Recipes against the plague – in pharmaceutical code?

By Tillmann Taape

Although the plague is best known for having wiped out about a third of Europe’s population in the fourteenth century, it continued to loom large as a threat to people’s health for hundreds of years, and medical writings on the Black Death or the ‘pestilence’ abounded (see e.g. Lisa Smith’s post on coffee as a cure for plague in eighteenth-century London). One of them, the Liber pestilentialis (1500) by the surgeon-apothecary Hieronymus Brunschwig (introduced here), was the first of its kind to be published as a printed book. Written in German, it had the potential to instruct a wide readership, reflecting Brunschwig’s mission to disseminate medical knowledge among laypeople. It struck me as somewhat odd, therefore, that quite a few of the recipes for remedies against the plague were given in Latin. What use were these to the readers of a book which was specifically addressed to all social ranks, including ‘common people’ who were not part of the Latin-speaking learned élite? Fortunately, Brunschwig provided an answer only a few pages on: simply copy the recipe on a slip of paper, send it off to your local apothecary, and collect your anti-plague pills a few days later.

Since Brunschwig was himself an apothecary in Strasbourg where the Liber pestilentialis was first published, one might suspect that by including these recipes he was hoping to advertise his trade, and draw attention to the knowledge and skill required to turn such coded messages into remedies. By his own admission, though, this only worked for readers who lived a manageable distance from an apothecary and could afford his services and ingredients, some of which, like theriac or amber, could be very costly. But Brunschwig also catered for those readers who lived in remote villages or were less well off. Often on the same page as the Latin instructions, he included an alternative recipe in German, using cheap everyday ingredients and simple household techniques.

This commitment to his less privileged readers, present in much of Brunschwig’s work, suggests that he was not printing recipes ‘in code’ simply in order to improve apothecaries’ image or to turn a better profit, much less to monopolise medical knowledge. There was, in fact, another very good reason for the use of Latin, as he explains in an intriguing comment: “Many recipes and ingredients cannot be succinctly expressed in the German language […], so I have left them in Latin.”

Some things are best left to professionals: mixing medicines at the apothecary's shop (from Brunschwig's 'Buch der CIrurgia')
Some things are best left to professionals: mixing medicines at the apothecary’s shop (from Brunschwig’s ‘Buch der CIrurgia’). (c) Wellcome Images

This points to a major difficulty faced by all medical authors writing in their native tongue. They were not only up against the disdain of learned physicians who wanted to keep all medical knowledge within university walls, well away from the ignorant ‘common people’. They were also facing the daunting task of creating a scientific vernacular in which to express medical concepts: how the human body works, what happens when it becomes diseased, and what to do about it. Finding their feet on uncharted linguistic territory and creating medical terminologies was the work of generations of practitioners from the middle ages to the early modern era. By the beginning of the sixteenth century, this process had come a long way, as Brunschwig’s writing shows: in his books on surgery and distillation (see here and here), he articulates elaborate techniques and medical theories in a confident technical vernacular – albeit one peppered with terms borrowed from Latin. In the case of specialist pharmaceutical ingredients and preparations, however, Brunschwig clearly felt that no adequate vocabulary was available in German. Some ingredients were just too  specific or too exotic to be known to the layman. Perhaps even more problematic were shorthand instructions such as fiat pulvis (it shall be a powder) or formentur pillule communi quantitatis (pills of equal quantity shall be formed). One can imagine what these few words translated to in practice: complicated series of decoctions, infusions, drying, boiling, grinding and mixing, all defined and learned over the course of an apprenticeship.

With no alternative to certain elements of Latin pharmaceutical jargon, then, the recipes in Brunschwig’s Liber pestilentialis inevitably fell into two categories. On the one hand, his wealthier readers had the option of having ‘professional’ remedies made according to the Latin recipes, which allowed them to tap into the entire range of medicinal ingredients and preparation techniques available at the nearest apothecary’s shop. Poorer folks and country dwellers, on the other hand, were offered a different type of recipe which could be articulated in the vernacular, required cheaper ingredients and could be managed at home.

 

‘Mercurialia are worrisome’: dangerous recipes

By Marieke Hendriksen

To anyone familiar with the practices of Thomas Dover (1662-1742), alias the Quicksilver Doctor, it may seem like mercury and mercury-based drugs were prescribed and taken rather indiscriminately by physicians, apothecaries and patients in the eighteenth century.[i] However, pharmaceutical handbooks, often written by experienced pharmacists under the auspices of university professors of medicine, give an entirely different view. These handbooks, some of which were reprinted in great numbers for decades, were aimed at professional apothecaries and other medical men. Although virtually every pharmaceutical handbook listed mercurial drugs, they all warn against using them too liberally.

Title page of the 1681 edition of the Medicina Pharmaceutica. Credit: Amsterdam University Library.
Title page of the 1681 edition of the Medicina Pharmaceutica. Credit: Amsterdam University Library.

A good example can be found in the four Dutch editions of the Medicina pharmaceutica, or Great general treasury of pharmaceutical medicine, which appeared between 1681 and 1741.[ii] In the first edition, at least nine different recipes involving mercury in some form are listed. Because of mercury’s alleged cleansing and purging properties, these cures were recommended for ailments as diverse as intestinal worms, venereal disease, and skin infections.[iii]

However, in the fifth book of that same edition, the volume on ‘Shop Compositions’ (drugs composed to sell ready made in the apothecaries’ shop), over half a page is spend on a warning about antimonial and mercurial drugs, summarized in the index as ‘Mercurialia zyn sorghelyck,’ which translates as ‘Mercurialia are worrisome.’ Following a list of drugs prepared from a variety of minerals, metals and stones, the author warns that it is not his intention to give the ‘Masters of medicine’ the idea that they should prescribe these dangerous cures often; only when there were no other options left should they revert to them.[iv] The other options, it appears, were mainly traditional herbal remedies, as the author writes:

God almighty has blessed us with some common or native herbs and remedies, that have such a power invested in them, that these can be used in general and without vicissitudes or thinking twice to cure the ill, so one should always use these first, before one turns to some dangerous and strange medicaments from chemistry; so it would be a great deception and recklessness to apply prepared Antimony or Quicksilver, if one is provided with other harmless and powerful remedies, as the former often needlessly do great damage, or could even cause death.[v]

Only if a disease did not respond to the herbal remedies could ‘dangerous chemical preparations’ be applied. As this was the first edition of the Medicina Pharmaceutica from 1681, and the first decades of the eighteenth century saw an increasing incorporation of chemistry in the academy, one might expect that the last edition from 1741 was less tentative about the prescription of chemical remedies.[vi] Previous editions had been printed in Brussels, but the 1741 edition was printed in Leiden–a city with one of the leading medical faculties of Europe at the time. The reprint even had a preface written by the Leiden professor of chemistry Hieronymus Gaub. Although the spelling of the 1741 edition was updated to modern standards, the same old warning was once again repeated.

This raises questions about the extent to which early chemical research and teaching at universities was changing professional medical men’s understanding and application of mercurial, or other chemically-based, remedies. Moreover, the apparent contrast between the cautions and warnings in professional handbooks like these and popular culture on the one hand, and the ostensible popularity of mercury remedies on the other, makes this a fascinating research topic.


[i] Also see Kenneth Dewhurst, The Quicksilver Doctor. The Life and Times of Thomas Dover Physician and Adventurer (Bristol: John Wright & Sons Ltd., 1957).

[ii] Robertus de Farvacques, Medicina pharmaceutica, of Groote algemeene schatkamer der drôgbereidende geneeskonst (Leiden: Isaak Severinus, 1741). De Farvacques, the personal physician of Charles II, was not really the author of this book. His name was used by the actual author, the Brussels friar Peter Gilles, to lend it more authority. See L.J. Vanderwiele, “Broeder Petrus Gillis S.J. (1620-1697), Auteur van Medicina Pharmaceutica of Drogbereidende Geneeskonst”, Kring voor de geschiedenis van de pharmacie in de Benelux. Bulletin. 69 (maart 1986): 8–16.

[iii] Robertus de Farvacques, Medicina pharmaceutica, of Groote algemeene schatkamer der drôgbereidende geneeskonst. (Brussels, Francois Foppens, 1681), Vol. V, 932-5, 951-5.

[iv] Ibid., 967.

[v] Ibid.: ‘Want aengesien Godt almachtigh ons met eenighe ghemeynsaeme, oft inlandtsche heylsaeme kruyden ende drôghen heeft ghejont, die met sulcken kracht zyn begaeft, dat-men ghemeynelyck met de selve sonder peryckel oft achterdencken de siecken kan ghenesen, soo behoort-men altoos eerst de selve the ghebruycken, eer men sich begheeft om eenighe ghevaerlycke ende vremde middelen uyt de schey-konst te nemen; soo dat het een groot bedrogh oft reuckeloosheydt soude wesen, achter den bereyden Antimonie oft Quick in ‘t werck te stellen, soo wanneer men versien is van andere schadeloose ende krachtighe remedien, door dien men also dickmaels sonder noot aen onsen evenaesten groote schade, jae de doodt selfs soude konnen aen-brenghen.’ (Translation mine)

[vi] On the formation of chemistry as an academic discipline in the early eighteenth century see Bruce Moran, Distilling Knowledge. Alchemy, Chemistry, and the Scientific Revolution (Cambridge, MA: Harvard University Press, 2005), chapter 4.

The Recipe Collection of the Last Medici Princess

By Ashley Buchanan

Two summers ago in the state archive of Florence I discovered, filed under the heading of “miscellaneous Medici,” a simple sleeve which held a collection of over 200 recipes that belonged to the last Medici Princess, Anna Maria Luisa de’ Medici (1667-1743). Born in 1667 in Florence, Anna Maria Luisa was the only daughter and second child of Cosimo III de Medici, Grand Duke of Tuscany, and Marguerite Louise d’Orléans. In 1691, she was married to Johann Wilhelm II von der Pfalz (1658-1716), Elector Palatine. She lived in Düsseldorf, her husband’s capital, until his death in 1716. A year later Anna Maria Luisa returned to her native Florence. During her twenty-six year absence neither of her brothers, Ferdinando or Gian Gastone, produced a Medici heir. With the death of her father and both of her brothers, Anna Maria Luisa became the last Medici.

Antonio Franchi [Public domain], via Wikimedia Commons
Electress Anna Maria Luisa de’ Medici by Antonio Franchi [Public domain], via Wikimedia Commons
Anna Maria Luisa’s collection of recipes covered topics as diverse as rare paint colors, desserts, fever waters, concoctions to control epilepsy and lung inflammation, and even forms of lapidary medicine. One rather strange recipe to control infant convulsions or a periodic fever (terzana) detailed how to make a powder from the precipitation of a pulverized skull of a man who died violently but was never buried, oriental pearls, red and white coral, yellow amber, and peony roots and seeds. Another simply prescribed female rhino blood for strokes and general blood flow, and yet another recipe recommended the vaginal insertion of St. Ignatius beans to “lower the monster of women.”[1]

Intrigued at what I had uncovered, I read on. I found that many of the recipes were straightforward directions for combining listed ingredients, like the infant convulsion powder, while others incorporated more complex alchemical techniques such as steeping, pulverizing, fermentation, and distillation. One of the recipes for fever water (acqua da febbre) called for the creation of a poisonous plant tincture and distillation of sulfur. The recipe then instructed to mix one ounce of each with Capraggine water (made from a European shrub) and leave it sealed to ferment in the sun for two days.

Pieces of folded paper and letters of correspondence grouped many of the recipes within the collection, making a few distinct categories apparent—techniques to create rare or secret paint colors and dye marble, the whitening of silks and lace, culinary recipes, and medicinal recipes and therapeutics. The sequential and identical page numbers penciled in at the top of every page indicated that these categories were the product of later archivists.

In addition to recipes for fever water, perfumes, and ointments, directions for applying balsams, and therapeutics for epilepsy and pleurisy (lung pain or inflammation), Anna Maria Luisa’s collection also included a lengthy and detailed Portuguese inventory of raw medicinal materials. This inventory not only listed materia medica, like roots and seeds from the Kingdom of Manica, beans from Manila, and “bread” from Timor, it also detailed the uses and virtues of each. Two pages, one written in Portuguese the other in Italian, were dedicated to the uses and virtues of Pietre Cordiali, or Goa Stones. The unknown author of the inventory explained that these stones, created by the lay Jesuit Gaspar Antonio, were the best heart medicines he had ever found, but could also be used to combat fevers, animal venom, poisons, and even kidney stones.

(Metmuseum.org), via Wikimedia Commons
Late 17th Century/Early 18th Century Goa Stone and container, Metropolitan Museum of Art (Metmuseum.org), via Wikimedia Commons

After reading through her collection, it was clear that Anna Maria Luisa collected recipes from her family’s ducal pharmacy (some of the recipes credit the Medici fonderia or are stamped with the Medici crest), received and exchanged recipes via courtly epistolary networks, and gathered exotic raw medicinal materials through Italian and Portuguese trade networks and Jesuit missionaries. As I read through the inventories of raw materials, it became apparent that Anna Maria Luisa’s collection was not only the product of European courtly customs, but was also connected to exploration, colonial expansion, and global exchanges through trade and missionary commerce, all of which facilitated the movement of people, things, and knowledge. 

Anna Maria Luisa’s recipes have become the foundation of my dissertation, which I have just begun researching. I look forward to sharing my findings as I search for what motivated Anna Maria Luisa to collect recipes, who (if anyone) she exchanged recipes with, and how she learned of the exotic raw materials she collected. On a larger scale, I hope this project offers the opportunity to study how people or groups outside institutional medicine contributed to the creation, dissemination, and legitimization of emerging scientific and medicinal knowledge. In this case, how did a Medici princess, courtly scientific patronage, Italian and Portuguese traders, Jesuit missionaries, and indigenous populations contributed to the discourse of early modern medicine through recipes?


[1] The rhino blood, presumably from Africa–“Dos Sangue d Abbada, Serve este sangue para cursos, e fluxos de sangue.” And the St. Ignatius beans from the Philippines–“Para fave (fazer) abaixar o menstro das molheres”

 

Dr. Crawford Long’s Remedy for Insect Bites – Another Use for Ether

By: Michelle DiMeo

On May 20, 1847, Dr. Crawford W. Long was called to see a child residing 6 miles outside of Jefferson, Georgia, who had been bitten by an insect four hours earlier. He was at least 100 yards away when he “distinctly heard her screams”. The child was in extreme pain and suffering from various symptoms, including stomach cramps, difficulty breathing, chest pain, and muscle spasms in the abdomen. The family had given her “about half pint of brandy … two portions of sen[e]ka snake root boiled in ^sweet^ milk and … two teaspoons full of Aqua ammonia, but all without the least benefit”. Dr. Long administered “eighty drops Tinct Opii, a teaspoonful of Hoffmans Anodyne, and the application of the strong Aqua ammonia on a pledget of cloth to the bitten part and retaining it until vesication was produced”. After seeing some improvement, he continued with doses of Hoffman’s Anodyne and the Tincture of Opium in thirty minute intervals, noting the patient was “greatly relieved”.[1]

Hoffman's Anodyne
With Permission from www.SureCureAntiques.com

The preferred remedy, primarily a combination of Hoffman’s Anodyne and opium tincture, worked as an anti-spasmodic and a pain-killer. Hoffman’s Anondyne was a compound sometimes known as “Spirit of Ether”, produced through a process of distillation. Though originally named after the German physician Friedrich Hoffmann (1660- 1742), the recipe was still popular across Europe and the US during the mid-19th century. One 1850s pharmaceutical study of the remedy’s chemical properties found that versions of it varied greatly between commercial manufacturers, between international pharmacopoeia, and from Hoffman’s original recipe.[2]

Dr. Crawford Williamson Long (1815-78), an American surgeon and anesthetist, is one of the first physicians to have administered ether as an anesthesia for surgery. After receiving his M.D. from the University of Pennsylvania in 1839, he practiced medicine in New York before returning to his home state, Georgia, in 1841. As early as 1842, Dr. Long used sulfuric ether during the surgical removal of a tumor. He continued to use ether in operations over the next few years, but he failed to publish his results until 1849, after anesthesia was already heralded as a major medical innovation.[3]

Dr. Long's Remedy for Insect Bites
The College of Physicians of Philadelphia, MSS 2/0093-01

While Dr. Long is celebrated today for his innovative use of ether in surgery, the double-sided single-page manuscript from which this story was taken shows that he was also using popular ether-based medical remedies to treat common household ailments, such as insect bites. After the turn of the nineteenth century, ether was drunk in medical remedies in the United States and Europe and became a popular recreational drug in many European countries.[4] In this manuscript, Dr. Long reports that he successfully administered this treatment a second time and he was writing this account specifically because “A great variety of Sovereign remedies have been recommendend [sic] ^as being usefullest^ for the treatment of bites of poisonous insects”, but there was “still great diversity of opinion among the Members of the Medical profession”.

Dr. Long’s narrative is also a good reminder to us that sub-divisions within the medical field were not as defined in the past as they are today: there was nothing wrong with a surgeon exploring pharmaceutical remedies. Further, the fact that he records in detail the household remedies his patient had already tried before he administered his own validates the possibility of their effectiveness, even if they were ineffective in this particular case, and it offers a good example of how diverse medical treatments were often intermingled.


[1] The College of Physicians of Philadelphia, MSS 2/0093-01, “Holograph remedy for poisonous insect bites, c. 1847”. This item also includes a typed donation letter from 1971 recording the provenance of the item.

[2] William Procter, Jr., “On Hoffman’s Anodyne Liquor”, American Journal of Pharmacy, 28, 1852, 213-18.

[3] W. M. Crawford, “An Account of the First Use of Sulphuric Ether by Inhalation as an Anaesthetic in Surgical Operations”, Southern Medical and Surgical Journal, 5, 1849, 705-713.

[4] Science Museum, “Ether”, http://www.sciencemuseum.org.uk/broughttolife/techniques/ether.aspx Accessed 11/9/2012.