Tag Archives: HEAT!

How Best to Treat the Heat in 1793 Beijing

By Marta Hanson

Translating traditional Chinese medical terms into modern English forces one to consider dramatic changes in medicine over the past two centuries. Take, for example, the modern Chinese phrase fa re for “fever,” which literally means “to produce (fa) heat (re).” Although today it refers to elevated body temperature, traditionally it referred to the preternatural heat that patients experienced dispersed throughout their bodies and only sometimes referred to elevated skin temperature.[1] In fact, before the late 19th-century, the English term “fever” also contained multivalent meanings and multifarious patterns of excessive heat.[2] Fever in the sense of having a temperature above the 97.3 to 99.5 °F human range was not even defined in western medicine, nor a convenient clinical thermometer invented to measure it, until the late 1860s.[3] Although many of the febrile-related symptoms that fall under the Chinese disease concept “Hot diseases” (rebing) could fit under the biomedical umbrella of acute-infectious diseases, in classical Chinese medicine they were originally conceptualized as caused by climatic configurations of qi (i.e., vital energy/matter).[4]

The Yellow Emperor’s Inner Canon: Basic Questions (ca. 1st c. BCE) originally distinguished two types of Hot diseases related to different types of climatic qi. The first included an acute-onset febrile disorders caused by external pathogenic qi related to changing seasons or local weather. The second was a type of “Cold Damage” (shanghan) acquired in the winter but which went dormant until the heat of the spring or summer manifested it as excessive heat and internally impairing dryness. The first Inner-Canon definition that Hot diseases could be due to other types of pathogenic climatic qi also facilitated conceptualizing epidemics as due to pathogenic environmental qi unrelated to the winter cold or local climate.[5] Nonetheless, no matter the original cause when excessive heat was the result, it had to be expelled.

An interesting case of disagreement on how best to “treat the heat” occurred in Beijing during a febrile epidemic (wenyi) in the spring and summer of 1793. The Qing official, Ji Yun (1724–1805) unusually responded to this epidemic by comparing the success rate of three therapeutic drug strategies. The first, associated with Zhang Jiebin (1563-1640), resulted in 80–90% mortality. The second, promoted by Wu Youxing (1582?-1652), was no more effective. But a third formula created by the living doctor, Yu Lin (ca. late 18th cent.), had successfully cured the concubine of the Chief Minister of the Court of State Ceremonies, Feng Yingliu (1741–1801) with a strong gypsum-based formula.[6] Ji noted that those who witnessed this were shocked but those who followed his method ended up saving countless lives.[7]

The three competing cures in Ji’s short anecdote illustrate well how Cold and Heat were the main metaphors used to understand the cause of epidemics and legitimate drug choices for treating them. Zhang’s “warming and tonifying” (wenbu) tonics were based on what the Cold Damage Treatise (Shanghan lun, ca. 220 CE) recommended for treating Hot diseases (believed to have their origin in winter Cold manifested in the summer). These included warming herbs such as Cassia twig (guizhi) and Ephedra (mahuang) to release cold via the exterior and Aconite (fuzi) to warm the exterior and expel cold.  [See rebing entry to far left in Figure 1]

Medication chart from the Gold-Dusted Cold Damage [Treatise] (Shanghan diandian jin, completed 1341, date of this printing unknown). Image credit: Wellcome Collection.
 Wu’s “purgative” (gongxia) formulas contained Rhubarb root and rhizome (dahuang) to purge downward, and even Betel Nut (binglang) to expel pathogenic qi.  Wu termed this anomalous qi (yiqi), deviant qi (liqi), or pestilential qi (liqi) in his Treatise on Febrile Epidemics (Wenyi lun, 1642). [See figure 2] As He Bian has written on this blog, Chinese rhubarb had its heyday in the eighteenth century, yet not all physicians were in accord with its suitability during epidemics.

 

Rhubarb from Li Shizhen’s Systematic Materia Medica (Bencao Gangmu) printed in 1596.

The third author named in this story, Yu Lin, later became famous for his recipe titled: “Epidemic-Clearing and Toxin-Dispersing Beverage” (Qing wen bai du yin). [8]  The fourteen-ingredient recipe was based on a combination of the White Tiger Decoction (baihu tang) that cleared out heat on the exterior with two other formulas.[9]  Yu’s recipe, however, featured crude gypsum (i.e., the “White Tiger”) in quantities at least three times the other main ingredients (raw foxglove root, rhinoceros horn, and coptis root). This made it an extremely Cold formula, and potentially life-threatening for those who thought Cold was the underlying cause and so used Zhang’s formulas. For Yu, however, Gypsum’s cold-cooling quality cleared excessive heat accumulated in the stomach system. [Figure 3 depicts this heat-clearing function of gypsum at the center of the man’s chest).

Depiction for White Tiger Decoction in Illustrations and Explanation of the Major Formulas of the Cold Damage Treatise (Shanghan lun dafang tu jie, 1833). Image credit: Wellcome Collection.

Expelling pathogenic Cold qi and warming the interior with aconite and cassia twigs, purging pestilential qi through the bowls with rhubarb, and clearing out the pathogenic Heat from the stomach with gypsum were thus all therapeutic strategies at play during the 1793 epidemic in the capital. The first framed the cause of the epidemic in latent winter cold that had to be dispersed. The second saw it as externally contracted pestilential qi that needed to be purged. Finally, the third considered it excessive heat that had to be cleared. Despite these major differences all three approaches nonetheless treated the febrile symptoms subsumed under fa re or, in the modern term, “fevers” as something that drugs could manage by adjusting the internal balance of Hot and Cold.

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Translations for Figures 1 and 3

Figure 1: From right to left are listed three disease concepts – Cold Damage, Wind Damage, and Hot Diseases. Their commonly used formulas are written below. The six formulas listed under rebing are from right going down and then to left going down: With sweat cassia twig decoction (han guizhi tang), Cassia twig and gypsum decoction (guizhi jia shigao), Cassia twig decoction together with gypsum, anemarrhena, cohosh, and ephedra (guizhi jia shigao zhimu sheng[ma] ma[huang], Without sweat ephedra decoction (wuhan mahuang tang), Evening produced (i.e., heat) gardenia, cohosh, and ephedra decoction (wan fa zhizi sheng[ma] ma[huang]), and Cassia twig decoction with ephedra and gypsum (guizhitang jia mahuang shigao).

Figure 3: From the right to left across the top is written. 1) “The assistant [drug] Amemarrhena (zhima) disperses dryness [and] produces jin [fluids].” 2) the space below the chin reads “protects the lungs.” 3) and to the left is written “licorice (gancao) harmonizes the stomach and rice (gengmi) assists the stomach qi.” 4) The 5-character phrases on either side of the oblong circle together state the therapeutic strategy “[When] the pathogenic [qi] has already changed into Fire, then clear, cool, and make it disperse.5)  In the long oval at the center of the body, the phrase instructs: “When it [i.e., the Fire} enters the stomach, use gypsum.”

[1] Nathan Sivin, Traditional Medicine in Contemporary China, Science, Medicine, & Technology in East Asia 2 (Ann Arbor: The University of Michigan Center for Chinese Studies, 1987), xxiv-xxv, 86, 108.

[2] Christopher Hamlin, More Than Hot: A Short History of Fever, Johns Hopkins Biographies of Disease (Baltimore: John Hopkins University Press, 2014).

[3] J.M.S. Pearce, “A brief history of the clinical thermometer,” QJM: An International Journal of Medicine 95.4 (1 April 2002): 251-52. Thomas Clifford Allbutt (1836-1925) invented the 6-inch thermometer that was first able to record a temperature in 5 minutes in 1866 and in 1868 Carl Wunderlich, using a foot-long thermometer put in the axilla (i.e., armpit), established the normal range from 36.3 to 37.5 °C or 97.3 to 99.5 °F.

[4] Shigehisa Kuriyama, “Epidemics, Weather, and Contagion in Traditional Chinese Medicine,” in Lawrence I. Conrad and Dominik Wujastyk, eds., Contagion: Perspectives from Pre-Modern Societies, (Aldershot, Hampshire: Ashgate Publishing Limited, 2000), 3-22.

[5] Marta Hanson, Speaking of Epidemics in Chinese Medicine: Disease and the geographic imagination in late imperial China (London: Routledge, 2011), 16-17.

[6] Gypsum is monoclinic calcium sulfate. See discussion of this episode in Hanson, Speaking of Epidemics, 2011, 126-27.

[7] Ji Yun 紀昀, Yuewei caotang biji 閱微草堂筆記(Jottings from Yuewei Hall), printed 1800. Repr. Shanghai: Shanghai guji chubanshe, 1980. Passage in juan 18, jotting #24, 458-9. Online access https://ctext.org/library.pl?if=gb&file=36038&page=45&remap=gb

[8] Jian Min Wen and Garry Seifert, translators, Warm Disease Theory, Wēn bing xúe (Brookline, Mass.: Paradigm Publications, 2000), 141.

[9] White Tiger Decoction is used to treat an illness pattern with great heat, thirst, and sweating and a surging and large pulse. For analysis of the logic of the formula see Craig Mitchel, Feng Ye, Nigel Wiseman, Shang Han Lun: On Cold Damage: Translations & Commentaries (Brookline, Mass.: Paradigm Publications, 1999), 316-24

Fevers and the Dog Star in Antiquity

By Laurence Totelin

Summer this year in the UK has been particularly hot; we have experienced a heat wave for the first time in almost a decade. The hot days between roughly the tenth of July and the fifteenth of August are known as the Dog Days, so called because they are under the astronomical influence of the Dog Star (canicula in Latin, hence the French “canicule”, sometimes also used in English), also known as Sirius. Greek and Latin poets, starting with Homer and Hesiod, sang of the effects of the parching heat on the environment and people:

When the golden thistle blooms and the chirping cicada
Sits in a tree and pours down its shrill song
Continuously from under its wings, it is the season of exhausting heat,
Then goats are fattest, wine is at its best,
Women are most lustful, but men are weakest,
Because Sirius dries up the head and the knees,
And the skin is parched by the burning heat.
[Hesiod, Works and Days 582-588]

The constellation Sirius in the ninth-century manuscript Harley MS 647 . Source: wikipedia

To the Greeks, women were wet and men dry. The heat of the Dog Days caused both men and women to become drier; this brought positive effects to women, who became more like the ideal male, but weakened men. That weakness, however, was not a morbid state; it was not an illness.

Medical texts composed in later antiquity described a disease called seiriasis, which was an inflammation of the meninges accompanied by a burning fever. Its name evoked the Dog Star Sirius, although the physician Soranus of Ephesus suggested that the origin of the word seiriasis might be slightly more complex:

Some people state that the disease is called ‘seiriasis’ after the star [Sirius], because of the fever; but others state that it is thus called after the sunken forehead, because among farmers ‘seiros’ is the name of a hollow object in which they put and keep seeds. [Soranus, Gynaecology 2.55]

Soranus, and other medical writers, recommended the application of various ingredients to the forehead as treatment for the illness: egg yolk mixed with rose oil, the leaf of the heliotrope, grated colocynth, the skin of melon, or the juice of nightshade with rose oil. Most of these products, available in mid-summer, were thought to be cooling, and therefore effective in the treatment of fevers: opposite is a cure for opposite. The heliotrope, however, was not known as a cooling drug. The therapeutic principle at play here seems to be that of homeopathy (similar is a cure for similar): the heliotrope, the plant that follows the heat of the sun, is a remedy for a burning fever.

An altogether more colourful remedy for seiriasis is recorded in Pliny the Elder’s Natural History:

The inflammation of infants which is called seirasis is improved by the bones that are found in dog excrement, worn as amulets. [Pliny the Elder, Natural History 30.135]

Girl playing with a dog on a Greek funerary stele, second century BCE. Credit: British Museum

Bone shards are sometimes found in dog poop, and these might be what Pliny was referring to here. This ingredient was most certainly chosen because of the perceived link between seiriasis and the Dog Star Sirius. One can only imagine the despair that would lead the sleep deprived parents of a sick child to put their trust in such an amulet.

The “Gentle Heat” of Boerhaave’s Little Furnace

By Ruben Verwaal and Marieke Hendriksen

Ruben Verwaal is curator of the historical collections at Erasmus Medical Centre, Rotterdam, and at the Museum for Communication in The Hague. He obtained his PhD in June 2018 with a thesis on the role of bodily fluids in eighteenth-century chemistry. Marieke Hendriksen is a postdoctoral researcher on the Artechne Project at Utrecht University and a long-time contributor to The Recipes Project. She specializes in the material culture of science and art in the long eighteenth century. Ruben and Marieke share an obsession with an eighteenth-century object that has since disappeared: a small chemical furnace.

With the introduction of chemistry into the university curriculum in the late seventeenth century, new practical needs arose for students  such as being able to perform experiments. Would it be possible to build a chemical furnace that provides a gentle heat, yields no smoke, and is safe for students to use? Herman Boerhaave (1668–1738) believed he found the perfect solution in, what came to be called, Boerhaave’s little furnace.

Portrait of Herman Boerhaave by Cornelis Troost, c. 1730.

Boerhaave was professor of medicine, botany and chemistry at Leiden University in the early 18th century.[1] Instead of starting with the most difficult experiments with metals and minerals, he was convinced that students were better off when they learned the techniques of through simpler processes, such as distilling leaves and flowers, and fermenting bodily fluids. But most chemical laboratories were equipped with elaborate devices too complicated for freshmen students, who in the eighteenth century could be as young as fourteen. Moreover, the brick-build furnaces were designed to create high temperatures, in which small and delicate materials like rosemary leaves would burn instantly.[2] Boerhaave hence needed a device that was low-cost, user-friendly, and would provide a gentle heat.

The plan for the oven, • H. Boerhaave, Elementa Chemiae, Quae Anniversario Labore Docuit in Publicis, Privatisque Scholis, (Leiden 1732).

A small wooden oven was the answer. Boerhaave claimed he had designed this type of furnace when he himself was studying chemistry in the 1690s. He opened the chapter on instruments in his chemistry textbook with the words: “I shall begin with my simplest furnace; which I invented forty years ago, when I practiced chemistry in no large study, where there was only one little chimney, and where I required several furnaces at once.”[3]

Woman at the Virginal and stove under her feet, by Jan Miense Molenaer, 1630-1640. Rijksmuseum, Amsterdam.

This kind of device was probably inspired by ordinary foot stoves. These little stoves, also known as foot warmers, were very popular in the Dutch Republic. Coming in a wide variety of shapes (square, octagonal, cylinder), these stoves often feature in books and paintings. Filled with glowing coals or peat, women placed the little stoves under their robes or blankets to keep warm.[4] Many foot stoves were equipped with a wire bail handle for lifting and easy transportation. Such stoves were used in carriages, sleighs, at home and in church to keep one’s feet warm. This ordinary foot warmer got new applications too, namely as tea and coffee stove,   and we suspect it was the model for the ‘simplest furnace’ in the Leiden chemical laboratory.

Woman carrying a little stove, Harmen ter Borch, 1648–1677. Rijksmuseum, Amsterdam.

The gentle heat produced by Boerhaave’s small oven proved very useful in performing all kinds of chemical experiments. Take rosemary, for example, the evergreen aromatic shrub. Distilled atop a “violent fire”, it would have been turned to flame, smoke, and ashes. But when rosemary instead was distilled at “summer-heat” (approx. 85º F), the mild operation would instead reveal the most volatile, fragrant and aromatic part of the plant ordinarily exhaled in summer. The same process could be applied to Angelica, basil, and all other aromatic plants.

Students in the Leiden laboratory, in Herman Boerhaave, Institutiones et experimenta chemiae (‘Paris’, 1724). Ghent University Library.

Boerhaave, in other words, attributed the success of his device to one’s control over gentle heat. Whenever the wooden oven was filled with hot pieces of coal or Dutch turf that was no longer smoking, it established a constant and moderate heat that could be kept up to 24 hours. As such, the instrument was perfect for students to perform all kinds of heating processes and distillations. In fact, he was so excited about this apparatus, that he claimed that “I believe eggs may be hatched by it”.[5]

Was Boerhaave’s little furnace really that user-friendly and effective as he claimed it was? We checked it out by recreating Boerhaave’s stove and performing experiments with it. Check out our next blog to entry to find out whether we succeeded!

Creating an oven from two old stoves… to be continued!

References:

[1] More on Boerhaave, see Marieke Hendriksen, “Boerhaave’s Mineral Chemistry and Its Influence on Eighteenth-Century Pharmacy in the Netherlands and England”, Ambix(2018) and Ruben Verwaal, “The Nature of Blood: Debating Haematology and Blood Chemistry in the Eighteenth-Century Dutch Republic”, Early Science and Medicine(2017).

[2] Boerhaave, Elementa Chemiae (Leiden:  Isaac Severinus, 1732), vol 2, experiment 1.

[3] Ibid., vol 1.

[4] Le Francq van Berkhey,Natuurlyke historie van Holland (Amsterdam: Yntema and Tieboel, 1769–1778), vol. 3, 706-707, 1200.

[5] Boerhaave, Elementa Chemiae, vol 1.

Tales From the Archives: A Recipe for Disaster: How Not to Distill Turpentine

In September 2018, The Recipes Project will be six years old. There’s been a lot of blogging on this platform, and we are so grateful to all our wonderful contributors. But with so much material on the site, it’s easy for earlier pieces to be forgotten. So, the editors have decided that, once a month, we’ll pull something out of the archives to share with our readers anew.

This month, I have chosen a piece written by Tillamann Taape. In this post, first published in July 2013, Tillmann writes vividly about alchemical disasters. Heat, unsurprisingly, comes into play. Enjoy!

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By Tillmann Taape

When sifting through early modern alchemical recipes, I am often struck by their inherent dangers which would make modern-day health and safety officers pull their hair out. Renaissance practitioners were remarkably unfazed by temperatures high enough to melt glass and metal, and they frequently recommended heating volatile and flammable liquid in sealed glass vessels which, by their own admission, had a tendency to crack if not handled with the utmost care. Surely these exploits must have gone wrong a lot of the time, resulting in burnt fingers or a faceful of boiling alcohol?

If we look at the stereotype of the alchemist in contemporary satirical literature, it seems that accidents came with the job. In his Ship of Fools (1494), German humanist and satirist Sebastian Brant echoes themes from medieval poetry in his depiction of the alchemist: a greedy and reckless fool whose dangerous and fruitless exploits leave him scarred, financially ruined and even blind. [1] As a source of historical information, satirical genres should of course be taken with a generous pinch of salt. It is significant to note, though, that early modern people saw alchemy as a potentially dangerous thing to do, even in times long before anything like today’s health and safety standards.

More direct evidence of alchemical disasters is, unfortunately, fairly rare. I would of course be delighted to be persuaded otherwise by readers of this blog, but to me it seems that while adepts of alchemy frequently wrote down instructions which sound like they might well blow up, they were frustratingly silent on whether this actually happened. I was quite thrilled, therefore, when I finally stumbled upon a first-hand account of an alchemical disaster: exploding stills, knocked-out practitioners and all. In his 700-page tome entitled Liber de arte distillandi de compositis or Large book of distillation, first published in 1512, my favourite surgeon-apothecary Hieronymus Brunschwig (introduced here and here) includes the following cautionary tale.

Brunschwig was distilling turpentine to separate the watery fraction from the valuable oil, and when nearly all of the water had come out, he was interrupted.

 I was called away to a patient, so the oil went into the water, and when I came back, a layer of oil was sitting on top of the water. I didn’t have the sense to simply decant off the oil, so I poured the lot into a new flask and thought I’d just extract the water by distillation. But I was called away again, and in the meantime the water evaporated from the oil, and some of it condensed on the side of the flask and dripped back into the oil, which rose inside the flask with a great tumult, and fumes erupted from the flask, blowing off the alembic. [2]

 A lot to handle: picture of a still from Brunschwig’s Large book of distillation. © Wellcome Images

A lot to handle: picture of a still from Brunschwig’s Large book of distillation.
© Wellcome Images

Things got worse when Brunschwig came back late at night and went to investigate the accident, telling his servant to bring along a light:

When the light arrived, the fumes touched it, and fire burst forth all around, and in the blink of an eye went out again, nevertheless burning off mine and my servant’s hair, clothes and eyebrows. We fell to the ground and did not know where we were, but before long we got up again and fetched a closed lantern so the same thing would not happen again, and threw ashes in the furnace to smother the fire. [2]

And this, dear readers of the Large book of distillation, is how you do NOT distill turpentine! Once the initial excitement about this truly adventurous tale had worn off, I realised that, to the historian, there was more to this anecdote than merely the satisfying confirmation that some procedures which look so precarious on paper did indeed go up in fire and smoke. In his description of this extraordinary incident, Brunschwig also reveals a number of interesting details about his everyday life and work. We get a glimpse of what it meant for an early modern practitioner to have multiple vocations. Juggling his alchemical activities with his duties as an apothecary and surgeon, it seems that Brunschwig could be called away to the aid of a patient at a moment’s notice, even at night. We also learn that he had at least one servant, and we can surmise that he did his distillations in an enclosed workshop, since a buildup of explosive fumes would be unlikely in the open air. Perhaps most importantly of all, this anecdote provides strong evidence that Brunschwig was actively performing many of the procedures he describes in his works, rather than just copying and compiling them for publication.

Anecdotes like these, then, are more than just an entertaining read and a well-earned reward for ploughing through hundreds of pages of Brunschwig’s Alsatian dialect with its erratic spelling. Descriptions of extraordinary events also grant us a glimpse into the reality of practicing alchemy, and into practitioners’ everyday life.

[1] On the stereotypes and changing ‘personae’ of early modern alchemists, see Tara Nummedal,  Alchemy and Authority in the Holy Roman Empire. Chicago: University of Chicago Press, 2007, Ch. 2.

[2] Brunschwig, Hieronymus. Liber de arte distillandi de compositis […]. Strasbourg: Grüninger, 1512.