Category Archives: Medical Practitioners

‘This one is good’: Recipes, Testing and Lay Practitioners in Early German Print

By Tillmann Taape

Title illustration from Brunschwig’s Small book of distillation. © Wellcome Images

Having recently finished my doctoral thesis on the printed works of Hieronymus Brunschwig, which have previously featured on the Recipes Blog (here and here), I am delighted to contribute to this series of posts on testing and trying (for an overview, see our re-posted summary of the Testing Drugs and Trying Cures conference). What better opportunity to share how it all came together, and reflect on the role of recipes and testing in the narrative.

Hieronymus Brunschwig (c.1450–c.1530), a surgeon and apothecary from Strasbourg, wrote the first printed books on surgery and distillation. In my thesis, Hieronymus Brunschwig and the Making of Vernacular Medical Knowledge in Early German Print, I read these uncommonly practical and technical books alongside records from the Strasbourg archives, about the craft guilds and medical practice. This allows us to make sense of Brunschwig’s practical vernacular medicine in relation to local intellectual trends, different forms of healing, the local milieu of guilds and artisans, and early German print culture.

Brunschwig’s first book was the Cirurgia of 1497, the first surgical manual in print. This, of course, was an opportunity to codify and re-define surgery. Brunschwig revives the medieval tradition of what Michael McVaugh has termed rational surgery (i.e. a learned as well as a practical art), to educate trainee surgeons and to present their discipline as a respectable and useful trade. Emphasising the need for skilled hands as well as a working knowledge of the human body, Brunschwig defends surgery on two fronts: against learned physicians’ rhetoric of superiority, and against other craftsmen’s deep-seated anxieties about occupations which were in contact with sick and dead bodies.

A surgeon treating an abdominal wound. Hieronymus Brunschwig, Dis ist das Buoch der Cirurgia (Strasbourg, 1497). © Wellcome Images.

The later books on distillation, published in 1500 and 1512, open up to a wider readership, including not only medical artisans such as surgeons or apothecaries, but also the ‘common man’ – a middling social layer of literate citizens, householders and other lay practitioners. This new kind of medical reader, as I have discussed in a previous post and elsewhere, is emblematised in the figure of the ‘striped layman’ which appears in numerous woodcut illustrations throughout Brunschwig’s works.

A conspicuously stripy student, from Brunschwig’s Cirurgia (1497). © Wellcome Images

Many of the recipes and instructions in the distillation books are adjusted for this type of reader. They start from scratch and are rich in technical details which are not found elsewhere in print or, to my knowledge, in manuscript. Although Brunschwig engages with complex ideas about the nature of matter and its manipulation, such as John of Rupescissa’s notion of a ‘quintessence’ in all things, he re-works them into manageable, pedestrian remedies. Rather than pursuing Rupescissa’s heavenly panacea, Brunschwig uses distillation to produce a type of middle-class quintessences: although earth-bound and imperfect, they were reliable and effective remedies in the hands of laypeople.

Detailed woodcut images of distillation apparatus and instructions for its use. Brunschwig, Liber de arte distillandi de simplicibus (Strasbourg, 1500). © Wellcome Images.

One overarching theme of my thesis is the artisan’s approach to understanding and manipulating nature. For a craftsman with no Latin, Brunschwig mined a surprising amount of knowledge from texts. But more importantly, I argue, he knew things through direct physical engagement with bodies, materials and technical processes. His books are full of instructions to probe wounds, check temperature by touch, inspect colour changes in the alembic, and smell or taste distilled remedies. His expertise was located as much in the body and its senses as in books.

Nonetheless, writing was a powerful tool for recording and communicating practical insights. From cautionary tales of exploding alembics to heroic accounts of successful cures, Brunschwig emphasises his own experience as a source of knowledge. The German term he uses for this type of knowledge, erfarung, is related to fahren, meaning ‘to travel’. In the early sixteenth century, it denoted a way of experiencing the world through one’s own senses, by moving through it or simply being in it in an active, attentive manner. Erfarung was compared, often unfavourably, to spiritual contemplation and introspection. Over time, however, doctors and students of nature such as Paracelsus came to see personal erfarung as the necessary labour of insight rather than a sinful distraction. The Book of Nature, they insisted, should be read with one’s feet. Brunschwig’s emphasis on his own and others’ erfarung was thus part of a larger vernacular culture of experiential knowledge, as well as learned debates about experientia which have often been the focus of historical accounts of a medical empiricism developing in the early modern period.

Recipes played a major part in Brunschwig’s codification of experiential medical knowledge. Some, as I have shown in a previous post, were presented in Latin pharmaceutical jargon likely unknown to laypeople. These recipes were closed to readers, who were meant to copy them out on a piece of paper and hand them to an apothecary who would manufacture the remedy according to his art and his experience. Although the great majority of recipes are in German, some of these are also presented as tried and tested, by Brunschwig himself or others, and do not call for ‘tweaking’ on the part of readers.

Other recipes, however, give alternative ingredients or leave the exact composition up to the practitioner’s judgment. Many recipes come without the author’s seal of approval, and their sheer number makes it seem unlikely that Brunschwig could have tested each one. Such ‘open’ recipes leave room for improvisation and testing. The ongoing work of erfarung runs on into readers’ own practice, and often spills out into the margins of Brunschwig’s printed books. In many surviving copies, early modern healers from different walks of life marked recipes with a magisterial probatum est, or a simple vernacular note such as ‘this one is good’.

In some of the earliest medical works in print, Brunschwig addresses a readership of lay healers and ‘common men’ which would come to represent a significant portion of the early German print market. Through his use of recipes embedded within a culture of erfarung, he involved his vernacular readers in a continued effort of empirical trying and testing.

Pursuing the themes of recipes and artisanal knowledge, I am delighted to be joining the Making and Knowing Project at Columbia University this summer, and look forward to sharing our work on making, testing, and trying, which has previously featured on this blog.

 

Theodorus Priscianus’ recipes for breast engorgement

By Louise Cilliers

We know very little about Theodorus Priscianus, only that he was a student of the famous Carthaginian physician, Vindicianus (late 4th century CE), and was thus also a native of North Africa. We can also deduce that he was a professional doctor. The work for which Theodorus is known, is the Euporiston (a book of easily obtainable remedies), which consists of four books of medical recipes, of which the fourth, the Gynaecia, contains treatments for women’s diseases. Due to its practical applicability, the Gynaecia was very popular in the later Middle Ages; it was excerpted on numerous occasions.

A carving showing a Roman midwife, Wellcome Collection. Credit: Wellcome Library.

The Gynaecia is dedicated to a midwife, a certain Victoria. In his preface, Theodorus states that he wants to “support her with his knowledge”, and he requests her to “faithfully, diligently and carefully… carry into effect the remedies for female ailments” as set out in his treatise. This knowledge was then to be disseminated among midwives and other women to help them in treating ailing women.

Theodorus’ Gynaecia comprises recipes for ten female ailments which he discusses. They are: engorgement of the breasts after parturition, swelling or contraction of the uterus, the mole, atresia, sterility, abortion, haemorrhage of the uterus, injuries to the uterus, the flux, and gonorrhoea. I will focus on engorgement of the breasts after parturition.

This is a very common problem that women experience after having given birth, and various procedures, such as poultices laid on the breasts, were followed in ancient times. Medicaments, made from vegetables and herbs used in the kitchen, were also given. Theodorus clearly has empathy with women whose breasts are taut, swollen or painful after birth. In not too serious cases, he recommends that a soft sponge soaked in a mild astringent, such as vinegar, be applied to the breast, and held in place by a light bandage. Alternatively soothing poultices, for instance, bread soaked in water-mead and oil or fresh pork fat can be laid on the breasts.

If the problem of engorgement has been resolved but the mother still wants to feed the baby, the breasts should be smeared with rush, egg and saffron, or crushed raisins mixed with the flour of beans, or pounded sesame seed mixed with vinegar and honey, or a mixture of pounded leaves of ivy and figs, or (even more directly from the kitchen) fresh pounded cheese with vinegar-honey – if these substances be made into a poultice, they would apparently have increased the fecundity of the milk.

If the patient cannot bear the weight of the poultice, the breasts must be steamed, and an even softer sponge soaked in an extract of marsh mallow, linseed and fenugreek plants be applied.

Purslane, one of the plants used in ancient breast poultices. Credit: Wellcome Library,

But if milk production should be stopped completely, alum or the seed of fleawort or coriander of purslane must be added to the aforementioned poultice, or the powder of a pounded millstone mixed with a wax salve should be applied. But if the breast has produced pus, it must be opened with appropriate aid, so that with one voiding they can be healed completely.

Throughout Theodorus warns that medicaments should be mild, and that all poultices should be applied with moderation, with consideration for the tender breasts.

Further reading:
You can find the text of Theodorus Priscianus’ Euporiston (in Latin) here.

Illustrated Recipes in Crophill’s Cookery

By Sarah Peters Kernan

While I was researching medieval and early modern cookeries for my dissertation, I came across several manuscripts that were notable in one regard or another but they did not make it into my final document. In the hope of inspiring further research, I am focusing on one of these books here. London, British Library, MS Harley 1735 is a fifteenth-century manuscript owned by a rural physician, John Crophill. This manuscript contains a cookery (fols. 16v–28v), remarkable not necessarily for its recipes, but its context and marginalia.

Harley 1735 is one of at least twelve cookeries located in manuscripts owned by medical professionals in fifteenth-century England. I have argued that these cookeries were primarily used as aspirational texts.[1] Professionals could learn about the foods they should aspire to eat as members of a rising social group. While occasional recipes may have been useful in their household kitchens or medical practices, the codicological context of these cookeries suggests that readers used the texts to familiarize themselves with what had been served to their social superiors as a way to fit in and excel in a new social environment. Recipes were a vehicle for shaping a group’s new identity.

The marginalia of Harley 1735 begs for a closer look, as it contains not textual notes, but illustrations. I cannot begin to describe my excitement when I first opened this manuscript! Expecting to see a plain text in black ink with occasional rubrication, I was delighted to see abundant marginal sketches of animals, fruits, nuts, vegetables, and cooking implements. While some other contemporary English and French manuscripts contain a sketch or two of distillation stills or fish (and one instance of a diagram for food preparation), this cookery contains tens of drawings on multiple folios. Furthermore, the sketches align with the recipes. Since all of the drawings are marginal and not integrated into the text, it is safe to assume that they were added after the cookery was copied.

Harley 1735, fol. 18r contains sketches of a dog, swan, rabbits, and grains of wheat. http://www.bl.uk/manuscripts/Viewer.aspx?ref=harley_ms_1735_f018r. (c)British Library Board Harley MS 1735
Harley 1735, fol. 18r contains sketches of a dog, swan, rabbits, and grains of wheat. http://www.bl.uk/manuscripts/Viewer.aspx?ref=harley_ms_1735_f018r. (c)British Library Board Harley MS 1735

While there are marginal sketches in other texts in the same manuscript, it is difficult to say with certainty that Crophill himself added the sketches. None of the images depict cooking actions or processes, but all of the drawings refer to ingredients in the recipes or an implement required to carry out the recipe. There is one exception: a sketch of a dog appears on a leaf with recipes for “Chaudon sauȝ of swannes,” “Amydoun,” and “Conyes in graue.”[2] The dog appears to be an illustrative accompaniment to sketches of a swan or rabbits in the same margin, visually chasing these necessary ingredients.

Harley 1735, fol. 25r contains sketches of several cooking implements and ingredients.. http://www.bl.uk/manuscripts/Viewer.aspx?ref=harley_ms_1735_f025r. (c)British Library Board Harley MS 1735
Harley 1735, fol. 25r contains sketches of several cooking implements and ingredients. http://www.bl.uk/manuscripts/Viewer.aspx?ref=harley_ms_1735_f025r. (c)British Library Board Harley MS 1735

Perusing the cookery, one finds implements like pots, mortars and pestles, bellows, and a knife. Other less identifiable implements also reside in the margins. There are fruits and vegetables like figs, dates, plums, grapes, and even leeks! Almonds appear several times, as well as other grains, which might be wheat, sugar, salt, or possibly spices (some of the grains are particularly difficult to distinguish from one another and the recipes contain many possible suggestions). Ginger root also makes an appearance. The supply of animals is particularly healthy; fish, rabbits, chickens, quail, swan, stag, cow, and the rogue dog prowl about.[3]

A manicule on Harley 1735, fol. 21r. http://www.bl.uk/manuscripts/Viewer.aspx?ref=harley_ms_1735_f021r. (c)British Library Board Harley MS 1735
A manicule on Harley 1735, fol. 21r. http://www.bl.uk/manuscripts/Viewer.aspx?ref=harley_ms_1735_f021r. (c)British Library Board Harley MS 1735
A stag on Harley 1735, fol. 19v. http://www.bl.uk/manuscripts/Viewer.aspx?ref=harley_ms_1735_f019v. (c)British Library Board Harley MS 1735
A stag on Harley 1735, fol. 19v. http://www.bl.uk/manuscripts/Viewer.aspx?ref=harley_ms_1735_f019v. (c)British Library Board Harley MS 1735

These sketches in the margins of Harley 1735 problematize my conclusion that the cookery was primarily an aspirational text. At first glance, the number of sketches, especially manicules, might seem to indicate that the book was regularly referenced in a kitchen.[4] However, the cookery lacks the food stains and markings regularly exhibited by manuscripts used in kitchens. The artist also clearly enjoyed sketching and may have chosen to artistically render the text based on a preference for drawing certain items, rather than a correlation with preparation of foodstuffs. And perhaps most importantly, some of the recipes accompanied by sketches were almost certainly not prepared by Crophill or his household; luxury recipes like “Chaudon sauȝ of swannes” accompanied by a sketch of a swan, or “Roo in sewe” with a drawing of a stag, were simply out of reach for non-noble preparation.[5] So while this cookery is a problematic cookery, I still believe it was primarily used as an aspirational text, rather than an instructional one.

Ultimately, I am still left wondering why the illustrations were added, since it is so unusual. No contemporary cookery in England or France matches the degree of illustration. European cookbooks did not include copious illustration until the late sixteenth century with Bartolomeo Scappi’s Opera (1570) and Charles Estienne’s L’agriculture et Maison rustique (1564), and the first heavily illustrated English cookery, Robert May’s The Accomplisht Cook (1660), was not published until 1660. Perhaps the sketches in Harley 1735 were a finding aid for Crophill or another reader. Perhaps the drawings were created for a more enjoyable reading experience; modern cookbook readers are certainly familiar with this concept! Another possibility is that the sketches were created out of the sheer enjoyment of drawing and the cookery margins were an available space. Crophill’s rural surroundings in Wix, Essex, could have inspired the copious and sometimes remarkably naturalistic drawings. Or perhaps the illustrations were created as a teaching aid or storytime delight for a child in the household, with the familiar animals more akin to a Beatrix Potter tale.

In any case, these remarkable drawings deserve much more attention, and could shed light on a host of topics, from available animal breeds and vegetal varietals, household objects, or illustrative practices in late medieval manuscripts.

 

NOTES

[1] Sarah Peters Kernan, “‘For al them that delight in Cookery’: The Production and Use of Cookery Books in England, 1300–1600” (PhD diss., The Ohio State University, 2016), 64–102.

[2] fol. 18r

[3] Lois Ayoub, “John Crophill’s Books: An Edition of British Library Ms Harley 1735” (PhD diss., University of Toronto, 1994), 24–5. Ayoub catalogues the sketches in the manuscript.

[4] fols. 21r, 22r–v, 23v, 26v–27v

[5] fol. 18r and 19v

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What’s in a name: Plaster of Paris

By Marieke Hendriksen

One of the problems we face as historians studying and reconstructing recipes is that the names describing ingredients, tools, and materials change over time, and that the meaning of terms itself changes over time. This is even the case with relatively recent recipes and materials that are in theory unchanged as I recently discovered. As part of my research for the ARTECHNE project, I recently looked at instructions for making anatomical casts from plaster from 1791.

Painted plaster cast of a large fibroma of the jaw, 1830s. Courtesy Surgeons' Hall Museums, RCSEd.
Painted plaster cast of a large fibroma of the jaw, 1830s. Courtesy Surgeons’ Hall Museums, RCSEd.

The creation of anatomical casts and models using plaster of Paris became increasingly popular towards the end of the eighteenth century, fuelled by the omnipresence of plaster in the visual arts and interior decoration, and the increasing importance of pathology and later physiognomy within the study of medicine. The latter meant that medical men were looking for durable three-dimensional ways to preserve diseased bodies and body parts that could not be preserved otherwise (e.g. in a preparation), either because decay could not be stopped or because the patient was still alive.

Johan Zoffany, The Portraits of the Academicians of the Royal Academy, 1771-72
Johan Zoffany, The Portraits of the Academicians of
the Royal Academy, 1771-72. Note the plaster models of antique statues around the room.

In his 1790 book The Anatomical Instructor, physician Thomas Pole (1753-1829) not only gave advice on how to make anatomical preparations and drawing, but also included over fifty pages on how to create, colour, repair and maintain plaster casts and models. Pole started the chapter on modelling with outlining the relevance of the quality of the plaster of Paris, or calcined alabaster, that was to be used. He explained that

Illustration of how to make a cast of a diseased bone from Pole's 1790 'Anatomical Instructor'
Illustration of how to make a mould of a diseased bone from Pole’s 1790 ‘Anatomical Instructor’

“…that of a middling price is used for making of moulds; the finer sort is for casts, to be poured first into the mould, when properly prepared; after it has formed a layer of about half an inch, more or less, according to circumstances, then the coarser sort is to be used to fill up the mould, or to give it sufficient thickness.”[1]

But exactly what were the various qualities of plaster for sale in London in the 1790s made of? The term ‘calcined alabaster’ tells us little, as alabaster was and is a collective noun that designates both various kinds of light-coloured, translucent and soft stone used mainly for carving decorative artefacts (often the minerals gypsum or calcite – the former much softer than the latter), and a specific compact and fine-grained variety of gypsum. In the decades after Pole’s publication, the French chemist Antoine François de Fourcroy (1755 –1809) would distinguish nine kinds of calcareous sulfate, one of which was sulfate of lime or common gypsum. In an 1810 ‘dictionary of the arts’ Fourcroy’s sulfate of lime or common gypsum was described as follows:

“Sulphat of lime, or common gypsum, or plaster-stone. This substance is white, more or less inclining to grey, interspersed with small brilliant crystals, easily cut with a knife. it is found disposed in Paris. We shall hereafter find, that it is not pure selenite, but owes its most valuable property, as plaster, to the admixture of another kind of earth. (…) Calcareous sulphat is likewise found dissolved in waters, as in the well-waters of Paris; it is never pure, but always combined with some other earthy salt, with base lime or magnesia. This salt has no apparent degree of taste. It decrepitates if a sudden heat be applied to it; it is then of an opaque white, in which state it is called fine plaster, or plaster of Paris: by this calcination it loses about twenty in one hundred.”[2]

Entrance to the Montmartre gypsum quarry. Probably early 19th century, artist unknown.
Entrance to the Montmartre gypsum quarry. Probably early 19th century, artist unknown.

As this fragment suggests, plaster of Paris indeed derives its name from a large and very pure gypsum deposit at the Montmartre and Menilmontant hills in Paris – there were plaster quarries at this site at least as early as the year 500. This led “calcined gypsum” (roasted gypsum or gypsum plaster) to be commonly known as “plaster of Paris”, even after the exhausted quarries were converted into Montmartre cemetery and the Buttes de Chaumot gardens respectively in the mid-nineteenth century. Although not all plaster came from Paris at the time Pole was writing, there is a fair chance that much high-quality plaster was indeed plaster from Paris.

Today, gypsum plaster, or plaster of Paris, no longer comes from Paris, but is still produced by heating powdered gypsum to about 150 °C. When mixed with water, this forms a paste that will harden within minutes, producing an exothermic reaction, which means it warms up. You can easily buy ‘plaster of Paris’ from artist’s supplies shops and online retailers, but none of these mention the exact chemical composition. Yet before I (or anyone else) can try my hand at reconstructing Pole’s instructions I will need to find out whether the best, finest plaster of Paris still contains a percentage of lime or magnesia, what the ‘coarser varieties’ that Pole described contained, and whether these are still available.

This project has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No 648718), and was supported by the Wellcome Trust (grant number 203403/Z/16/Z).

[1] Pole, Thomas. The Anatomical Instructor ; or an Illustration of the Modern and Most Approved Methods of Preparing and Preserving the Different Parts of the Human Body and of Quadrupeds by Injection, Corrosion, Maceration, Distention, Articulation, Modelling, &C. London: Couchman & Fry, 1790: p. 202-3.

[2] Wilkes, John. Encyclopaedia Londinensis, Or, Universal Dictionary of Arts. Vol. 4. London: J. Adlard, 1810: p. 230.