The Royal Touch: A Monarch's Divine Ability to Cure Scrofula Was an Established Ritual When James I Came to the English Throne in 1603. Initially Sceptical of the Catholic Characteristics of the Ceremony, the King Found Ways to 'Protestantise' It and to Reflect His Own Hands-On Approach to Kingship

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Towards the end of 1603 the Venetian Secretary in London, Giovanni Carlo Scaramelli, reflected on the death of Elizabeth I (1533-1603) in March of that year and the new beginning represented by the accession of her successor, lames VI and I (1566-1625). Scaramelli remembered that as soon as the Scottish king acquired his English crown he had said that, unlike his Tudor predecessors, he would not practise the most significant aspect of English sacral monarchy, the miraculous healing of scrofula by the royal touch, as he did not wish 'to arrogate vainly to himself such virtue and divinity, as to be able to cure diseases by touch alone'. In June, during the preparations for his coronation, Scaramelli had also heard lames say that he would not touch for scrofula 'as the age of miracles is past, and God alone can work them'. These remarks might have been surprising given that James was an eloquent proponent of divine right monarchy, though the reason for them was partly that he had already ruled Scotland for 19 years, a country that had no tradition of royal healing. But James' articulation of scepticism towards the royal touch, as far as is known the first ever expressed in public by a monarch of England, represented an extraordinary break with tradition.

During the early modern period it was widely thought that Edward the Confessor (c.1003-66) was the first English king to touch for scrofula and that since then every English king had practised the royal touch by virtue of heredity. The ability to heal scrofula was also associated with the anointing of the monarch's hands at the coronation, which accounted for any breaks in the direct line of succession.

Scrofula was also known as the King's Evil and its primary cause was thought to be sin, especially the collective sins of the nation. The healing of scrofula by the king was thought to cleanse the body politic and make it more godly. Scrofula is known in the modern world as tubercular adenitis, that is the inflammation of the lymph nodes brought about by the tuberculosis bacillus. The lymph nodes of the neck are especially vulnerable to such infection and when scrofula is untreated painful abscesses and suppurations occur which can affect the face and eyes. The bovine strand of the bacillus is particularly robust and so scrofula was transmitted largely via unpasteurised milk; the disease has almost disappeared from the developed world, though it is found in some minority ethnic communities in the West and is still prevalent in parts of Africa and Asia. Scrofula can manifest as episodic, chronic or even fatal and was endemic in pre-modern England where doctors struggled to cure it and usually recommended the royal touch for especially difficult cases. Healing by touch was a thaumaturgic act, an imitation of Christ that displayed the ultimate charismatic quality that any Christian ruler could possess. The royal touch was practised by the sovereigns of England and France and it proclaimed the sacral nature of their monarchies: the rulers of both kingdoms were anointed in the manner of Old Testament kings, ruled by grace of God and regularly touched and healed the sick, although royal therapeutics were not expected to cure everyone immediately and those who remained ill were usually thought to lack faith.

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English monarchs held public healings at which people from all ranks of society sought the royal touch as well as smaller, private ceremonies for those with connections at court. By the middle of the 16th century those who wanted access to public healings had initially to undergo a medical examination by a royal surgeon to ensure that they did have scrofula, after which they were admitted to the next ceremony. The healing ritual was structured around a liturgy of prayers and passages from the New Testament, while the royal surgeon led each person up to the monarch, in front of whom both knelt in obedience; the king or queen regnant then used both hands to touch and stroke the ill person's scrofulous sores. …