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This is a contribution from Communities of Practice in the History of English. Edited by Joanna Kopaczyk and Andreas H. Jucker. © 2013. John Benjamins Publishing Company This electronic file may not be altered in any way. The author(s) of this article is/are permitted to use this PDF file to generate printed copies to be used by way of offprints, for their personal use only. Permission is granted by the publishers to post this file on a closed server which is accessible to members (students and staff) only of the author’s/s’ institute, it is not permitted to post this PDF on the open internet. For any other use of this material prior written permission should be obtained from the publishers or through the Copyright Clearance Center (for USA: www.copyright.com). Please contact [email protected] or consult our website: www.benjamins.com Tables of Contents, abstracts and guidelines are available at www.benjamins.com

“These two, Physitians and Chirurgeons, are to be intimate friends together” Early Modern English community of medical practitioners Anna Hebda and Małgorzata Fabiszak Adam Mickiewicz University, Poznań

1. Introduction The advent of printing was a major technological development that changed the elitist, university-centered scholastic learning tradition towards a more open, more educated Renaissance society. As Stillman (1970: 46) notes “[t]he change in composition of scientific scholarship that followed the advent of the printed book consisted essentially in the addition of self-educated men and talented amateurs of liberal education to the ranks of those who made substantial contributions to science”. He also contrasts the petrified university ways of conducting linguistic and philosophical analyses of learned texts as means of preserving the old rather than gaining new knowledge with the practice of empiricists, in the case of physics known as the mechanicals, who developed their ideas through observation and experimentation. Vernacular translations of Greek and Latin manuscripts published in relatively inexpensive printed editions enabled these non-university, selfeducated people to place their own discoveries in the context of the then accepted scientific theories. When it comes to medical practice in Early Modern England, Wear (2000) notes that there were no regular institutions comparable to today’s hospitals, where patients could receive professional help. Most illnesses were treated at home and it was often the responsibility of the women to provide help in health-related issues. This is why the production of health guides and regimens appealed to a wide readership. At the same time the market for various medical professions was relatively unregulated and ranged from uroscopists, astrologers, ministers’ wives, apothecaries to surgeons and physicians. (A more detailed comparison of the last two groups is given in Section 3.) To ascertain the quality of medical advice and to control the access of non-regulars to the health market, the university-educated physicians © 2013. John Benjamins Publishing Company All rights reserved

252 Anna Hebda and Małgorzata Fabiszak

created the London College of Physicians in 1518, which attempted to regulate the medical practice. Their own approach was based on thorough knowledge of Latin and Greek medical texts, in particular the writings of the Hippocratic school (420– 350 BC), the treatises of Galen (AD 126–206) and, to a smaller extent, the Arabic tradition preserved in medieval manuscripts. The basis for a physician’s education was a degree in arts and, in addition, they studied for another 7 years to receive the title of a Doctor of Medicine from an English University (Wear 2000: 25). Their training was, to a large extent, based on a rhetorical tradition of text analysis. This philological bend in their studies and an attempt to monopolize the market of medical practice earned them a bad press in the period (cf. Nutton 1985). Nutton (1985) presents a different perspective on the activities of the London College of Physicians, which he places against a broader, European background. For him, their major goal was not so much to unfairly stifle the competition, but to ensure the standards of medical practice. In France, surgeons and apothecaries – the major guilds competing with the physicians, studied Galen to create a surgical theory that would support their manual dexterity in dressing wounds and setting broken bones or to expand their knowledge and understanding of the medical uses of herbs. In England, a physician, John Caius, advocated the reform of university medicine. He insisted on teaching practical anatomy. He also lectured to barbersurgeons for almost twenty years at the explicit wish of King Henry VIII, starting in 1546 (Nutton 1985: 84–85). The present paper seeks to investigate whether corpus linguistic methods (Key Word in Context (KWIC), keyness analysis, n-grams analysis) will reveal a difference in linguistic strategies of writers from these two competing groups of medical practitioners, i.e. physicians and surgeons. As the method employed in this study combined quantitative and qualitative methods, the collocations identified by KWIC, keywords, and n-grams were all later examined in context to inform their classification in semantic areas and interpretation of the results that could be related to the socio-cultural background of the communities of practice. For this purpose the corpus of Early Modern English Medical Texts (Taavitsainen and Pahta (eds.) 2010) will be used as a data source, while the socio-historical framework will be provided by the concept of “community of practice”. In the following section we will define the notion of the community of practice, in Section 3 we will link the two communities of practice under investigation – physicians and surgeons – to the text genres characteristic of these two professions, and then we will shortly characterize Galen’s humoral physiology to motivate the choice of search words for the KWIC analysis and turn to the empirical sections. The paper ends with conclusions.

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Early Modern English community of medical practitioners 253

2. Communities of practice as a framework for historical research The concept of the community of practice was originally developed as a tool for “describing and understanding how professional communities (tailors or insurance company employees) induct and train new members, and perpetuate set routines for accomplishing specific tasks” (Lave and Wenger 1991; Meyerhoff 2003: 403). In a more recent research, however, it is defined as an aggregate of people who come together around mutual engagement in an endeavor. Ways of doing things, ways of talking, beliefs, values, power relations – in short, practices – emerge in the course of this mutual endeavor. As a social construct, a community of practice is different from the traditional community, primarily because it is defined simultaneously by its membership and by the practice in which that membership engages.  (Eckert and McConnell-Ginet 1992a: 464)

The characteristic features of a community of practice, central and prerequisite for its existence, are, then, mutual engagement, a joint negotiated enterprise and a shared repertoire of common resources for negotiating meaning (e.g., specialized terminology, linguistic routines, pictures, regular meals, gestures) (Wenger 1998: 85; Holmes and Meyerhoff 1999: 175).1 The identity and the linguistic repertoire of a community of practice are in a state of flux. As Eckert and McConnell-Ginet (1992b: 10) point out, [a] way of speaking in a community does not simply constitute a turning on of a community-specific linguistic switch, or the symbolic laying of claim to membership in that community, but a complex articulation of the individual’s forms of participation in that community with participation in other communities that are salient at the time. In turn, the linguistic practices of any given community of practice will be continually changing as a result of the many saliencies that come into play through its multiple members.

It is only natural then to expect that with time, the linguistic code of a given community of practice will change and that the repertoires used by different communities of practice will exhibit considerable differences.2 In diachronic research it is texts that play the role of informants, for it is in the written mode that the legacy of past generations has come down to us. External criteria such as the origin, subject matter, or the social and communicative function of a text determine its genre (Biber 1988; Rissanen et al. 1997: 9; Taavitsainen 1997: 187). In the present study, genres are understood as representing specific communicative strategies of authors writing for particular audiences (Taavitsainen 2010: 31–35), or communities of practice.3

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254 Anna Hebda and Małgorzata Fabiszak

3. Communities of practice and their written legacy Early Modern English Medical Texts Corpus (EMEMT) (Taavitsainen and Pahta (eds.) 2010) has been selected as a collection of texts meant for a distinct readership, written by medical practitioners from one of the specified groups, i.e. communities of practice. Naturally, members of one of these groups could at the same time be members of other groups, but while within a particular group, following the premises of the community of practice framework, they would engage in group-specific activities, rituals and use specific linguistic strategies that would identify them as members of a given community of practice. EMEMT is a collection of medical texts written between 1500–1700 and consisting of various medical genres: general treatises and textbooks, treatises on specific diseases, health guides and regimens, recipes, surgical and anatomical treatises and philosophical treatises. Sixteenth and seventeenth century medical writing is particularly interesting as it was the time when the writing in the vernacular language started equalling and exceeding that in Latin. With increasing literacy and the decreasing prices of the printed works, especially pamphlets, the readership of medical texts grew steadily (Taavitsainen and Pahta (eds.) 2010). In the Early Modern period, the medical practitioners constituted a diverse group of professionals. Wear, French and Lonie (1985: xiv) describe the medical landscape of the period in the following words: In the sixteenth century there was a wide variety of medical expertise available ranging from wise-women, charmers, wizards or magicians, astrologers, priests and ministers and their wives, herbalists, empirics and barbers to pharmacists, surgeons and physicians. In terms of articulateness and literary remains the latter group appear to predominate.

For the analysis in the present paper three different subsets of EMEMT texts have been selected to investigate the differences and similarities in the linguistic repertoires of surgeons and physicians, i.e. (1) Surgical and Anatomical Treaties (301,701 words), (2) General Treatises and Textbooks (178,416 words) and (3) Regimens and Health Guides (208,584 words). The first group of texts was written mainly by the established surgeons for the apprentices in the field. Surgeons were considered craftsmen and were associated with barbers, who specialized in external operations on the body. They were organized in a guild and the craft was learned through apprenticeship (Taavitsainen 2010). Chamberland (2009) describes the emergence of corporate ethos in the London guild of barbers / surgeons through their attempts to establish the code of conduct and standards of practice. They thus fulfil the definitional criteria for the community of practice, as they are mutually engaged in a joined enterprise and share a repertoire of both professional and linguistic practices. © 2013. John Benjamins Publishing Company All rights reserved



Early Modern English community of medical practitioners 255

Surgeons, similarly to pharmacists, were at the time viewed as serious and dangerous competition to university-educated physicians who, unlike surgeons, did not rely so much on the experience of medical practice as on the knowledge they derived from Greek and Latin manuscripts. For them, medicine was one of the great triad of academic disciplines, along with theology and law, and studied with a similar method of text exegesis. No wonder that they were not the most popular healers, as pointed out by Pelling and White (2003). To curb the competition from other medical practitioners, they supported the introduction of licensing legislation in Tudor England (Hughes 2006) and tried to control the practice through the College of Physicians. They can be thus considered another community of practice of medical practitioners with a shared set of beliefs and interests that they have cooperatively attempted to enforce on the “irregulars”. The second sub-corpus of the analyzed texts, i.e. General Treatises and Textbooks, was predominantly written by physicians for the learned, university-educated audience and can be considered a good source for investigating their shared linguistic repertoire. The third sub-corpus, namely Regimens and Health Guides, was written by physicians with a lay audience from the middle and upper classes in mind (Taavitsainen 2010). It could be reasonably expected to show how the expert linguistic strategies were adapted to the needs of nonexpert audience. However, as will be demonstrated in Section 4, the qualitative analysis of KWIC lines for the verbs of flowing, fundamental for the humoral theory, shows that this was not the case. The non-distinctive use of these words in all three EMEMT sub-corpora, as illustrated by the collocate analysis, seems to indicate how well-known the dominant codified Galenic humoral view of human physiology was and how little the two communities of practice differed with respect to this set of beliefs. Having defined and described the two communities of practice, i.e. surgeons and physicians (Taavitsainen 2010), and the genres representing their linguistic practice, in the following section we move on to the analysis of the use of linguistic expressions motivated by the humoral theory of human physiology. 4. The theory of four humors by Galen Humorism is a theory of the four temperaments popularized in the second century AD by Galen of Pergamon, a Roman physician, who employed it to account for the process of digestion. According to the doctrine, one’s physical and psychological wellbeing depends on the balance among the four humoral fluids, namely yellow bile, black bile, phlegm and blood. Should the balance be tipped in favor of one of the basic substances (and it was easily affected by such factors as one’s age, the climate, or the time of year), not only would an associated personality type emerge, but a disease © 2013. John Benjamins Publishing Company All rights reserved

256 Anna Hebda and Małgorzata Fabiszak

would result as well (Geeraerts and Grondelaers 1995: 156–157; Kuropatnicki 2003: 2006ab). Table 1 illustrates the system of humoral correspondences. Table 1.  The correspondences among the four humoral fluids (after Geeraerts and Grondelaers 1995: 156–157) characteristic element temperament organ colour taste season wind planet animal

phlegm

black bile

yellow bile

blood

cold and moist water phlegmatic brain/bladder white salty winter North Moon turtle

cold and dry earth melancholic spleen black sour autumn West Saturn sparrow

warm and dry fire choleric liver/stomach yellow bitter summer South Mars lion

warm and moist air sanguine heart red sweet spring East Jupiter goat

What follows is that, originally, each of the substances was located in a different body part (phlegm in the brain or the bladder, black bile in the spleen, yellow bile in the liver or the stomach, and blood in the heart) and a surplus of any of the four fluids would determine a person’s character as phlegmatic, melancholic, choleric, or sanguine, respectively. Geeraerts and Grondelaers (1995) claim that the widespread use of the anger is liquid in a container metaphor proposed by Lakoff and Kövecses (1987) (cf. Kövecses 1986, 2000) is motivated by the humoral theory of the four temperaments and that this early theory of human physiology informs the folk understanding of emotions to the present, as evidenced by the fossilized, conventional metaphors and idioms such as: He is boiling with anger. 5. Corpus linguistic analysis of the language of physicians and surgeons In this section we will employ three corpus linguistic techniques to analyze the patterns of language use in the three selected types of texts. These techniques are the analysis of the Key Word in Context (KWIC), of keyness, and of n-grams. The KWIC analysis allows the researcher to identify the left and right co-text of the searched lexeme, in this way facilitating the qualitative analysis of lexemes with which the term in question co-occurs. This serves as an indication of the use of the term by various groups of writers. The analysis of keyness consists in the production of word lists for every corpus separately. Then the word lists can be compared © 2013. John Benjamins Publishing Company All rights reserved



Early Modern English community of medical practitioners 257

and show the positive and negative keyness, that is the words which appear significantly more frequently (positive keyness) or significantly less frequently (negative keyness) in one corpus in comparison to the other. Log likelihood or chi-square tests are used to calculate the significance. In n-gram analysis, also known as lexical bundles analysis (cf. Kopaczyk, this volume), the computer programme automatically identifies strings of n number of words facilitating the identification of phrases or collocations recurring in the text under analysis. All three of these techniques should contribute to the understanding of the extent to which the linguistic repertoires of surgeons and physicians differed from each other. The linguistic focus of the KWIC searches will concentrate on the verbs which play a key role in presenting the Galenic doctrine. The set of verbs under investigation includes: flow, boil, fill, burst and contain. The left and right contexts of the verbs were examined for the type of fluid and the name of the organ, or body part, where the process occurred. Table 2 presents the findings based on the data from medical texts divided into the three groups under investigation. First the results from the texts written by surgeons and for surgeons are presented, as they should differ most from the other two types, texts written by physicians for other physicians, and texts written by physicians for the lay audience. The focus is on the type of substance (grammatically expressed as the subject) and the organ or body part (in the position of the object) co-occurring with a given verb. Table 2.  The use of flow, contain, fill, burst and boil in Surgical Treatises, General Treatises and Textbooks and Regimens and Health Guides in EMEMT fluid

verb / subset of texts / community of practice

organ / body part

urine, humour, blood, meliceria, evil humours

flow / Surgical Treatises / surgeons

wounds of the bladder, wounds of the body, pores of the body, members

humour, blood, black choler, flow / General Treatises / yellow choler, watery and physicians whitish matter, urine, sweat, phlegm, phlegmatic matter, melancholy, excrements (‘excretions’), the juices of the pancreas humidities (i.e. pathological fluids in the body), blood, choler, phlegmatic excrements, melancholy, humour, sweat, moisture

flow / Regimens and Health Guides / physicians for lay readers

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part of the body, voids, gall, spleen, veins and bladder, brain, belly and guts, stomach, head, trunk, mouth and nostrils, thin gut, duodenum, veins and arteries, nerves, throat, spinal marrow stomach and belly, veins, arteries, the head, concavities and weak body parts, guts

258 Anna Hebda and Małgorzata Fabiszak

Table 2.  (continued) fluid

verb / subset of texts / community of practice

organ / body part

spittle, warm blood

contain / Surgical Treatises / surgeons

ventricle, the head, veins and arteries, well (i.e. salivary gland)

water, moisture, blood, humour, phlegmatic or watery humour, phlegm, lymph, acid juice

contain / General Treatises / physicians

flesh, veins, arteries, brain, lymph ducts, medulla spinalis, body parts, the fountain of blood, nerves, stomach

blood, poisons, humour

contain / Regimens and Health Guides / physicians for lay readers

the old or young, blood

urine, blood, feces

fill / Surgical Treatises / surgeons

arteries, bladder, guts

evil/vicious humours, dewy fill / General Treatises / humour, fumes, evaporations, physicians excrements, phlegm, vitious (i.e. nourishing) humours

stomach, veins, members of the whole body, body, head, liver

good humidity, fumes, putrified (i.e. putrid) humours, water, excrements, raw humours, milk, excremental humours, corrupt humours, fresh new moisture, discordant humours, bad humours, crude humours, gross phlegmatic humours, fury and madness

fill / Regimens and Health Guides / physicians for lay readers

vomit, the mouth, stomach, blood, belly, the body, veins, women

sweat, blood

burst / Surgical Treatises / surgeons

ventricle, artery

blood

burst / General Treatises / physicians

vessels, veins, arteries

hot vapours, sweat

burst / Regimens and Health Guides / physicians for lay readers

blood

boil / Surgical Treatises / surgeons

melancholy juice

boil / General Treatises / physicians

humours, water, natural heat, boil / Regimens and Health blood Guides / physicians for lay readers

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body, stomach



Early Modern English community of medical practitioners 259

As can be seen in Table 2, in all three types of texts the verbs in question are used in similar co-texts. While surgeons seem to focus on the fluids they can see, i.e. blood, urine, spittle, sweat, meliceria, they also refer to the body fluids as humors and mention “evil humours”, clearly indicating their awareness of the humoral theory of physiology. The physicians, regardless of whether they write for other physicians or for lay people, when using the selected verbs refer to the same types of fluids and organs. Let us have a look at the textual examples illustrating one of the verbs. The surgeons’ community of practice in their treatises on anatomy describe urine, (evil) humor, blood, meliceria, as flowing through the wounds in the bladder, wounds, and pores in the body and members. These uses can be illustrated with Excerpt (1) below:

(1) He must be thus annointed and ordered, two or three daies togither or more, as you see occasion, vntill the fluxe of flegmatike matter doth begin to flow from the mouth moderately, which doth happen commonly within two, three, or fower daies, &c.  (Clowes, Lves Venerea)

The physicians’ community of practice in their treatises on particular diseases cover a wide range of body fluids: humour, blood, black choler, yellow choler, watery and whitish matter, urine, sweat, phlegm, phlegmatic matter, melancholy, excrements (“excretions”), the juices of the pancreas, which could flow through a number of bodily organs and cavities conceptualized as containers: parts of the body, voids, the gall, the spleen, veins and the bladder, the brain, the belly and guts, the stomach, the head, the trunk, mouth and nostrils, the thin gut, duodenum, veins and arteries, nerves, the throat, spinal marrow. An illustrative example is provided as (2).

(2) it [palsy] may come from innate Causes, or cold pituitous Humours, which relax and dissolve the Tone of the Nerves (A treatise of diseases of the Head, Brain and Nerves)

When physicians wrote for the general audience they seem to have used similar technical vocabulary describing the flow of bodily fluids as they did in the writing addressed at their own community of practice. In Regimens and Health Guides they referred to humidities, blood, choler, phlegmatic excrements, melancholy, humour, sweat, moisture, which could flow through stomach and belly, veins, arteries, the head, concavities and weak body parts, guts. Indeed if we compare (2) from an expert text with (3) from a text for the lay public it is difficult to notice any difference:

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260 Anna Hebda and Małgorzata Fabiszak



(3) The vse and propertie of Cholere, is to flowe into the guttes, that it might scoure theim, and clense them from Flegmatike excreme~tes, and that it might helpe their excrecion (that is) that it might raise and stire vp the vertue expulsiue, to driue out the egestions in due tyme.  (Moore, Hope of health)

When it comes to the use of the verb flow Examples (1)–(3) could well come from the same text. The KWIC analysis of the selected verbs did not reveal any qualitative differences in the use of the investigated verbs. The KWIC analysis will now be followed with the analysis of keyness. Table 3 presents the top key (content) words selected from a list of 200 keywords for each of the communities of practice under study, grouped into lexical fields. Table 3.  Key words in Surgical Treatises vs. General Treatises and Textbooks in EMEMT Lexical field

Surgical Treatises

General Treatises and Textbooks

Body parts and organs

bone(s), member(s), arm, artery(-ies), ventricle, liver, muscles, heart, breast, panicle, (body) part, head, leg, lips

stomach, body

Symptoms

wound(s), ulcer, tumors, bullet (wound), shot, boil, soreness, strain

fever, clyster, sick, disease(s), sickness, signs, vomit, temperature, cough, apoplexy, thirst, distemper, pulses, dryness, draught, palsy

Treatment

cut, set, put, plaster, ordain, make

purging, sleep, observe, do, bath, conserve, evacuations, exercise, drinking

Drugs

cure, medicines, balm, turpentine, vinegar, unguent, wax, extract, oil, powder, roses, wine

syrup, pill(s), violets, medicine(s), milk, dose, roots, seeds, flowers, sage, betony, concoction, treacle, ounce, wormwood, herbs, pepper, almonds, honey, nutmegs, mixture, spoonfuls, grains, leaves, potion, decoction

Names

Iohn, Hippocrates, Yates, Aristotle, Guido, Celsus



Disciplines

chirurgery, anatomie, physick



Food



food, meats, beer, nourishment

Humoral Theory

warm

day, night, choler, phlegm, melancholy, temperate, hot, cold, elements, moist, juice, earth, four, black, air, moisture, dry, morning, urine, red, Venus, afternoon, heat, moist, winter

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Early Modern English community of medical practitioners 261

The comparison of the keywords in the two groups of texts shows that while both communities of practice (surgeons and physicians) were aware of the classical traditions in their disciplines (Hippocrates, Aristotle); in Surgical Treatises references to these authors come across as more frequent. One can only hypothesize as to the reasons behind it. It may be indicative of an attempt on the part of the surgeons to find a theoretical framework to their practice or to add credibility to their works by referring to figures of authority. References to the humoral theory, on the other hand, are visibly more frequent in General Treatises and Textbooks, reflecting different interests of the two communities of practice. The surgeons mostly focused on the treatment of wounds and bone fractures and treated them with cutting or setting and applying balms, extracts, unguents, vinegar and turpentine on the body surface. The physicians, on the other hand, had a more difficult task at hand – they treated bodily internal sickness and diseases, the symptoms of which were fever, vomit, cough, palsy, apoplexy, and quickened pulse. They also considered behavioral changes, such as distemper. Following their theory of physiology, they observed their patients holistically, analyzing their diet and behavior. Consequently, treatment consisted in attempting to regulate and secure the balance of the four humors with the help of syrups, decocts, concoctions and potions. They also ordained baths and purges. The examination of n-grams is the last step in our corpus analysis of the linguistic repertoires of the two communities of practice: surgeons and physicians. Given that 2-grams and 3-grams are not infrequently composed of function words alone, we decided to focus on 4-grams as carriers of linguistic information. Following Kopaczyk (2013 and this volume), we narrowed down the qualitative analysis of the 4-grams to those strings whose token frequency was higher than ten.4 The search returned 155 such 4-gram types for Surgical Treatises, 70 4-gram types for General Treatises and Textbooks, and 83 types for Regimens and Health Guides. They are listed in Tables 4a and 4b in order of decreasing frequency. Kopaczyk (forthc.) analyzed the formulaicity of medical texts from EMEMT with 3-gram lexical bundles and in her analysis proposed a grouping of these into a number of semantic areas. We follow the proposed classification in Table 4a and 4b; however, in some cases we suggest slightly different categories (these are in italics) when they seemed to be better suited for the purpose of the present paper, i.e. a comparison of linguistic repertoires of two communities of practice: surgeons and physicians. Table 4a presents semantic areas related to medical theory and practice. Interestingly, contrary to what the key word analysis has shown, regarding the humoral theory and the interest of the two communities of practice therein, formulaic references to Humorism are to be found in texts written by physicians as well as in those authored by surgeons. Kopaczyk (forthc.) refers to the 3-grams © 2013. John Benjamins Publishing Company All rights reserved

© 2013. John Benjamins Publishing Company All rights reserved the nature of the, of the nature of, the substance of the, by reason of the, thing that is seen, hath the name of, is caused by the, the cause of the, pain in the Head

a sufficient quantity of, with a sufficient quantity, of each one ounce, half an ounce of, the rest of the, in a sufficient quantity, sufficient quantity of water, the quantity of the, and an half of, ounce and a half, ounce and an half

the substance of the, by reason of the, the motion of the, in the cure of, motion of the heart, wounds of the head, the cure of the, complexion cold and dry, the first is that, the consumption of the, the cure of wounds, to the consumption of

of each half a, of each one ounce, of each one dram, of each three ounces

white of an Egg, the White of an, Oil of Roses and, with Oil of Roses, with the White of, from the fire and, the Roots of the, Bread as will make, of an Egg and

causes, symptoms and effects of treatment

quantification, measurements and dosage

ingredients

the cause of this, cause of this impediment, by reason of the, of this impediment this, if it do come, for the health of, He that hath a, in the use of, This impediment doth come, is hard of digestion, the substance of the, for this complexion to, show of a man, the Health of the

the heat of the, is hot and dry, is cold and dry, is hot and moist, of the nature of

Regimens and Health Guides

of the Roots of, of the Flowers of, of which is made of the Juice of, Oil of Sweet Almonds, it is made of, of the Leaves of, of the Oil of, of the following Julep

the Flux of Blood, cold and dry and, the nature of the, Galen is hot and moist, the heat of the, is says in the, the heat of the, a Flux of blood, as Galen says in hot and dry, of a cold and, of a hot and, Signs of a hot

reference to humoral theory

General Treatises and Textbooks

Surgical Treatises

4-grams: semantic areas

Table 4a.  4-grams in Surgical Treatises, General Treatises and Textbooks and Regimens and Health Guides in EMEMT, semantic areas related to medical theory and practice

262 Anna Hebda and Małgorzata Fabiszak

the Bones of the, parts of the Body, of Man s Body, if the Wound be, the parts of the, of the Heart and, of the Body and, of wounds in the, of the Head and, part of the head, the body of man, the Lips of the, the Wounds of the, Lips of the Wound, the upper part of, bones of the head, of the brain and, part of the Body, the bone of the, substance of the brain, upper part of the, the rest of the, the sides of the, Ventricle of the Heart, members of the body, of the head the, by the space of, of the Body The, of the body of, of the Bones of, the Region of the, the skin of the, the Veins and Arteries, all the parts of, from the brain and, in wounds of the, of the parts of, of the Wound and, the middle of the, in the fore part, of the Breast and, the flesh of the, the head of the, the mouth of the, wounds in the head, of the body as, of the heart is, of the vena cava, on the right side, out of the veins, out of the vena, right Ventricle of the, the beginning of the, the bottom of the, the heart is the, the right ventricle of, hinder part of the, in man s body, of the body it, of the Liver and, of the Stomach and, of the Veins and, the hinder part of, the holes of the, the lower part of, any part of the, but if the Wound, from the heart and, in the right side, left Ventricle of the, lower part of the, Member of the Body, of the back and, the Orifice of the

the strength of the, is an official member

as will make it, is made as follows, make it into a, it were necessary to, the way of the, then strain it and, with a gentle fire, and is thus made, apply it to the, it from the fire, on a Linen cloth, take it from the

the midst of the, the end of the, in the midst of, in the time of, in the beginning of, in the mean time, at the same time

body and its parts

qualities

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procedures

time and sequence

parts of the body, of the body and, of Man s body, in man s body, of a man s, part of the body, the body of Man, of the body The, of the stomach and, all parts of the, in the stomach and, of the Body is, of the body as, the mouth of the

in the Morning and, the beginning of in the time of, by little and little, the, the Morning and from, in the mean the beginning of the, the time time, in the midst of, the midst of the of pestilence, time of the year

Mix them and make, was cured as follows, is to be taken, be applied to the, mix them for a, them and make a

the temperature of the

part of the body, of Man s body, parts of the body, of the body and, of the Stomach and, of the whole Body, in the Head and, the Marrow of the, the parts of the, all the Parts of, of the Body is

Early Modern English community of medical practitioners 263

264 Anna Hebda and Małgorzata Fabiszak

Table 4b.  4-grams in Surgical Treatises, General Treatises and Textbooks and Regimens and Health Guides, semantic areas related to discourse practice 4-grams: semantic areas

Surgical Treatises

General Treatises and Textbooks

clarification

it is to be, that is to say, for the most part, And this is the, as I have said, which is to be

that is to say, for the that is to say, for the most most part, the thing part, and therefore it is, that is, it is to be, that is to wit and therefore it is, the most part of

passing of knowledge from other languages

Regimens and Health Guides

In english it is, english it is named, is the latin word, the latin worde in, greek it is named, In greek it is, it is named a, word In greek it, latin word In greek, word In english it, in latin it is, latin it is named, latin word In english

text organization

the Anatomy of the, in the first book, in his book De, the first book of, Question what is the, upon the Anatomy of, Questions upon the Anatomy, the first is the, the original of the, under the name of

advice

is to be noted, to be noted that, they are to be, ought not to be, it be in the, but if it be, if it be not, that it may be

Whether it is not, that it may be, and if it be, if it be not, the knowledge of

hedges

as it were a, is as it were

is as it were

Capitle doth show of, the Breviary of health, in the capitle named, doth show of a, in the first book, Breviary of health The, it is to be, look in the capitle, book named the Breviary, first book named the, named the Breviary of, the first book named, doth show of the, it is named the

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it is not good, is not to be, it is good for, is good for the, is to be noted, it is good to, to be noted that, ought not to be, For this matter look, is not good for, it ought to be, that it be not, this matter look in



Early Modern English community of medical practitioners 265

embedded in our 4-grams as descriptions of quality; however, in the present context, the focus on the hot or cold or moist nature of symptoms can be easily related to the humoral theory of human physiology (see Table 1). In all three types of texts, 4-grams point to the authors’ preoccupation with causes, symptoms, and effects of treatment. Kopaczyk (forthc.) suggests a different division here and interprets lexical bundles with nature and use as abstract nouns. Upon a close reading of the KWIC lines with these bundles and in the context of medical professionals’ communities of practice we suggest that these be included into the semantic area of causes, symptoms, and effects of treatment. Both surgeons and physicians use 4-grams in describing ingredients, but their quantification, measurement, and dosage seem more important for the physicians, as indicated by the number of various patterns in this category. The surgeons, as could be expected, focus more on various body parts and of all the categories it is the body that appears to be their predominant field of interest. They also use more formulas when talking about the procedures of treatment or the preparation of drugs, and describing qualities of the patients or symptoms unrelated to the humoral theory. 4-grams referring to time and sequence, however, are equally common, whatever the authorship of the text. Table 4b presents 4-grams related to discourse strategies and text organization. The analysis of 4-grams related to discourse strategies and text organization revealed two considerable differences between the texts written by surgeons and those authored by physicians. When writing Regimens and Health Guides, physicians clearly addressed lay people with very little or no knowledge of classical languages, as suggested by the use of such expressions as … is the latyn worde, in englyshe yt is, or latin word in english, etc. Physicians were also the ones to speak from the position of authority more often and give advice to the less-learned, as follows from, e.g. it is good for, it is not good, it ought to be, or for this matter look. Kopaczyk (forthc.) names this semantic area “efficacy”, pointing to the potential benefits of the described treatment. However, as these phrases appear far more often in the Regimens and Health Guides than in Surgical Treatises or General Treatises and Textbooks we interpret them as advice to the less educated. 6. Conclusions The corpus linguistic analysis of the linguistic repertoire of the two communities of practice, surgeons and physicians, has yielded some interesting results. At the methodological level, our analysis is a strong argument in favor of mixed – qualitative and quantitative – approaches to linguistic analysis. The qualitative analysis of the KWIC lines for the verbs of flowing highlighted the similarities between the © 2013. John Benjamins Publishing Company All rights reserved

266 Anna Hebda and Małgorzata Fabiszak

two communities of practice. In fact, it showed that not only the texts for surgeons and physicians, but also those written by physicians for a more general readership, used Galen’s humoral theory of physiology as a framework for describing healthand disease-related issues. At the same time the quantitative analyses, keyness and n-grams, have pointed to the area of difference between the two communities of practice. The keyness analysis facilitated the identification of two distinct primary areas of interest for the two groups, i.e. bone fractures and wounds for surgeons and internal diseases for physicians, as well as their preferred methods of treatment. It also pointed to the fact that references to the authoritative names in the field achieved higher keyness in the Surgical Treatises than in the physician’s General Treatises, as if the physicians took the authority of the ancient texts for granted and concentrated on the theory of physiology, while the surgeons treated them as shibboleths of learning. The n-grams analysis further corroborated the keyness results with respect to the distinct areas of interest of the two communities of practice under scrutiny, although not necessarily when it comes to the references to Humorism attested in both groups of texts. It also revealed how physicians positioned themselves as men of authority towards the readers of Regimens and Health Guides. The study was not free of certain limitations. As it employed an already available corpus as a source of data and not a self-compiled corpus, it had to rely on the division and classification of texts into sub-corpora proposed by its compilers. Thus the authorship of the General Treatises and Textbooks, while predominantly consisting of university-educated physicians, could also include apothecaries and midwives, thus reducing the precision of the quantitative analyses. Also, we have treated the time span of 200 years (1500–1700) as a uniform period. Dividing it into smaller 50 year sub-periods or focusing only on the first (1500–1550) and last five decades (1650–1700) could potentially allow us to observe a higher degree of divergence in the qualitative analysis of the three text types of the earlier period in comparison to the general analysis of the 200 year span. We leave this possibility open for further research with higher diachronic granularity. Overall we hope to have shown that the socio-cultural concept of communities of practice can be effectively applied in historical research and in combination with a number of corpus linguistic methods it can facilitate research into and description of the linguistic repertoire of groups of professionals in Early Modern England.

Acknowledgements The authors would like to thank the editors, the anonymous reviewers and Prof. Ute Smit for the helpful comments on the earlier versions of this paper. Needless to say, all the shortcomings are ours.

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Early Modern English community of medical practitioners 267

Notes 1. For a detailed list of community of practice-constitutive criteria, see Holmes and Meyerhoff (1999: 176, after Wenger 1998: 130–131) and for the differences between a community of practice and a speech community: Holmes and Meyerhoff (1999: 179, Table 1). 2. With regard to medical discourse Taavitsainen (2010: 35) observes that “texts for heterogeneous lay audiences are very different from treatises aimed at professional people”. 3. This approach is akin to that of Diller (1996), who stresses the significance of genre as a potential factor accounting for variation in historical emotion talk. 4. Even though the subcorpora are of varying length, we used the same cut off point. When the threshold for the 4-grams from General Treatises and Textbooks (the smallest subcorpus) was lowered to higher than 5, the number of types rises to almost 500. Then there is an increase of examples in the ingredients, quantification, causes, symptoms and effects and time and sequence semantic areas. It does not seem to undermine, but rather strengthen, the observation made for the frequency >10.

References Biber, Douglas. 1988. Variation across Speech and Writing. Cambridge: Cambridge University Press. Chamberland, Celeste. 2009. “Honor, brotherhood and the corporate ethos of London Barbers – Surgeons’ Company, 1570–1640.” Journal of the History of Medicine and Allied Sciences 64 (3): 300–332. Diller, Hans-Jürgen. 1996. “Joy and mirth in Middle English (and a little bit in Old): A plea for the consideration of genre in historical linguistics.” In Middle English Miscellany. From Vocabulary to Linguistic Variation, ed. by Jacek Fisiak, 83–106. Poznań: Motivex. Eckert, Penelope, and Sally McConnell-Ginet. 1992a. “Communities of practice: Where language, gender, and power all live.” In Locating Power. Proceedings of the 1992 Berkeley Women and Language Conference, ed. by Kira Hall, Mary Bucholtz, and Birch ­Moonwomon, 89–99. Berkeley: Berkeley Women and Language Group. Eckert, Penelope, and Sally McConnell-Ginet. 1992b. “Think practically and look locally: Language and gender as community-based practice.” Annual Review of Anthropology 21: 461–490. Geeraerts, Dirk, and Stefan Grondelaers. 1995. “Looking back at anger. Cultural traditions and metaphorical patterns.” In Language and the Construal of the World, ed. by John Taylor and Robert E. MacLaury, 153–180. Berlin / New York: Mouton de Gruyter. Holmes, Janet, and Miriam Meyerhoff. 1999. “The community of practice: Theories and methodologies in language and gender research.” Language in Society 28: 173–183. Hughes, John Trevor. 2006. “The licensing of medical practitioners in Tudor England: Legislation enacted by Henry VIII.” Vesalius: Acta Internationales Historiae Medicinae 12 (1): 4–11. Kopaczyk, Joanna. 2013. The Legal Language of Scottish Burghs. Standardization and Lexical Bundles (1380–1560). Oxford / New York: Oxford University Press. Kopaczyk, Joanna. Forthcoming. “Formulaic discourse across Early Modern English medical genres: Investigating shared lexical bundles.” In Meaning in Words, Texts and Discourse in the History of English, ed. by Andreas H. Jucker, Daniela Landert, Annina Seiler, and Nicole Studer.

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268 Anna Hebda and Małgorzata Fabiszak

Kövecses, Zoltán. 1986. Metaphors of Anger, Pride, and Love. Amsterdam: John Benjamins. Kövecses, Zoltán. 2000. Metaphor and Emotion: Language, Culture, and Body in Human Feeling. Cambridge / New York: Cambridge University Press. Kuropatnicki, Andrzej. 2003. “Medycyna angielska w okresie Tudorów [English medicine in Tudor times].” Archiwum Historii i Filozofii Medycyny 66 (2): 109–117. Kuropatnicki, Andrzej. 2006a. “Rozpoznanie i terapia w szesnastowiecznej Anglii [Diagnosis and Therapy in 16th century England].” Annales Academiae Medicae Silesiensis 60 (3): 254–258. Kuropatnicki, Andrzej. 2006b. “Zawód lekarza w szesnastowiecznej Anglii [The medical profession in 16th century England].” Annales Academiae Medicae Silesiensis 60 (3): 259–263. Lakoff, George, and Zoltán Kövecses. 1987. “The cognitive model of anger inherent in American English.” In Cultural Models in Language and Thought, ed. by Dorothy Holland and Naomi Quinn, 195–221. New York: Cambridge University Press. Lave, Jean, and Etienne Wenger. 1991. Situated Learning: Legitimate Peripheral Participation. Cambridge: Cambridge University Press. Meyerhoff, Miriam. 2003. “Communities of practice.” In The Handbook of Language Variation and Change, ed. by J. K. Chambers, Peter Trudgill, and Natalie Schilling-Estes, 402–417. Oxford: Blackwell. Nutton, Vivian. 1985. “Humanist surgery.” In The Medical Renaissance of the Sixteenth Century, ed. by Andrew Wear, Roger K. French, and Iain M. Lonie, 74–99. Cambridge: Cambridge University Press. Pelling, Margaret, and Frances White. 2003. Medical Conflicts in Early Modern London: Patronage, Physicians, and Irregular Practitioners, 1550–1640. Oxford Studies in Social History. Oxford: Clarendon Press. Rissanen, Matti, Matti Kilpiö, Merja Kytö, Anneli Meurman-Solin, Saara Nevanlinna, Päivi Pahta and Irma Taavitsainen. 1997. “Introduction.” In English in Transition: Corpus-based Studies in Linguistic Variation and Genre Styles, ed. by Matti Rissanen, Merja Kytö, and Kirsi Heikkonen, 1–16. Berlin: Mouton de Gruyter. Stillman, Drake. 1970. “Early science and the printed book: The spread of science beyond the universities.” Renaissance and Reformation 6 (3): 43–52. Taavitsainen, Irma. 1997. “Genre conventions: Personal affect in fiction and non-fiction in Early Modern English.” In English in Transition: Corpus-based Studies in Linguistic Variation and Genre Styles, ed. by Matti Rissanen, Merja Kytö, and Kirsi Heikkonen, 185–266. Berlin: Mouton de Gruyter. Taavitsainen, Irma. 2010. “Discourse and genre dynamics in Early Modern English medical writing.” In Early Modern English Medical Texts: Corpus Description and Studies, ed. by Irma Taavitsainen and Päivi Pahta, 29–56. Amsterdam: John Benjamins. Taavitsainen, Irma, and Paivi Pahta (eds.). 2010. Early Modern English Medical Texts: Corpus Description and Studies. Amsterdam: John Benjamins. Wear, Andrew, R. K. French and I. M. Lonie (eds.). 1985. The Medical Renaissance of the Sixteenth Century. Cambridge: Cambridge University Press. Wear, Andrew. 2000. Knowledge and Practice in English Medicine, 1550–1680. Cambridge: ­Cambridge University Press. Wenger, Etienne. 1998. Communities of Practice: Learning, Meaning and Identity. Cambridge: Cambridge University Press.

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