Last month, Rebecca Laroche (12/03/2013) examined the first recipe in a manuscript owned by Anne Layfielde and dated 1640, housed at the Medical Historical Library of The College of Physicians of Philadelphia. The section of the manuscript compiled by one “Cal: Downing” contains a remarkable number of attributions, many to Elizabeth Downing – a woman who, Rebecca suggested, could be the “Mistress Downing” whose recipes appear in the printed Natura Exenterata: Or Nature Unbowelled (1655).
I’d like to consider another woman whose name appears repeatedly in the Layfielde manuscript as well as in printed medical manuals: the Countess of Exeter. Seven references to the Countess of Exeter appear in CPP 10a214. While the manuscript never says so specifically, this is most likely Frances Cecil (1580-1663), who married Thomas Cecil, Earl of Exeter in 1610.[1] The Countess’s reputation in matters of health proved weighty enough that she is named in the dedications to a number of early modern printed books, though, curiously, her recipes are not part of those books (and male physicians’ are). Thomas Bonham dedicates The Chyrurgians Closet to the Countess because he finds “amongst men (to me known) none so much affecting this noble Science as I could wish.”[2] Her reputation as a model household manager led Gervase Markham to dedicate the 1623 edition of Country Contentments, or The English Huswife to her; his assertion that the Countess’s endorsement could make his “weak and disable[d]” book “strong in the world” underscores her long-standing reputation as a practitioner of household medicine.[3] Thus, even though the Countess’s recipes themselves are not included, or at least not credited, in these books, their authors rely on her popular reputation as a medical practitioner to situate their writings.
Downing’s manuscript section calls on the Countess’s authority as well, naming her as a source for recipes for ailments ranging from “looseness of the body” to sudden swellings. And even more interestingly, the manuscript labels four recipes as “probatum per Countess of Exeter.” A recipe for “the Ulcer or stone in the bladder” goes so far as to specify that the medicine was “made by Mr Whatton apothecary of Stamford, probatum per Countess Exeter.” This endorsement carries a personal ring, suggesting that the compiler’s contact with the Countess is more immediate than with the apothecary. The manuscript, as a result, conjures images of the compiler and the Countess in personal conversation about their medical work.
While written testimonials could certainly follow along with well-travelled recipes, the Layfielde manuscript’s many references to the Countess raise tantalizing questions about the compiler’s medical connections. How closely did the compiler know the Countess? Did they exchange recipes in person? If not, how did her recipes end up in the CPP manuscript? The answers to these tantalizing questions could offer us a greater understanding not just of how recipes travel, but of how manuscript and print worked together to lend practitioners like the Countess a reputation for medical prowess.
[1] Alastair Bellany, ‘Cecil , Frances, countess of Exeter (1580–1663)’, Oxford Dictionary of National Biography, Oxford University Press, 2004; online edn, May 2006 [http://www.oxforddnb.com/view/article/70625, accessed 23 March 2013]
[2] Thomas Bonhman, The Chyrurgians Closet (London, 1630).
[3] Gervase Markham, Country Contentments, or The English Huswife (London, 1623).
This is the third in a series of monthly posts on this topic.
The last line of a recipe for a nerve ointment within Anna Maria Luisa’s (1667 – 1743) collection of culinary, alchemical, and medicinal recipes reads: “this being a balm, and particular secret, which is made only in the S.A.R. fonderia, and not in another location, even if others say they have the same recipe.” Five of Anna Maria Luisa’s recipes—two fever waters, one ointment for nerves and another for burns, and a powder to control epilepsy—are attributed to the fonderia of the most serine royal highness, the grand duke of Tuscany. Of these five, three are printed on small sheets of paper and prominently emblazoned with the Medici crest. The printed recipe for fever water stated that this particular water was useful for reoccurring fevers, both malignant and acute. The directions praised the water’s success in moderating the heat of fevers in patients of all ages. It advised giving the water four or five times in the morning, but suggested reducing the dosage based on age. Of all the recipes in Anna Maria Luisa’s collection, this is the only printed text with multiple copies. The fact that this recipe was printed, and three copies remain in her collection, suggest that this particular fever water was widely used and produced by the Medici palace fonderia, or pharmacy.
Established by Cosimo I in the Palazzo Vecchio, the Medici Granducal fonderia was a laboratory where naturalists, alchemists, herbalists, pharmacists, and distillers experimented with recipes and techniques for medicinal therapeutics in addition to other metallurgical pursuits. Cosimo’s son, Francesco I, moved the fonderia to the Casino di San Marco, and again in 1586 when a new fonderia opened in the Uffizi. In 1643, Grand Duke Ferdinando II donated an additional room in the Uffizi dedicated to curiosities like stuffed exotic animals and even an Egyptian mummy, which also served in the production of medicines.
The studiolo or alchemical laboratory of Francesco I de Medici inside the Palazzo Vecchio (via wikimedia commons)
By the seventeenth century, and continuing well into the eighteenth century, the Uffizi fonderia was famous for its pharmaceutical production. The remedies produced in the Medici fonderia were gifted by the Grand Dukes and Duchesses in precious caskets to nobles and kings of Europe, the Middle East, and even the Americas. Numerous letters within the Medici archive (now available online, thanks to the Medici archive project) attest to the value of Medici medicines as diplomatic gifts. In 1630, Anna Maria Luisa’s great-grandmother, the Grand Duchess Maria Magdalena (Von Hapsburg), sent oils from the fonderia as a diplomatic gift to the Crown Prince of Spain.[1] In 1637 military captain and diplomat Piero della Rena, who at the time of writing was being held captive by the Pasha of Tripoli, wrote Grand Duke Ferdinando II and proposed a plan to negotiate his ransom. In order to expedite his release, Rena suggested that in addition to money, Ferdinando send an amicable letter, a tent made of damask cloth, and a box of medicinal oils (una cassetta di olii di fonderia).[2] Clearly the products produced by the palace pharmacy were held in high esteem and as such possessed great value—value that could be used for the promotion of the Medici personally and politically.
Anna Maria Luisa’s recipes attest to the avid pursuit of alchemical and technical “secrets” at the Medici court. Later male and female Medici family members set up their own fonderie for the production of medicinal oils and therapeutics. The courtly patronage of science not only highlighted the Medici’s splendor and command of nature, it also produced tangible products, like fever waters. As a member of the Medici family, Anna Maria Luisa had access to these recipes to add to her own collection, to gift for diplomatic relationships, or to exchange for other recipes. The inclusion of the Medici crest and attribution to the Medici palace pharmacy was a way in which Anna Maria Luisa could increase the value of her recipe collection. As I continue my research, I am interested in investigating Anna Maria Luisa’s interaction with the granducal fonderia. Like other Medici dukes and duchesses, did she set up her own fonderia or did she patronize the existing granducal fonderia? Understanding Anna Maria Luisa’s affiliation with the granducal fonderia will reveal whether she was a patient who used and circulated Medici therapies, or if she was also a patron and practitioner of medicine.
[1] ASF, Mediceo del Principato 4962. (Entry 11641 in the Medici Archive Project Documentary Sources database.)
[2] ASF, Mediceo del Principato 4274 folio 196. (Entry 22136 in the Medici Archive Project Documentary Sources database.)
As Katherine Allen has pointed out in her post, distillation was regarded as a powerful way of separating and purifying earthly matter, and was central to the alchemical pursuit of the philosophers’ stone. And, yes, the odd gallon of whisky was also a much-welcomed product. This view of distillation is reflected in the textual processes that charaterise the Western alchemical tradition. Beginning with twelfth-century translations of Arabic texts into Latin, scholars constantly excerpted, compiled, translated, and digested all available knowledge, identified what was useful, and then compounded it to suit different tastes and purposes.
This double importance of distillation – techical and textual – is highlighted in the first distillation handbook ever printed, the Liber de arte distillandi de simplicibus, also known as the Small book of distillation, which was published in 1500 by the Alsatian surgeon and apothecary Hieronymus Brunschwig (c.1450–1512). While this book contains numerous recipes for distilled waters, it can also be seen as representing in itself a recipe for acquiring and presenting medical knowledge. Despite its Latin title, it was written in German, and quickly became a best seller, no doubt cashing in on the growing popularity of distilled medicinal waters. To teach his readers the art of distilling, Brunschwig drew on his wide reading (over three thousand books, according to him) and practical experience to concoct ingredients from different traditions of knowledge.
Brunschwig was well-versed in the alchemical literature, which at the time mainly circulated in manuscript form. Publishing his book in print, Brunschwig introduces a broad public to an alchemical understanding of matter, and how it can be transformed and purified. In fact, the process of distillation itself is defined in these terms, as “nothing but to separate the subtle from the gross and the gross from the subtle, […] to make the physical more spiritual, [so that it] may more easily penetrate the human body with its secret powers and virtues” (SB 1509, fol. 6r.). This extraction of the useful from the superfluous is also an important process in vernacular medical literature, and Brunschwig extracts not only from alchemical sources, but also boils down the essence of the learned medical tradition.
With reference to ancient textual authorities such as Galen and Dioscorides, he briefly explains the workings of the human body in terms of the four humours which govern an individual’s ‘complexion’, with diseases representing a deviation from this humoural balance. This can be readjusted by administering medicines distilled from plants, or even animals, with the appropriate qualities.[1] This precarious balancing act means that a sound knowledge of medical ingredients was essential, which is why a large portion of the Small book is taken up by a herbal section. It offers some of the best botanical woodcuts produced at the time, paired with encyclopaedic entries listing each plant’s appearance, medicinal qualities, and the distillation process by which these might best be extracted.
The third major source for Brunschwig’s distillation project, artisanry, has closer links with alchemy than one might at first suspect: as historian Pamela Smith has shown, early modern craftsmen subscribed to an alchemical worldview, and were confident that their personal observation and direct physical engagement with natural material was a reliable source of knowledge.[2] Brunschwig shared this view: based on his own experience with distillation procedures, he is able to anticipate pitfalls (e.g. don’t let a heated glass vessel cool down too quickly, or it will crack!), and to dispense practical advice on the quality and proper manipulation of different stills and vessels. This technical know-how boiled down into an easy-to-follow series of short chapters, which really starts from scratch. There is even a life-sized picture of a mould which should be used to shape the curved bricks needed for building a round furnace, and set in its centre, was a poem summarising the key points to remember.
A mould for shaping bricks from Brunschwig’s distillation manual. Bayerische Staatsbibliothek München, Res 2 M.med. 35, f. 11v-12r. (http://www.bsb-muenchen.de)
Brunschwig’s manual, then, not only contains valuable recipes for harnessing nature’s healing powers through distillation, it also represents in itself a recipe for the production of a best-selling and highly usable book: he compounds his knowledge of texts with his own experience and observation. He digests, extracts, and purifies his intellectual and technical ingredients, and where other compilers often produce turgid mixtures of jumbled-up recipes, Brunschwig manages to distill clear and useful knowledge from learned medical, alchemical and artisanal traditions. His example was followed by many early modern compilers of medical printed books, and the Small book itself went through an intriguing series of transformations in its various editions, including an English translation which appeared as early as 1527. But we certainly shouldn’t think that the story of textual digestion and excerption stops there: as Katherine Allen discussed, and as I have seen in the Small book, readers were assiduously annotating their copies. They highlighted what was most useful for them, added to the information, and cross-referenced entries, thus achieving another level of distilling textual knowledge.
[2.] P. Smith, The Body of the Artisan: Art and Experience in the Scientific Revolution (Chicago: University of Chicago Press, 2004); Idem., “In a Sixteenth-Century Goldsmith’s workshop”, in L. Roberts, S. Schaffer and P. Dear (eds.), The Mindful Hand (Amsterdam: Royal Netherlands Academy of Arts and Sciences, 2007), pp. 33–57; Idem., “What is a Secret? Secrets and Craft Knowledge in Early Modern Europe”, in E. Leong and A. Rankin (eds.) Secrets and Knowledge in Medicine and Science, 1500–1800 (Farnham: Ashgate, 2007), pp. 47–66.
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.
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.
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.”2 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.”
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 anumberofearlierpostshere, 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.
3Eight 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.