Revisiting He Bian’s Fetch Me at Pearl Nest Street: Rhubarb Pills as Panacea in Qing China

Today we revisit He Bian’s fascinating post from 2018. Here, He tells us about the global trade in Chinese rhubarb (dahuang) roots, panaceas and notions of difference in premodern theories of the body. Fascinated by this post and want to learn more about drugs in early modern China? You’re in luck as He’s monograph Know your Remedies: Pharmacy and Cultures in Early Modern China is now out with Princeton University Press. Have you ordered your copy? Elaine Leong


He Bian

In the late eighteenth century, American ginseng opened up a new niche market in Qing China. At the same time, Chinese rhubarb (dahuang) roots, harvested from the northwest regions of the empire, were transported by Chinese traders all the way to the southeast coast and sold off to foreign customers in Canton (Figure 1). Part of these transactions took place in the Ryukyu Kingdom (present-day Okinawa Islands), a vassal state of the Qing but also an important node of global trade that crisscrossed the West Pacific. At some point in 1789, the Qing court issued an edict to the Ryukyu king that explicitly forbade him from selling rhubarb to Russians, with whom the Qing was then engaging in an all-out trade war. Rhubarb featured prominently in the Qing strategy because they believed that Europeans imported so much of this drug that they could not live a day without it.[1]

Figure 1. Chinese or Turkish rhubarb (Rheum palmatum): flowering and fruiting stem with leaf. Coloured zincograph after M. A. Burnett, c. 1842. Credit: Wellcome Collection, https://wellcomecollection.org/works/cvty3qqk
Figure 1. Chinese or Turkish rhubarb (Rheum palmatum): flowering and fruiting stem with leaf. Coloured zincograph after M. A. Burnett, c. 1842. Credit: Wellcome Collection, https://wellcomecollection.org/works/cvty3qqk

Yet is it really true that pharmacological visions in early modern China and Europe were so different that they could not possibly reach a consensus over rhubarb’s properties ? Classical Chinese pharmaceutical literature listed rhubarb as a drug with a “very cold” nature, and generations of physicians were taught not to use the cold drug in curing cold-natured diseases. This suggested that Russians (and other Westerners, as seen in this post on rhubarb in early modern England) had different bodies than the Qing Chinese, as they depended on rhubarb as an all-round cure. Pharmacological theories, in other words, engendered a vision of difference that seemed insurmountable.

During my recent reading of Qing medical recipe books, however, I discovered that rhubarb in fact functioned as nothing short of a panacea for Qing Chinese. This is evident in the text Bianyong liangfang (Excellent Recipes for Expedient Use), which appeared in the Jiaqing reign (1796-1820). Compact (only 2-juan in length) and very nicely printed (with carved woodblocks), it arranges pills, powders, tinctures, and decoctions by symptom. The book has about 120 pages, and most recipes are merely a few lines in length. What surprised me was that one very long recipe at the end of the text takes up the entirety of 13 pages. The remedy in question, mi shou Qingning wan (Secretly transmitted pill of purity and tranquility), calls for “several dozen pounds” of good quality rhubarb roots as the principal ingredient. Rubbed clean and steeped in rice water, the rhubarb was sliced, sun-dried, processed with “ash-less good rice liquor” for three days, and then put through a lengthy, elaborate protocol of fifteen rounds of steaming. Each steam involved a different set of herbs. Finally, makers took the resultant rhubarb paste, mixed it with “yellow ox milk” (using cooked honey as substitute if there was no milk), boy’s urine, ginger juice, and rolled it into tiny pills. The recipe listed hundreds of common illnesses that could be treated with this pill, ranging from headache and hemorrhage to gynecological disorders.

Figure 2. Luo Benli ed. Bian yong liang fang. Vol. 2b, p. 50b. c. 1796-1820. Princeton University Library. Downloadable PDF available at http://pudl.princeton.edu/objects/fn107159v
Figure 2. Luo Benli ed. Bian yong liang fang. Vol. 2b, p. 50b. c. 1796-1820. Princeton University Library. Downloadable PDF available at http://pudl.princeton.edu/objects/fn107159v

I have tried to look up this recipe in earlier Chinese medical texts, and my preliminary findings suggest that it probably came into existence no earlier than the seventeenth century. It became wildly popular in the eighteenth century, and recipe books serve as evidence of its widespread consumption. On the last page of Bianyong liangfang (Figure 2), the compiler, Luo Benli, announced that he had a batch of rhubarb pills prepared during his tenure in Guizhou – a southwestern province of China – and that, in case of emergency, readers could “call upon my house on Pearl Nest Street” and look for the “residence of Mr. Luo of the Ministry of Defense (bingbu Luo zhai).” Pearl Nest Street (zhuchaojie), a neighborhood in Qing Beijing not far from the Forbidden City, featured prime real estate. As a military official who had served in the frontier provinces, Luo was less bound by medical norms of the day and possessed the financial and political capital to manufacture elaborate pills like these. Was there, in other words, a sub-culture of health and medication championed by military elites such as Luo, which stood distinct from classical prescriptions?

One last word about this recipe that hints at a hidden connection between different cultural realms in early modern China: Sun Xingyan (1753-1818), a prominent scholar who combed through medieval sources for fragments of ancient texts, published the same recipe for Pill of Purity and Tranquility in his scholarly series. The inclusion of this Qing text alongside ancient monographs so bewildered modern bibliographers that they mistakenly attributed the recipe’s author to a seventh-century figure. In fact, Sun Xingyan made it clear that it was a contemporary remedy and provided an elaborate scholarly argument to defend rhubarb’s all-around efficacy to cure both hot and cold-natured illnesses. He also suggested that “vulgar physicians” despised the pill because if everyone had access to this remedy then their businesses would be lost. Therefore it does appear that, when it comes to rhubarb, Qing Chinese scholars and military commanders were no less enthusiastic than what they imagined about the Russians.

[1] I recommend this excellent essay by Chang Che-Chia (translated by Penelope Barrett) for more on this curious episode.

Revisiting Chelsea Clark’s The Wonders of Unicorn Horns: Preventions and Cures for Poisoning

Editor’s note: Today, we revisit a wonderful post from Chelsea Clark in 2012 on the intersection of magic and medicine from Early Modern England. Drawing on the seventeenth century  manuscript ascribed to the herbalist Johanna St. John, Clark examines the symbolic power remedies to unwind magical forces.  In this case, the remedy for the malicious magic of poison rests on unicorn, bezoar stones, and the bones of stag hearts.  Magical ailments, after all, would necessitate magical cures.  R.A. Kashanipour


By Chelsea Clark

Johanna St John’s Book, Credit: Wellcome Library, London

In Johanna St. John’s recipe book, the mysterious “Banister’s Powder by Dr Bates” lay nestled between the equally intriguing “Mrs Archers way of makeing My Lady Kents Powder” and the beginning of the letter “R” section of St. John’s efficiently organized recipe book. There is no indication what type of recipe this “Banister’s Powder” was, besides a powder, or what it’s intended use was. Following several pages of recipes for “pox” and “pills” this “Powder” is the tail end of St. John’s letter “P” section, however, even knowing this context offers little information. An analysis of the “Banister’s Powder” ingredients suggests a link between St. John’s early modern medicinal recipes and the presence of magical beliefs associated with medicine in the early modern period.

The first three ingredients required to make the “Banister’s Powder” are: powdered Unicorn horn, east bezoars, and the “bones” of a stag’s heart. Each of these ingredients had longstanding associations with the belief they were capable of preventing or countering the effects of poisoning. To a modern eye, these appear strange items to reside alongside many complicated recipes which rely on an expansive knowledge of medicinal, rather than magical, properties. These ingredients indicate that magical beliefs remained acceptable practices among home practitioners in the early modern period. This is possibly because the science to disprove them was not advanced and medical practitioners were only beginning to be skeptical and move away from such unreliable remedies.

The prevention and cure of poisoning was a genuine concern before and throughout the early modern period. It was quite common to be bitten or stung, to consume poisonous berries, roots, or herbs, or to believe a spell had been cast by a witch (Jackson, 96). It was also common for physicians to diagnose poison as the cause when they could not determine the source of an ailment (Auble, 17). This led to the necessity for remedies to detect, prevent and cure poisoning.

Rhinoceros Horn Vessel, Credit: Wellcome Library, London

 

Pharmacy sign, Credit: Wellcome Library, London

Unicorn horns were actually believed to come from the mythical creature and possess its symbolic purity and strength, though they were most often a narwhal tooth or powdered rhinoceros horn. The horns were commonly powdered and used in poison antidotes or as vessels to drink from before or after ingesting poison (Jackson, 97). Unicorn horns were also believed to have properties which allowed them to detect poison (Knight, 245). In addition to being thought to detect, prevent or cure the effects of poison, the horns were also thought to strengthen your heart, relieve headaches, resist the plague and pestilence, expel measles and small pox, and cure “falling sickness” in children (Brockbank, 3) all of which were reoccurring ailments in the early modern period.

 

Bezoar stones were solid masses from the intestines of goats, sheep or deer that were primarily believed to detect poisons but also, in some cases thought to provide a cure if small amounts of the stone were consumed. “Oriental” or “East” Bezoars, as St. John called for, were the most valuable type which came from a Persian wild goat (Jackson, 97). It was occasionally consumed, but more commonly mounted on a chain and dipped in to drinks to nullify the effects of poison if there was any (Jackson, 97). Queen Elizabeth I reportedly kept one “sett in golde hanging at a little Bracelett … The most parte of this stone being spent” indicating the Queen mounted and consumed her stone (Auble, 18).

Mounted Bezoar Stone, Credit: Wolfgang Sauber

The belief in the magical powers of the “bones” from a stag’s heart originates from a folk tale. The tale is that stags ate poisonous snakes by sniffing them out of holes and then after which they rushed to drink water. The “bones” in their heart were believed to be what protected the stags from being poisoned. The “bones” were actually caused by the degeneration of arteries into flat, oblong bone like objects. Powdering and consuming this “bone” was seen as a preventative measure to protect against the effects of poisoning (Jackson, 97).

Unicorn horn, bezoars and “bones” from a stag’s heart, were the key ingredients to the “Banisters Powder” in St. John’s recipe book. Because of the longstanding beliefs about these ingredients and their associations with poisoning detection, prevention and cures, this recipe was perhaps intended to cure or prevent poisoning. One can imagine the remedy would have been thought to be fool-proof against poison because it combined the powers of each of these ingredients. Although there was a movement away from magical remedies and cure-alls among physicians in the Early Modern period, belief in the curing power of magical objects was still present in the lives of home practitioners such as Johanna St. John. What we would consider scientifically impossible, they were only beginning to discover.

A strong belief in unexplainable phenomenon was common practice and popular beliefs are difficult to dispel, especially when they hold significant symbolic value. Just the other day the North Korean state media associated the discovery of a Unicorn Lair with their new young leader. It is hoped this association would strengthen the nation’s confidence in their young leader because of the symbolic meaning of the Unicorn and its ties to the state’s history. This example illustrates that a belief in the symbolic power of an object, like a Unicorn or its horn, bezoars, or “bones” from a stag’s heart can transcend both time and logic, persisting even when its truth is questionable.

Works Cited:

Auble, Cassandra. “The Cultural Significance of Precious Stones in Early Modern England.” Dissertations, Thesis, & Student Research, Department of History, University of Nebraska Paper 39 (2011).

Brockbank, William. “Sovereign Remedies: A Critical Depreciation of the 17th-Century London Pharmacopoeia.” Medical History 8.01 (1964): 1-14.

Jackson, William A. “Antidotes” Trends in Pharmacological Sciences 23.2 (2002): 96-98.

Knight, Katherine. “A Precious Medicine: Tradition and Magic in Some Seventeenth-Century Household Remedies” Folklore 113.2 (2002): 237-247.

Revisiting Hannah Newton’s Bitter as Gall or Sickly Sweet? The Taste of Medicine in Early Modern England

Editor’s note: Today, we revisit a post by Hannah Newton, author of a wonderful book on illness and recovery called Misery to Mirth: Recovery from Illness in Early Modern England. In this post, Newton explores the essential gustatory qualities of premodern medicines.  Common afflictions of the era often affected all the senses, including the palate of tastes. As shown here, a remedy’s excessive bitterness or sweetness could, in fact, be an essential part of its remedial qualities. To that bitter pill! R.A. Kashanipour


By Hannah Newton

Adriaen Brower’s The Bitter Potion (1640) depicts a man’s reaction to the taste of a medicine – his face is contorted in an expression of deep revulsion (Figure 1). The image seems to confirm Roy Porter’s generalisation that ‘pre-modern medicine tasted foul’.[1] Contemporary medical recipes and patients’ memoirs tell a more complicated story, however. While some remedies were full of bitter ingredients, others were pumped with sugar. Below, we will see why this was the case, and discover that the actual flavours of medicines sometimes bore little relation to how they were actually experienced. This research is part of a new Wellcome Trust project, Sensing Sickness, which investigates the impact of disease on the five senses, and uncovers the sounds, sights, smells, tastes, and tactile sensations of the early modern sickchamber.

Figure 1: ‘The Bitter Potion’, 1640; by Adriaen Brouwer; © Städel Museum – U. Edelmann – ARTOTHEK

Bitter medicines

Amongst the most common bitter ingredients in early modern medicines were the herbs wormwood and aloes. Lady Barret’s remedy against ‘any illness in the stomach’ contains 4 drams of aloes, together with myrrh, saffron, and brandy. The Ayscough family’s recipe book suggests a remedy ‘to drive away agues’ composed of wormwood, marigold leaves, agrimony, and mugwort. A rare insight into the imagined reaction of a patient to these bitter drugs is provided in a collection of Italian medieval novels, published in English in 1620: as ‘soone as’ the man’s ‘tongue tasted the bitter Aloes, he began to cough and spet extreamly, as being utterly unable to endure the bitternesse’. Once taken, the mere sight of ‘the vessel in which the potion is kept’ is enough to provoke vomiting in some patients, wrote the physician William Bullein (c.1515-76). So notorious was the bitterness of aloes, it was used as a metaphor for describing any unpleasant experience, including pain, grief, and spiritual guilt.[2]

Figure 2: ‘Twenty Trees, Herbs, and Shrubs of the Bible. Chromolithograph, c.1850’, by MacFarlane and Erskine; Wellcome Collection, CC BY
Figure 3 : ‘Twenty Trees, Herbs, and Shrubs of the Bible. Chromolithograph, c.1850’, by MacFarlane and Erskine; Wellcome Collection, CC BY

Why did medicines contain these bitter ingredients? According to popular legend, the medicine has to be ‘as bitter as the disease’ for it to work. This idea is rooted in Galenic understandings of disease and treatment. Disease was due to the malignant alteration of the body’s humours, the constituent fluids of living creatures, and it was removed when the humours had been rectified or evacuated. Bitter medicine facilitated this process in two ways – first, it helped ‘devide, [and] extenuate…grosse and clammy humours, that they may be ready to flowe out’ of the body’.[3] Metaphors of cleaning were used in this context: the Dutch physician Levinus Lemnius (1505-68) averred, ‘the filth…of the humours stick no lesse to these mens bodies than the…dregs do to vessels, which must be soked…with pickle’, a bitter vinegary mixture, ‘to make them clean’. The second stage of evacuation was the movement of the humours from the body’s interior to its exit points, such as the bowels, where it could be expelled through defecation. Bitter medicines could be given to induce such movements. Lemnius explained that seeing that ‘attraction is made by the similitude of substance’, there must be a ‘natural familiarity’ between ‘the humour [to be evacuated] and the medicament’. Since the most noxious humours were bitter, medicines should be bitter too. Quoting Hippocrates, Lemnius expanded, ‘Physick when it come[s] into the body, it first…draws unto itself, that which is most…like unto it, then it moves the…humours…and forceth them out’. This idea was familiar to laypeople as well as doctors.

Sweet medicines

Although bitterness was necessary for purgative physic to work, the ‘cunning Physician…tempereth his bitter medicines with sweet and pleasant drinke’.[4] It was hoped that by disguising the bitter flavour, the medicine would be easier to swallow. This intervention was particularly important when it came to treating children, whose tolerance for bitter tastes was especially low due to the sensitivity of their taste-buds. This is still an issue today: in one survey, over 90 percent of paediatricians reported that a drug’s taste is the biggest barrier to completing a course of treatment. The most popular sweeteners in early modern England were sugar and honey. Speaking of her ‘speciall medecine’ for jaundice in c.1608, Mrs Corlyon instructed that ‘you must make it pleasant with Sugar according to your taste more or lesse’ (Figure 4). Anne Glyd’s recipe ‘Against the chin cough’ from the mid-seventeenth century states that it should be taken with ‘hony…or what the child likes best’.

Figure 4: Extract from Mrs Corlyon’s ‘A Booke of divers medecines’, 1606; MS 313, Wellcome Library, London

Intriguingly, these sweetened medicines did not always taste sweet. Recalling a recent illness, the natural philosopher Robert Boyle (1627-91), observed that some of his remedies had been, ‘sweetened with as much Sugar, as if they came not from an Apothecaries Shop, but a Confectioners. But my Mouth is too much out of Taste to rellish anything’. The Galenic explanation for these altered perceptions was that the organ of taste, the tongue, is ‘filled with some strange fluid’ during acute illness, which mixes with the gustatory juice of the medicine, so that ‘all things would seem salty to taste, or all bitter’.[5] Other causes were the drying of the tongue from the ‘fiery heat’ of fevers, or the presence of bitter humours in the mouth.[6] So familiar was the experience of altered taste that religious writers found it a useful metaphor to invoke when describing the more abstract idea that sinners fail to relish wholesome counsel. The Yorkshire minister Thomas Watson (d.1686), wrote in his treatise on repentance, ‘Tis with a sinner, as it is with a sick Patient[:] his pallat is distempered; the sweetest things taste bitter to him: So the word of God which is sweeter than honey-comb, tastes bitter to a sinner’.

We tend to be disparaging about premodern medicines, assuming they were deeply unpleasant. This brief foray into the gustatory qualities of remedies demonstrates that such a reading is too simplistic, and does not take into account the often benevolent intentions behind the use of bitter treatments, nor the attempts of practitioners to make their remedies more palatable. In any case, I think we need to be more wary about assuming the actual qualities of medicines were perceived by patients, since many diseases impaired the patient’s capacity to taste.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

[1] Roy and Dorothy Porter, In Sickness and in Health: The British Experience 1650-1850 (London, 1988), 105; see also Lucinda Beier, In Sickness and in Health: The Experience of Illness in Seventeenth-Century England (Cambridge, 1985), 170.

[2] E.g. Mark Frank, LI Sermons preached by the Reverend Dr. Mark Frank (1672), 391.

[3] A. T., A rich store-house, or treasury for the diseased (1596), preface. See also William Bullein, The government of health (1595, first publ. 1559), 9-10.

[4] William Kempe, The education of children (1588), image 31.

[5] Galen, ‘On the Causes of Symptoms I’, in Ian Johnston (ed. and trans.), Galen on Diseases and Symptoms (Cambridge, 2006), 203-35, at 220-21, 189. This text was available in Latin in the early modern period, translated from the Greek by Thomas Linacre as De symptomatum differentiis et causis (1524).

[6] Helkiah Crooke, Mikrokosmographia a description of the body of man (1615), 631.

Revisiting Katherine Allen’s Tobacco Smoke Enemas in Eighteenth-Century Domestic Medicine

Editor’s note: Today, we revisit a post from 2013 on the myriad and curious uses of tobacco in early modern England.  European imperialism turned the New World domesticate used primarily in ritual into a global commodity of leisure and health.  As Katherine Allen notes in this post, eighteenth century healers also employed tobacco as a remedy for a range of ailments, from rheumatoid pains to the plague.  Tobacco smoke, administered through a pipe called a glister, was used to treat intestinal inflammation and hernias, even in home recipes. This tends to give new meaning to ‘smoke ’em if you got ’em,’ I say.  R.A. Kashanipour


By Katherine Allen

Over the holiday I was working on a transcription of an eighteenth-century recipe book and came across an initially humorous recipe for treating ‘the winde & Collick’ (Wellcome, WMS 3500) which goes as follows:

And so is tobacco given in A pipe [when] it is well Lighted the small end to be oyled and put up into ye fundament and some body put the great end into their Mouth and blow the smoake up into the body this never fails to give ease to the winde collick you may put A small Glister pipe into the body and put the small end of the pipe Tobacco in the End of ye Glister pipe this way will Convey the Smoak into ye body very well. (fol. 87r.)

This surprising description of getting a companion’s assistance in administering the remedy has inspired me to write this post on the history of the familiar phrase ‘to blow smoke up one’s arse [ass]’ and the possible use of tobacco glisters in eighteenth-century domestic medicine.

Tobacco Plant. Image Credit: http://www.spamula.net/blog/i41/non3.jpg

Tobacco (Nicotiana tabacum) is a type of herb in the night shade family Solanaceae. It was smoked by indigenous peoples in the Americas as far back as 1000BC, but gained popularity in Europe and in global markets through trade in the sixteenth century. By the eighteenth century, tobacco was a popular luxury good in England and was increasingly consumed more for pleasure than medicinal treatment.

But how was tobacco used as medicine in the early modern era? Discussing the humoral and astrological qualities of tobacco, Nicholas Culpeper stated in an eighteenth-century version of his herbal that it was a hot and dry herb under the dominion of Mars. Tobacco was useful as an infusion for vomits, rheumatic pain, and piles. As a distilled oil, it was used for aching teeth however, ‘the distilled oil is of a poisonous nature; a drop of it taken inwardly will destroy a cat’. Culpeper also praised tobacco as an expectorant, a digestive aid, and a pesticide for vermin and for preventing plague.[1]

Those who are familiar with recipe collections will have surely come across at least one recipe using tobacco, and the most common recipe seems to have been a tobacco ointment. The Tyrrell Family collection has one such recipe which called for bruised tobacco leaved infused in red wine and then boiled in hog grease along with tobacco juice and beeswax.[2] Tobacco has astringent qualities and acts as a coagulant, and would have been an effective ingredient in salves for treating wounds. Another recipe stated that the tobacco salve ‘is an excellent Mundifier [cleanser] and healer of old sores, and Ulcers, if the sores be first washed with a little good brandy, which ought to be done, till the sores look fresh, which it will do in 3 or 4 dayes if this course be taken.’[3]

Wellcome, WMS 7822, fol. 11r. Image Credit: Wellcome Library

But, when and how did tobacco smoke enemas come into use and how did this treatment come to be in a household book of remedies? The phrase ‘to blow smoke up one’s arse’ means to get a rise or reaction out of someone, sometimes by giving them insincere compliments for attention. This phrase originates from the practice of using smoke enemas to resuscitate near-drowned victims via stimulation and it was first practiced by indigenous groups in North America.[4]

During the eighteenth century, tobacco smoke enemas were used by humane societies across Europe, including the Royal Humane Society in London, to resuscitate victims.[5] Culpeper included the tobacco enema under treatment advice for the inflammation of the intestines induced by colic or hernia and suggested that it ‘is of singular efficacy in obstinate stoppages of the bowels, for destroying those small worms called ascarids [roundworms], and for the recovery of persons apparently drowned.’[6] Physician Richard Mead was a proponent of the tobacco glister, using it to treat iatrogenic drowning caused by immersion therapy for hydrophobia and mania, and later Thomas Sydenham wrote a treatise on its use in bowel obstructions.[7] The use of this treatment declined in the early nineteenth century when it was affirmed that the nicotine found in tobacco can stop blood circulation if there is too much in the body, as in the case of an enema.[8] By the mid-nineteenth century the enemas were not used by the medical faculty.

Tobacco Pipe Enema circa 1773. Image Credit: http://en.wikipedia.org/wiki/File:Tobacco_smoke_enema.png

There is no author associated with the tobacco glister recipe found in MS 3500, but it is likely that this information was communicated to the compiler by a physician. This particular collection is dated 1688-1727 and was owned by a Mrs. Meade (and others), but it does not appear that she was related to Dr. Richard Mead. Several of the recipes are however directly attributed to Dr. Richard Lower for treating the young Nathaniel Meade, one of which is a purge dated the 1st of December, 1688.  There is also one recipe attributed to Dr. Needham on the page before the tobacco glister recipe.

Considering that tobacco enemas were only in vogue from the mid-eighteenth century to the early nineteenth century, it is unusual to find this medical advice in a domestic collection, let alone one dated from the early eighteenth century. As it is improbable that an eighteenth-century household would have had its own tobacco pipe for administering a glister for bowel complaints, I suspect that this recipe is an example of a physician’s remedies being copied into a domestic collection. More importantly, this is an example of how recipe books were continually evolving and being updated alongside innovations in the medical faculty. What started as a chuckle over an amusing recipe has led me to explore the history of this peculiar remedy from its use by the medical faculty to its indigenous origins; giving a whole new meaning for me to the phrase ‘blow smoke up one’s ass’.

 


[1] Nicholas Culpeper, Culpeper’s Family Physician; or Medical Herbal Enlarged. Vol. 2 (London, 1782). p. 134.

[2] Wellcome, WMS 7822. Anon [Tyrrell], ‘Collection of Medical and Cookery Receipts, 17thC-18thC’, fol. 11r.

[3] Wellcome, WMS 1796. Anon, ‘Collection of Cookery and Medical Receipts, c. 1685-c.1725’, fol. 64r.

[4] Raymond Hurt et al., The History of Cardiothoracic Surgery from Early Times (London: Parthenon, 1996). p. 120.

[5] Lawrence Ghislaine, ‘Tools of the Trade, Tobacco Smoke Enemas’ The Lancet vol. 359 issue. 9315 (April 2002): 1442.

[6] Culpeper, p. 281.

[7] Thomas Sydenham, ‘Schedula Monitoria, or an Essay on the Rise of a New Fever’ in Benjamin Rush, The works of Thomas Sydenham, M.D., on acute and chronic diseases: with their histories and modes of cure (Philadelphia: B & T Kite, 1809). p. 383.

[8] Ghislaine, 1442.