Health Education Research Advance Access originally published online on April 27, 2005
Health Education Research 2005 20(6):656-664; doi:10.1093/her/cyh030
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An example of health education in the early 17th century: Naturall and artificial Directions for Health by William Vaughan
Epidemiology and Health Sciences, The Medical School, Stopford Building, University of Manchester, Manchester M13 9PT, UK
E-mail: Anne.Charlton{at}man.ac.uk
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Abstract |
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In 1600, William Vaughan, a Doctor of Civil Laws, published the first edition of his health education manual entitled Naturall and artificial Directions for Health. In all, seven editions appeared over the next 33 years. Changes were made to the title and contents, but the same six general areas were covered in each, i.e. (1) Air, fire and water, (2) Food and drink, (3) Sleep and early rising, (4) Evacuations, (5) Infirmities and death, and (6) Restoration of health. Although Vaughan was writing before the scientific revolution, and had to base his advice on the current theories of the four humours, miasma, stars and the supernatural, research over the intervening four centuries has proven many of his messages to be correct, e.g. clean air and water, a balanced diet, olive oil, low animal fat, red wine, fibre, exercise, and avoiding tobacco use, to mention but a few. In Vaughan's day, these messages were new to many readers and the method of health education used was simply to present the information for people to act on. Behavioural research carried out in the last century has changed the approach to health education by involving decision-making processes, self-efficacy building and social support.
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Introduction |
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TopAbstractIntroductionAim of this paperMethodVaughan's advice in Naturall...DiscussionConclusionReferences |
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‘They that observe a good diet, neede no artificiall Physicke’ said William Vaughan in the fifth edition of his book, Naturall and artificial Directions for Health, derived from the best philosophers, as well moderne as auncient (Vaughan, 1617
). He was using the word ‘diet’ in the older, more general sense as defined in the Shorter Oxford English Dictionary as ‘way of living or thinking’ as well as food (Little et al., 1933) as the content of his book makes clear. The first edition of Directions for Health was published when the author was 25 years old (Vaughan, 1600). The original is in the British Library, St Pancras Reading Rooms (shelf mark c.110.a.13). It was the first of seven editions (Vaughan, 1602, 1607, 1612, 1617, 1626, 1633). By the time the last edition was published it had undergone many revisions, rededications, and changes of title, printer and publisher. That Vaughan considered it was popular is shown in his preface to the 1626 edition ‘The good entertainment which this Worke of mine hath found abroad from time to time for these twenty six yeares space, now induceth mee to review and polish the same...’.
William Vaughan, variously described as a scholar, writer, poet and colonial promoter (Cell, 2000), was a Doctor of Civil Law and not a physician. He comments on this in the preface to the 1633 edition, as follows:
Onely here lies one maine scruple to be removed, for my intrusion into other men's jurisdictions; that being no professed Physitian, I have written of that subject that belongs not to my vocation. Judicious Reader, accept in good part this my excuse: For all that I am not a Practitioner of this noble Science, yet my chiefest pleasure ever since my childhood, hath been to read more books of Physicke then of any other, in regard of my own health, which I saw might have proved more distempered and crazed, if I trusted in others more then in my own in sight.Vaughan appears to be one of the early non-medical health educators, whose successors are legion.
In themes defined in the 1600 and 1602 editions are as follows:These themes are maintained in general terms throughout the seven editions, although their content, length and emphasis differ as he updates and expands the text according to his changes in knowledge and experience, reflecting his own travels, new discoveries, publications, fashions, imports, and his interest and involvement in colonization of Newfoundland.The causes of the preseruation of mans health be six. The first, Aire, fire and water. The seconde, meate and drink, such as we vse for nourishment. The third, exercise and the tranquillitie of the body. The fourth, moderate sleepe and early rising. The fift, auoydaunce [voiding] of excrements, vnder which Phlebotomie, purgations, vomits, sweat, bathes, carnall copulation and such like are contained. The sixt cause of health is mirth temperately vsed.
I have used the 1612 edition as the basis of the paper for several reasons. (1) As the fourth edition it is midway in Vaughan's series, thus providing a central point from which earlier and later editions can be viewed. (2) The main content was established and matured by this edition. (3) The particular copy I used at the Wellcome Library had been annotated by one of Vaughan's early readers, possibly a puritan, judging from the writing, language and comments. Personally, I found these indications of early reactions to the author's messages provided a fascinating insight into its audience. Wherever earlier or later editions differ significantly from that of 1612, I have referred to them. It is a small book (9 x 14.5 cm), written mainly in question and answer form, with a comprehensive contents list; all of which suggests it was intended as a quick reference book to be carried around. Only the last two editions are larger.
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Aim of this paper |
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TopAbstractIntroductionAim of this paperMethodVaughan's advice in Naturall...DiscussionConclusionReferences |
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Vaughan was writing before the scientific revolution, and had as his background the work of Hippocrates, the theory of the four humours, observation, folklore and the supernatural. The causes of most diseases were unknown, and knowledge of the structure and function of the human body was very limited. Four hundred years later, science has provided us with a sound and detailed basis for health education advice. The aim of this paper is to examine Vaughan's text in the setting of late Elizabethan England and to consider it in the light of current health education theory.
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Method |
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Continuum content analysis of historical texts was developed for the purpose of tracing and monitoring specific scientific and medical discoveries and social changes that occurred between the date of the original publication and the present day (Charlton, 2005
). Taking Vaughan's key topics as starting points, various methods were used to trace them over the four intervening centuries. Electronic and printed sources, including journal articles and books published over the period, enabled continuity of information to be established. So much data are available that it has been necessary to summarize rather than to provide detailed references under each of Vaughan's topics. |
Vaughan's advice in Naturall and artificial Directions for Health, 1612 |
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Section 1: Air, fire and water
These three short chapters on air, water and fire strongly reflect major issues of the period.
Air
‘Miasma’ (bad air or smells) was then considered to be a major cause of disease and Vaughan makes the point that air is often impure especially near mines and forges and ‘doe but marke how feavers, rheumes and plagues are engendered by reason of troubled aire, and of low marshie grounds: on the contrarie, how our health is continued, refreshed and recovered in drie or sandie countries’. ‘For oftentimes, it is seene that sicke folks doe recover their former health only by a change of air’. Keeping rooms cool in hot weather and warm in cold weather; rectifying corrupt air by perfuming chambers with specified herbs and vinegar; sweeping rooms ‘neatly’ at least once a day; and ‘Going out, hold in the mouth a pill of an Orange, or a piece of the root of Angelica’ feature as ways of overcoming bad air, as are conditions and locations for good housing. In the 1617 edition, in answer to the question ‘If the Ayre be hardly corrupted, how then happens the Plague?’, Vaughan writes ‘Laying aside supernaturall causes, surely the sluttishnesse of roomes, and multitudes of lakes and dunghills, together with the nastinesse of servants, which neglect to ayre and brush such cloathes as they have in their custody, doe engender a venomous vapour...’. Perhaps brushing clothes removed plague-carrying fleas?
Water
The need for clean water is also emphasized, water supplies being rain water, river water and fountain water. ‘Water is best which runneth from a higher to a lower ground’ and running on clay where it would be better clarified than on stone. He also tells how to purify waters that begin to putrefy: ‘This is performed by the addition of some small proportion of the oyle of sulphur, or else Aqua vitae wel rectified, incorporating them both together’.
Fire
Fire is best of sweet and dry wood. ‘In Germany they vse stoves which questionlesse cannot but dull the Spirits’. It was many years before fumes from stoves were shown to be harmful. He was against artificial sweats: ‘But in Spring time they may be vsed against the itch and small Pockes’.
Section 2: Food and nourishment, what's good and bad
Almost half the book is devoted to food. Not only is there a complete section on food, running to over 40 pages, but food also features prominently in other chapters, including the quarterly, monthly and daily ‘dyet’, and the evacuations chapters.
Vaughan clearly felt that diet had become unhealthy. He thought people lived longer before the biblical Flood than in the early 17th century, because ‘It was not long after Creation and God made all things good’. ‘The soyle [soil] was then gay, trim and fresh. The floud [inundation] took away the fatnesse thereof’. ‘They were ignorant of our delicate inventions and multiplied compounds. They knew not of our dainty cates [delicacies], our marchpanes [fancy cakes], nor our superfluous flibber [flighty] sauces. They were no quaffers of wine or Ale nor were they troubled with so many cares, and vainglorious pomps’.
Bread
‘Bread made of pure wheat flowre, well boulted from all branne, and finely moulded and baked, comforteth and strengtheneth the heart, maketh a man fat, and preserueth [preserveth] health’. Nevertheless, by 1626, he adds ‘For melancholicke men, or them that are bound, Bread somewhat branny, is knowne to be wholesome and loosing’.
Meat and fish
He recommends mainly white meats from poultry and game as being ‘meates of an excellent temperature, and fit to continue the body in health’, although he considers that hare, duck, goose and swan ‘doe dispose the body to melancholy’. ‘Mutton, Beefe, Kid, Veale, Pigges and Rabbits, are meates easie to be digested and doe engender good bloud’. Venison, bacon and offal ‘doe breed raw humour in the stomack, and fluxes’. He follows this information with a veritable ‘Mrs Beeton’ of recipes.
Many fish are listed, especially river ones, all with cooking instructions. The oyster recipe is especially interesting ‘Oysters rosted on the imbers [embers], and then taken with oyle, pepper and the iuyce [juice] of Orenges, provoke appetite and lechery. They must not be eaten in those months which in pronouncing want the letter R’. He also recommends a way to keep oysters fresh for a few days, but the annotator says he is completely incorrect in this!
Fruit and vegetables
Vaughan was ambivalent about fruit, considering that people only eat it for ‘wantonnesse’ [a whim] and not for any good or nutritive value. The French habit of eating fruit after meals as ‘desert’ is unnatural, himself believing it should start the meal and eating too much fruit could cause greensickness in women and ‘morphew’ [a scurvy or leprous condition] ‘or else some flatulous windy humor’ in men. In spite of these warnings, many fruits are listed to ‘qualifie the blood’ and ‘represse choleric humours’. Ripe pears after meat ‘cause appetite, and fatten bodies. And if you drinke a cup of olde wine after them, they will doe thee much good’. Way ahead of his time, he recommends, twice, the use of lemon juice for scurvy. ‘Our Mariners lately returned from their East Indian voyage confesse, that their only remedy against the Scuruie [scurvy], and other diseases at sea, is the iuyce [juice] of Lemons’.
In the early editions, very few herbs and vegetables are listed, but many more have been added to later editions. By 1633, they are divided into three groups: hot (e.g. sage, mint and rocket), cold (e.g. lettuce and endive) and temperate (e.g. spinach and parsley). For each, he gives uses, sometimes medicinal and sometimes culinary, and adds cautions, e.g. in 1626 he says ‘Rocket alone is not wholesome in salads; for it procures the head-ache and heateth too much wherefore it must be used with cold hearbs, and then the nature of it is to provoke urine, and cure the cough’.
Dairy products
Of dairy produce, he says ‘Cheese being the thickest part of the milk is most nourishing, but it makes the body bound and stipticke’. Although approving of butter, he greatly prefers olive oil, mainly because it ‘better resisteth corruptions than butter’ and ‘Oyle is more wholesome and necessary then butter as well for a mans health, as for the preparing of sundry meates and sallades’. ‘I confesse there be many kindes of Oyle, yet none like to the oyle Olive, which I here do onely commend ...’. Our annotator adds ‘Oyl olives, fine candied Narbonne or Minorca honey each one ounce, lemon juice 1/2 ounce, well mixed together and spread on bread is an excellent supper’.
Honey
Not only does the annotator like honey, Vaughan himself recommends it strongly ‘The use of Honey is so soveraigne, that nothing in our cold Countries comes neer it for goodnesse and perfection’. He quotes Marsilius Ficinus as rating it a safeguard for long life and a true buckler against diseases.
Condiments and spices
Vaughan approves of salt, but most particularly as a preservative for meat. Pepper, cinnamon, ginger, cloves and nutmegs all meet with his approval, as does saffron, which ‘reioyceth the heart, comforteth the stomacke and procureth sleepe, but you must not take too much of it’.
Beer
‘Beere which is made of good malt, well brewed, not too new, nor too stale, nourisheth the body, causeth a good colour, and quickly passeth out of the body. In Sommer it availeth a man much, and is no less wholesome to our constitutions than wine...’.
Wine
Wine, taken temperately, he says ‘refresheth the heart and the spirits, tempereth the humours, ingendereth good bloud, breaketh flegme [phlegm], conserueth [conserveth] nature and maketh it merry as the Princely Prophet says, wine reioyceth [rejoiceth] the heart of man’. Here our annotator has added ‘whoso taketh more than comporteth herewith sinneth’. Vaughan cautions his readers with regard to Muscadell, Malmesie and Browne Bastard in the following terms ‘These kinds of wines are only for married folks, because they strengthen the back, yet I wish them to be very chary in the drinking thereof’. In the earliest editions, his greatest praise goes to Rhenish wine, of which he says ‘of all other the most excellent, for it scoureth the raines [kidneys] of the back, clarifieth the spirits, provideth urine and driveth away the headache, specially if it doth proceede from the heat of the stomach’. In later editions, he expresses strong approval of red wines, except late at night for those inclined to gout. He goes on to provide horrific recipes for making drunks sober and making ‘Tossepots’ hate wine—the latter involving green frogs and fried owl eggs!! In later editions, these are replaced by ‘three or four eels placed in the wine until they die’.
Section 3: Sleep, early rising and dreams
Sleep
This is short and loses its individual status as a section in later editions. Nevertheless, Vaughan has strong feelings about it. ‘Moderate sleepe strengtheneth all the spirits, comforteth the body, quieteth the humours and pulses, qualifieth the heat of the liver, taketh away sorrow and assuageth furie of the minde’. He recommends 7 hours sleep for sanguine and choleric men and 9 hours for phlegmatic and melancholic men. He considers sleeping at noon to be very dangerous unless sleeping in a chair with your shoes off (so they do not return harmful vapours) and your head covered. Although he is greatly in favour of early rising as a general principle, he is supportive of staying in bed ‘if the aire be corrupt, as in plague time, inclined to moistnesse, as in raynie [rainy] or mistie weather, or thundring’.
Dreams
Vaughan also embarks on a discussion of dreams, which he says are tokens of things past and significants of things to come. He classifies them into three types—divine, natural and supernatural.
Section 4: Evacuations
This section is very varied in content and the easiest way to consider it is probably to take each of Vaughan's chapters separately.
Exercise
‘Exercise is that which maketh the body light, increaseth naturall heate, and consumeth superfluous humours, which otherwise would clotter and congeal within the body’. He recommends walking, if it is not too slow, in the early morning in spring, summer and autumn, and to ‘climbe a steep hill until you pant (in colde seasons)’ and hanging by the hands on a thing above your reach so your feet do not touch the ground. Old men should have their joints rubbed with a linen cloth as their exercise and shortwinded men should ‘use loud reading and disputations, that thereby their winde pipes may be extended and their pores opened’.
Urine
Urine is described as being the lighter part of blood proceeding from the raines [kidneys]. ‘Most laudable’ urine is somewhat red and yellow like gold, not white, thick or gravelly. ‘Black or greene coloured vrine, declareth death most commonly to ensue’.
Fasting
Going without a dinner or supper once a week is ‘wonderful commodious for them that are not cholericke or melancholicke, but full of raw humours’.
Venerie
It is ‘best to use carnall copulation in Winter, and in Spring time, when nature is desirous without the needs of Arts dregs, and at night, when the stomacke is full, and the body somewhat warme, that sleepe immediately after it may lenify the lassitude caused through the action thereof. In Sommer in June and July when the spettle thickens on the ground, it cannot be good’. ‘Moderate Venerie is very expedient for preseruation of health. It openeth the pores, maketh the body light, exhilerateth the heart and wit and mitigateth anger and fury.’ But what advice can he give to ‘wifeless bachelors and husbandless maides’? ‘First, they must refraine from wine, and venerous imaginations, and not vse to lye in soft down beds. Secondly, they must addict themselves to read the Bible and morall Philosophy. Thirdly, they must exercise often their bodies. Lastly, if none of these prevaile, let them vse the seed of Agnus castus and they shall feel a strange effect to follow.’
Baths
Cold and natural baths are good for rheumes, dropsies and gout ‘But no man distempered through Venery, Gluttony, watching, fasting, or through violent exercise, presume to enter into them’. ‘You will find it wonderfull expedient, if you bathe your head foure times in the yeere, and that with hot lie made of ashes. After which you will cause one presently to powre two or three gallons of fountain water vpon your head. Then let your head be dryed with cold towelles. Which sodaine [sudden] powring of cold water, although it doth mightily terrifie you, yet nevertheless it is very good, for thereby the naturall heate is stirred within the bodie, baldnesse is kept back, and the memory is quickned.’
Blood-letting
Vaughan was generally not in favour of this treatment, but considered it to be safe at certain times of year.
Purgations
All purgations have poisonous effects, and their frequent use is dangerous and aging, Vaughan asserts. He gives recipes for purgatives for phlegm, choler and melancholy, and a list of eight things to take into account in purgations: (1) quality of the purgation, (2) time of year, (3) climate of the country, (4) age of the patient, (5) his custom, (6) the disease, (7) the strength of the sick person and (8) the place of the Moon. He gives recipes for glisters [suppositories], e.g. honey, wheat meal, fresh butter ‘make your glister into a long form, dip it in oyle, and use it’.
Tobacco was used for medicinal purposes in the early 17th century and Vaughan includes it as a purgative. Even in the early editions, he warns of the dangers if its use for this purpose and goes into considerable detail in discussing the effects of the ‘abuse’ of tobacco. In later editions he gives it a chapter to itself and the wording suggests that he read the anti-tobacco tracts by Philaretes (Philaretes, 1602) and King James I (King James I, 1604). However, he recommends it here: ‘Cane tobacco well dried, and taken in a cleane Pipe fasting, in a moist morning, during the Spring and Autumne, cureth the megrim, the toothache, obstructions proceeding of cold, and helpeth the fits of the mother’.
Vomits
‘A vomit is the expulsion of bad humours (contained in the stomack) upwards. It is accounted the wholesomest kinde of Physicke: for that, which a purgation leaveth behind it a vomite doth root out.’ He provides a number of recipes for emetics, suggesting that, if they fail to work in an hour, ‘stick your left middle finger in your mouth and you shall be holpen’.
Common sicknesses
By the 1626 edition, this chapter had been accorded its own section, with many treatments and ‘cures’ for a wide range of health problems, including corns (soften overnight with a bruised snail before cutting).
Section 5: Infirmities and death
Mental and emotional problems
Perhaps unusually for the early 17th century, Vaughan includes mental illnesses. ‘As the cure of the bodyes griefes consists chiefly in the knowledge of those causes which engender them: so in like manner for the cure of spirituall maladies, we must search out the causes from which they do proceed’. As for bodily illnesses, mental illnesses have inward and outward causes. He discusses emotions, including love, jealousy, anger, choler, sorrow, fear and envy. The contemporary annotator has added several notes to this section. For example, where Vaughan describes the above emotions as ‘spirituall passions’ our annotator adds ‘(Spiritual only as they affect the mind, for otherwise they are all horribly Carnal)’ and after the notes on ‘what is love?’ he adds ‘by his using the word lust here tis plain he means carnal Love in opposition to both Mental or Divine’.
Ages of man
The age of man is divided into seven periods as follows: infancy (our annotator says 7 years); childhood, 7 years (up to 14 years); stripling, 8 years (to 22 years); young man (up to 34) characterized by being witty, magnanimous and well-adjusted; man's age, 16 years (up to 50) covetous and choleric; old age, 12 years (50–62), characterized by equity, religion and temperance; real old age, up to 80 years (‘to which fewe attaine’), melancholicke and most slow, drooping, decrepit, froward and cold!
The four humours
During the lifetime there are dangerous or ‘climacteriall’ years, every 7 according to Vaughan, ‘due to Saturne, who most commonly is cruell and noysome unto us’. The 56th year, or grand climacteric, is very dangerous. He also gives a list of critical dates in each month, and recommends that people who are ill should consider these dates and also the time of day because of the dominant humour at that time. Vaughan defines the humours as ‘a moist and running body, into which the meate in the Liver is converted, to the end that our bodies might be nourished by them’. The four humours were: sanguine (blood), hot, moist, fatty and centred in the liver, dominating the body for 6 hours, from 21:00 to 03:00; flegmaticke (phlegm), white, brackishlike unto sweat and properly placed in the kidneys, dominating from 03:00 to 09:00; cholericke, hot fiery, bitter and like unto the flower of wine, ‘cleanes guts of filth, makes liver hot and hinders bloud from putrefaction’, dominant from 09:00 to 15:00; melancholicke, black, earthly, resembling the lees of bloud, seated in the spleen, dominant from 15:00 to 21:00. All bodily functions and personal traits were seen in the context of the predominant humour in a person's body, thus general well-being, treatments and specific health needs were prescribed on that basis. For example, Vaughan says, ‘Melancholic men need light perfumed chambers, young good meate (beware Beefe, Porke, Hare and wildebeests). Use Borage and Buglosse in their drinke, musicke is meet for them, always keep their bellies loose and soluble’.
Section 6: Restoration of health
Here Vaughan brings together much of his earlier advice in a quarterly, monthly and daily ‘dyet’ or regimen. Whilst much of the advice has been given earlier in the book, the way in which it is focussed on particular seasons provides us with considerable insight into the conditions which had to be coped with at that time.
The quarterly diet
The quarterly ‘dyet’ discusses what to eat and drink in the four seasons, when to use different treatments, and, for winter, how to keep warm. ‘I cannot but commend the Dutchmens providence above our own’, says Vaughan, adding that they wear fur round their necks and woollen socks. In summer he says, ‘to heal wounds is difficult and perillous’. We picture ‘summertime when the living is easy’, but this was not necessarily true. Cold was easier to deal with than heat. In winter, fires could be lit and rooms warmed, but in summer there was no effective way to keep the temperature down, thus food went bad, bacteria bred quickly and diseases were rife.
The monthly diet
The monthly ‘dyet’ adds detail to the seasonal one. Each month is characterized. For example, March is a month of diseases, August is a threatening season and in November ‘black melancholy endeauours to domineere in our bodies’. Food and drink for each month are suggested, e.g. clearing things such as pottage of leeks and herbs in March; a hot buttered loaf with sugar and cinnamon for breakfast in November. Other advice includes baths in March, June and July; early rising in June so ‘good husbands doe fetch long vagare [strolls] through the pleasant fields to provoke appetite’! Study in October when the temperature is neither too hot nor too cold. In November ‘Now you may safely drinke a pipe of Tobacco fasting, if you fear rheumes’.
Means to prolong life
In addition to recipes for various syrups, Vaughan emphasizes the importance of mirth, which he says enlarges the heart and distributes much natural heat with the blood. If, as Vaughan says, ‘God afforded Mirth unto men that they might be induced to seek after His Divine Maiestie’, our annotator in the 1612 edition asks ‘How is Mirth then generally abused?’. ‘All haile Doctor Dyet, Doctor Quiet and Doctor Merry-man’ to prolong life, says Vaughan, in later editions.
The daily diet
The daily diet is in 16 steps taking the reader through their day and night from stretching on awakening, through toilet procedures, meals, work, prayers and sleeping (‘Sleepe first on your right side with your mouth open, and let your nightcap be somewhat thick quilted, have a hole in the top, through which the vapour may goe out’), to awakening next day.
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Discussion |
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TopAbstractIntroductionAim of this paperMethodVaughan's advice in Naturall...DiscussionConclusionReferences |
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Although Vaughan was writing before the Age of Enlightenment, and had, therefore, to base his arguments on the medical theories and beliefs of his time, many of his messages have stood the test of time and are similar today, although with differing theoretical underpinning.
Health education books were popular in the 17th and 18th centuries. People were eager for guidance in the preservation of their health and treatment for minor ailments and injuries. For example, Cotta (Cotta, 1612), Hart (Hart, 1633), Cheyne (Cheyne, 1724) and Wesley (Wesley, 1747), the last of these running to 39 editions, well into the 19th century, all have a similar basis to that of Vaughan's publication.
It is impossible in a short paper to present a complete continuum content analysis of Vaughan's book, but it is worthwhile taking four items that are still of major importance in current health education and tracing their progress over the intervening four centuries.
Clean air and water
During the 19th century, the capacity of bacteria to turn food ‘bad’ and to cause many diseases was discovered by Pasteur, Koch and others, and the bacteria were identified (Lomas, 2003). Airborne and water-borne spread of bacteria were observed, studied and prevented (McAleavy et al., 2002). The problem of bad housing, overcrowding, and polluted air and water in British cities was also a major cause for concern in the 19th century (Hill, 1875), and action was taken to reduce it by provision of clean water supplies, clean air acts and establishment of good sewage systems. However, even now, the issue of air pollution by tobacco smoke still needs to be addressed in some areas. From the 18th to 20th centuries, the development of inoculations and vaccinations enabled some diseases to be prevented, disinfectants killed bacteria thus preventing their spread, and pharmaceuticals, including penicillin, enabled many more diseases to be treated successfully.
Exercise
Although exercise has always been valued, it is only recently that its real importance in disease prevention has been scientifically confirmed (Stewart and Kleihues, 2003).
Diet
Interest in a balanced diet in Great Britain was high during World War II in the planning of rations, but it was not until the 20th century that diet for disease risk reduction began to be seriously investigated, especially in the context of cancer risk reduction (Doll and Peto, 1981). Vaughan would have been glad to see that many of his recommendations including red wine and olive oil (Doll et al., 1994; Trichopoulou et al., 2000), white rather than red or processed meat (Norat et al., 2002), and fresh fruit and vegetables (Bueno-de-Mesquita et al., 2002) have all been supported by scientific research. However, one of Vaughan's greatest contributions to health education was his observation that lemon juice prevents scurvy. It was 150 years before Lind published his famous treatise on this topic (Lind, 1753) and the subsequent Admiralty order for lemon juice to be carried on all ships (BBC History, 2004).
Tobacco
Vaughan's doubts were confirmed and his rather hesitant recommendations completely negated. In 1954, the link between cigarette smoking and lung cancer was definitely proven (Doll and Hill, 1954), and many subsequent publications found smoking to be the main cause of many serious diseases.
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Conclusion |
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TopAbstractIntroductionAim of this paperMethodVaughan's advice in Naturall...DiscussionConclusionReferences |
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Although Vaughan, writing at the beginning of the 17th century, had to base his health education advice on the knowledge and theories available at that time, many of his messages have since been scientifically proven to be appropriate and are still in health education manuals today. However, the style of education changed in the 20th century. Vaughan and his contemporaries provided new information for their readers, which was likely to trigger action. Most of this information is now well-known to present-day readers and health education currently involves behavioural strategies to trigger action (Bandura, 1977
; Tones, 1979; Ajzen and Fishbein, 1980; Becker, 1984). |
References |
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Ajzen, I. and Fishbein, M. (1980) Understanding Attitudes and Predicting Social Behavior. Prentice-Hall, Englewood Cliffs, NJ.
BBC History (2004) James Lind (1716–1794). Available: http://www.bbc.co.uk/history/historic_figures/lind_james.shtml.
Bandura, A. (1977) Self-efficacy: towards a unifying theory of behavioural change. Psychological Review, 64, 191–215.
Becker, M.H. (ed.) (1984) The Health Belief Model and Personal Health Behavior. Slack, Thorofare, NJ.
Bueno-de-Mesquita, H.B., Ferrari, P., Riboli, E. on behalf of EPIC (2002) Plant foods and the risk of colorectal cancer in Europe: preliminary findings. In Riboli, E. and Lambert, R. (eds), Nutrition and Lifestyle: Opportunities for Cancer Prevention (IARC Scientific Publication 156). IARC Press, Lyon, pp. 89–95.
Cell, G.T. (2000) Sir William Vaughan. Dictionary of Canadian Biography. University of Toronto/Universite de Laval, Toronto.
Charlton, A. (2005) Tobacco or health 1602: an Elizabethan doctor speaks. Health Education Research, 20, 101–111.
Cheyne, G. (1724) An Essay of Health and Long Life. George Strahan, London and J. Leake, Bath.
Cotta, J. (1612) A Short Discoverie for several sorts of ignorant and inconsiderate Practisers of Physicke in England. With Directions for the safest election of a Physitian in necessitie. William Jones and Richard Boyle, London.
Doll, R. and Hill, A.B. (1954) The mortality of doctors in relation to their smoking habits. A preliminary report. British Medical Journal, i, 1451–1455.
Doll, R. and Peto, R. (1981) The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. Journal of the National Cancer Institute, 66, 1191–1308.[Web of Science][Medline]
Doll, R., Peto, R., Hall, E., Wheatley, K. and Gray, R. (1994) Mortality in relation to consumption of alcohol: 13 years observations on male British doctors. British Medical Journal, 309, 911–918.
Hart, J. (1633) The Diet of the Diseased. Thomas Allot, London.
Hill, O. (1875) Homes of the London Poor. Macmillan, London.
King James, I. (1604) A Counterblaste to Tobacco. R. B., London.
Lind, J. (1753) A Treatise of the Scurvy. Printed by Sands, Murray and Cochran, Edinburgh for A. Millar, London.
Little, W., Fowler, H.W. and Coulson, J. (1933) The Shorter Oxford English Dictionary on Historical Principles. Revised and edited by C. T. Onions. Oxford University Press, Oxford.
Lomas, T. (2003) The Development of Medicine for OCR GCSE. Hodder and Stoughton, London.
McAleavy, T., Patterson, D. and Whittock, M. (2002) Medicine and Public Health through Time. Hodder & Stoughton, London.
Norat, T., Lukanova, A., Ferrari, P. and Riboli, E. (2002) Meat consumption and colorectal cancer risk: dose response meta-analysis of epidemiological studies. International Journal of Cancer, 98, 241–256.
Philaretes (1602) Work for Chimny-Sweepers or A Warning for Tabacconists. Thomas Bushell, London.
Stewart, B.W. and Kleihues, P. (eds) (2003) World Cancer Report. WHO/IARC, Lyon.
Tones, K. and Green, J. (2004) Health Promotion: Planning and Strategies. Sage Publications, London, Thousand Oaks. New Delhi, pp. 77–106.
Trichopoulou, A., Lagiou, P., Kuper, H. and Trichopoulos, D. (2000) Cancer and Mediterranean dietary traditions. Cancer Epidemiology, Biomarkers and Prevention, 9, 869–873.
Vaughan, W. (1600) Naturall and artificial Directions for Health, derived from the best philosophers, as well moderne as auncient. R. Bradocke, London.
Vaughan, W. (1602) Naturall and artificial Directions for Health, derived from the best philosophers, as well moderne as auncient, 2nd edn. R. Bradocke, London.
Vaughan, W. (1607) Naturall and artificial Directions for Health, derived from the best philosophers, as well moderne as auncien, 3rd edn, newly corrected, revised and enlarged. R. Jackson, London.
Vaughan, W. (1612) Approved directions for health both naturall and artificiall: derived from the best physitians as well moderne as auncient. Teaching every man how he should keepe his body and mind in health: and sicke, how hee may safely restore it himselfe, 4th edn. R. Jackson, London.
Vaughan, W. (1617) Directions for health; derived from the best physitians as well moderne as auncient. Teaching every man how he should keepe his body and mind in health: and sicke, how hee may safely restore it himselfe, 5th edn. R. Jackson, London.
Vaughan, W. (1626) Directions for health, naturall and artificiall: derived from the best phisitians, as well moderne as antient. Francis Williams, London.
Vaughan, W. (1633) Directions for health: naturall and artificiall: derived from the best phisitians, as well moderne as antient, 7th edn. John Harison, London.
Wesley, J. (1747) Primitive Physicke: or an Easy and Natural Method of Curing most Diseases. Published privately, London.
Received on August 10, 2004; accepted on March 16, 2005
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