable than his father. The new king insisted on formality at all times, never allowing a visitor to be seated in his or his queen’s presence. But however aloof he was with other members of his court, Charles enjoyed conversing relatively freely with Harvey, with whom he shared a number of intellectual interests.

Harvey and the king discussed medicine, natural philosophy and the physiology of the numerous animals belonging to the Crown. Sometimes Harvey would crave an audience with Charles, in order to show him a ‘pretty Spectacle and Rarity of Nature’. On one occasion he brought a petrified child’s skull, excavated in Crete, into the royal presence; His Majesty ‘wondered at it & looked content to see so rare a thing’.

Harvey professed to value learning over titles. ‘When he perceived’, a friend said, ‘that honours and other decorations of that kind’ were not, in the main, given as rewards for ‘uprightness of character’ or ‘dedication to philosophy’, he ‘passed all these things by’ – meaning perhaps, that he never petitioned the king for a knighthood. Harvey did not, it seems, covet a title; being the king’s personal physician, and one of his resident intellectuals, was apparently satisfaction enough.

The doctor was certainly satisfied with the wealth that accompanied his meteoric rise through the social and professional ranks. His unconcealed enthusiasm for money may have been frowned on at court. Self-interest was no more an aristocratic virtue than it was a Christian one, the principal value of money, according to aristocrats, being that it enabled one to improve the commonwealth, by helping the poor, or furthering diplomatic and religious causes. Yeomen such as Harvey believed, however, that they might justly enrich themselves as it was their only means of climbing the social ladder.

Harvey methodically accrued a considerable fortune through his services to the Crown and his lucrative private practice. As a physician he drove a very hard bargain, and insisted his patients stuck to it. He often pursued outstanding payments via the courts, even when the legal costs added up to far more than the fees in question. For Harvey there was doubtless a principle at stake – his right to be paid a fee for a service rendered.

Thomas Harvey may have instilled this principle in his eldest son, along with other yeoman values. Yeomen were supposed to live with the utmost temperance and thrift. Although he enjoyed dressing the part of the courtier physician, Harvey’s ‘tastes in food, and other necessities of life’ were, a friend said, always of the simplest kind. Like the rest of his family too he was renowned for tight-fistedness.

Harvey ensured that his money did not, in the words of another shrewd yeoman of the period, ‘lye idly by hym’; instead, according to a contemporary biographer, ‘as soon as he had gathered together any [sum] of value he either bought property therewith or put the same out to Interest’. He purchased from one William Lodges of Gray’s Inn a ‘new brick tenement lying in a street called Hart street in Covent Garden’ which he presumably rented out. He also acquired ‘fifty-nine acres of land in the Parish of Petham Kent’ from Thomas Court of Waltham. And when the time was ripe, Harvey sold on his purchases. William Laud, the Archbishop of Canterbury, and one of King Charles’ trusted counsellors, purchased from the physician and his brothers the ‘vicarage rectory & parsonage’ that were formerly part of ‘ye late Priory of Folkestone’, indicating that Harvey speculated in property that had formerly been sacred.¹

In all these dealings Harvey was assisted by his father. Thomas, along with his six other sons, had moved up to Hackney in London from Kent, some years after his wife’s death in 1605. All of the Harvey boys prospered in the capital, under the watchful eye of their father. While John advanced at court, the others (Thomas, Daniel, Eliab, Matthew and Michael), having been apprenticed in trade, now made fortunes as merchants of goods from the Levant and Far East. All of the boys made their father the treasurer of their lands, as their wily old ‘pinchfart penny-father’ (as parsimonious patriarchs were known) was ‘as skilful to purchase Land as they to gain Money; and he kept, employed, and improved their farmings to their great advantage’.

Thomas exhorted his sons to ‘live in the fear … of Almighty God and unite with one another fast knit together, as [you] may be evermore a helpe one to another’. They followed this advice assiduously, each assisting the others with advice, favours and money. The yeoman patriarch must have delighted in watching their collective ascent to wealth, ‘seeing the meanest of them of far greater estate than himself’ being one of his two great ambitions.

Sometime after 1614 Thomas set about realizing his other dream – achieving the status of gentleman. He applied to the Garter King of Arms for permission to bear a coat of arms, an honour only conferred (officially at least) on those ‘whose race and blood or virtues do make noble and knowne’ – that is to say, men of distinguished pedigree, or those whose families had performed great services to Crown and country. In reality, it was often simply a question of hard cash. Prospective gentlemen had to prove that they possessed a fortune of several hundred pounds, dressed well, kept servants, and were wealthy enough to bribe the relevant officials. Men of gentle birth often complained of the corruption which made it possible for yeoman, such as ‘Shakespeare ye player’, to qualify as gentlemen.

Having satisfied the Garter King of Arms of his fortune (while spuriously claiming, for good measure, descent from the thirteenth-century Mayor of London, Sir Walter Harvey) Thomas was allowed to present a pattern for his coat of arms to the College of Heralds. The shield contained silver crescents, the emblem of Levant merchants, a testament perhaps to Thomas’ intimate involvement with his sons’ commercial ventures. When the design was approved, the yeoman born became a made gentleman and so did his male descendants.

A version of the Harvey coat of arms, which can be seen on several posthumous portraits of William Harvey, evidencing the family’s pride in having secured gentlemanly status.

A weary but doubtless satisfied Thomas passed away in 1623, in his mid-seventies, escutcheons with the Harvey coat of arms proudly adorning his coffin. Displaying no trace of sentimentality, William decided to perform the autopsy on his father’s body himself, Thomas encouraging his son’s medical studies in death as well as in life. Harvey was rewarded by the opportunity of examining his father’s exceptionally ‘huge’ colon, an anatomical curiosity which he would refer to in his public lectures.

1 The full extent of Harvey’s land and property portfolio only came to light in 2001, when a wrought iron Armada chest, adorned with flowers and allegorical figures, and dating from around 1600, was discovered. Various descendants of the Harvey family appear to have placed documents relating to their forebears within the chest, and shut them up in around 1820 to lay undisturbed there for almost two centuries.