Tag Archives: domestic medicine

‘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.

 

“A very secure recipe for the cure of all kinds of tertian and quartan fevers”: Medicine and Malaria in Late-Colonial Lima

Albarello drug jar used for cinchona bark, Spain, 1731-1770. Image Credit: L0057419 Science Museum, London © Wellcome Images
Albarello drug jar used for cinchona bark, Spain, 1731-1770. Image Credit: L0057419 Science Museum, London © Wellcome Images

Stefanie Gänger

“Squeeze a serving of bitter oranges”, advised “The True Physician” (El Médico Verdadero), a manuscript recipe collection dated Lima 1771, “strain the juice through a canvas” and “blend that in a clean glazed pot with the same amount of pure water and with four ounces of white sugar”. “Bring that to a boil over the fire, then remove the (…) foam with a spoon (…) and when the decoction is clean you let it seethe a little longer and then remove it from the heat, let it cool, and (…) then add the amount of powdered cinchona they sell in the pharmacy for one real, or two adarmes of the said powder (…), tossing the decoction until it is well blended”. Taken “the day of the fever”, the recipe concluded, this was a most “secure” remedy “for the cure of all kinds of tertian and quartan fevers”. (1)

“The True Physician” is one of a handful of manuscript recipe collections from Lima and its environs that have survived into our present – in archives, private libraries or, as in this particular case, as transcriptions made by early-twentieth century historians. Virtually all of them contain one or several medicines against “tertian and quartan fevers” – afflictions that can retrospectively be diagnosed as plasmodium vivax and plasmodium malariae infections, forms of malaria that haunted the viceregal capital throughout the colonial period. Both vivax and malariae are nonfatal and more benign than the tropical form of malaria, falciparum, but both have relapses as their signature dynamic: large sectors of the Lima population in the late-colonial period would have been accustomed to suffering from bouts of malaria – chills and rigors that extend through febrile paroxysms every 48 or 72 hours – frequently in the course of their lives.

A number of publications in circulation in the city, from the yearly almanac to health advice manuals, counselled Lima’s inhabitants on how to prevent malarial fevers or afford relief if they struck. The anonymous author of “The True Physician” – the manuscript is only signed “un curioso, a term that referred broadly to persons who practised medicine without a medical degree – appears to have been an avid reader, particularly of the latter format. He had copied several passages from Manuel Gutierrez de los Rios’s handbook version of Francisco Solano de Luque’s 1732 Lapis Lydos Apollinis and of Benito Jerónimo Feijóo y Montenegro’s enlightened Teatro Crítico Universal (1726-1739), though he also adopted advice on nutriments from Ioannes Bruyerinus Campegius and cited a series of treatises on medicinal plants, from Pedanius Dioscorides and Ibn Masawaih to Hieronymus Bock. He probably belonged to the upper stratum of Spanish or elite Indian society in late-colonial Lima, the handful of men and women sufficiently well-off to be able to afford a medical library and not to mind spending a real or two on remedies. Possibly he was a householder, though one who felt called to dispense his knowledge beyond the circle of his family, to the men and women working on his estate and, occasionally – as transpires from his remarks – the priest of the local parish.

Though he cited profusely throughout the collection, the curioso also picked up ideas for recipes in conversation – orange juice to ease bladder irritations, for instance, from a story he heard about “the lawyer Casasola” who had “recovered from strangury accidentally just by eating sweet oranges”. He cited neither written nor oral authority, however, for his reliance on cinchona in the “very secure recipe”, perhaps because the bark was a widely shared empirical tradition by the late-eighteenth century. Cinchona had been part of Andean pharmacopeia long before it entered European materia medica in the mid-seventeenth century and a century later was administered by titled physicians, Indian healers and householders alike in Lima. The curioso found cinchona was a strikingly “infallible and certain” cure against malaria and so it was: the bark contains natural alkaloids that interfere with the growth and reproduction of the malarial parasites in the red blood cells and its administration would have afforded prompt relief from malarial fever. The bark requires no specific mode of preparation to unfold its curative properties. The reason behind the proliferation of culinary variations – especially sugary fruit concoctions – we find in medical notebooks like “The True Physician” presumably lay in the difficulty of getting a weakened sufferer to swallow the bark: cinchona tastes by all accounts sickeningly bitter.

I am still at the very beginning of my “Malaria and Medicine in Lima” project but I hope to have excited your anticipation; I will report more as the project progresses.

(1)    Receta muy segura para la curación de toda suerte de tercianas y quartanas de que siempre se han experimentado maravillosos efectos (1777), in: El Medico verdadero. Prontuario singular de varios selectisimos remedios, para los diversos males à que està expuesto el Cuerpo humano desde el instante que nace. You’ll find this and other Lima recipes transcribed in volume three of La medicina popular peruana, ed. Hermilio Valdizán and Angel Maldonado (Lima: Imprenta Torres Aguirre, 1922).