17th Century England, 17th Century Europe, Bubonic Plague, Caesarian Sections, Charles II, David Thewlis, Great Fire of London, London, Medical Stuff, Meg Ryan, Restoration, Robert Downey Jr, Sam Neill
“In 1660 Charles II was restored to the English Throne ending 11 years of Oliver Cromwell’s bleak Puritan rule. Thus began the age of Restoration. It was an era of scientific discovery, artistic exploration, and luxurious sensuality. It was also a time of natural disasters and archaic medical practices. Science was pitted against superstition. This is the story of one man’s journey through the light and dark of those times.”
So begins Restoration (1995, dir. Michael Hoffman, based on Rose Tremain’s 1989 novel of the same name), a modest little film about a young doctor, Robert Merivel (Robert Downey, Jr.), who earns the attention of the new king Charles II (Sam Neill) by curing Charles’ sick spaniel. Merivel is a talented young physician but also a libertine and wastrel by nature. Once ensconced at the court as the caretaker of the royal hounds, he indulges in his penchant for wine, woman, and buffoonery. Then one day, Charles tells him that one of the king’s mistresses has become jealous of another of his mistresses, and so Charles has decided to marry her off to Merivel. The marriage is to be a sham; Merivel is forbidden to sleep with his own wife, who has no real interest in him anyway, but the reward is an estate in Suffolk and a knighthood.
Unable to say no, Merivel weds Celia (Polly Walker) and begins his life as a country gentleman, but soon finds himself falling in love with his wife. Celia views her time in Suffolk as an exile and wishes to be restored to Charles’ court, while Merivel schemes to extend his wife’s absence from court in hopes that she will come to love him. But his scheme is exposed and an angry Charles evicts him from the estate and reclaims Celia.
Destitute and homeless, he seeks out an old medical student friend, John Pearce (David Thewlis), a Puritan who has opened a sanitarium for the mentally ill, where Merivel meets Katherine (a rather out-of-place Meg Ryan), an emotionally disturbed Irish woman whom he falls in love with and gets pregnant. This gets both of them kicked out and they wind up destitute in London just in time for the Bubonic Plague to hit London, and soon after that, the Great Fire of London.
The story is basically a redemption narrative. Merivel begins his fall when he succumbs to the pleasures of the court and slowly loses his passion for medicine. He bottoms out when he is evicted from his estate and slowly begins to recover his passion at the sanitarium, where he proposes treating the deranged inmates by playing music and letting them dance (in one of those stock Hollywood scenes where the skeptical authorities reluctantly allow something unconventional and it proves so transformative that even the authorities embrace it).
Medicine repeatedly brings out the best in Merivel, even when it leads to complications. His dance therapy leads to his relationship with Katherine, who helps him emerge from his emotional deadness. But later he realizes that their baby needs to be delivered by caesarean section, a procedure that Katherine will not survive. This turns out to be the world’s prettiest c-section, with virtually no blood. Katherine controls her pain so well she doesn’t even need to be held down and a viewer coming in partway through the scene might be forgiven for thinking that her moans and writhing were signs that someone was giving her cunnilingus. Afterward, she gets a nice soft-lighting post-operative death scene. In case anyone is missing the point of what I’m saying, this is ludicrous. Pre-modern caesarean sections were horrific affairs, done without anesthetic and therefore unendurably painful for the mother, many of whom probably died from the pain alone, let alone the blood loss and organ trauma.
The birth of his daughter and the loss of his mistress force Merivel to grow up. He decides to confront the Bubonic Plague and is horrified to discover that the Royal Hospital has been filled with sick patients who have been boarded up in a large room with no medical treatment. He literally breaks down the boards to get to his patients and tenderly eases the pains of the dying and helps the rest recover.
It’s a decent little film. Downey is well-cast in the type of role he’s best known for, the charming rake who struggles with his addictions, but Restoration was made just before he began his own infamous descent in drug addiction, and so his performance lacks the knowing edge of some of his later roles. The rest of the cast is mostly quite solid, including Hugh Grant as a high-strung artist assigned to paint a portrait of Celia and Ian McKellan as the faithful steward of Merivel’s estate. Neill seems just a bit off as Charles II, lacking the real man’s self-depricating sense of humor and charm, and as I said, Meg Ryan feels totally inappropriate, like no one realized she was actually cast in the romantic comedy filming next door.
The Medical Details
The film wants to be a criticism of the appalling state of medicine in the late 17th century, a theme it has in common with The Madness of King George. The prologue text tells us that medicine is “archaic” and that “science was pitted against superstition”, but the film never really delves into that critique enough to really work. There’s a nice scene early on where Pearce and Merivel attend an anatomy lecture that’s being delivered in Latin; that’s accurate but it’s a passing detail, and the medical education of the time is barely commented on, other than that it requires expensive books and that Merivel should be grateful that his father, a glover, was able to arrange a medical education for him.
We only see Merivel actually practicing medicine a couple of times, mainly at the sanitarium, when he performs the caesarean section, and when he treats the Plague victims. He occasionally examines patients, listens to their heartbeat through a tube, and so on, but it’s mostly just incidental details. But the real problem is that the film really doesn’t have much idea of what 17th century medicine actually involved.
Physic, as elite learned medicine was called at the time, was essentially theoretical preventative medicine, an expensive medical practice, in contrast to surgery, which was considered a lower-status form of medical practice that involved a range of practices including the extraction of teeth, the setting of broken bones, the (rather painful) removal of bladder stones, and the like. Physic and surgery were essentially opposites; few physicians were also surgeons, the way that few neurosurgeons are also massage therapists.
Down to the early 19th century, medicine emphasized humoral theory, which held that the body had four primary fluids: blood, phlegm, yellow bile (what you bring up when you vomit) and black bile (exactly what they thought that was is a matter of debate); all other fluids, like sweat, semen, and urine, were secondary fluids created from one of the primary fluids. Each primary fluid was either hot or cold and either wet or dry, so that blood was hot and wet, yellow bile was hot and dry, phlegm was cold and wet, and black bile was cold and dry. Observable symptoms such as sweating, fever, clamminess, vomiting, and diarrhea were all signs that one humor had gotten out of balance; so if a patient was feverish and sweaty, he had an excess of the hot, wet humor, while if the patient had a fever without sweats, he had an excess of the hot, dry humor. The appropriate remedy was to remove the excess humor from the body, so the feverish sweaty patient could be bled, while the feverish non-sweaty patient could be given an emetic to induce vomiting. Diet was also important, because certain foods stimulated the different humors; healthy patients would be told to eat or avoid certain foods based on the disposition of their body.
The humors also affected personality, and provided the basis for a theory of psychology. A patient with a frenzied, excessively fussy, or angry personality was choleric, so the treatment for those afflicted by violent outbursts might be to bleed them (that’s why King George’s doctor wants to cup him). Those who suffered from depression, sleeplessness, and the like were melancholic, because they had an excess of black bile. The leading work on the subject in the 17th century, Robert Burton’s The Anatomy of Melancholy, felt that social factors such as poverty, isolation, sadness, and fear were as important as humoral imbalance. He began the process of separating depression from its perceived bodily causes and its evolution into a primarily mental or spiritual condition (although modern pharmacology has started reversing that development by emphasizing the biochemical component of depression). Burton prescribed a range of treatments including drugs and herbs, work and moderate exercise, diet, sex, exposure to nature, and in very extreme cases blood-letting.
Burton’s work was extremely influential, and would probably have influenced the Puritan sanitarium, especially since Burton, as a clergyman, also feels that sin can cause melancholy. But there’s little sign of serious therapeutic efforts at the sanitarium, except in the case of Katherine. Her melancholy mostly manifests as insomnia and an obsession with walking strangely. She seems much less ill than most of the patients there, but Pearce insists on bleeding her to induce sleep. She responds well to Merivel’s dance therapy, but what really seems to put her mind back in order is getting busy with Merivel. I’m not sure what’s really dictating the plot here, Burton’s Anatomy, or the misogynistic idea that difficult women just need to get laid more.
Merivel’s dance therapy is certainly novel but it’s not exactly scientific; it’s just feel-good nonsense. (And the film seems rather confused about Pearce’s beliefs. In the novel, Pearce becomes a Quaker, basically on the far liberal end of the Christian spectrum of the time. In the movie, though, he says he’s become a Puritan, who were on the far conservative end of the Christian spectrum of the day; it’s like rewriting a vegan hippie from San Francisco as a Christian fundamentalist home-schooler from Alabama and thinking that somehow the character would be the same person either way. The idea that Puritan doctors would allow dance therapy is absurd, since they considered dancing profoundly immoral.)
Merivel’s c-section was standard medical practice at the time; the general idea was if the mother is going to die anyway (because the baby was too large for the birth canal), the surgeon might as well try to save the baby. But the c-section is a surgical procedure, and Merivel is a physician; he may have watched surgery, but he’s never performed it. Additionally, physicians of his day would have received no hands-on obstetrical training whatsoever; that was left to midwives. Having him perform a caesarean section would be like asking your chiropractor to do it.
His treatment of the quarantined patients is mostly just basic nursing; giving them food and water and helping make them comfortable. Medicine at the time had few ideas about how to actually treat the Plague, although fumigation with tobacco smoke was popular at the time (and we see that at the court of Charles II; there’s an absurdly large brazier-pendulum that swings over a bed). Because they had no clear idea how to treat the Plague, London authorities ordered the establishment of suburban pest-houses where sick patients could be quarantined; their houses were to be shut up and marked with a red cross and “Lord have mercy on us”, for forty days, after which the house could be opened up again and marked with a white cross, so that no strangers would stay there for another twenty days. The film gets this wrong, since it treats the Royal Hospital as a pest-house and marks it with a white cross, rather than a red one. (For those interested in how London responded to the Plague, the National Archives in London has a nice educational page about the issue, complete with a few primary documents.)
At one point Merivel dons a physician’s plague mask, which gives the film a great visual image, but he immediately takes the mask off when he gets to his patient, which would have defeated the whole purpose of such a mask. The beak of such masks was stuffed with aromatic herbs on the theory that they would purify the air so the physician would not get sick when treating contagious patients.
The result of all of this is that while the film wants to offer a critique of 17th century medicine, it can’t really muster the energy to engage with the material in any real way. Merivel is a “modern” physician only to the extent that he acts a little more like a modern doctor than Pearce does. His criticism of the medicine of his day is limited to a speech about dance therapy and his insistence on helping the Plague victims die less painfully. There’s no mention of humoral theory or Burton’s work on melancholy or anything that would give the viewer any insight into either traditional medical theories or why Merivel might think differently.
The film works much better with its central metaphor of Restoration, which operates on multiple levels. The political restoration of the monarchy brings with it a restoration of the decadence of the English court (as Merivel quips early in the film, “rich men can go to heaven again”) after the Puritan interlude that banned pleasures such as theater and dance. Merivel loses both his true calling in life and his social position, and gradually recovers them. Celia longs for her restoration to court and the affections of the king, while Merivel restores both physical and emotional health to various patients, although in a couple of key situations he is unable to help those he loves most. He is repeatedly reunited with old friends and given a chance to fix past mistakes. While it’s not a brilliant film by any means, it’s nice to see a Hollywood film that deals so effectively with a central theme a little more sophisticated than “freedom!”
Want to Know More?
Restorationis available a couple of ways on Amazon.
Rose Tremain’s Restorationis highly regarded and worth reading if you’re a fan of historical novels.
Charles II is a very important English king, since his reign marked the re-establishment of the English monarchy. Tim Harris’ Restoration: Charles II and His Kingdoms, 1660-1685seeks to place Charles in the center of the political life of his reign. This is an important argument, since traditional scholarship has tended to see Charles as politically passive and at his best when he wasn’t taking action.