Saturday, 23 November 2013

"Beer: So much more than just a breakfast drink."

A wise cartoon character named Homer Simpson once declared, “here’s to alcohol: the cause of, and solution to, all of life’s problems!”  Now Homer may not be entirely accurate, but the early modern English saw alcohol as a cause of, and a solution to, a surprising number of their problems. 

Despite the characterization of the English as a nation of beer drinkers, they were ale drinkers until sometime in the 16th century.  Food historian Ken Albala noted that the English didn’t begin to brew beer with hops until at least 1520.[1]  Beer consumption rose and it quickly became a beverage consumed daily by a large percentage of the population.[2]  Brewing and selling beer became a key part of the English economy and the government took steps to regulate the sale almost immediately.[3]   

Why did the English so quickly transition from their English ale to a Continental beer?  Well, many may have preferred the bitter hoppy flavour of beer when compared with lighter ale.  However, as Peter Clark argued, beer’s higher alcoholic content packed more power than ale while remaining just as cheap.[4] 

By the middle of the 17th century, beer was such a popular drink that Richard Short declared that “it is the custome of English to drink beer therefore we must drink beer, and consequently no water.”[5]  It’s important to note that this wasn’t universal: Richard Wiseman, my favourite early modern surgeon, was (in)famous for drinking only water.  Moreover, there were some who simply were too poor to drink beer regularly.  James Lackington’s 18th century memoir reveals that he and his wife were too poor to purchase meat frequently, much less spend money on beer.[6] 

And, despite the prevalence of beer, alcoholism was also certainly still an issue as this ballad demonstrates:

And if I passe by the ale-house doore,
My host will say, looke there goes he,
I knew him rich but now hee's poore,
And thus strong beere has undone me.    
Indeed, while the alehouse was a social space and beer, in general, an accepted, everyday sort of beverage, there was an understanding that too much alcohol was a social ill that ended in poverty and poor marriage relations.

That Man thats always drinking
Amongst the drunken Crue
His estate must needs be sinking
Without any more ado;
That I might be an example
To all that go astray,
That every Man may mend his life
And be warn'd by me this day…

…At two a clock i'th morning
I would come drunken home
If my Wife but chance to speak a word
I would kick her about the room
And call her Bitch and Whore
I'de abuse my one dear Wife
I was a Villain for my pains
To live such a wicked life

By the end of this particular ballad, the man has abused both alcohol and his wife and has even lost his job and health – all because of beer. 

The exact opposite is presented in this particular jaunty drinking song that praises beer as a preserver of health:

Drink is the thing supports our lives,
and fills our hearts with ease,
This makes us kind unto our Wives,
while them we strive to please:
It makes good blood run in our veins,
and banishes all fear;

It puts good reason into brains,
When Mault, etc.
This spoils the Doctors trade likewise,
by which they get such Wealth,
Most strangely this preserves the eyes,
as it maintains the Health.

Early modern English medical books and manuscripts are full of suggestions that the patient consume ale, beer, or aqua vitae (distilled spirits).  Indeed, hospital accounts list beer expenditures with other foods and drink.  At St. Bartholomew’s Hospital in London, a patient in 1687 could expect 3 pints of beer daily while a “House of Correction” in Suffolk offered 1.136 litres of beer per day.[7]  Beer was simply included as a normal daily beverage – even to those who were very ill.

Hospital weekly expenditures.  Beer is listed twice!
Beer was also used medicinally.  Here, included in an Elizabeth proclamation on the plague, is a medicine meant to induce sweat – and likely fever – to help cure a patient.  Bayberries are to be imbibed in either ale,  beer, or white wine.

Bayberries in ale or beer as a plague treatment
Nicholas Culpeper recommended beer for those with cold and dry brains:

Such whose Brains are cold and dry, have admirable Memories, and are fantastick in their actions, fearful, and think every thing they do, whether it be Meat or Drink, or Exercise of Body, doth them harm, they sleep very badly &c.

A Cup of strong Beer with Nutmeg and Sugar is an excellent mornings draught for such People; for although I would have such as have their Brains too hot and moist fly from strong Beer and Wine as fast as from a Dragon, yet is it exceeding good for these.

Beer was even used to treat children. Thomas Sydenham used the following to treat feverish children:

Let two Leeches be applied, one behind each Ear, and a Blistering Plaister to the hinder part of the Neck. Let them be purg'd with the Infusion of Rhubarb in Beer.  

Finally, I leave you with John Lampard’s posset-drink which he used to treat smallpox (by making his patients vomit):

And because I have seen some Country-People make their Posset-drink very ill, I will tell
you how, and likewise how much I do usually make to be imploy'd in the working of one

I take most commonly two Quarts of Milk, and when it is ready to boil I do pour thereinto a quart of strong Beer but not too stale (because that would make the posset have a sowre Taste) and so let it stand over the fire until it be clear.

And that Night I do usually give the Patient three of my Fever Pills as big as a pease, and a draught of strong Liquor after them, having supped (either not at all, or) two hours before.

Beer was used as part of a complicated treatment for everything from plague, to small pox, and fevers in children.  Not quite a panacea, but it sure came close.

Please don’t make a posset-drink at home.  Though, if you do, let me know what it’s like. You can find me on twitter as @medhistorian

[1] Ken Albala, Food in Early Modern Europe, Westport, CT: Greenwood Press (2003), 81.
[2] Joshua Scodel, Excess and the Mean in Early Modern English Literature, Princeton, NJ: Princeton University Press (2002), 207.
[3] Richard Unger, Beer in the Middle Ages and Renaissance, Philadelphia, PA: University of Pennsylvania Press (2004), 140.
[4] Peter Clark, “The Alehouse and the Alternative Society,” in Puritans and Revolutionaries ed. Donald Pennington and Keith Thomas, Oxford: Clarendon Press (1978), 51.
[5] Richard Short, Peri Psychroposias. London (1656), 55-56.  Water did, of course, remain a popular beverage (but that’s a whole other article!).
[6] Robert Jütte, Poverty and Deviance in Early Modern Europe, Cambridge: Cambridge University Press (1994), 75.
[7] Ibid., 77.

Monday, 18 November 2013

"Hey Doc, How Long Do I Have?: Early Modern Prognostication

A man hasn’t been feeling well for a few weeks, so he goes to his doctor for a testing checkup. After a week or so the doctor asks him to come in to discuss results.
Doctor: “I'm afraid I have some very bad news. You're dying, and you really don't have much time left.”
Patient: “Oh, no!  That’s dreadful news! How long have I got, doc?”
Doctor: “Ten.”
Patient: “Ten what?  Months? Weeks?”
Doctor: “Nine…Eight…Seven…”[1]

Prognostication was a tool that early modern physicians had adopted from the ancient Greek doctors.  While examining the patient, instead of asking the patient for his symptoms, a good doctor would describe the symptoms suffered to display his knowledge of the disease.  He would then predict whether or not the case was mortal and proceed with his treatment accordingly. 

At first glance a common sense approach, prognostication was also allowed the physician “to recognize hopeless cases, so that he could avoid them.”[2]  Unsuccessful cases, especially those ending in a patient death could lead to legal proceedings, would likely hamper further business, and were definitely to be avoided.

In addition, giving the patient a more-dire-than-actually-warranted prognostication was also practiced frequently.  Richard Head, an early modern writer, detailed this technique in his satirical work The English Rogue: Continued Part 2:
“if it were but a prickt finger, he would make a great matter of it, and tell you what danger you had been in if you had staid but a minute longer; instancing how such a one his Patient by only cutting of a Corn, and drawing blood, it turned to a Gangrene, which by had handling of unskilful Chyrurgions growing worse and worse, they were at last inforced to send for him, who in a few days made him perfectly sound, that otherwise (had he not come to him) must inevitably have perisht.”

The purpose was two-fold.  First, by emphasizing the severe nature of the wound the practitioner reassures the patient that he is correct in seeking treatment for a minor ailment.  The tale of the gangrenous corn continues to work in this vein, invoking fear in the patient, ensuring that he will return for further minor wounds, hopefully convince others to do the same.  Second, the technique leaves open the window for further treatment and enhanced cost, thus lining the practitioner’s pockets for very little exertion. 

Hugh Chamberlen, physician to Charles II, wrote about this sort of behaviour, noting that harsh prognostications were used by physicians too:

“Physicians of mighty Prudence  and small Integrity ever gain by Frightful Prognosticks; for, if the Patient dies, their early Prognostick gives them great Reputation for knowing so long before, what must come to pass at last, and if the Patient recovers, the cure is the more Miraculous, because the condition was so Desperate.”

Quick and accurate prognostication was definitely a valued ability.  Numerous quack practitioners, in fact, advertised their ability to prognosticate at a glance.

For the most part, however, practitioners sought to prognosticate accurately in order to treat effectively their patient.  This was a practical process where practitioners would, in fact, discuss the patient’s symptoms and read the signs thereof to determine the disease and how dire the situation.  This took much training and, as the surgeon Peter Lowe, wrote in 1597, practitioners needed to read and educate themselves about diseases and their signs, patient characteristics, and even the weather to prognosticate correctly!

Paul Barbette gives an example of a typical prognostication guide for ruptures or hernias (mid 17th century):

“Prognosticks: In little Children, Ruptures are easily cured; in aged people, slowly or not at all, especially if the Peritonæum be burst. If the Intestines be filled with Wind or Excrements, there follows pain; and if that be not suddenly removed, an Inflamation, Gangrene, and at last Death it self.”

Some methods of prognostication leave us shaking our heads.  I leave you with my favourite plague prognostication method from John Hester’s The pearle of practice:

“Take a quick Frog, and lay it with the bellie next the sore: if the partie will escape, the Frog will burst, in a quarter of an houre.  Then lay on another, and this you shall do, till not more do burst, for they draw forth the venome.  I have beene told that a dried tode will in better sort do the same.  If none of the Frogs do burst, the partie will not escape, this hath bene often prooued.”

Am I the only one with a favourite prognostication practice?  If not, let me know on Twitter @medhistorian

[1] A truly terrible joke about medical prognosis and I apologize for putting you through it. 
[2] Medicine Before Science: The Business of Medicine from the Middle Ages to the Enlightenment.  Cambridge: Cambridge University Press, (2003), 16.  For more on prognostication see also: Stephanie Moss and Kaara L. Peterson, Disease, Diagnosis, and Cure on the Early Modern Stage. Burlington, VA: Ashgate Publishing Company (2004). 

Monday, 11 November 2013

The humble Petition of Walter Rosse, Chirurgion

The wars of the seventeenth and early eighteenth centuries provided numerous positions for surgical practitioners.  From the English Civil War (1642-1651) to the War of Spanish Succession (1701-1714), surgeons consistently had the opportunity for state service.  These positions were, of course, fraught with danger with little by way of monetary compensation. 

Upon leaving service or attempting to set up civilian practices, surgeons were left adrift and many failed to gain meaningful employment or incorporate themselves successfully into civilian life.  Many tended to be in desperate financial straits and were forced to resort to petitioning for funds in or jobs in order to feed themselves and their family.

At the Restoration, surgeon Walter Ross found himself at a loss.  He had served as a Royalist surgeon, was taken prisoner at Worcester by the Parliamentarians, and forced to care for wounded prisoners.

Ross’s petition, transcribed below, was accompanied by a similar statement witnessed by three men to prove its veracity.  Ross sought recompense for lost funds, claiming that he had spent all of his wealth caring for wounded soldiers.  The tale is one of loss and loyalty; Ross emphasized that it was only his faithful service to the royal cause that led to both his current condition and his request for financial aid.  The letter is formulated as an appeal for deserved charity and payment for his loyalty.

The impact of Ross’ letter and signed testimony is unknown:

To the Kings most Excellt Matie The humble Petition of Walter Rosse Chirurgion
Sheweth That whereas your Pats. Peticoner hath beene constantly Loyall (ever since the beginning of the late Rebellion) unto your sacred Mats Interst which hath occasioned his frequent sufferings, but more particularly with your Mates at Worcester, where your pet.  was taken prisoner, and the Rebells finding him to be a Chirurgion appointed him to take care of the wounded prisoners, who were in a most sad and suffering Condicon, had not your petr ingaged his whole creditt and fortune (having then his subsistance and ffamely in England) for procuring of Medicines and other necessaries for their Recovery, which reduced your pet. his Wife and Children to a most necessitous Condicon.

May it therefore please your Royall Maties to take consideration of the petisson, and...the low Condition of your poore Petr., and grant him…of the ffinds of Scotland, as may in some measure repaire his sad losses, Soo that hee his wife and children may have a subsistence to live.

And as in duty bound your petr shall pray.

Walter Rosse

Saturday, 9 November 2013

Of Quacks and Caustics: When Evidence Didn't Matter?

In 1694, surgeon William Cowper and other members of the Royal Society gathered to test a Vulnerary Powder peddled by an apothecary named John Colbatch.  The powder, Colbatch argued, was a styptic that staunched the flow of blood and allowed wounds to heal much faster.  Given the growing importance of military action in the period i.e. Third Anglo-Dutch war (1672-1674) & the Nine Years’ War (1689-1697), a medicine that could help out on the battlefield would be invaluable.

William Cowper and his hair.
 In keeping with the Scientific Revolution’s emphasis on empirical knowledge, Colbatch claimed that he did numerous animal experiments that proved his powder’s efficacy:

“I began to make Experiments upon Dogs and other Animals, Wounding them in the most desperate manner I could contrive; and in about a Hundred Experiments that I made, I had not above five that miscarried.”[1]

London surgeons felt this too good to be true and responded with everything from polite disbelief to outright scorn.  Did Colbatch, a mere apothecary, stumble upon a revolutionary new method of treating wounds?  Or was he yet another quack on the London landscape?  

Cowper, a noted surgeon and anatomist, decided to replicate Colbatch’s experiments to test the powder himself.  In a letter published in the Philosophical Transactions of the Royal Society, he noted:

“THE Report of Wonderful Cures wrought by Mr. Colbatch's Styptick Pouder, so entertained the Expectations of divers Persons, that amongst others I thought my self obliged to obtain some convincing Proofs of its Operations.”[2]

To begin, Cowper experimented on two dogs, applying Colbatch’s Vulnerary Powder to their wounds.  In both cases, the dogs recovered suitably and Cowper and his colleagues were excited, their hopes raised that Colbatch had, indeed, developed a powder that could help save lives.

Keeping in mind the successful animal experiments, Cowper and his colleagues made their way to London’s St. Bartholomew’s Hospital and applied the powder to the stump of a man who had his arm amputated above the elbow and to the stump of a young teenage boy who had his leg amputated below the knee. 

In both cases, Colbatch’s powder proved ineffective:

“Some hours after these Operations, both these Patients suffered extravagant Pains: Three days after, the Applications were taken off, and had any Person, a stranger to what had been done, seen the Stumps, he would have supposed nothing less than an actual Cautery had been applyed, or could have occasioned such large Escars, and so horrid an Appearance; which did sufficiently denote this Vulnerary Pouder (as it's called in a late Publick Paper) to be a violent Caustick. The Pouder was applyed with all imaginable fairness, and in the Presence of the Inventer, who I think has no Reason to imagine those Surgeons who made use of it in the Hospital, had any Design to prevent its Success, since it's well known They were rather Prejudiced in its Favour, than on the contrary.”[3]

Disappointed, Cowper prepared his report on the unsuccessful experiment and sent it off to the Royal Society.

Colbatch was furious and decried Cowper’s assessment.  Not only was his powder successful, but it was a painless application!  Any disagreement was chalked up to malice and jealousy.[4] 

Indeed, as he wrote later, the experiment’s outcome was fabricated!  Writing in 1699, Colbatch claimed that while others had said that the two patients suffered and had continued bleeding, that he had seen no such thing.  Rather, upon visiting the patients the day after, they related that they were well!

“Before I was capable of speaking to him, he rose up in his Bed, and prayed most heartily for me, telling me he believed no man, that ever had an Arm cut off, was so well as he.”[5]

A London surgeon, known only as W.W, wrote in response to Colbatch’s treatise and lambasted him as a quack.  With regard to the dogs Colbatch experimented on he wrote, “I am fully satisfied they all died save, one, who had his Leg cut off.”[6]

W.W. continued to list Colbatch’s cases, analyzing the treatments, commenting upon the patients which he had seen, and noting either Colbatch’s errors or lies.  And last, to prove that the powder really was caustic, W.W. had it tested only to discover that it “consists of a Vitriol of Copper” and some “Sugar of Lead.”[7]

He concluded: “I suppose the best Way of applying of it will easily appear to be to throw it into some nasty Puddle of Water; which by its Filth, is excused from the use of Man and Beast.”[8]

Colbatch had numerous surgeons and physicians against him.  Repeated experiments and publications questioned his medical theories and cures.  W.W. went so far as to analyze and critique almost every cure Colbatch wrote about. 

Yet, none of this could ruin Colbatch’s reputation once and for all because the most important  people – the patients – were either not listening, not caring, or not believing.

Colbatch may have been blacklisted by many a medical practitioner, but the upstart apothecary from Worcestershire died Sir John Colbatch, wealthy physician.

What do you think?: Was Colbatch a visionary well-rewarded or a quack who got lucky?  Let me know in the comments and on twitter @medhistorian

[1] John Colbatch, Novem Lumen Chirurgicum, London: printed for D. Brown (1695), “To the Reader.”
[2] William Cowper, “An Account of some EXPERIMENTS lately made on Dogs,” Phil Trans.  Feb. 1694.
[3] Ibid.
[4] Colbatch, Novum Lumen, “To the Reader.”
[5] Colbatch, A Collection of Tracts, London: printed for Dan. Brown (1699), 70-71.
[6] W.W. Novum Lumen Chirurgicum Extinctum, London: printed by Andrew Bell (1695), v.
[7] Ibid., 61.
[8] Ibid., 63.

Monday, 4 November 2013

Extract of Sun and Other Panaceas

Panacea n. A remedy, cure, or medicine reputed to cure all diseases (OED).

From elixirs of life to snake oil, the desire for a universal remedy appears to be, well, universal.  Rather than mythical fountains and alchemical principles, the modern West has seemingly invested its hope in the exotic.  Think about the recent marketing of new “superfoods” like açai and goji berries - these fruits and their juices were hailed as cure-alls for everything from obesity to cancer.  Clever and aggressive marketing trumped scientific evidence for several years.

Early modern treatises and medical advertisements are replete with panaceas in various forms – pills, potions, and even amulets engraved with charms.  Business-savvy medical practitioners, whether they practiced legally or not, advertised and sold their cure-alls in bookshops, pubs, and coffeehouses.  It was a one-stop shop.  Imagine enjoying your cappuccino with some intellectual conversation and being able to pick up the latest thriller and shop for your VD medication at the same time.

Ned Ward, a late seventeenth century author described this surreal experience:

The walls were hung with gilt frames…which contained abundance of rarities,viz., Nectar and Ambrosia, May Dew, Golden Elixirs, Popular Pills, Liquid Snuff, Beautifying Waters, Dentifrices, Drops, Lozenges, all as infallible as the Pope…good in all cases, curing all distempers; every medicine pretends to nothing less than universality.  Indeed had not my friend told me ‘twas a coffee-house I should have took it for the parlor of some eminent mountebank.[1]

Even other handbills made reference to the ubiquitous nature of these ads.  David Edwards placed his advert in the “most Eminent Coffee-houses about the Town” despite acknowledging that most other ads were for “Pretenders to Physical Cures”![2]  Edwards was careful to set himself and his panacea apart.  Effectively saying, “I’m not a doctor, but you should trust me anyway,” Edwards emphasized that he was merely publicizing an effective treatment discovered during his travels.  He was merely doing his civic duty by informing Londoners of a medicine that would “do the whole business of a Physician, and half that of a Chyrurgion.”[3] 

Medicines that could be said to do the surgeon’s job were particularly popular.  Understandably so given the terrifying nature of surgical operations at the time!  John Russell, who boldly depicted patients undergoing manual operations in his ads, also hawked his own panacea.  His poetically named Spiritus Vitae Deauratus or Golden Spirit of Life promised to cure baldness, bad breath, deafness, amenorrhea, tuberculosis, and even cured burns and bruises.[4]

Lockyer’s Pill was probably one of the most (in)famous panaceas in early modern England.  Lionel Lockyer or Lockier (1600?-1672), a quack physician, advertised his Pillulae Radiis Solis Extractae in several handbills from the 1650s onward.  Modesty was not a trait with which Lockyer was overburdened as both his handbills and gravesite monument attest.

The caption under Lockyer's grave (though somewhat smug) portrait reads:

The true Effigies here you may behold
Of Him, who for avoiding others ill
Hath Gain’d a Med’cine far excelling Gold
And known to all the World for Lockiers Pill.

Title page to Lockyer's 1664 work.

A portion of Lockyer's epitaph reads:
His virtues & his PILLS are soe well known..
That envy can't confine them vnder stone.
But they'll surviue his dust and not expire
Till all things else at th'universall fire.

Lockyer described his pill as a gentle remedy for all ailments in all persons regardless of sex, age, and constitution.  It was such a gentle remedy – in contrast to the harsh chemicals on the market – that no harm came to a 7 year old boy who took 10 pills at once when his father was not paying attention.[5]  In addition to being gentle, Lockyer’s Pills supposedly cured everything from leprosy to syphilis to gout.  It cured rickets in children, allowed barren women to carry a child to term, and even cured scurvy.

Indeed, he wrote, if army and navy physicians and surgeons had given his pill to their patients, they would have saved tens of thousands of lives![6] 

Outrageous claims to efficacy were supported by a series of case studies and testimonials.  Providing names, dates, and locations in much the same way as medical practitioners did in their treatises, Lockyer related tale after tale of successful cures brought about by the blessing of his pill.[7] 

One such tale was that of James Carr who suffered from cancer in his nose and had been treated ineffectually by numerous physicians and surgeons.  Given over by them as incurable, Carr went to Lockyer, purchased only two boxes of pills and was cured.  Interestingly, Lockyer gave Carr’s current residence.[8]  Whether or not curious potential customers approached Carr (or if Carr really was treated), we’ll never know.   

Unfortunately, Lockyer never published the pill’s ingredients and claimed to only have revealed its contents to three other men.  He did, however, deny openly that it contained harsh chemicals like mercury or sulphur of antimony.[9]  Alas, he only hinted once at a potential ingredient, describing the pill as “of a solar Nature.”[10]  Yes, the only hinted ingredient Lockyer revealed in his advertisement was sunlight.

While one may describe a particularly sublime dessert as containing clouds and happiness, “extract of sun” is not a particularly convincing medicinal ingredient.  Lockyer’s claims were, of course, decried.  An apothecary named William Johnson attacked Lockyer’s claims, lambasting him for bastardizing chemical preparations and calling for him to “either confess himself ignorant, or a Notorious Lyer in Print.”[11] 

Johnson described his method of breaking down Lockyer’s pill and testing for its ingredients in his Agyrto-mastix (1665).  He determined that Lockyer’s pills were in fact made up of antimony!  The pills, for which Lockyer charged 16 shillings per ounce were readily available and sold by apothecaries for only 3 pence.  Johnson, furious, noted that “either he [Lockyer] is so ignorant, he knows not what Antimony is, or else he resolved to deceive the World.”[12]  

Lockyer may not have been a particularly sincere or ethical medical practitioner, but he certainly was successful – his will reveals funds and assets at death over £2000.[13]

Let me know what you think on twitter @medhistorian 

[1] Ned Ward in Harold Cook, Decline of the Old Medical Regime in Start London, Ithaca: Cornell University Press (1986), 41.
[2] David Edwards, The Most Excellent Universal Pill, London (1670).
[3] Ibid.
[4] J. Russell, The Admirable Virtue of Spiritus Vitae Deauratus, London (between 1650-1665).
[5] Lionel Lockyer, An Advertisement, concerning those most excellent pills, London (1664), 2.
[6] Ibid., 6-7.
[7] For more on case studies see Sandassie, “Evidence-Based Medicine? Patient Case Studies in English Surgical Treatises 1660-1700,” Medical Humanities 34 (2008), 11-18.
[8] Lockyer, 7-8.
[9] Ibid., 12-13.
[10] Ibid., 2.
[11] William Johnson, Agyrto-mastix, London: printed by T. Mabb for Henry Brome (1665), 37.
[12] Ibid., 125-128.
[13] TNA PROB 11/339/91.