Category Archives: Elaine Leong

Testing Drugs and Trying Cures

By Elaine Leong and Alisha Rankin

Miniature (no. 37.181) from 15th century manuscript in Dresden: Galen, and assistant with a pestle and mortar, and a scribe in an apothecary’s shop. © Wellcome Images

As readers of this blog well know, early modern Europe was aflood with recipes and drugs. One central question has long preoccupied many of us –  just how did our historical actors assess, test and try out recipes, drugs and materia medica? A few summers ago, a group of historians of science and medicine gathered to discuss just this question. This month, we present our ideas and findings in a special issue of the Bulletin of the History of Medicine. To celebrate the launch of the special issue, several authors of the volume will share their work on The Recipes Project. Tuesday’s post revisited Ashley Buchanan and Tillmann Taape‘s report on the original 2014 conference. Over the next few weeks, we’ll learn more about the research of Erik Heinrichs, Valentina Pugliano, Alisha Rankin and Justin Rivest. Finally, Tillmann Taape, who just completed his PhD at the University Cambridge (congrats!) also adds his voice to the series by reflecting on how theme of drug testing features in his doctoral dissertation.

To get us started on our month of ‘Testing Drugs and Trying Cures’, we wanted to say a few words as the organizers and editors of the project. First, you might ask, what do we mean by ‘Testing Drugs and Trying Cures’? Over the course of the project, we found that it was useful to view ‘testing drugs’ and ‘trying cures’ as two overlapping but distinct phenomena.

As the essays in the special issue show, physicians and apothecaries developed clear rules and practices for testing drugs as materials – from sensory analysis of materia medica to chemical analysis of substances like mineral waters or alchemical medicines. This kind of ‘testing drugs’ largely focused on gaining knowledge on the substances’ medicinal properties and played a particularly significant role in the discovery and adoption of materia medica from the New World and in assessing and establishing authenticity of exotic and/or expensive medicaments.

Paolo Antonio Barbieri, The Spice Shop, 1637. Image from Wikimedia.

‘Trying cures’, on the other hand, describes the widespread practice of trying remedies and other kinds of cures on human bodies. If ‘testing drugs’ was mainly conducted by learned physicians and apothecaries, ‘trying cures’ was performed by a broad range of healers. Within the home, women and men applied and observed the effects of remedies on family and household members. Likewise, physicians and other practitioners prescribed diets, medicines and other cures to their patients, again observing and recording the effects. Ample evidence of this kind of ‘trying cures’ survive in a range historical sources from the use of ‘probatum est’ to expressions of personal experience, customisation and rejection of recipes in household recipe collections (for more on this, see posts here and here).

For us, these two categories ‘testing drugs and ‘trying cures’ serve as helpful heuristic tools to untangle the assessment practices used by early modern practitioners. We see the two categories not as separate boxes but rather as overlapping and often intertwined practices. Many healers merged testing and trying by using patient tests to determine a substance’s properties or to refine methodologies in both drug production and application. These themes of testing and trying occupied a central place in the making of medical knowledge across a vast chronological span and broad geographical regions and social contexts. The essays in the special issue examine these crucial knowledge practices in Europe c. 1300-1800 (go here for a table of contents).

Several main themes emerged from this collaborative project. First, medicine was always an experiential art and the essays in the special issue demonstrate clear continuities between the learned physicians’ uses of experience/experiment in the Middle Ages and early modern experimental interests. Learned medicine made deliberate use of experience from a very early date and pharmacy was an area where the gathering of experiential knowledge was particularly pronounced. The senses – touch, taste, smell, sight and hearing – played vital roles in determining the properties of drugs and their effects on the human body.

Concurrently, as many essays in the volume demonstrate, structured drug testing had a long history. Medieval physicians developed meticulous rules for drug testing, as Michael McVaugh’s essay shows, although they left no record of actual medical trials. This focus on establishing protocols for drug testing continues throughout the medieval and early modern period, with significant expansion in scale and scope. By the eighteenth century, the testing of mineral spa waters (in Michael Bycroft’s essay) or proprietary drugs (in Justin Rivest’s essay) became large-scale undertakings situated in learned academies and hospitals.

When taken together, the essays in the ‘Testing Drugs and Trying Cures’ special issue collectively argue that ‘experimental thinking’ played a crucial role in learned assessments of medicine and drugs throughout the Middle Ages and early modern period. From the time of Galen, drug testing was structured and evidence-based with an aim to produce transferable results. For us, this fascinating and multifaceted story of premodern drug testing enriches and extends current histories of experimentation and we hope that our explorations into topic will inspire others to join us too!

Further Reading and Acknowledgements:

This post is a very condensed version of Elaine Leong and Alisha Rankin’s ‘Testing Drugs and Trying Cures: Experiment and Medicine in Medieval and Early Modern Europe’, Bulletin of the History of Medicine, 91 (2017), 157-182. The full version of the article is available here. The entire special issue is available here.

The ‘Testing Drugs and Trying Cures’ project was funded by the Max Planck Society as part of the Minerva Research Group’s ‘Reading and Writing Nature in Early Modern Europe’.  We also extend our grateful thanks to all the participants of the 2014 workshop, the editors of the BHM and the anonymous reviewers of the articles in this special issue.

Tales from the Archives: Testing Drugs and Trying Cures Workshop Summary

In September 2016, The Recipes Project celebrated its fourth birthday. We now have over 500 posts in our archives and over 120 pages for readers to sift through. That’s a lot of material! (And thank you so much to our contributors for sharing such a wealth of knowledge on recipes.) But with so much material on the site, it’s easy for earlier pieces to be forgotten. So, the editors have decided that, every now and then, we’ll pull something out of the archives to share with our readers anew.

Over the next few weeks, The Recipes Project will feature a selection of case studies from the current issue of the Bulletin of the History of Medicine on “‘Testing Drugs and Trying Cures”. This special issue grew out of a 2014 workshop held at Max Planck Institute for the History of Science in Berlin. We were very lucky to have two then graduate students Ashley Buchanan and Tillman Taape, join us for and grateful that they took the time to pen the post below. It seems fitting to begin this month on testing drugs and trying cures with a revisit to their post. Elaine (editor).

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By Ashley Buchanan and Tillman Taape

What did it mean to test a drug or try a cure in the early modern world? This was the central question for a group of scholars who gathered for a workshop at Max Planck Institute for the History of Science in Berlin, Germany.  Since recipes emerged as one of the key themes throughout the workshop, and because the conference’s location in Berlin made it difficult for scholars outside of Europe to attend, we thought we might share a brief summary of the “Testing Drugs and Trying Cures” papers, in the hopes that we could bring the workshop’s key ideas and discussions to a larger audience.  What emerged from an exhilarating two days of discussion and debate was the conclusion that historians of science and medicine should not privilege experiment and experimentation as fixed categories, but should understand the multiple ways in which physicians, apothecaries, artisans, institutions, and individuals in the early modern world tested, tried, investigated, experienced, modified, observed, and measured medicinal remedies and materiae medicae.

As written forms of medical and pharmaceutical knowledge and practice, recipes played an important part in the testing of drugs and cures, and our discussion raised larger questions surrounding the nature and purpose of an early modern recipe.

705px-ScuolaMedicaMiniatura
A miniature depicting the Schola Medica Salernitana from a copy of Avicenna’s Canons.  From Wikimedia Commons.

Michael McVaugh’s paper opened the discussion by exploring how medieval physicians went about testing drugs. Learned doctors in the Middle Ages might appear helplessly hidebound, and inclined to follow ancient authorities over experimentation. In contrast, McVaugh showed how a group of Montpellier physicians in the fourteenth century established something of an experimental program. Medieval physicians, however, were not testing to find a cure, but to determine the quality, strength, and effectiveness of a drug as it pertained to a particular person’s complexion. McVaugh underscored an important difference in the purpose of medieval drug testing. Physicians tested not for universal effectiveness, but to determine the quality of a drug – was it hot, cold, moist, or dry.

Duclos-title-page
Title page of the Academy’s Observations sur les eaux minérales (1675). From http://cures.hypotheses.org/the-workshop/programme-2/bycroft-michael

Although it became clear in our roundtable discussion that we should be wary of labeling such practices as obvious precursors to the experimental philosophies of the Scientific Revolution, many of the papers showed that the importance of specific tests resonated throughout the early modern period. Evan Ragland’s paper, for example, traced the use of the phrase periculum facere (‘to make a trial’) in physicians’ writings on medicine, anatomy and chemistry. Similarly, Michael Bycroft showed that French physicians and chemical experts of the Académie des Sciences became increasingly interested in the exact composition of mineral waters. Contrived tests such as color indicators or the analysis of residues after evaporation increasingly became the touchstone of proper inquiry.

McVaugh, Ragland, and Bycroft’s papers all underscored the need to understand the specific nature and purpose of testing in each historical context. Continuing to emphasize the importance of historical context, Francesco Paulo de Ceglia’s paper showed just how different the purpose of testing could be in the context of seventeenth century blood miracles in the Kingdom of Naples. Catholics tested the liquefaction of the blood of their patron saint to explore the limits of nature. By discovering nature’s limits, you could then determine what was truly miraculous. Protestants, on the other hand, tested various materials and recipes to recreate the liquefaction of blood to cast doubt on the alleged miracle.

san-gennaro
Reliquary containing a glass ampoule of San Gennaro’s blood. From La Repubblica.

In the context of testing, drugs and cures are often under scrutiny in the form of recipes detailing their production and administration. While recipes emerged from many of the papers as very important forms of knowledge, it proved virtually impossible to define exactly what a recipe was. Recipes can be very short or very detailed, ranging from a mere list of ingredients to careful step-by-step instructions. If there is one thing recipes have in common, it is the need for testing, trying, modifying and adapting to different conditions. While constructing an all-encompassing definition of a recipe proved futile, all agreed that it was fruitful to understand recipes as an important genre in early modern science and medicine.

apotheke_enhausen_l
From http://www.gn.geschichte.uni-muenchen.de/aktuelles/archiv_2011/archiv_2013/science_and_medicine/index.html

For her investigation on the testing practices of Venetian apothecaries, Valentina Pugliano emphasized the difference between experiment and experience. Venetian apothecaries were less concerned with testing drugs (in a traditional sense) than they were with the experience or truthfulness of their ingredients. Testing by inspection, smell and taste was also important in this pharmaceutical context, to ensure that the ingredients were what the merchant had promised them to be, and not a cheap substitute with inferior properties. For Pugliano’s apothecaries, the important issue that required testing was the authenticity of the ingredients rather than the efficacy of the finished product; after all, most preparations had proved their worth since antiquity. Like McVaugh, Pugliano questioned traditional “Baconian” understandings of what it meant to experiment and test and argued for more nuanced notions of testing and trying, which included observing, measuring, evaluating, and experiencing.

Image_Samir
Title page of Johannes Christophorus Homann’s Dissertatio inauguralis medica de medicinae cum geosophia nexu quam auspice deo prpitio (Hala Madgeburica, Hendelius, 1725). From http://cures.hypotheses.org/the-workshop/programme-2/boumediene-samir

With early modern Europeans’ increasing forays into the New World, however, more and more materiae medicae were found which were absent from ancient medical writings. Pliny and Dioscorides were silent on such substances as guaiacum wood, Peruvian bark or New World balsam, so their medicinal properties had to be newly investigated. Antonio Barrera-Osorio and Samir Boumediene’s papers added America, or the New World, into the discussion. Both emphasized the role of new drugs and materia medica in the rise of European experimental practices. New drugs and new medicinal recipes required new ways of testing.

Antonio Barrera-Osorio’s paper argued for an empirical culture in the Spanish empire, which was well suited to respond to these challenges. He showed how his protagonists gathered information about New World remedies from natives or travellers and experimented with ways of preparing them. Some of these drugs and recipes were deemed so important for the economy and health of the empire that the Spanish crown ordered tests in hospitals all over Castile. Samir Boumediene’s paper elaborated on the issue of making workable recipes for newly discovered drugs. Once more, taste and smell were important assays, but drugs such as guaiacum and Peruvian bark were also tested on a larger scale. Dispensing them to the poor inmates of charitable hospitals (as happened in France and Germany) helped to determine their effect, and to establish recipes, which indicated how to adjust the treatment in individual cases.

books
Andreas Cleyer, Specimen Medicinae Sinicae (Frankfurt, 1682). From http://cures.hypotheses.org/the-workshop/programme-2/hanson-marta-and-pomata-gianna

Gianna Pomata and Marta Hanson’s paper showed how recipes also functioned as vehicles of knowledge between different cultures. Recipes, as either formula or prescription, were both found in European and Chinese medical cultures. According to Pomata and Hanson, it was the familiar genre of the recipe that facilitated the transmission of Chinese pharmacology to Europe in the second half of the seventeenth century. Similarly, Carla Nappi argued that the Manchu medicinal recipes of the Qing court were spaces of encounter and medical translation in the early modern world. Pomata, Hanson, and Nappi demonstrated how the recipe served as the common ground between European and Chinese medicine and made the translation of Chinese pulse medicine and the transmission of Chinese materia medica possible in the seventeenth and eighteenth centuries.

Although recipes are difficult to characterize as a genre, it is clear that they are fascinating objects of historical study. More often than not, they are fluid rather than fixed forms of knowledge, requiring adaptation at every turn. They bring together ingredients, practices and often practitioners from all over the world, and themselves have a tendency to aggregate into larger collections. As written manifestations of gestures and processes, they play an important part in testing, assessing and modifying drugs and cures.

Seasonality @ The Recipes Project

By Elaine Leong

Franconian asparagus at farmer’s market of Bamberg (Image courtesy of Wiki Commons)

Happy May Day everyone! I am very excited to be on-point editor for the 2017 May edition of The Recipes Project. Living in Germany, where there is a ‘saison’ or a ‘- zeit’ for almost everything – Spargel (asparagus), Erdbeerkuchen (strawberry cake), Kurbis (pumpkin), Pflaumen (plums), Balkon (balconies – meaning party time!), I have grown accustomed to anticipating and welcoming the changing of seasons. Further inspired by the official first day of summer, I decided to invite a group of like-minded contributors to explore the theme of seasonality in this month’s edition.

In fact, both the joys and constraints of seasonality have been on my mind in this academic year. In the fall, through reading the letters between Johanna St. John and her steward Thomas Hardyman, I gained insight into the complex planning strategies used by early modern householders to ensure a table laden with enticing food and drink. Johanna’s frank instructions offered a glimpse into the everyday pressures faced by mistresses and servants to guarantee turkeys at Christmas, uninterrupted supplies of fresh butter, cheese, bacon all year round and a beautiful show garden in the spring and summer months. The letters very quickly revealed that whilst the St. John household was busy all year round, certain times of the year were particularly task-filled as the household collective strove to seed, cultivate and harvest and to preserve foodstuffs and produce medicines by sugaring, candying, distilling and brewing. The profound impact of the changing seasons on food and medicine preparation does not come as a surprise to those of us who spend time in recipe archives and, indeed, in the recent years there have also been contemporary calls to return to the land. For example, Johanna’s struggle with raising turkeys prompted me to revisit Barbara Kingsolver’s thoughtful Animal, Vegetable, Miracle where the author writes engagingly about her adventures in rearing heritage turkeys. As I cycle past the asparagus stands (soon to be strawberry stands) on my way to work, I relish the fleeting joy of spring produce and concurrently breathe a sigh of relief that, thankfully, I can rely on Germany’s specialist strawberry grower Karl’s to pick and make the delicious Erdbeer Traum (strawberry dream) jam which my family so loves in our Victoria Sponge Cake.

Commissioned during the ‘hungry gap’, this month’s posts work together to interrogate notions of seasonality in historical recipes across a range of geographical and temporal contexts and knowledge spheres. Food historians Rachel Snell and Molly Taylor-Polensky examine the technologies and methods used to preserve seasonal produce for year-round consumption and the various cultural reasons driving this work. Taking a slightly less sunny stance and drawing upon the recipe notebook of Rebeckah Winche, literary scholar and ecofeminist Jennifer Munroe prompts us to re-examine our interdependent relationship with other animals, plants, soil and climate on our planet.

Of course, notions of seasonality extended well beyond food and medicine, as art historian Jenny BoulBoullé  shows that artisans and craftsmen were also keenly aware of the effects of changing seasons. Representing the flourishing Artechne project, Jenny’s post reminds us of the importance placed upon season by both pre-modern artisans and 19th and 20th century scholars who so eagerly attempted to reconstruct historical recipes. Taking us into the realm of alchemy, Tillmann Taape discusses how distillation processes were used to make medicines and human bodies prevail against seasonal cycles of generation and decay.

Turning to the Chinese context, He Bian explores a late 14th century guide to living seasonally and introduces readers to the various recipes for food and medicines included within. Examining later readings and discussions of the guide, He questions whether seasonality, a classic theme in ancient Chinese medicine, came under critical scrutiny of early modern scholars. Our edition closes with a post by Caroline Petit who, taking us back in time to the ancient world, examines an intriguing story told by Galen. Taken together, these posts highlight the continued role played by seasonality in recipe practices and knowledge.

I hope that you all enjoy this special issue of The Recipes Project!

 

 

The Order of Things (2)

By Saskia Klerk, with Sietske Fransen.

Over a year ago, Sietske and I started our ongoing series on a Dutch recipe collection BPL 3603, kept in the Leiden UL. We have already learned much about the manuscript and its compiler from examining a number of entries. But, as Sietske showed in her most recent post, there is more to discover by turning our attentions to the organization of the manuscript as a whole.

We recognized a certain order to how the recipes were entered into the 70-folio volume. Especially the fact that a first set of pages (p. 1-76) is alphabetized and a second set (p. 77-122) isn´t, appears significant. Still, some anomalies remained a bit of a mystery to us. A closer look at the alphabetical organisation of the first part was a big eye opener.

We can be sure that, as Sietske has suggested, the recipes in the volume were transcribed from a collection of recipes kept in a notebook or on loose slips of papers, which then formed the basis for further collecting.[1] The recipes were initially ordered alphabetically, mostly according to the affliction they were supposed to cure.

The manuscript allocates only one page to the letter "E", marked on the top right corner.
The compiler allocated only one page to the letter “E”, marked on the top right corner.

To fit his recipes into the manuscript, the compiler took into account how much room he needed for each letter. The number of pages assigned varied from one half-filled page for afflictions starting with “E” (p. 11), to the seven full pages for the letter “O” (p. 32-38).

Crucially, he marked only the recto pages with a letter in alphabetical order and initially left the verso pages blank. In this way, the verso pages remained open for additions and their letter grouping could be assigned later, creating a flexible information organisation system. Additional recipes transcribed on the verso pages tended to start with or contain the letter on surrounding recto pages.

A variety of tobacco illustrated in Johannes Neander´s Tabacologia (Leiden 1622).

The letter T shows how this system worked. Two and a half recto pages were filled with cures for toothaches and loose teeth (p. 55, 57 and 59), leaving space on the last recto page for additional recipes. Two of their verso pages are assigned to cures for consumption and split nipples on the one hand and a discussion of the virtues of tobacco on the other (p. 58). Importantly, the one page in the manuscript that remains completely blank is a verso page (p. 60).

Many recipes were later added onto the initially blank pages. This arrangement meant that on the verso pages of part one, we find materials that the compiler came across after he designed the manuscript with the alphabetical organisation.

As Elaine Leong has pointed out here, arranging recipes within a basic, alphabetical organisation is not as straightforward as it might seem. Clearly, this was the experience of the compiler of BPL 3603.

Practicalities such as running out of space on a page, forced him to reconsider how he categorized recipes. For example, due to space constraints, he entered recipes for the same affliction under as many as three different letters. When the page on dysentery (Rode Loop p. 47) under R was full, the collector grouped further recipes under L with recipes for lame Limbs instead (p. 28) and also under the much broader defined “afflictions of the belly” in the B section, particularly with recipes against diarrhea and stomachache.

His efforts to organize his recipes provides a perspective on how decisions about appropriate treatment could be informed by the organization of medical knowledge on paper.

Seventeenth-century physicians tended to organise their knowledge around illnesses rather than recipes, in order to choose a treatment. Various complaints, loose teeth and joint pain for example, could be subsumed under one disease, scurvy, and treated with the same remedies. On the other hand, dysentery (Rode-loop) distinguished itself from diarrhea (Buick-loop) by the presence or absence of blood in the stool, and each required different treatments.

This manuscript reveals the different organizational options that this compiler´s focus on recipes presented him with. He considered the area or part of the body where an illness occurred, its different common names, the letter that a recipe contained or started with, its main ingredient or manner of preparation.

An unexpected result of choosing where to put a new recipe on paper, the compiler of our manuscript also created new relations between illnesses and treatments. Why not try a recipe for dysentery in case of diarrhea or stomachache? The creative arrangement of recipes by the compiler might have led to more such epistemic effects than we initially realized.

[1] The recipe collection of Constantijn Huygens (1596-1687), a prominent diplomate and poet, remains in the form of such untranscribed and unorganized notes and slips of paper, in the Dutch Royal Library: Mss. KB: KA 47.