Some doctors still refer to patients as cases: ‘a case of jaundice’ or ‘a case of diabetes’, as if patients were not people but receptacles of disease. The custom is deeply engrained. Reginald Hilton, a physician at London’s St Thomas’s Hospital in the 1940s, would greet the arrival of ‘a case of syphilis’ with a relish that suggested it had been delivered by his wine merchant.
If we applied the same tradition to nominating medicine’s ‘strangest case’, the first candidate would be Simon Forman, variously described in history books as an Elizabethan doctor, womaniser, astrologer, theatre-goer, necromancer and purveyor of love potions – all of which occupations he pursued with energetic dedication. Historians treasure his diaries because they include descriptions of the plays he saw at the Globe Theatre, including Macbeth, The Winter’s Tale, Cymbeline and Richard II, but the diaries have also much to offer any seeker of oddity in medicine.
Forman was born near Salisbury but, after an unhappy spell as a teacher, moved to London and, at the age of 27, set himself up as a practitioner of physic, surgery and magic. Unlike most London doctors, he stayed in the capital during the plagues of 1592 and 1594, when he is said to have saved many lives and acquired a reputation as a courageous man and a good physician. His success drew the attention of the Royal College of Physicians, which, angered by his ‘alternative’ methods of healing, summoned him for an examination. His scanty knowledge of anatomy and the medical dogma of the day provoked ‘great mirth and sport among the auditors’ and the College banned him from practising in London.
Nine months later, when he defied the ban and prescribed a potion to a man who died after consuming it, he was sent to prison. For seven years after his release, he conducted a guerrilla war against the College, which responded by employing spies to watch his house and by sending phoney patients to consult him. Forman won the war in 1603 when Cambridge University granted him a licence to practise ‘the cure of ills of all kindes and substances of the human boddy’.
Forman’s practice made use of three rooms in his house in Lambeth. In the first, his main consulting room, he offered the standard medical treatments of the day supplemented by ‘metoposcopy’, a form of soothsaying which used the techniques of palmistry to analyse markings on the face, particularly the lines on the forehead and the position of warts. This was also the room in which he concocted love philtres and aphrodisiacs for those who felt the need of them. In the second room Forman cast astrological charts and told fortunes, and in the third, he arranged assignations between those seeking partners. If things went well in the third room, the couple would move to the second for an astrological assessment of their compatibility, and then to the first to receive the potions that would enhance their relationship.
Forman had a large and fashionable practice. He treated the impresario Philip Henslowe for an itching face, Robert Burton – for melancholy, of course – and Archbishop Whitgift for jaundice. He also treated Shakespeare’s lover Emilia Lanier (probably the Dark Lady of the sonnets) before persuading her to become his own mistress, and Shakespeare’s landlady, Mrs Mountjoy. Her tenant was behind with his rent and she wanted a prediction of his prospects. Forman offered her a posset ‘to ease her humor’.
One regular patient was Frances Howard, daughter of Lord Howard of Bindon, who first consulted him as a young girl with ‘night flutterynges of the heart’. He asked her to visit him one night when her heart was actually fluttering and he then ‘devoided me of my nyght-gowne and, having give me a potion to drive out devills, soothed me uponn my breasts until I was plees’d’.
A few years later, she asked him to cast her horoscope so ‘that I might see to what estate I should be raysed’. With the help of astrolabes, charts and almanacs, Forman, ‘his beard brystlyng and his eye bryte’ told her she should change her estate three times. She readily complied. First she married the son of a wealthy alderman who ‘dy’d leaving me unchilded’, then an earl who also conveniently died, and finally bagged a duke.
Forman’s reputation for necromancy attracted rich merchants wishing to heap ill luck upon competitors, churchmen seeking preferment, gamblers needing a change of fortune, and lovers seeking to attract their beloved or to murder their rivals. Yet most of his 2,000 consultations a year, half of them with women of child-bearing age, were with poor people, many of whom he saw for free.
His reputation for what modern tabloids call ‘sex in the surgery’ may have been created by women who offered sexual favours in lieu of a fee. He made no secret of his womanising, and recorded each encounter in his diaries, using the codeword ‘halek’ for coition. His diary for 9 July 1607, when he was aged 55, records: ‘Halek 8 a.m. Hester Sharp, and halek at 3 p.m. Anne Wiseman, and halek at 9 p.m. Tronco [his pet name for his wife]’. He was also happy to oblige ladies who suspected their husbands were infertile and to exploit the empathy he established with young women who consulted him. ‘He bedded me,’ said one, ‘and there was no more to it than that. Now I am round with child, and it is his doing.’ He was proud of his sexual profligacy and dreamed of seducing Queen Elizabeth.
Despite Forman’s reputation as a magician, most of his patients came to him with common ailments – sore throats, toothache, cut fingers, warts, ‘coffs & chokyngs’, broken bones – all recorded punctiliously in his notebooks and treated with the usual remedies of the day. He pulled teeth, bound wounds and practised the great medical cure-all of the time – bleeding patients with leeches or by lancing a vein to drain off ‘infected’ blood. His treatment books record that he used euphorbium for palsy, turpeth for croup, white arsenic for lipuria, and snake venom for ‘dropsicall afflictions’.
Indeed, his books suggest Forman shouldn’t be written off as an exploitative quack. He kept detailed diaries and medical casebooks, made voluminous notes from medical and scientific texts, and defined protocols for conducting scientific research. He published a pamphlet on ways of determining longitude and showed fine discrimination by taking an interest in everything except politics. His writings build a picture of Renaissance medical science that may seem strange to us only because we look at it in retrospect. After all, when Forman got his Cambridge licence, Galileo, whom no one would dismiss as a quack, was teaching astrology to medical students in Padua who believed that they needed to know what the stars foretold for their patients if they were to diagnose and treat them successfully and prepare their medicines at favourable times.
Like the respected doctors of Padua, Forman believed that astrology helped him evaluate his patients. Women were particularly difficult to treat, he claimed, because their health was regulated by their wombs and their sexual activity, subjects on which they were notoriously duplicitous. Astrology revealed to him whether a woman was sexually active and enabled him to assess her disease. And by showing he knew she was being honest or dishonest about her sexual life, he could win her confidence. That has the makings of a convincing story, which is more than can be said for many of the tales told to their patients by Forman’s enemies at the Royal College of Physicians.