Dr Ross Mitchell FRCPE
Hundreds of years before the Christian era, Celtic tribes from the Rhine and Danube began to spread into Western Europe and by 300 B.C. they were considered the greatest people on the continent. By the 1st Century A.D. they were well established throughout the British Isles but gradually, under pressure from Romans and later from Teutonic tribes they became confined to the west, in Ireland, Wales and Cornwall, and to Scotland north of the River Forth, the south-east being largely Anglo-Saxon. From the 9th Century, the incursions of Norsemen modified Celtic customs in the Western Isles but did not radically change them, for the Norse were absorbed into Gaelic culture just as the Normans in England became Saxon in their ways. Despite their geographical divisions, the Celtic realms of the British Isles shared in common the ancient traditions handed down by word of mouth from their Iron Age ancestors. Nevertheless, the separation of Celtic Scotland from Ireland by the Norse command of the sea did accentuate the growing difference in language and culture between the two countries.
By the Middle Ages, Celtic social life was organised on the clan system of lineage based groups usually owning and occupying a particular territory and having political and legal implications. Clansmen were predominantly kinsmen of their eponymous progenitor but a clan would also include unrelated families drawn in for protection or other benefits and in time assuming the clan patronymic. The chief of a clan held sway by the consent of his warrior kinsmen and maintained in his retinue men versed in the arts - bards to extol his virtues in poetry and song, harpists to praise the mighty deeds of his forebears, judges and lawyers to interpret and administer the law, and leeches (Gaelic 'lighiche' a physician) skilled in medical craft. Below these learned classes were the freemen, labourers and slaves, their lives a drudgery contrasting with those of the warriors, who spent their lives hunting and fighting for sport or in battle, activities central to their aristocratic lives.
In the Highlands and Islands there were few books in circulation before the 18th Century, perhaps no more than half a dozen in Gaelic, so that we have little evidence of the health of the people. It is probable, however, that once the dangers of birth, infancy and early childhood were past, the general health of these Celtic communities was good. Their diet of oatmeal, fish, dairy produce and fruit was nutritious and deficiencies were not widespread, though rickets did occur. The earliest traveller from outside the area to write down a description of the Western Isles was Donald Munro, High Dean of the Isles, in 1594. His rather inadequate account was followed by the fuller and more percipient observations of Martin Martin, an islander trained as a physician in Leyden, who visited the Hebrides in 1695 at the request of Sir Robert Sibbald, who played a major role in the foundation of this College. Martin noted that the people were 'healthful and strongbodied' and not troubled by the epidemic diseases which were prevalent elsewhere and became such a scourge in Western Scotland in later centuries. He remarked that 'perhaps there is no part of the habitable globe where so few bodily imperfections are to be seen' and thought the best health was enjoyed by the people of the Isle of Jura, where 'no epidemical disease prevails'. After visiting St Kilda he said that the inhabitants 'never had a potion of physick given to them in their lives . . . a phisician could not expect his bread in this commonwealth'. However he also remarked that in Lewis 'smallpox, which comes but seldom, sweeps away many young people' and noted that children are also affected by 'chin-cough' (whooping cough, in Scots 'kinkhoast').
The health of a highland chief and his immediate kinsmen would be safeguarded by his hereditary physician according to strict legal requirements. For example, any man who injured a friend or neighbour physically was obliged by law to provide for the care of his victim until recovery was confirmed by the physician. The care of the common people was another matter, for illness and injury would be treated within the family, with the advice of a wise woman or healer versed in the herbal remedies and healing charms handed down through many generations. With the arrival of the Christian religion to replace the old druidic rituals, Irish scholarship flourished, spread to other Celtic lands and no doubt brought with it some skills in tending the sick. The later clan physicians would have known about the nostrums and charms of folklore and ignored or disparaged them in public. Nevertheless, with their inability to cure prevalent diseases such as smallpox, they probably tacitly condoned the herbal and other remedies of wise women, though their written manuscripts did not record such indigenous treatment and were based almost entirely on classical sources. They translated into Gaelic the great medical texts originally written in Greek, Latin or Arabic, adding glosses of their own, and in so doing extended medical knowledge and made it more widely accessible throughout the Celtic world.
In the early Middle Ages, therefore, there were emerging two streams of health care in Celtic society - the art of medicine as practised by the clergy and later by the clan chiefs' physicians and the great body of folklore passed down by oral tradition. As this wealth of folk medicine is of greater antiquity, it will be considered first before describing professional medical provision.
Beliefs about health and disease are seldom unique to one society, for they tend to pass from one community to another by word of mouth and the tales of itinerant travellers. Thus, for example, eating a mouse was considered a cure for bed-wetting throughout Europe in the Middle Ages but there were local variations: in the North of Scotland, the custom was to eat the mouse from a spoon made of horn taken from a living animal - 'a quick horn spoon'. In Scotland the line between Highlands and Lowlands was never precisely defined in cultural terms and there was always some intermingling of ideas, especially in the marginal areas of Atholl, Angus and Mar. However, certain practices are recorded as having been widespread in the Celtic areas and may therefore be considered as characteristic in their detail if not unique in concept.
In the early Celtic world, there was general belief in the supernatural - fairies, demons and the threat of the evil eye ('droch-shuil') and there were certain people who were believed to have occult powers while others were able to exorcise evil spirits. These beliefs were complemented by a deep knowledge of the therapeutic properties of plants, animal products and other materials, even water. The wise women and other gifted individuals would use these medicinal substances in combination with charms and incantations in the treatment of disease.
A great variety of plants was used in Celtic medicine and there was a general familiarity with common herbs. Some of these were undoubtedly of real value, though many were probably ineffective and achieved any perceived result through the belief of people in the accompanying charms and spells. Thus a poultice of hemlock applied to a skin cancer with the appropriate incantation was believed to remove the growth, at least in some cases.
Certain plants had a general application, such as the medicinal tea made from the common speedwell. Others were reserved for particular conditions. The juice of juniper berries was thought to be effective in curing epilepsy. Infusion of wild garlic was one of many remedies for bladder stone and infusion of tansy got rid of intestinal worms. Figwort was widely used for healing cuts and sores: it was called the plant of the thunderer ('lus an torranain') after Toranis the Celtic god of thunder, who gave his name to the island of Taransay. Some plants were used for magical purposes. For example, the sap of the rowan tree (mountain ash) was given to newborn infants to ward off evil spirits.
In Skye, seaweeds such as dulse were used as treatment for headache, colic, constipation and worms.
Animals and Animal Products
Eating a mouse to cure bed-wetting has been mentioned and many other animals had specific uses. A common belief throughout the British Isles was that whooping cough could be cured by passing the sufferer under the belly of a horse, when the disease would be transferred to the animal. In most areas a piebald horse was specified but in the Celtic world it had to be a white horse, perhaps in contrast with the malevolent black water horse, the mythical kelpie. The Celtic Scots also believed that asthma could be alleviated by smearing deer grease on the soles of the feet, whereas the Irish considered a dandelion potion to be more effective.
In the Western Isles, the ubiquity of seals meant that products of these animals were used for many purposes. The wearing of a sealskin girdle resulted in the relief of sciatica and the fresh flesh of young seals was given for diarrhoea. In St Kilda, the fat of seafowls ('gibean') was used to heal wounds and this 'gibean of St Kilda' was highly prized in Skye and other islands for the same purpose.
Charms and Spells
In his book 'Carmina Gadelica' Carmichael listed large numbers of runes and incantations in Gaelic, each of which was appropriate to a particular situation or disease. There was a widespread Celtic belief that fairies were especially predatory around the time of childbirth and it was customary to put a piece of cold iron in the mother's bed to prevent abduction of the mother and her baby. The newborn infant is still vulnerable to evil spirits until baptism, which should therefore be undertaken as soon as possible. Neonatal convulsions were thought to represent struggles to escape the fairies' clutches. It was generally believed that, if a baby arrived feet first, he was born to be hanged and that, if the fingernails were cut before one year of age, he would become a thief.
In later life a charm ('sian') could be put on someone to protect him from injury, perhaps in battle, or to ward off the ill-effects of the evil eye. Exorcism of demons was often undertaken with various specialised rituals for the demons of jaundice, epilepsy, erysipelas, local infections such as styes and so on. A magical cure for epilepsy was to bury a black cock at the spot where the patient had had his last fit.
Rickets and the resulting deformity were common in mediaeval Scotland and became even more widespread as diets deteriorated after the 18th Century. It was generally believed that blacksmiths, particularly if descended from several generations of smiths, possessed preventive and therapeutic powers, provided that an exact ritual was followed which varied in different areas. According to the practice of 'laying' in the Highlands, the rickety child was washed with special water before sunrise and then placed with due ceremony on the anvil, when the smith passed his tools three times over the child.
Plant, animal and magical cures were commonly combined with water, often administered three times. However, the medicinal qualities of water alone were highly regarded, especially if it came from a particular river or well. In Ireland, drinking water three times from certain rivers was thought to be effective in mumps. Therapeutic properties were attributed to special wells in the Highlands, such as the Well of Balquhidder, which was reputed to cure whooping cough, and a well at Borve in Harris, which was efficacious against 'stitches and gravel'. A well in North Uist ('tobar an deididh', well of the toothache) gave complete relief from toothache if three draughts of water were drunk in quick succession. Wells were often identified with local gods and the healing properties attributed to these deities.
The Water of Life - 'uisge beatha' in Gaelic, usquebaugh in Scots and whisky in English - was understandably considered to be almost a panacea, given for a variety of ailments but believed to be specific for smallpox. In 1785, the right of Forbes of Culloden to distil duty-free whisky at Ferintosh in Cromarty was withdrawn by law, which prompted Robert Burns to write:
Thee Ferintosh! O sadly lost!
Scotland lament frae coast to coast!
Now colic grips an' barkin' hoast
May kill us all!
Clearly confidence in the medicinal value of whisky endured in Scotland long after the Middle Ages.
No doubt many early Celtic leeches used plant and animal products in good faith and believed in their efficacy, though later generations of physicians relegated them to folklore. Conversely, however, some ancient Celtic remedies, such as giving the thyroid gland of a sheep born on St Brigit's Day to a child with cretinism, may have been compatible with the scientific facts that form the basis of modern therapeutics.
As Christianity spread through Ireland, the welfare of the poor and needy became the purview of the monastic institutions and gradually there emerged certain families with close connections to the clergy who practised medicine. For example, the O'Cassidy physicians of Fermanagh ranked as 'erenaghs' - tenants of bishops living on church lands and accorded ecclesiastical status. Some such medical families took their names from their profession, such as MacInlea (from the Irish 'liaigh', a leech) or O'Hicky (from 'icidhe', a healer). As the clan system developed in both Ireland and Scotland, the chiefs began to surround themselves with personal entourages of learned men, including physicians, and the link with the Church progressively diminished, though the hereditary nature of medical practice continued.
The clan system in Scotland emerged in the 12th Century and flourished for 500 years. While the status of many individual clans rose and fell during that period, the largest of them - e.g. Cameron, Campbell, Chattan, Maclean and Mackenzie - grew in power and status. After the Battle of Largs in 1263, the withdrawal from the Western Isles of the kings of Norway and Man allowed Clan Donald to become the pre-eminent clan in the area and in the mid-14th Century John Macdonald of Islay assumed the Lordship of the Isles. This ancient title, probably Norse in origin and based on sea power, was widely recognised and respected: thus in 1350 a dispensation by the Pope referred to 'John of the Isles, Lord of the Isles of Scotland'. Although nominally under the Crown of Scotland, Clan Donald held semi-autonomous sway over Western Scotland until the Lordship was finally forfeited to the Crown at the end of the 15th Century.
In this relatively stable society, the hereditary scholarly classes thrived. Notable among them were the Morrisons, judges ('breves') to the Macleods of Lewis, the MacCrimmon pipers to Macleod of Dunvegan, the MacMhuirich bards to Macdonald of Clanranald and the Beaton physicians to the Clan Donald and other clans. Learned families serving clan chiefs were sometimes related to him. For example, Hector Maclean was bard to his kinsman Maclean of Duart in 1650 and was reputedly the last poet in Mull to serve in this way. More usually, the scholarly family was unrelated by blood but became part of the clan by agreement, generally acquiring clan lands in exchange for professional service. Many of these families came originally from Ireland. Members of the O'Muirgheasain (Morison) family were hereditary poets in Ireland from the 15th Century, came to Mull early in the 16th century and entered the service of Clan Macleod. Throughout the middle Ages, there was much passage of learned men between Scotland and Ireland, especially of poets and musicians, who went to Ireland periodically for further study. Medical men, too, were often of Irish origin but they tended to go to continental centres for professional refreshment, because there they practised according to the same classical traditions.
The early physicians appointed to noble Irish families were highly educated men, with connections to the great European medical schools such as Louvain and Padua. Some, such as the O'Canavans - hereditary physicians to the O'Flahertys - established medical schools of their own in Ireland. Many Irish doctors practised in European countries and one of the Dunleavy family, who were in the service of the O'Donnells in Ireland, became physician to the King of France. Other well-known Irish medical families were the O'Callahans, physicians to the MacCarthy kings of Munster, and the O'Sheil physicians serving the MacMahons, the ruling family of Monaghan. In Celtic Scotland there were comparable medical families. The Macleans in Skye were physicians to Macdonald of Sleat until the 18th century, the last hereditary physician (Dr John Maclean) dying in 1790. In Argyll, the O'Conachers gave medical service to Clan Campbell and were granted land in Lorne in return. The Campbells were also served by Maclachlan physicians. In the 16th Century, O'Connors from County Laois in Ireland were known to be practising medicine in the Scottish Highlands.
By far the best-known and most widely dispersed of the hereditary physicians in Scotland were the MacBeth or MacBeatha family (in English 'Beaton' and in French 'Bethune'), who originated in Ireland and came to Scotland from about 1300 A.D. onward. They first settled in Islay and spread from there to Mull, Skye and mainland Scotland. Over the succeeding centuries, as their fame grew, there was much coming and going of Beaton physicians throughout Scotland from Sutherland to Argyll and beyond. Some returned to Ireland and a branch practised medicine in Mayo (perhaps because drugs and simples from the Near East were imported there). In 1473 James, Lord Courcy of Kinsale in Ireland, granted lands along with 'medical dignity' to Rory MacBetha, who belonged to the MacBeth family from the Western Isles of Scotland.
In the Western Isles, Beatons became physicians to the Macdonalds of Skye and North Uist and to Clanranald in South Uist. Their standing was further enhanced when they were appointed as hereditary physicians to the Lords of the Isles. Even after the Lordship had been forfeited, a Royal Charter of 1609 issued in Edinburgh confirmed Fergus Beaton as Principal Physician to the Isles.
From early days, the Beatons provided medical services to the Royal House of Scotland. In the 14th Century, Patrick MacBeth or Beaton was physician to King Robert I (the Bruce) and it is said that virtually every Scottish, king thereafter until the 18th Century was attended by a Beaton physician. One of them probably attended King James VI and I on his deathbed. When his son, Charles I, went from London to Edinburgh for his Scottish coronation, he was accompanied by a Dr Beaton, though there is doubt whether he was related to the medical dynasty. In the 15th Century a Beaton family was established in north Fife, just across the River Tay from the estates near Monifieth in Angus, which undoubtedly belonged to one of the Beaton family of Islay. The physician who accompanied Charles I to Edinburgh belonged to the Fife Beatons and the Rev. Thomas Whyte of Liberton, who married into the Beaton family of Skye, claimed that the two dynasties were related by blood. It is hard to believe that, when virtually every Stewart king had a physician from the famous Beaton family, only the Dr Beaton in the service of Charles I was from another unrelated family. However Bannerman, who wrote the definitive history of the medical Beaton family in 1998, believes that Whyte was mistaken and certainly there is no other evidence of a link.
With the final disappearance of the Lordship of the Isles in the mid-16th Century, the influence of the Beaton family began to wane and the last recorded Royal Physician from the Beaton dynasty was Fergus Beaton of Islay, who died in 1628. The Beaton family continued to provide medical services to chiefs of clans Donald, Maclean and others until the 18th Century, the Mull branch of the family being particularly well known. One of them, John Beaton (1594-1657) was physician to Maclean of Duart. In 1700 the Welsh scholar Edward Lhuyd met John Beaton's son, the Rev. John Beaton, in Ireland and commented that he was a learned member of the famous medical family. In 1716 a Dr. Donald Beaton, who was probably the last hereditary physician to Macdonald of Sleat, wrote a medical certificate testifying to the ill-health of his chief.
Like other hereditary physicians, the Beatons practised medicine in the classical tradition of Aristotle and Galen but combined this with the use of medicinal plants and other traditional therapeutic measures, whose efficacy they doubtless verified by their own observations. We know from Beaton manuscripts in the National Library of Scotland that they were versed in the use of botanical remedies and Edward Lhuyd noted that the Rev. John Beaton was an expert botanist as well as being probably the last person to receive a traditional bardic education. It should be noted that, whereas in other parts of the British Isles surgeons developed from barbers and until comparatively recently were of inferior status to physicians, the Celtic physicians combined medical and surgical skills, and were expert in such procedures as trephining, venesection and cutting for the stone. Hence the old Gaelic saying about the Beaton family:
Clann 'ic Beatha a'ghrinn,
Luchd snaidheadth chnamh is chuislean.
MacBeths of the polished ways,
Men who slit bones and veins.
The attachment to clans of hereditary learned men began to decline in the 17th Century and died out in the succeeding one. In the early period of the clan system, bards and breves were ranked higher than leeches in the chief's hierarchy of attendants but physicians gradually rose in status and in the end were the last of the learned men to be attached to the chiefs' retinues. As late as 1784, descendants of the hereditary medical dynasties were still established as physicians to some of the great families in the Western Isles, though generally clan affiliations had ceased. Many members of the medical families continued to practise medicine but in the Lowland Scottish tradition based on university medical schools and apprenticeships, rather than in the traditional Celtic way.
In the 17th Century the power of clan chiefs began to wane as central government increased and the clan system weakened, a process that accelerated after the 1745 Jacobite Rising. Drawn by the cosmopolitan life of Edinburgh and London, many chiefs sold land to raise money and, as their debts increased, demanded higher rents from their clansmen. Between 1763 and 1775, twenty thousand people left the Highlands for the colonies to escape the rack-renting of their chiefs, who then began to evict their remaining tenants from the more fertile lands and set them to gathering kelp, a valuable seaweed fertiliser. Finally, when the market for kelp collapsed in the 1820s, the chiefs began to transport their people to North America or Australasia. Thus, for example, when the widow of the 16th chief of the Macdonells of Glengarry sold their estates in Knoydart in 1852, most of the remaining people were evicted and those left faced destitution and starvation. In the middle of the 19th Century, three-quarters of the population existed on relief from the Destitution Boards, which was never sufficient. Inevitably emigration increased further because of grinding poverty and recurrent famines. The result of these changes, accentuated by post-Jacobite oppression and the crop failures of the 1840s, was disintegration of the ancient systems of Celtic society. Living conditions deteriorated until they reached a low ebb and medical care dwindled throughout the Highlands and Islands until it was virtually non-existent. At the beginning of the 19th Century there was no doctor at all in the Island of Mull, home to so many famous physicians in the past. In 1854, when the senior doctor in Inverness, a Dr. Crichton, visited the west coast after a Member of Parliament had reported widespread starvation, he found the people dying of malnutrition and consumption and noted that there was no medical man in the area and little or no parish relief.
In the second half of the 19th Century things began to improve and a few qualified doctors began to practise in the larger Highland towns. Some gave outstanding service, like the Skyeman Dr David Ross, M.D. of Edinburgh, who fought and succumbed to an outbreak of typhus in Portree in 1887. For the general population, however, there was little health care and diseases such as tuberculosis, cholera, typhoid and dysentery persisted long after they had diminished in the rest of the United Kingdom. Not until the beginning of the 20th Century, when a Liberal government established a Highlands and Islands Medical Fund, was it possible for every Gaelic community to have the services of a medical practitioner.
J. Bannerman, The Beatons (Edinburgh, 1998)
A. Carmichael, Carmina Gadelica (Edinburgh, 1928)
M. Dillon and N. Chadwick, The Celtic Realms(London, 1967)
J. Hunter, Last of the Free (Edinburgh, 1999)
M. Martin, A Description of the Western Islands of Scotland circa 1695. (London, 1703)
D. S. Thomson, The Companion to Gaelic Scotland (Oxford, 1983)