Category Archives: Bodies

Medicinal Compounds, Efficacious in Every Case

By Lisa Smith

Perhaps the most famous cure-all of all time is Lydia E. Pinkham’s Vegetable Compound, immortalized in song as “Lily the Pink” (or “The Ballad of Lydia Pinkham”).* Although the original vegetable compound aimed to treat women’s ailments, the song suggests—tongue in cheek–that it might have much wider, rather miraculous applications. The boy with sticky out ears learns how to fly; the man who thought himself Julius Caesar becomes emperor of Rome.

Ridiculous. How, after all, could one drug cure so many ailments? In the modern world, cure-alls just don’t make sense.

But they did at one time. In early modern Europe, cure-all medicines were as likely to be sold by elite physicians as by “quacks” and were often made domestically. These treatments made sense. In a humoral body, with its properties of cold, hot, wet and dry, many seemingly different problems might have the same underlying cause.

Bridget Hyde’s book, late seventeenth century. Wellcome Library, MS 2990, f. 52v. Image Credit: Wellcome Library.

“Dr Stevens’ Water” was a common remedy in English remedy collections kept by well-to-do families. Authors sometimes provided lists of a treatment’s “virtues”, which usefully explain the underlying rationale. Bridget Hyde, for example, described Dr. Stevens’ Water as good for the vital spirits, inward colds, palsy, dropsy, gout, bladder stones, weak sinews, barrenness, worms, tooth-ache, stomach, and “rayns of ye back”. (Reins of the back refers to a urinary or genital discharge.)

An even more impressive and random list than Lydia Pinkham’s Vegetable Compound! What all of these illnesses had in common, however, was that they were caused by cold and wet humours. Looking up each ingredient in herbals and pharmacopoeias reveals that herbs like nutmegs, cloves, mace, aniseeds, lavender and rosemary (for example) had warming and drying properties.  Rosemary was ruled by the Sun and Aries; given its warming and comforting properties, it was commonly prescribed for any problems caused by cold humours. Mace, ruled by Venus, was chiefly used for treating problems of the womb.

Sometimes the connections are surprising. “Pertes de sang” (or blood loss) in French collections could refer to general losses of blood, excessive menstruation or uterine bleeding, miscarriage – or diarrhoea.  For example, one remedy for fluxes of blood in Mme Lievain’s book (Wellcome Library MS 3258, f. 132) also specified its use in diarrhoea. The main herb, cinquefoil, was commonly used for stomach problems as well as fluxes of all kinds, with a cooling property to sweeten the blood.

Most cure-alls did not try to treat everything, but had a clear rationale and focused on a group of closely-related ailments.

That said, not all cure-alls were created equal — and there were some weird ones out there. Lionel Lockyear, for example, claimed that his pills had the extract of the sun in them. Even better than Lily the Pink, then…

Broadsheet advertising L.Lockyer’s patent medicine. Image Credit: Wellcome Library.

*A rather entertaining song, though it needs an ear worm alert.

This has been cross-posted at the Cliopatra award-winning Wonders & Marvels, a fun group blog that focuses on odd stories and interesting historical tidbits. 

More on multi-purpose remedies can be found in my article, “Imagining Women’s Fertility before Technology”, Journal of Medical Humanities, 31, 1 (2010): 69-79.

A Bag of Worms: Treating the Sick Child in Early Modern England, 1580-1720

By Hannah Newton

Parents today are all too familiar with the problem of worms in children. Tiny, threadlike creatures, they cause terrible itching. How did parents in the past respond to this common childhood complaint? In the following paragraphs, I use early modern collections of medical recipes, doctors’ casebooks, and medical treatises, to find some answers.

L0016479: Karl Asmund Rudolphi, ‘Entozoorum sive vermium intestinalium histor’: courtesy of the Wellcome Library, London. 

Worms were defined as ‘Annimals generated in the body, variously hurting the Operations of the Body’.[1] Growing out of rotting food in the stomach, these creatures were ‘deservedly reckoned among those Diseases which frequently afflict Infants and Children, seldom…troubling people of Years’.[2] The reason, according to the physician John Pechey, was that ‘Children eat greedily, and are delighted with…sweet things’, such as summer fruits and candied cherries, foods which easily putrefy and ‘nourissheth and fedeth’ the worms.[3] Children’s bodies provided worms with the ideal conditions to grow, because they were thought to be more moist and warm than adults, qualities which promoted putrefaction.[4]

The symptoms of worms were well known. ‘Worms are known to be in a Body’, stated Daniel Sennert in 1664, ‘when there is much spittle and a stinking breath, troublesom sleep, gnashing of teeth, crying and bawling’.[5] If the infestation continued over a long period, the patient became emaciated, as Walter Harris observed in his casebook: his thirteen-year-old patient ‘was much liker a Skeleton than a live Boy: His Face was like that of one raised from the Grave, his Eyes hollow; his Nose sharp, and his bones only covered with skin’. The child’s ‘ratling joynts’ could scarcely ‘carry him from one end of the room to another with the swiftness of a Snail’, lamented Harris.[6]

A child’s drawing: MS 1796 (From a collection of cookery and medical recipes written by two unidentified compilers. c.1685-c.1725), f.125v. Image courtesy of the Wellcome Library, London.

How were children treated? ‘A special regard’, declared John Pechey in 1697, ‘is to be had to the Methods and Medicines, for Children by reason of the weakness of their bodies, cannot undergo severe methods or strong Medicines’.[7] Instead of using the usual remedies of the day – vomits, purges, and bloodletting – children were to be treated with milder medicines, such as ointments and suppositories.

Medical texts and manuscript collections of remedies are replete with recipes to remove worms. In 1664, the doctor ‘J.S.’ prescribed suppositories made of honey, by which ‘the Worms [are] drawn by sweetnesse, [to] the lower parts of the Guts’, where they could be voided by natural defecation.[8] Like children, worms loved sweet things, and could be tempted out of the body this way.

Wellcome Library, MS 1340 (Katherine Jones, Collection of medical receipts, c. 1675-1710), f.87v. Image courtesy of the Wellcome Library, London.

Other, more bizarre treatments were recommended. In the late 1600s, Lady Mary Dacres suggested the following ‘rare thing for Wormes in…children’: ‘Tak[e] five live earth worms…sew them up in a piece of muslin, and lay them upon the navill’.[9] The London gentlewoman Katherine Jones suggested a similar remedy: she instructed, ‘Take Earth worms’, and put them ‘in a linnen bag, and bind the bag to the navel of the Child all night’.[10] It is not clear how these treatments were thought to work, but it is possible that people believed there existed a sympathy between similar creatures, so that when the earthworms died, so too did the worms in the child’s body.

Whilst early modern medicines might seem odd to modern eyes, it is clear that doctors were motivated by compassion. Francis Glisson noted in 1651 that he wished to make his remedies ‘grateful & pleasing to the sick Child’.[11] Clearly, children were regarded as different from adults, and in need of special medical treatment.

Occasionally children’s own thoughts leave a trace in the sources. In 1650, the Essex clergyman Ralph Josselin recorded in his diary the words of his eight-year-old daughter Mary, who was suffering from worms: she pointed to her tummy, and cried, ‘poore I poore I’. Five days later Mary died. [12]

Dr Hannah Newton is Wellcome Trust Fellow at the University of Cambridge, and the author of The Sick Child in Early Modern England, 1580-1720 (OUP, 2o12). Her current research project is about recovery from illness in the early modern period.


[1] J.S., Paidon nosemata; or childrens diseases both outward and inward (London, 1664), 167.

[2] Franciscus Sylvius, Dr. Franciscus de le Boe Sylvius of childrens diseases…also a treatise of the rickets (London, 1682), 127.

[3] John Pechey, A general treatise of the diseases of infants and children (London, 1697), 119. Thomas Phaer, ‘“The Booke of Children: The Regiment of Life by Edward Allde” (London, 1596, first publ. 1544)’, in John Ruhrah (ed.), Pediatrics of the Past (New York, 1925), 157-95, at 182.

[4] Nicholas Culpeper, Culpepers directory for midwives: or, a guide for women . . . the diseases and symptoms in children (1662), 239.

[5] Daniel Sennert, Practical physick the fourth book in 3 parts: section 2: of diseases and symptoms in children (London, 1664), 259.

[6] Walter Harris, An exact enquiry into, and cure of the acute diseases of infants, trans. William Cockburn (London, 1693), 129.

[7] Pechey, A general treatise, 15.

[8] J.S. Paidon nosemata, 172-3.

[9] British Library, Additional MS 56248 (Lady Mary Dacres, ‘Recipe Book…for cookery and domestic medicine, 1666-96’), 59v.

[10] Wellcome Library, MS 1340 (Katherine Jones, Collection of medical receipts, c. 1675-1710) 87v.

[11] Francis Glisson et al, A treatise of the rickets being a diseas common to children, trans. Philip Armin (London, 1651), 344.

[12] Ralph Josselin, The Diary of Ralph Josselin 16161683, ed. Alan Macfarlane (Oxford, 1991), 201

Early Modern Breast Surgeries and Recipes

I’ve been a teaching assistant twice for a two-semester survey of the history of western medicine offered at the Johns Hopkins University. The full sequence takes undergraduates from Hippocrates to Obamacare, with the second semester covering the Enlightenment to the present. One of the pleasures of teaching a discussion section during the second semester is that it allows me to explore the history of our own institution with a group of undergraduates, many of whom themselves hope to work in healthcare and perhaps to study medicine at Johns Hopkins.

Halsted
William Halsted. Source: National Library of Medicine, IHM. 101417923.

A key, fascinating figure in the early history of Hopkins–and one who bridges central course themes as we shift from the early modern, to the modern, to the contemporary–is William Halsted. He was one of the “Big Four,” a brilliant surgeon, an accidental cocaine addict. Halsted is well known for his role in the history of mastectomy, and in this as in other areas of his career he can illuminate these themes for students. His life and career, for example, epitomize the promises and perils of developments in nineteenth-century surgery. I also believe that the history of radical mastectomy has particular power for many because the tensions that the measure introduced into the lives of sufferers continue to be recognizable in our own. We all have friends and family who have suffered from and with cancer and cancer therapies, and many have faced decisions over difficult breast surgeries. These tensions also persist at the level of public policy. For instance, just in the last few days, as I was preparing this post, I listened to a contentious panel discussion on the American public radio program “The Diane Rehm Show” about routine mammography.

I don’t want to suggest that our and our loved ones’ medical experiences are in any way the same as Halsted’s patients’, much less those of early modern people who contemplated going under the knife, but I do want to suggest here that making such connections may help us and our students think about and empathize with historical actors who often seem very foreign from us. Recipe books might seem like poor sources for doing this, but if we look closely I think that there is in fact evidence of a great deal of emotion and drama. It is visible, for instance, in recipes that heal breasts, especially breasts threatened by dire maladies and consequently surgeons’ tools.

Amputation
Halftone of Bodleian Library window. Source: National Library of Medicine, IHM. 101409068.

As scholarship such as Lucinda Beier’s on the London surgeon Joseph Binns has shown us, workaday early modern surgeons did not perform much invasive surgical work.1 Opening the body and reaching into it with tools and chemicals was usually a last resort, but it was one some surgeons and sufferers were willing to undertake. Operations like craniotomy, lithotomy, and, of course, limb amputation are the best known pre-modern measures. Surgeons also sometimes cut into afflicted breasts, removing portions of breasts or even amputating them entirely.

A vivid instance of an early modern breast surgery can be found in the writings of Richard Wiseman. Wiseman was sergeant-surgeon to Charles II and an influential surgical author. One of his published cases describes the sufferings of a twenty-six-year-old “Country maid.”The woman was afflicted with an ulcerated cancer of the right breast “arising from some accidental Bruise.” It had progressed to a grim stage. Wiseman decided the breast could not be cured, and urged that it should be cut off before “a Fungus” which he thought lay deep in the breast “should be fixed to the Ribs.”

Wiseman
Richard Wiseman. Source: National Library of Medicine, IHM. 101432120.

Wiseman won some sort of consent, though how ready it was is perhaps indicated by his explanation that she and her companions “were not unwilling that it should be cut off” and that their decision took a month. Wiseman himself seems to have been much more eager, having just received “the Royal Stiptick liquor” at the king’s command. He saw the surgery as “seasonable” for experimenting with it, in the presence of “some Friends who desired to see the efficacy.”

I should warn you that his description of the operation is difficult to read. Like many early modern surgeons’ description of operations, it also largely occludes the patient and her experience. I will quote it at length here, however, because I think that it gives a powerful glimpse of what an invasive procedure was like at this time. But please skip the next two paragraphs if that is not a glimpse you’d like to take. Wiseman’s associate, the physician Walter Needham,

pulled up the Breast while I made a Ligature upon the basis of it, and cut it off. The two Arteries bled forcibly out, till Doctor Needham applied a wet Button [lint soaked in the water] on the one, and… [an assistant] applied the other… [One] stopt the Bleeding at that very instant… but the bloud dribbled from under the other: which we supposed happened by reason of the bloud streaming upon it in the putting it on. But by the application of a fresh Button the Bleeding there also stopped. During this the Lips of the wound were brought nearer to each other by a cross stich. We then applied our Digestive with convenient Bandage over it, and laid the Patient in her Bed. [They left, and] In our absence she fainted, and upon the drinking a draught of cold water vomitted, and her Breast bled through the Dressings. Upon sight thereof I took off the Dressings, and seeing one of the Arteries seepe, I applied a fresh Dostil [dossil], and stopt it: but it being night, and dreading mischief might happen if it should bleed again, I sent for a small Button cautery, and that way secured it. (“I secured that Artery by the touch of a hot Iron,” he explained in another account of the operation.)

The woman had some difficulties after the operation, but she returned to the country a month and a half later. Once there, however, the cicatrix “fretted off” and the ulcer grew. She returned to Wiseman, who treated her successfully. “Since which time,” he concluded, “I have seen her often in Town in very good health, and her Breast firmly cicatrized, without pain or hardness.”3

It’s surgical measures like this that give us a sense of what what authors and compilers had in mind when they collected remedies that saved breasts destined for the knife or powerful chemicals. The Johanna St. John collection, featured in a number of earlier posts here, has a striking example. It is “For a Cancer in the Breast”:

A piece of a sheep skin taken off the Flank of the sheep lay the skin side to the breast changing it once in 12 hours & in hot weather once in 6 hours this was used to a woman whose breast was to be cut off but was not broke & it kept her very many years without any pain or trouble & at last died of another disease La Child knew the woman to whom it was taught by a French man.4

This tale, as well as the information about the provenance of the remedy and the presence of similar examples, indicates the involvement of collectors in a world of remedies for serious medical problems that offered them the chance to control the measures they used and offered them the hope of avoiding the most unpleasant. Quacks offered something similar when they peddled non-mercurial pox treatments.5

I am very interested to know whether you’ve found similar sorts of material in recipe books that might give evidence of therapeutic preferences. I’m also interested in how recipes (these sorts and others) have been or could be used in teaching the history of pre-modern medicine, especially to students in survey courses. In my favorite activity from the first half of our survey, we give groups of students a selection of seventeenth-century medical advertisements and ask them to think about what the advertisers were offering, how they offered it, and why it may have been appealing to consumers. Would it be possible to design similar sorts of lessons using selections from recipe collections? How else can we use collections and recipes in the classroom, especially when teaching students that are new to early modern history and working with primary sources?

 

 

1 “Seventeenth-Century English Surgery: The Casebook of Joseph Binns,” in Christopher Lawrence (ed.), Medical Theory, Surgical Practice: Studies in the History of Surgery (London: Routledge, 1992): 48-84, and Sufferers and Healers: The Experience of Illness in Seventeenth Century England (London: Routledge & Kegan Paul, 1987), chp. 3.

2 Michael McVaugh, “Richard Wiseman and the Medical Practitioners of Restoration London,” Journal of the History of Medicine 62 (2007): 125-40. He briefly discusses this case on 133-34.

3 Eight Chirurgical Treatises, 3rd ed. (London: for B.T. and L.M., 1697), Wing W3106A, pg. 108-109, “Observat. of a Cancerous Breast cut off.” Phil. Trans. 8 (1673): 6039. Italics removed.

4 Wellcome MS 4338, fol 18v. I’ve modernized the spelling here.

5 For instance: Andrew Wear, Knowledge and Practice in English Medicine, 1550-1680 (Cambridge: Cambridge University Press, 2000), 271.

Gumpowder? A strange little recipe for sensitive teeth…

If you go to your bathroom and check the ingredients in your well-known brand of sensitive toothpaste, you may well find that the recipe contains the active ingredient potassium nitrate. Also known as saltpetre or nitre, this naturally occurring mineral is found in foods as a preservative (e.g. corned beef), and used in fertilizer, cigarettes, blood pressure medicines and fireworks. Since medieval times it has formed one of the main ingredients in gunpowder, and it is this connection that has also given potassium nitrate a long association with teeth and gums.

Many of the seventeenth and eighteenth century recipe books in the Wellcome Library’s manuscripts include treatments for gunpowder burns, but some also proposed that gunpowder could be therapeutic. Katherine Jones, Lady Ranelagh (sister to the famous chemist Robert Boyle), recommended a ‘little gunpowder’ applied in a linen cloth to ease toothache. On one page of Anne Brumwich’s recipe book (Wellcome MS 160, p.83) we can find nine recipes for toothache remedies written in two different hands. One, ‘An aproved medecine for ye toothake’ (approved meant that it worked) required gunpowder, aniseed water and lint, mingled together to ‘make a litell thing’.

Once the sufferer had picked their tooth very clean, the recipe instructed them to push the preparation into the tooth, taking care not to allow any of the mixture down the throat.

A century later, in A Treatise on the Scurvy (1795) David Paterson introduced his fellow naval surgeons to a wonderful, and apparently unknown remedy for scurvy: during a voyage in 1784, he claimed, he had restored the health of eighty sick seamen not with lemon juice, fresh fruit or vegetables, but with the potassium nitrate extracted from the gunpowder in his ship’s stores. Paterson’s remedy was soon forgotten, until in 1828, a desperate surgeon named Charles Cameron, having used up all his supplies of lemon juice, remembered Paterson’s recipe. Cameron was stranded in the calms near the equator and he was faced with a ship’s hospital full of scorbutic convicts, less than half way through the voyage to Australia. He extracted the nitre from the powder, dissolved some of it in vinegar, and mixed some more with vinegar and lime juice. He also added a little sugar (to taste?!) The effects were ‘miraculous’.

For the Navy, if Cameron was right, this was a money-saving opportunity; nitre was cheap and did not decompose over time. In the following decades surgeons continued to experiment with different remedies for scurvy until, in 1840, the Admiralty decided to perform a large-scale experiment to determine once and for all the best scurvy remedy. Over the next four years the surgeons of sixty ships transporting fifteen thousand convict men from Britain and Ireland to Australia received crystallised citric acid, potassium nitrate, and lemon juice. Their instructions clearly forbade the surgeons from trying to cause scurvy during the voyage but if the disease did appear, the patients were to be divided into three groups, each group receiving one of the remedies. Of course, the surgeons often had their own ideas, and often altered, combined and varyed the doses according to their own personal favoured recipe. So, while Surgeon Deas mixed some nitre with lime juice and some with citric acid, and felt that both mixtures were useful, Alexander Bryson gave each group the remedies mixed in a glass of wine, water and sugar. After many of the convicts developed severe scurvy, Bryson finally decided that potassium nitrate was ‘objectionable’. The surgeons had come to very different conclusions about the value of potassium nitrate but the results of the experiment were clear; potassium nitrate was abandoned as useless, lemon juice was in for good.

In the mid 1970s, dental researchers – in laboratories this time, rather than on ships – began to report a strange occurrence: mixing potassium nitrate with toothpaste seemed to reduce dental sensitivity in sufferers.  More work confirmed the compound’s beneficial effects, but the scientists still admitted that they were unclear why it should work; being soluble, it seemed that it should simply dissolve in water and wash out of the teeth at first rinse.

Jump forward again to the present, and potassium nitrate is often used as the active ingredient in products for sensitive teeth. So we have come a long way in medical understanding since women like Anne Brumwich stuffed aching teeth with gunpowder soaked lint, or Victorian naval surgeons dosed their convicts with nitre in the certainty that it helped with scurvy, and yet nitre has proved persistent: these earlier ideas about potassium nitrate’s ability to reduce not only the pain of toothache, but the symptoms of scurvy – a disease so commonly experienced in the mouth and gums – are worth wondering about.

 

Katherine Foxhall is a Wellcome Postdoctoral Researcher in History at King’s College London. Currently working on a history of migraine, Katherine has worked in the past on the history of migrant health, maritime quarantine, and illnesses including scurvy, cholera and typhus. Her book, Health, Medicine and the Sea: Australian Voyages, c. 1815- 1860 has recently been published with Manchester University Press.