Category Archives: Medicine

What’s in a name: Plaster of Paris

By Marieke Hendriksen

One of the problems we face as historians studying and reconstructing recipes is that the names describing ingredients, tools, and materials change over time, and that the meaning of terms itself changes over time. This is even the case with relatively recent recipes and materials that are in theory unchanged as I recently discovered. As part of my research for the ARTECHNE project, I recently looked at instructions for making anatomical casts from plaster from 1791.

Painted plaster cast of a large fibroma of the jaw, 1830s. Courtesy Surgeons' Hall Museums, RCSEd.
Painted plaster cast of a large fibroma of the jaw, 1830s. Courtesy Surgeons’ Hall Museums, RCSEd.

The creation of anatomical casts and models using plaster of Paris became increasingly popular towards the end of the eighteenth century, fuelled by the omnipresence of plaster in the visual arts and interior decoration, and the increasing importance of pathology and later physiognomy within the study of medicine. The latter meant that medical men were looking for durable three-dimensional ways to preserve diseased bodies and body parts that could not be preserved otherwise (e.g. in a preparation), either because decay could not be stopped or because the patient was still alive.

Johan Zoffany, The Portraits of the Academicians of the Royal Academy, 1771-72
Johan Zoffany, The Portraits of the Academicians of
the Royal Academy, 1771-72. Note the plaster models of antique statues around the room.

In his 1790 book The Anatomical Instructor, physician Thomas Pole (1753-1829) not only gave advice on how to make anatomical preparations and drawing, but also included over fifty pages on how to create, colour, repair and maintain plaster casts and models. Pole started the chapter on modelling with outlining the relevance of the quality of the plaster of Paris, or calcined alabaster, that was to be used. He explained that

Illustration of how to make a cast of a diseased bone from Pole's 1790 'Anatomical Instructor'
Illustration of how to make a mould of a diseased bone from Pole’s 1790 ‘Anatomical Instructor’

“…that of a middling price is used for making of moulds; the finer sort is for casts, to be poured first into the mould, when properly prepared; after it has formed a layer of about half an inch, more or less, according to circumstances, then the coarser sort is to be used to fill up the mould, or to give it sufficient thickness.”[1]

But exactly what were the various qualities of plaster for sale in London in the 1790s made of? The term ‘calcined alabaster’ tells us little, as alabaster was and is a collective noun that designates both various kinds of light-coloured, translucent and soft stone used mainly for carving decorative artefacts (often the minerals gypsum or calcite – the former much softer than the latter), and a specific compact and fine-grained variety of gypsum. In the decades after Pole’s publication, the French chemist Antoine François de Fourcroy (1755 –1809) would distinguish nine kinds of calcareous sulfate, one of which was sulfate of lime or common gypsum. In an 1810 ‘dictionary of the arts’ Fourcroy’s sulfate of lime or common gypsum was described as follows:

“Sulphat of lime, or common gypsum, or plaster-stone. This substance is white, more or less inclining to grey, interspersed with small brilliant crystals, easily cut with a knife. it is found disposed in Paris. We shall hereafter find, that it is not pure selenite, but owes its most valuable property, as plaster, to the admixture of another kind of earth. (…) Calcareous sulphat is likewise found dissolved in waters, as in the well-waters of Paris; it is never pure, but always combined with some other earthy salt, with base lime or magnesia. This salt has no apparent degree of taste. It decrepitates if a sudden heat be applied to it; it is then of an opaque white, in which state it is called fine plaster, or plaster of Paris: by this calcination it loses about twenty in one hundred.”[2]

Entrance to the Montmartre gypsum quarry. Probably early 19th century, artist unknown.
Entrance to the Montmartre gypsum quarry. Probably early 19th century, artist unknown.

As this fragment suggests, plaster of Paris indeed derives its name from a large and very pure gypsum deposit at the Montmartre and Menilmontant hills in Paris – there were plaster quarries at this site at least as early as the year 500. This led “calcined gypsum” (roasted gypsum or gypsum plaster) to be commonly known as “plaster of Paris”, even after the exhausted quarries were converted into Montmartre cemetery and the Buttes de Chaumot gardens respectively in the mid-nineteenth century. Although not all plaster came from Paris at the time Pole was writing, there is a fair chance that much high-quality plaster was indeed plaster from Paris.

Today, gypsum plaster, or plaster of Paris, no longer comes from Paris, but is still produced by heating powdered gypsum to about 150 °C. When mixed with water, this forms a paste that will harden within minutes, producing an exothermic reaction, which means it warms up. You can easily buy ‘plaster of Paris’ from artist’s supplies shops and online retailers, but none of these mention the exact chemical composition. Yet before I (or anyone else) can try my hand at reconstructing Pole’s instructions I will need to find out whether the best, finest plaster of Paris still contains a percentage of lime or magnesia, what the ‘coarser varieties’ that Pole described contained, and whether these are still available.

This project has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No 648718), and was supported by the Wellcome Trust (grant number 203403/Z/16/Z).

[1] Pole, Thomas. The Anatomical Instructor ; or an Illustration of the Modern and Most Approved Methods of Preparing and Preserving the Different Parts of the Human Body and of Quadrupeds by Injection, Corrosion, Maceration, Distention, Articulation, Modelling, &C. London: Couchman & Fry, 1790: p. 202-3.

[2] Wilkes, John. Encyclopaedia Londinensis, Or, Universal Dictionary of Arts. Vol. 4. London: J. Adlard, 1810: p. 230.

 

From the dry sands of Egypt… Greek medicine labels on papyrus

By Isabella Bonati

Amongst the many objects depicted in the “unswept floor” mosaic by Heraclitus (II cent. CE) there is a drug container (unguentarium) with a narrow, probably folded, papyrus tag suspended from its neck. This tag likely offered the identification of the content, possibly an ointment or some aromata, stored into the unguentarium. This striking mosaic provides archeological evidence of the common use of medicine labels across the ancient world. [1]

imm1-unswept-floor-mosaic
Drug container with papyrus label. Detail of the asàrotos òikos mosaic (“unswept floor”) by Heraclitus, Gregorian Profane Museum (Vatican Museums), cat. 10132.

Like the modern patient information leaflets, the practice of labeling containers was particularly useful in medical contexts. In spite of the perishability of their support, some of these labels on papyrus have been preserved by the dry sands of Egypt. One example is a strip of papyrus cut on all sides (8,5 cm x 22 cm), dating back to the first half of the III century BCE on paleographical ground (SB XIX 12074).[2]

imm2-papyrus-with-a-list-of-spices
Ptolemaic list of aromata and honey on papyrus (SB XIX 12074), Ann Arbor, Michigan University, Library P. 3243

The papyrus contains a list of five spices – cassia, cinnamon, nard, myrrh and saffron – and two specific kinds of honey – the Cretan and the Theangelic – commonly used in medical recipes. The strip was folded vertically down the center in order to obtain five panels of equal size. Then a notch was cut along the right-hand fold producing two holes. It is likely that a string was passed through the holes to suspend the folded sheet from or attach it to some other object, such the container storing the remedy obtained by the ingredients mentioned in the list, like in the mosaic image above. Thus, this papyrus seems to represent a concrete specimen of the practice illustrated in the “unswept floor” mosaic.

This particular medical label belongs to a broader context. Greek medical papyri coming from Egypt, dating from the III century BCE to the VII century CE, represent a body of evidence offering a rich and veritable picture of medical tradition over this thousand-year period.[3] Indeed, aside from literary fragments and adespota handbooks copied by professional scribes, practical medical texts constitute the largest group of surviving papyri. Thus, collections of drug recipes used by physicians and medical prescriptions written on single papyrus sheets attest to the wide variety of remedies circulating in Egypt at the time.

Among the medical papyri discovered and published so far, just a few of them – about 10 items – may be interpreted as medicine labels. These share formal and material features. Often the writing is concise and the small papyrus is expressly cut from a larger sheet of a particular thickness. According to the kind of information they contain, these labels on papyrus, parchment or ostraca may be divided in three categories: some of them carry only the name of a drug or medicine, others only the therapeutic indication introduced by pros (“against”) plus the name(s) of the disease(s) in accusative, reproducing the typical formula of the epangelia of the medical prescriptions. A third category displays both the therapeutic indication and the name of the medicinal substance, occasionally followed by the quantity. So, these last specimina have features more similar to actual recipes. A papyrus strip measuring 10,6 x 4 cm, P.Prag. III 249 (VII CE),[4] may serve as an exemplar of this category:

‘Against spreading ulcers. Of incense ounce(s)…’

imm3-p-prag-iii-249
Medicine label on papyrus (P.Prag. III 249), Prague, National Library P. Wessely, Prag. Gr. III 1204 v

In conclusion, in the everyday practice, these tags were attached to – or stored with – small containers or boxes for aromata and medicaments by the pharmacopolai, the apothecaries who were used to sell drugs and pharmaceutical products to the doctors. These inscribed labels likely identified the content of small jars or vases circulating on the trade-market: they are a surprising witness of both the medical practices and the commerce in the ancient world, as is concretely revealed by the dialogue between the archaeological and papyrological evidence survived from the telling silence of the past.

[1] The “unswept floor” mosaic asàrotos òikos is in the Gregorian Profane Museum (Vatican Museums). This detail is taken from L. Taborelli, Sulle ampullae vitreae. Spunti per l’approfondimento della loro problematica nell’ottica del rapporto tra contenitore e contenuto, ArchCl 44 (1992) 311, cf. pp. 326-7 for description and bibliography. For the entire mosaic see http://mv.vatican.va/3_EN/pages/x-Schede/MGPs/MGPs_Sala01_03.html#top.

[2] Editio princeps by A.E. Hanson, A Ptolemaic List of Aromata and Honey, TAPA 103 (1972) 161-6. For the image reproduced below see http://quod.lib.umich.edu/a/apis/x-1906.

[3] On medical papyri see, e.g., I. Andorlini, Prescription and Practice in Greek Medical Papyri from Egypt, in H. Froschauer-C.E. Römer (Hrsg.), Zwischen Magie und Wissenschaft, Ärzte und Heilkunst in den Papyri aus Ägypten. Katalog der Asstellung, Österreichische Nationalbibliothek, Wien 2007, 23-33.

[4] Editio princeps by R. Luiselli, Etichetta di sostanza medicinale (Gr. III 1204 verso), in R. Pintaudi-D. Rathbone (eds.), Papyri Graecae Wessely Pragenses (P.Prag. III), Firenze 2011, 157-8, from which the image is taken (Pl. XLVI).

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Isabella Bonati is currently completing a Post-Doctoral Fellowship in Papyrology at the Department of Letters, Arts, History and Society (L.A.S.S.) of the University of Parma, Italy, where she is involved in research activities in the ERC project DIGMEDTEXT (Online Humanities Scholarship: A Digital Medical Library based on Ancient Texts). She holds a PhD in Papyrology from the University of Parma and she received an Yggdrasil grant 2012-2013 at the University of Oslo. Her main research interests are concerned with papyrology, especially lexical studies. Other research interests include classical philology, linguistics, archaeology, history of medicine. For list of her publications go here.

Notes from a Newly Discovered English Recipe Book

By Francesca Vanke

Sir Robert Paston (1631-1683) of Oxnead Hall in Norfolk was known in his own time for his loyal support of Charles II, his magnificent house and kunstkammer collection, his political activities, and for his chymical and alchemical pursuits. His family died out in the early eighteenth century with the premature deaths of his grandsons, and today the Pastons are remembered mostly for the famous letters of an earlier generation. However, some seventeenth century items survive: inventories, documents, artefacts and an enigmatic painting The Paston Treasure in Norwich Castle Museum, which depicts some of Robert’s and his father’s collection. (Figure 1). This is the subject of a current research project between Norwich Castle Museum and the Yale Center for British Art, culminating in a joint exhibition in 2018.

The Paston Treasure, anonymous, Dutch School, c1665, oil on canvas, Norfolk Museums Service
The Paston Treasure, anonymous, Dutch School, c1665, oil on canvas, Norfolk Museums Service

Recently further evidence of Robert Paston’s activities was discovered: his manuscript notebook, probably dating from late 1650s-1670s. This comprises some 250 culinary, medical, alchemical, cosmetic and artistic recipes, fascinating both for their variety, and for their varied cited sources. An FRS elected 1661, Paston’s associates included many of the noted scientists and intellectuals of his day, although his most frequent known correspondent and co-experimenter was Thomas Henshaw (1618-1700) with whom he worked for more than twenty years on the ‘red elixir’, a version of the Philosopher’s Stone.

Many of the medical recipes in Paston’s book were not uncommon and may be found in similar form in contemporary English publications such as An English Huswife or The Queen’s Closet Open’d. Others, such as his cure for The Falling Sickness (Figure 2) appear more unusual.

Robert Paston, Earl of Yarmouth, Recipe Book Containing Medical, Chemical and Household Recipes and Formulas. James Marshall and Marie-Louise Osborn Collection, Beinecke Rare Book and Manuscript Library, Yale University
Robert Paston, Earl of Yarmouth, Recipe Book Containing Medical, Chemical and Household Recipes and Formulas. James Marshall and Marie-Louise Osborn Collection, Beinecke Rare Book and Manuscript Library, Yale University

Remedies for falling sickness appear regularly in English recipe books. The most frequently cited ingredient in these is peony, a plant with ancient precedents for its curative properties. One of Paston’s recipes also cites peony tincture, but the other involves a distillation of chopped magpies ‘intrails, feathers and all’, an ingredient which does not seem to have a ready precedent in English recipe books.

To use live birds in recipes was not unknown. As Michelle DiMeo has commented previously on this blog  ‘oil of swallows’ as an unguent for joint pains appears in several sources in this period. However, research so far has uncovered the use of magpies or, seemingly interchangeably, swallows, for epilepsy, referred to as Aqua picarum epileptica and Aqua Epilepticae Hirundinum, in only two sources apart from Paston’s book.

There appears no obvious rationale for this use of black and white birds, although the similarities in colouring between swallows and magpies do raise the question whether the use of magpies, traditionally considered as magical birds in many cultures, may have arisen initially as a more readily available alternative to swallows, the elusive and migratory habits of the latter perhaps proving somewhat inconvenient. It may have been believed that the colouring was of more significance than the species, and that any black and white bird would be efficacious.

The use of birds to treat epilepsy seems unrelated to their use for aching joints, and the appearance of this recipe in an English book is intriguing. Both the sources uncovered so far are of French origin. The first is Pharmacopœia Galeno-chymica Catholica published in 1656 by Johan Daniel Horst (1616-1685) which, his sub-title states, is post Renodaeus et Quercetanus, namely, after Jean de Renou (1568 – 1620 ) and Joseph du Chesne (c.1544-1609). In 1676, Thomas Sherley’s Medicinal Councels or Advices, a translation from Theodore de Mayerne’s (1573 – 1655) French original, lists a similar recipe, the source of which he cites as Guillaume Rondelet(1507 – 1566) (pg 140).

Robert Paston’s scientific associates included many with European connections such as Samuel Hartlib (ca. 1600 – 1662), Frederick Clodius (1625 – 1661) and Sir Kenelm Digby (1603 – 1665), whose close links with French alchemists during his long stays in Paris have recently been explored by Lawrence Principe, in “Sir Kenelm Digby and His Alchemical Circle in 1650s Paris: Newly Discovered Manuscripts.Ambix 60 (2013): 3-24. Paston, who was involved in alchemical pursuits from a young age, also met Theodore de Mayerne, and owned a manuscript, Sloane MS 2222, which once belonged to the famous physician, although the extent and nature of their association is not known.

Jean de Renou, Joseph du Chesne and Guillaume Rondelet were closely connected with Mayerne. As Principe has pointed out, (op cit) Digby associated with du Chesne when in Paris. Robert Paston’s citing of this unusual epilepsy recipe therefore maybe further evidence of his continental contacts and influences, either via Digby, or Mayerne himself.

Research into Robert Paston as an alchemist and chymist is new, but on-going, and his connections with Mayerne and others are only beginning to be considered. This falling sickness recipe suggests that further research in this direction would be fruitful. Promising new material is emerging, and the Norwich/Yale research partnership has provided an unprecedented opportunity for an in-depth focus on this little-known English alchemist. Even preliminary research into Paston and his work has positioned him squarely within the fascinating and important group of scientists operating during this most influential mid seventeenth century period.

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Francesca Vanke FSA is Keeper of Art and Curator of Decorative Art at Norwich Castle. She gained her BA in classics from Oxford, and an MA in art conservation and PhD in history from Camberwell College of Art. Her academic speciality is collecting history, but she researches a wide range of related subjects. Her studies have recently included seventeenth century material culture, alchemy and recipes for the research and exhibition project she is working on, together with the Yale Center for British Art and a group of other curators and scholars.

Ancientbiotics: Medieval Medicines for Modern Infections

By Erin Connelly

In 2015, Youyou Tu jointly won the Nobel Prize in Physiology or Medicine for the development of a new therapy (Artemisinin) to treat Malaria, a disease which has been on the rise since the 1960s. Significantly, the antimalarial component was successfully extracted from the plant Artemisia annua only after consulting the instructions found in the ‘ancient literature’ of traditional herbal medicine.

As the drugs (chloroquine or quinine) used to combat the malarial parasite have experienced decreased efficacy, such is the case with a wide range of conventional antimicrobials. In fact, major pharmaceutical companies and government agencies have identified antimicrobial resistance as one of the most pressing concerns for global health. The World Health Organization (WHO) stated in September 2016 that antimicrobial resistance is ‘an increasingly serious threat to global public health that requires action across all government sectors and society.’

In response to this threat to global health, the Ancientbiotics team was formed. Originally based at the University of Nottingham, the team is an interdisciplinary group from the Arts and Sciences comprised of microbiologists, medievalists, parasitologists, wound specialists, and pharmacists, who are united by the belief that novel avenues of antibiotic discovery are crucial, along with the shared conviction that the past can inform the future. At the same time that Youyou Tu was awarded the Nobel Prize for her work with malaria, the Ancientbiotics team was investigating a tenth-century Anglo-Saxon remedy for eye infection, known as Bald’s eyesalve. The full paper is available here.

Recipe for an eyesalve from Bald’s Leechbook, England (Winchester?), mid-10th century, Royal MS 12 D XVII, f. 12v. Image and caption credit: British Library
Recipe for an eyesalve from Bald’s Leechbook, England (Winchester?), mid-10th century, Royal MS 12 D XVII, f. 12v. Image and caption credit: British Library

The 1,000-year old recipe has been shown to effectively kill a range of microbes, including, but not limited to, Methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumoniae, Escherichia coli (E. coli), and leishmania. All of these species are causes of chronic, opportunistic, drug-resistant, or difficult to treat infections. While each ingredient in the eyesalve demonstrates some antimicrobial activity on its own, what is remarkable is that only in the combination of ingredients, exactly as specified by the medieval instructions, do we see the synergistic, potent antimicrobial effect in clinically realistic infection models.

An interview on Radiolab with Freya Harrison and Christina Lee is available to explain the full story of Bald’s eyesalve.

Clusters of Methicillin-resistant Staphylococcus aureus (MRSA) Image Credit: Annie Cavanagh, Wellcome Images https://creativecommons.org/licenses/by-nc-nd/4.0/
Clusters of Methicillin-resistant Staphylococcus aureus (MRSA) Image Credit: Annie Cavanagh, Wellcome Images
https://creativecommons.org/licenses/by-nc-nd/4.0/

The Ancientbiotics project also extends to medical texts of the later medieval period. The Lylye of Medicynes (Lylye) is one such text that offers a diverse range of recipes, including many promising treatments for infectious disease. The Lylye is the only extant Middle English translation of Bernard of Gordon’s Lilium medicinae; it exists in one fifteenth-century manuscript (Oxford Bodleian Library MS. Ashmole 1505). The Lylye is most notable for its pharmaceutical content. There are nearly 6000 individual ingredients in the text; 3500 of those ingredients are contained in 360 specific recipes, which represent over 110 disease states (many of which include symptoms of infection). One of the eye recipes is currently being tested at the University of Nottingham and research is ongoing to identify those ingredients which interact with the same antimicrobial synergy found in Bald’s eyesalve.

Lylye of Medicynes, Oxford Bodleian Library MS. Ashmole 1505 Image Credit: Erin Connelly
Lylye of Medicynes, Oxford Bodleian Library MS. Ashmole 1505 Image Credit: Erin Connelly

I am also working on the first published edition of the whole text of the Lylye in order to allow accessibility for increased scholarship. A forthcoming paper (2017) in the proceedings from the 8th Annual Disease, Disability, and Medicine in Medieval Europe conference (‘Treating Infected Wounds in the Middle English Translation of Bernard of Gordon’s Lilium medicinae’) conveys in greater detail the potential of this text to be mined for antimicrobial recipes.

You may read a little bit more about the Lylye of Medicynes in these short blog posts from 2014: ‘ȝif it be a pore man . . .’: Healthcare for the Rich and Poor in the Lylye of Medicynes and ‘þe best mylke is womman milke’: Does Breastmilk Heal?

As a truly interdisciplinary effort between the Arts and Sciences, the Ancientbiotics project has opened new and significant pathways to antimicrobial drug discovery, but it has also challenged the popular categorization of the medieval period as a ‘Dark Age,’ and the centuries-long pattern of dismissing medieval medical texts as ‘unenlightened’ by reason and scientific discovery. In a paradigm-shifting manner, the efficacy of medieval medicines against modern infections instead shows that medieval practitioners were operating within a lengthy tradition of observation and experimentation with recipes that may inspire present day research.