When people fell sick in pre-industrial England, what medical facilities were available for them [132]? Well-off city-dwellers had access to an integrated pyramid of practitioners. At the top was the physician, whose job was to diagnose the complaint, make a prognosis of likely developments, prescribe treatments and medicines (which the apothecary would then dispense), and provide attendance and advice. ‘Physic’ called itself a liberal profession, founded upon a superior, university education. Physicians serving the social elite were expected to have a genteel demeanour to match that of their patients. Top physicians crowded into the capital, where fellows and licentiates of the Royal College of Physicians enjoyed by charter a monopoly of practice [17]. Around 1600, London physicians numbered nearly fifty, and in the seventeenth century the College jealously and zealously upheld its privileges through the law courts. Beyond the metropolis, a sprinkling of physicians practised in corporate towns, cathedral cities and wherever a better class of patients could be found. At least eleven physicians practised in Norwich between 1570 and 1590, six of them academically trained. Outside the cities, distribution of university-educated physicians was scanty, though many claimed to practise ‘physic’.

Humbler in status than the physician was the surgeon. His was a manual craft rather than an intellectual science, involving the hand not the head. His job – very occasionally, hers, for there were a few female surgeons – was to treat external complaints (skin conditions, boils, wounds, injuries and so forth), to set bones and perform simple operations.