Category Archives: Medicine

Bitter as Gall or Sickly Sweet? The Taste of Medicine in Early Modern England

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

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. I also discuss some of these issues in my forthcoming open access book, Misery to Mirth: Recovery from Illness in Early Modern England (OUP, June 2018).

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. In the next stage of my project, I seek to discover how the other four senses were affected by illness and treatment.

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[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.

Fragrant Protection: Saffron in Medieval China

By Yan Liu

In 647, an emissary from Gapi, a kingdom in northern India, presented a plant called “yu gold aromatic” (yu jin xiang) to the court of Tang (618-907). The foreign herb flowered in the ninth month of the year, with the shape of a lotus. The color of the flowers was purplish blue, and their fragrance could be smelled over tens of paces.

This account comes from a tenth-century institutional history of Tang (Tang huiyao), in a section that reviews a list of plants and animals submitted by the foreign countries to the Tang. The event took place at a time when the Tang was ascending to a powerful and cosmopolitan empire, expanding its territory into Central Asia. As a result, the period witnessed a vibrant material exchange between China and India, Tibet, Persia (and from the mid-seventh century on, the Arabic empire), and even as far as Europe (see Edward Schafer’s classic work on this topic, also see an earlier post). Saliently, a wide array of foreign aromatics entered China, such as aloeswood and camphor from Southeast Asia, frankincense from India, and myrrh from Persia, which greatly enriched Chinese pharmacy.

What then is “yu gold aromatic”? Most likely, the name refers to saffron in medieval Chinese sources. “Gold” (jin) probably specifies the color of the flower, and “aromatic” (xiang) naturally points to its characteristic smell. Intriguingly, the word “yu” conjures up a fragrant herb in ancient China, which was used to scent ritual wine. Therefore, medieval Chinese writers took a familiar word from the past to name a foreign plant thereby readily integrating it into their own cultural terrain.

Not surprisingly, the earliest account of saffron in Chinese sources identifies the herb as a wine-scenting agent. According to a third-century text on natural history (Nanzhou yiwu zhi), saffron grew in Kashmir—still a major site of saffron production today—where local people offered its fresh flowers to Buddha whilst collecting the withered flowers to make fragrant wine. In the following centuries, saffron entered China either as a diplomatic gift (shown in the opening story) or as a commodity of trade. It was an expensive substance due to the intense labor involved in harvesting the three red stigmas of each flower. To obtain one pound of saffron, based on one estimation, seventy thousand flowers must be manually collected. This “circumstantial rarity,” to use Paul Freedman’s term, has made saffron one of the most costly spices in the world.

How was saffron used in medieval China? Noticeably, it became a powerful antidote. According to the eighth-century pharmacological work Supplement to Materia Medica (Bencao shiyi), saffron can dispel all types of noxious odors. Often mixed with other aromatics, it can eliminate malignant qi and demonic possession in the body. Later medical texts (Fig. 1) make it explicit that the fragrant plant can counter all poisons, highlighting its antidotal value.

Figure 1: Illustration of saffron in an early 16th-century pharmacological text (Bencao pinhui jingyao, 1505). Image from Zhonghua dadian, ed. Zheng Jinsheng, 2008

In addition, saffron appeared in Buddhist healing rituals. In a seventh-century scripture titled “Sutra of Golden Light,” we encounter a recipe of thirty-two aromatics (saffron included) that promises to cure all disorders and ward off adverse influences (Fig. 2). In particular, the recipe recommends that the aromatic mixture be employed to cleanse the body, with the following instruction: on the eighth day of the month, take an equal amount of each aromatic, pound and sift them, and collect the powder. Next, cast a spell on the powder for one hundred and eight times before adding it into water to wash the body. Situating drugs in a proper ritual—in this case an incantatory performance—was vital for their efficacy.

Figure 2: A recipe of thirty-two aromatics in the 7th-century Buddhist text Sutra of Golden Light. The purple box highlights saffron, written in both Chinese and Sanskrit names. Dunhuang manuscript S. 6107. Image courtesy of the International Dunhuang Project (British Library).

 

Given its strong scent, saffron was also used as a perfume in medieval China. The seventh-century medical work Essential Emergency Recipes Worth a Thousand in Gold (Beiji qianjin yaofang) by Sun Simiao, for example, offers a number of recipes to perfume clothes. One utilizes eighteen aromatics including frankincense, clove, aloeswood, musk, and saffron. Upon pounding into powder, they are mixed with boiled honey and jujube, and made into pills. Burning these pills creates vapor to scent clothes. Due to the high price of saffron at the time, it is conceivable that only the wealthy elites could afford such a perfume. Consistent with this, several Tang poems associate saffron with the sumptuous clothes of elite women. The scent of the exotic flower became a sign for patrician beauty.

Finally, I must say a few words about saffron as a spice in China. This is the primary function of the herb today, especially in Indian and Middle Eastern cuisine. It also constituted the chief use of the herb in medieval Europe, for enhancing the flavor and color of food. Yet the culinary use of saffron was minimal in medieval China; we have to wait until the 14th century, when China was under Mongol rule, to see the use of saffron as a spice, especially for preparing meat dishes. This practice, though, remained marginal in the following centuries. Today in China, saffron, curiously called “Tibetan Red Flower” (zang hong hua), is harnessed primarily as a medicine, not as a spice. Why? This is a fascinating puzzle that awaits further research, which invites us to ponder the untold journeys from smell to taste, from medicine to food, from the exotic to the familiar.

Recipes and the Senses: An Introduction

By Hannah Newton

Lubin Baugin, Still-life with Chessboard (The Five Senses) (1630). Wikimedia.

 

Our enjoyment of food depends not just on how it tastes and smells, but also on what it looks, feels, and sounds like. Crispness, for instance, is perceived when we hear a ‘snap’ as the food breaks between our teeth. This relatively new understanding of gastronomic experience explains the recent explosion of recipe books designed to entice all five senses. In fact, a ‘sensorial revolution’ is taking place across most fields of history. This month’s thematic series, edited by Hannah Newton and Elaine Leong, gives a flavour of what might be gained by applying such an approach to the history of recipes; there are 7 contributions, spanning several disciplines, chronologies, and regions, from ancient Rome to eighteenth-century England. To put the posts in context, this introduction provides some background on sensory history.

Approaches

There are many ways to do sensory history. Perhaps the most influential has been the ‘grand narrative’ approach: scholars such as Marshall McLuhan and Walter Ong claimed that a ‘major sensory transition’ took place between medieval and modern times in the way the senses were ranked. In medieval Europe, societies privileged the ‘lower senses’ of touch and taste, but with the march of modernity the ‘nobler’ senses of sight and hearing came to the fore. Although this scholarship has been heavily criticised – not least for its disparaging attitude towards medieval people – the question of change over time rightly remains fundamental to sensory history. Yan Liu’s post in this series is a good example: he shows how the use of the spice saffron in China has been transformed since medieval times, from an antidote against evil powers to a flavour enhancer in cooking.

Another approach to sensory history involves focusing on a particular sensory organ, or a context directly linked to that sense. Examples include Stuart Clark’s Vanities of the Eye (2007), which explores anatomical and philosophical understandings of vision, and Holly Duggan’s Ephemeral History of Perfume, which uses scent as a window into cultural attitudes to smell.  One downside to the single-sense approach is that in daily life we perceive the world through all our senses, not just one, and the senses themselves influence one another. Several of the contributions to this series demonstrate these interactions nicely: Barbara Di Gennaro Splendore  reveals that the 17th-century apothecary ‘knew substances through “his whole person”’, and William Tullett makes similar observations about 18th-century perfumers.

A third way to study the senses is the ‘sensescape’ approach. This is where scholars take a particular environment or activity, and analyse the multiple sensations that were perceived within it. Bloomsbury’s six-volume series, Cultural History of the Senses, showcases some of the most popular sensescapes, which include the marketplace, street, and church. Donna Bilak’s post is an example of this approach: she uncovers the intriguing sensations reported in the iatrochemical laboratory of the 17th century New England puritan Gershom Bulkeley, which included ‘urinous’ flavours. What Bilak, and many of our other contributors reveal, is that people from the past consciously mobilised their senses when going about their everyday work, whether as a medical practitioner, perfumer, or chef.

Challenges

One of the biggest obstacles to doing sensory history relates to evidence: most sensory stimuli are ephemeral, leaving no direct historical trace, which means we have to rely on written descriptions or images to access past sensory experience. Unfortunately, this is far from straightforward, due to the difficulties people encountered when putting sensory experiences into words. Peter Charles Hoffer labels this the lemon problem: ‘I can taste a lemon and savour the immediate experience, but can I find words to convey to another person exactly what that sensation was?’

To meet these challenges, exciting new techniques have been devised by historians to recreate past sensations, which involve the use of ‘immersive technology’, such as artificial smells and tastes. By activating our own senses, the intention is to ‘replicate sensation in a world we have (almost) lost’. Historians of science and food deploy similar techniques, re-enacting past experiments (e.g. or making foodstuffs (e.g. here and here), to reach a closer understanding of contemporary worldviews. Tillmann Taape and Erica Rowan, two of our contributors, are both engaged in this sort of innovative work. Admittedly such approaches do attract sceptics. For instance, Mark Smith warns that while it is possible to reproduce a particular sensation from history, the way we ‘consume’ that sensation may be different from the way it was experienced at the time. Indeed, an experience of a sensation may even change over a person’s own lifetime, as Hannah Newton’s post reveals: for early modern patients, what they would normally perceive as pleasant tastes – such as sweet cordials – were found during illness to be disgusting, owing to the effects of noxious humours on the taste-buds.

Despite the challenges involved, our contributors are optimistic about applying a sensory approach to the study of recipes. So long as we accept that sensory perceptions are culturally contingent, there is no reason why it is not possible to glimpse how past societies understood and experienced sensations.

 

Tales from the archives: Spring: when thoughts of fancy turn to itchy, watery eyes

In 2017, The Recipes Project celebrated its fifth birthday. We now have nearly 650 posts in our archives and over 160 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.

Spring  started a few days ago in the northern hemisphere. Here in the UK, the weather is getting warmer – and wetter – after a very cold month. The days are lengthening, and the flowers starting to bloom. All this loveliness, however, is slightly tempered by pesky hay fever, which seems to affect me earlier every year. This seems the perfect opportunity to revisit a post by our own Lisa Smith first published in May 2014 on early-modern remedies for watery eyes. Enjoy!


By Lisa Smith

A number of my Tweet-friends have recently been complaining about the severity of their hay fever this spring. @KateMorant asked:

Is there any #earlymodern advice/ recipes for hay fever? I’ll try anything short of applying leeches to eyes.

Advert for Histantin, a Burroughs Wellcome and Co antihistaminic agent showing a couple eating a picnic in a field while a farmer piles hay onto a cart, 1965. Image Credit: Wellcome Library, London.

But… trying to figure out what people might have used to treat their symptoms in early modern England is no easy matter. The term hay fever, according to the Oxford English Dictionary, was not used until 1829. What we know now as “hay fever” was first described in 1819 by Dr. John Bostock, who presented his own case for study as being “an unusual train of symptoms”: itchy, swollen and watery eyes, sneezing, and difficulty breathing. Over the years, Bostock had tried bleeding, purging, blisters, diet, Peruvian bark, steel, opium, mercury, cold bathing, digitalis… and, of course, many eye remedies. None of these had apparently helped.

Keeping in mind the relatively new description of hay fever as an ailment, I decided that the best way to track down early modern hay fever remedies would be according to symptoms. Of the symptoms typically associated with hay fever, itchy eyes are the easiest to trace—and even this was no mean feat.

I started off with the Wellcome Library’s wonderful online collection of seventeenth and early eighteenth century recipe books. Although there are lots of remedies to treat eye problems, many of these were a bit general, such as “The Lady Iveys Eye Watter” listed in the Johnson Family’s book (1694-1725). These eye drops, which included the white of a new laid egg, spring water and alum, could be used to treat “all distempers in yr Eyes pertickuler for any thing that grows”. So, although allergy-ridden eyes could in theory be treated with this remedy, it was not the most specific choice.

Fortunately, none of the remedies I looked at used this as an ingredient! Thomas Rowlandson, A Village Doctress Distilling Eyewater, 1800. Image Credit: Wellcome Library, London.

The Brumwich family (1625-1700) may have been hay fever sufferers, as there were three somewhat more useful remedies in their collection: “A watter for eyes that are red & watterey aproved”, “A resceipt for wattering eyes” and “A water for sore eyes whose lides are all swelled”. All had an “X” or a “+” beside them, indicating—along with the one “aproved” that the recipes had been tried. The “watter for eyes” was essentially a sugar water that could be sponged or dropped into the eyes, while “A resceipt” included orris [iris] root and white copris [possibly a beetle?] steeped in water. The “water for sore eyes” used red rose water and powdered aloes. Of course, there is no guarantee that these were for allergy symptoms, especially as the third recipe was included alongside remedies for blindness and sore eyes.

None of them give me any confidence.

The English Physician enlarged (1718) by Nicholas Culpeper, however, offered some potential explanations—as well as solutions—for itchy, watery eyes. A juice of celandine, field daisies and ground ivy in clarified water with dissolved sugar was a “soveraign remedy for all pains, redness, watering”, which sounds promising, but it also treated pins and webs and skins and films (p. 10). Barley, which was ruled by Saturn, could be cooling and cleansing, especially for inflammation problems (pp. 29-30). Eye drops distilled from green barley gathered at the end of May was particularly good for sufferers who had “Defluctions of Humours fallen into their Eyes”. Both remedies suggest that symptoms might be seen as defluxions (a discharge of fluid) or inflammations. Makes sense.

But another type of classification in Culpeper put itchy, swollen eyes alongside poisons and the venemous bites. This made sense; the blood in such cases was seen as poisoned and overly hot. White beets and borage and bugloss were all ruled by Jupiter, which made them cleansing and strengthening. The beets could treat internal obstructions, headaches, venemous bites, eye inflammations and—interestingly—“wheals”, something rather like a hive (pp. 36-37). Borage and bugloss roots and leaves were good for putrid and pestilential fevers and poisons, while the leaves and seeds might help cleanse the blood and excess heats. The distilled water could be used as an eye wash for red and inflamed eyes (pp. 50-51). Modern hay fever sufferers, no doubt, will also understand this parallel with poisoning, with  pollen and dust acting as daily sources of misery.

Trying to identify hay fever-like symptoms in early modern England is a difficult business, as these eye remedies reveal. And this, before we even get to the sneezing! A quick digital search through Culpeper’s on Eighteenth Century Collections Online shows that all references to sneezing were in positive terms. For example, under “Clary, or more properly Cleer-Eye”, Culpeper noted that the powder of the dry root “provoketh Sneezing and thereby Purgeth the Head and Brain of much Rheum and Corruption” (p. 90). In other words, while Culpeper offered up lots of remedies for the eye symptoms, nothing could—or should—be done about the sneezing.

Sneezing: nature’s way of purging the body? But at least no leeches were required…