Category: History of Medicine

Grading Sir Hans Sloane’s Research Paper

Get Tastylia (Tadalafil Oral Strips) to buy Posted on December 3, 2015 by - Botany, Early Modern History, Hans Sloane, History of Medicine, Patients, Remedies

ربح المال It’s that time of year when grading is on an academic’s mind. With first-year assignments still fresh in my head, I recently found myself frustrated by Sir Hans Sloane’s “Account of Symptoms arising from eating the Seeds of Henbane” (Philosophical Transactions, volume 38, 1733-4).

Tastylia Australia Letters by Sir Hans rarely feature on this blog—and that’s for a good reason: there aren’t very many by him in his correspondence collection. But he did, occasionally, send in reports to the Royal Society… some of which were better than others. I love reading the early eighteenth-century Philosophical Transactions; many of the authors knew how to tell a cracking story, with a clear narrative arc of event, evidence and interpretation.

Not so much this offering from Sloane.

Filberts. Credit: Agnieszka Kwiecień, Wikimedia Commons.

http://secon.se/al277.php?z4=Lw%3d%3d Filberts. Credit: Agnieszka Kwiecień, Wikimedia Commons.

http://paxxo.se/?praktika=F%C3%B6r-Viagra-100-mg-p%C3%A5-n%C3%A4tet&dbb=3f Sloane’s account began in 1729 when “a Person came to consult me on an Accident, that befell four of his Children, aged from four Years and a half, to thirteen Years and a half”. The children decided to have a foraged snack from the fields by St. Pancras Church, thinking that the seeds they’d found were tasty filberts. But foraging can be a risky business and the children took ill. Their symptoms included great thirst, dizziness, blurred vision, delirium and sleepiness. For Sloane, the symptoms suggested henbane poisoning; Sloane’s initial diagnosis was reinforced after examining the seeds that the father had brought in to show him. Sloane prescribed bleeding, blistering at multiple points, and purging at both ends: “And by this Method they perfectly recovered.”

i rischi delle opzioni binarie This could have made for a solid medical case study: who better to bring together clinical observation with botanical detective work? But for Sloane, the real story was the seeds rather than his diagnostic prowess. I withheld judgement. At this point, I was curious to see where Sloane, the narrator, would take his readers.

Four poisonous plants: hemlock (Conium maculatum), henbane (Hyoscyamus niger), opium lettuce (Lactuca virosa) and autumn crocus (Colchicum autumnale). Credit: Wellcome Library, London.

http://www.arredo.ch/?dered=bin%C3%A4re-optionen-regeln&0fe=6e Four poisonous plants: hemlock (Conium maculatum), henbane (Hyoscyamus niger), opium lettuce (Lactuca virosa) and autumn crocus (Colchicum autumnale). Credit: Wellcome Library, London.

indikator binära optioner Sloane went on to describe how the symptoms of delirium can offered important clues. Henbane delirium was very different from regular fevered delirium, but had much in common to the delirium caused by datura (“a species of stramonium”) and bang of East-India (“a sort of hemp”–indeed). Unfortunately for the reader, he did not describe any of these forms of delirium.

corso trading online He then noted that the delirium from all three herbs was different from that “caused by the rubbing with a certain Ointment made use of by Witches (according to Lacuna, in his Version and Comments upon Dioscorides)”. The witches’ ointment instead would “throw the Persons into deep Sleep, and make them dream so strongly of being carried in the Air to distant Places, and there meeting with others of their diabolical Fraternity; that when they awake they actually believe, and have confess’d, that they have performed such extravagent Actions.”

http://www.tentaclefilms.com/?yutie=opzioni-digitali-soldi&ab1=cd I see. From faux-filberts to witches’ ointment in four easy steps…

A sculpture of a man with toothache. Wood engraving after Mr. Anderson. Credit: Wellcome Library, London.

http://azortin.pl/?rtysa=opcje-binarne-dla-pocz%C4%85tkuj%C4%85cych&a8f=4d A sculpture of a man with toothache. Wood engraving after Mr. Anderson. Credit: Wellcome Library, London.

Henbane wasn’t all bad, though. Sloane recounted, for example, that several years before, a “Person of Quality tormented with this racking Pain [of tooth-ache]” was treated by an empiric who used henbane. The sufferer was desperate—“his Anguish obliging him to submit to any Method of procuring Ease”—and he allowed the empiric to funnel smoke into the tooth’s hollow before (allegedly) removing tooth-worms. If this case sounds familiar to regular readers, it should be. Sloane procured one of the maggots from the sufferer, then sent it to Leeuwenhoek who examined it in detail and found it to be an ordinary cheese worm rather than a so-called tooth-worm.

Although Sloane knew that the wormy tale was fake, he pointed out that “upon the whole”, the henbane would have offered pain relief. And in any case, presumably, a good tale about tooth-worms bears repeating. Sloane also took the chance in his conclusion to make a dig at empirics who, through “slight of Hand” acquired a reputation for their remedies’ success, “which from the Prescription of an honest Physician would be taken little Notice of.”

So ends the account

****

Essay Comments

Sir Hans,

There is much of interest in this paper: your medical cases on henbane and tooth-worms are intriguing and your ability to identify both seeds and poisoning is impressive. I also appreciate the historical perspective that you bring to this study with your discussion of witch ointments.

However, there are a few ways in which this essay could be strengthened. The essay lacks analysis as you move quickly between subjects–a recent case, types of delirium caused by different seeds, and an old case. These are all fascinating issues in their own right, but you lapse into storytelling with each instance without ever going into detail about their significance. For example, in the middle section, you aim to connect different seeds to different types of delirium, but you never provide any discussion about the specifics (apart from the witches’ delirium): how did the childrens’ delirium present? What does delirium caused by bhang or datura look like? In what ways are each of these similar or different? This would help the reader to understand your thought process in diagnosing the patients and in identifying poisons.

It is also worth more carefully considering the title you’ve chosen: “An Account of Symptoms arising from eating the Seeds of Henbane”. A good title should reflect the content of the essay. However, only the first section of your paper considers symptoms actually caused by eating henbane seeds. The second section is potentially related, but needed to be more closely linked to make the connection clear; this would have been done to good effect by comparing the specifics of each drug and their symptoms to the case of henbane poisoning you introduced. The third section is only tangentially related—although you discuss a medical case and henbane is involved, you consider henbane’s therapeutic qualities rather than symptoms arising from its use. You could usefully have omitted the case in its current state, particularly since the section focuses on making value judgements about empirics and examining tooth-worms. That said, if you really do think it necessary to keep the section, you needed to consider henbane’s effects in more detail. Even more crucially, you might consider changing the title: “An Account of the Effects of Henbane” would have neatly pulled the three strands together in a more coherent fashion.

This essay has the potential to be a wonderful example of your diagnostic and botanical mastery, especially if you took more time to consider the narrative arc. Rather than scattering your energies by telling several stories (henbane, witches or tooth-worms), focus instead on one strand. Don’t be afraid to toot your own horn by showing off what you know and how you know it, instead of just sharing a collection of interesting tidbits.

So what grade should we give it…?

On Hans Sloane’s Copies of De Humani Corporis Fabrica

Title page. Vesalius, De humani corporis fabrica libri septum, 1555. Credit: Wellcome Library, London.

Title page. Vesalius, De humani corporis fabrica libri septum, 1555. Credit: Wellcome Library, London.

Thanks to Felicity Roberts, I’ve learned that a copy of Vesalius’ De Humani Corporis Fabrica Librorum Epitome (Basel, 1543) once owned by Hans Sloane went up for auction at Christie’s on 15 July.  Although the list price was a £70,000-£100,000, the book ended up going for £60,000.

Christie’s has just started a Discovery series of short videos to highlight pieces with particularly interesting histories. First up: Sloane’s book! Go take a look at “The ‘Google Maps’ of the Human Body” now.

What I love about this video and post is how well it captures Sven Becker’s enthusiasm when it came to finding something unexpected in the course of researching the book’s provenance. The sale also caused some excitement on the C-18L listserv, with some contributors wondering whether the book had been stolen or its notes forged.

Alison Walker, who leads the British Library’s Sloane Printed Books Project, attended the auction and has been tracing the book’s provenance in more detail. This has required a bit of digging, but the process involved in uncovering a book’s history is fascinating. It’s worth quoting Alison’s findings (which she shared in an email to me) at length. She reports that the book, which was from the Duke of Westminster’s collection,

seems to have been sold as a duplicate by the British Museum in 1769, and appears as lot 336 on p. 12 of S. Baker and G. Leigh, A Catalogue of the Duplicates of the British Museum which will be sold by auction… April 4 1769 and nine following days, London, 1769. Normally one would expect to see a British Museum duplicate sale stamp on the book, but it seems to have been omitted in this case. It is listed on p. 54v of the interleaved copy of J.A. van der Linden, Lindenius renovatus, 1686, which Sloane used as his catalogue of Latin medical books. The book may have been acquired by Sloane in the 1720s or 1730s, though there is no precise acquisition date in his catalogue, and no indication of its previous provenance.

Vesalius, De humani corporis fabrica, 1543. Credit: Wellcome Library, London.

Vesalius, De humani corporis fabrica, 1543.
Credit: Wellcome Library, London.

She has now included the book in the Sloane Printed Books database–a useful tool for suggesting the comings and goings of books in Sloane’s library over the years. (And, believe me, it is easy to lose track of time when playing with the database.)

The British Library still holds several other versions of De Humani Corporis Fabrica once owned by Sloane, including an especially fancy Epitome printed on vellum. And along the way, the British Library has sold off other copies from Sloane’s collection. For example, one 1555 edition of the book now at the Royal Society library was purchased during a duplicate sale in 1830.

Although there was a bit of excited speculation about fraud or theft surrounding this sale, a bit of historical detective work can uncover a much more prosaic explanation. Records do sometimes get lost–or never created, as in this case.

The featured image: putti killing a dog, from book 7 of De Humani Corporis Fabrica (Basel, 1555). Credit: Wellcome Library, London. I’ve always hated putti.

Bad Blood and Indecent Expressions

By Matthew DeCloedt

Standing before the Jamaican government’s ‘Councill’ in the spring of 1689, an unnamed doctor explained how comments spoken under his breath could have been construed as defamatory. He was, the man said, simply unhappy with how the administration had treated him and might have accidentally said as much in the presence of others.

Bow Street. Credit: https://www.oldbaileyonline.org/static/Trial-procedures.jsp

Bow Street Trial. Credit: https://www.oldbaileyonline.org/static/Trial-procedures.jsp

Allegations of slander and libel were common features of public life in eighteenth-century Britain and its colonies. Manuals were even available to help those accused of having spoken ill of the government defend themselves.[1]

Proof, in the form of witness testimony or a presumption of law, was required to convict an accused of libel in the 1680s. Such evidence established the defendant had the requisite state of mind when publishing defamatory material.[2] Without prima facie proof of sedition in the form of a printed text, the Council needed witnesses to substantiate the charge. In this case, it was the doctor’s word against his accusers’.

According to a letter written by H. Watson, resident of Jamaica, the doctor accounted for his actions before the tribunal by stating:

yt on ye sight of ye fleet sailing away [from Jamaica], & ye paym’t of his money not secured he might passionatly utter many indecent expressions, but not intentionally.

The doctor appealed to the rash character in every reasonable person, arguing that such sentiments could come out of anyone’s mouth. Hans Sloane must have disagreed, for it appears that he himself levelled the allegation against the doctor.

Sloane’s accusation of slander was substantiated by two witnesses who claimed they “heard [the doctor] say ye very same he spoke [to Sloane], w’ch they declared on their oaths”. Fortunately for the doctor, “severall witnesses… who were [near]by… either did not hear or would not remember w’t he spoke”.

Second Battle Of Virginia Capes. Licensed under Public Domain via Wikimedia Commons.

Second Battle Of Virginia Capes. Licensed under Public Domain via Wikimedia Commons.

Watson does not divulge the Council’s final determination, so it is unclear whose word convinced it one way or the other. Regardless, the doctor claimed he would appeal to the Prince of Orange if he were found culpable. He expected “sudden releif from Coll Molesworth who is expected here [in Jamaica] w’th as much earnestness, as ye Turks expect Mahomet”.[3] In Watson’s view, therefore, relief was not anticipated anytime soon.

Was Sloane simply a patriot, unwilling to abide a slight against the Crown? Or, was there bad blood between himself and the doctor?

In the Natural History of Jamaica Sloane relays an account of one ‘Sir H. M. aged about 45, lean, sallow, coloured, his eyes a little yellowish, and belly a little jutting out, or prominent’. The Gentleman’s Quarterly claimed some years later that this patient of Sloane’s was Sir Hender Molesworth, not Sir Henry Morgan, as was previously supposed.

If this is true, Molesworth was one of Sloane’s patients and followed his instructions for a time. He seemed to be improving, but grew frustrated with the slow progress and consulted another physician. According to Sloane, his condition was not ameliorated by his personal habits. Perhaps it was the fact that he was unable

to abstain from Company, he sate up late, drinking too much, whereby he[…] had a return of his first symptoms.[4]

Sloane implored Molesworth to listen to his advice. Dr. Rose shared Sloane’s view and they convinced him to follow their directions once again.

Molesworth was getting better, but took a turn for the worse: “On this alarm he sent for three or four other Physitian”. The latter came to a conclusion that contradicted Sloane. The treatment Molesworth followed “almost carried him off”. Instead of going back to Sloane, he contracted a black doctor and his condition grew worse still. Finally: “He left his Black Doctor, and sent for another, who promis’d his Cure, but he languished, and his Cough augmenting died soon after.”

Molesworth died July 27, 1689. This is shortly after Watson’s letter reached Sloane, so it is possible that nothing ever came of Sloane’s accusation. Sloane might have taken offence at being replaced by a black doctor, choosing to exact revenge through trumped-up charges of treason. Whatever the case, there was likely a personal angle to the matter and Sloane does not seem to have acted as a disinterested protector of the Crown. Molesworth may have uttered indecent expressions, but Sloane was just as willing to dispense with good manners and reply in kind.

[1] C. R. Kropf, “Libel and Satire in the Eighteenth Century”, Eighteenth-Century Studies 8, 2 (1974-5), 153.

[2] Philip Hamburger, “The Development of the Law of Seditious Libel and the Control of the Press”, Stanford Law Rev (1985), 707.

[3] Could ‘Coll Molesworth’ have been a relation of Sir Hender Molesworth, whom he expected would come to his rescue?

[4] Sir Hans Sloane, A Voyage to the Islands Madera, Barbados, Nieves, S. Christophers and Jamaica (London: B.W., 1707), Volume 1, xcviii-xcix.

On Tooth Worms

St. Apollonia, patron saint of tooth pain. Francisco de Zurbaran, 1636.

St. Apollonia, patron saint of tooth pain. Francisco de Zurbaran, 1636.

The 9th of February is St. Apollonia’s Day and, in the U.S., National Toothache Day. So I offer you tooth-worms, which–as Nicolas Andry described them in An account of the breeding of worms in human bodies (1701)—“occasion a deaf Pain mix’d with an itching in the teeth; they insensibly consume the Teeth, and cause a hideous Stink” (85). On 3 July 1700, John Chamberlayne wrote to Hans Sloane on the matter of his own tooth worms.

Now, these men were not people with particularly weird ideas, even for the time. Rather, the idea that toothaches were caused by worms had been around for a very long time. For a good overview of this verminous history, you should read Lindsey Fitzharris’ post on “The Battle of the Tooth Worm”.

This idea was still widely held in the late seventeenth century, even by the intellectual elite. For example, at a Royal Society meeting on 18 July 1678, Robert Hooke compared a growth within a tree trunk to tooth rot. At this point, Society members digressed into discussions of worms causing rot and the removal of tooth worms. In one case, a woman extracted the worms with a sharpened quill; in other cases, “the same thing was done by the help of the fumes of henbane seeds taken into the mouth; whereby the saliva falling into a basin of water held underneath, would discover several living worms, supposed to issue either from the gums or teeth”.[1]

Old knowledge could even, seemingly, be supported by investigations using new technologies. In a letter published in the Philosophical Transactions of the Royal Society in 1684, Anton van Leewenhoek described his microscopical observations “about Animals in the Scurf of the Teeth”. Leeuwenhoek started with his own teeth, “kept usually clean”. He examined other samples of tooth plaque from two women, an eight-year old and two old men.Using his microscope, he discovered several sorts of creatures, some like worms, in the plaque—so many that “they exceed the number of Men in a kingdom”. These creatures, though, were present in sound, healthy teeth. Could these be tooth worms?

Leeuwenhoek was not so convinced by 1700 when two of his letters “concerning Worms Pretended to be Taken from the Teeth” was published in the Phil. Trans. He had examined two worms “taken out of a corrupt Tooth by smoaking”, one of which was still alive after four days in the post (sent on 4 July 1700). Leeuwenhoek believed it came from the egg of a type of fly that laid their eggs in cheese. He rounded up more worms from his local friendly cheesemonger and ran several experiments (including watching the worms copulate).

As to how the worms ended up in the teeth… Teeth—or, flesh more specifically—were not the worms’ natural habitat. The flies took nine days to mature, but meat needed to be salted or smoked sooner. Leeuwenhoek instead believed that the worm specimens had come from a patient who

had some time before eaten Cheese laden with young Worms, or Eggs of the above-mention’d Flies, and that these Worms or Eggs were not touch’d or injur’d in the chewing of the Cheese, but stuck in the hollow Teeth.

Gnawing worms had caused the tooth pain. Or did they?

For his work on bodily worms, Andry had also examined some worms “that a Tooth-Drawer took off of a Lady’s Teeth in cleaning them”. Based on this case, Andry concluded that tooth worms rotted the teeth, but did not cause any pain. These small, long and slender worms with round black heads bred “under a Crust that covers the Surface of the Teeth when they’re disorder’d” (38).

To the modern reader, Leeuwenhoek’s argument is more sensible. Sure, there might be microscopic creatures living on the teeth, but they were not the same as the so-called tooth worms… which were really more cheese worms than anything. But at the time, Andry’s version would have been compelling. Worms were thought to breed in unclean conditions and, as Andry made clear, they could breed under a crust on an unhealthy tooth: it was the disorder in the tooth, not the worm, that caused the pain.

James Gillray, Easing the Tooth-Ach, 1796. Credit: Wellcome Library, London.

James Gillray, Easing the Tooth-Ach, 1796. Credit: Wellcome Library, London.

When John Chamberlayne, Fellow of the Royal Society, wrote to Sloane about his own tooth-worms, he did so in the interest of advancing knowledge and reporting on an efficacious treatment. He did not ask for Sloane’s advice, but instead reported on his visit to Mr. Upton, known for his “tooth-candling” expertise. Using heat and smoke, Upton removed rheum from Chamberlayne’s gums and extracted ten or twelve worms. This was apparently on the low side, since Upton on a really good day could remove sixty worms.

Chamberlayne claimed that he ordinarily had no faith in men such as Upton (meaning: irregular practitioners, sometimes known as quacks), but many gentlemen of his acquaintance had attested to the success of Upton’s treatment. Of course, given that Chamberlayne also described his teeth as “loose and corrupted”, he may also have been willing to try anything for what must have been terrible pain!

Chamberlayne was familiar with the wider discussions about bodily worms, referring, for example, to Leeuwenhoek’s 1684 article in the Phil. Trans. Besides the report, Chamberlayne may have taken a chance to do his bit for knowledge in another way: he may have sent Sloane some tooth worms. Is it just coincidence that Chamberlayne’s letter to Sloane was dated 3 July 1700 and that Leeuwenhoek referred to worm specimens sent on 4 July 1700?

Whatever the case, one moral of the story is: choose your cheese wisely if you have bad teeth.

[1] Thomas Birch, The History of the Royal Society of London, vol. 3 (1757): 428.

Measles in History

The terror of smallpox lives on in popular memory, but measles are often dismissed by many as just a childhood disease: How much harm could it really cause? And aren’t childhood diseases useful for breaking in immune systems anyhow? We overlook measles at our peril, as recent outbreaks, such as the Disneyland one, have shown. It only takes one sick person for the disease to spread rapidly among those who can’t be vaccinated (such as babies), those whose vaccines are incomplete or unsuccessful, and those who opted out of vaccination.

But is measles really comparable to smallpox, or am I being a bit extreme? Well, in early modern Europe, measles—more specifically, its complications–was considered as deadly as smallpox.

Credit: Wellcome Library, London.

Credit: Wellcome Library, London.

In 1730, physician Thomas Fuller published Exanthematologia: Or, An Attempt to Give a Rational Account of Eruptive Fevers, especially of the Measles and Small Pox. Fuller addressed it to Sir Hans Sloane and the Royal College of Physicians. In part, this was a strategy to situate the book as part of the reformed and rationale medicine that Sloane championed as the College’s President.

But it would have appealed to Sloane who had promoted smallpox inoculation and had a longstanding interest in fevers. Not only did he help to popularise the use of Peruvian bark for treating fevers, regularly using it in his own practice, but he took an interest in the publication of Edward Strother’s Criticon Febrium: or, a critical essay on fevers in 1716 (Preface). Strother, perhaps not coincidentally, was also a fan of Peruvian bark (48).

Fuller classified and described the various types of fevers with rashes or pustules, concluding that the most dangerous were smallpox and measles. Although the two diseases were very different, they had something crucial in common, being contagions that could be spread through one’s breath or skin pores (93). These “venemous fevers” were produced by a venom that was mild, unless over-heated—then the fevers became “more killing than even the Plague itself” (119).

Measles, even in its most benign state, is a miserable experience. The symptoms include: coldness and shivering; yawning; queasiness and vomiting; anguish; headache and backache; quick and weak pulse; great heat and thirst; short, painful breathing and oppession of the breast; hypochondriac tension and pale urine; watchfulness and drowsiness; convulsions; weakness and heaviness; redness, swelling, and pricking of eyes, lids and brows; involuntary tears and sneezing; sore throat, hoarseness, runny nose, and perpetual cough (142).

Fuller noted that not only did the cough always come before the measles, but that the pain in one’s chest and shortness of breath were much worse in measles than smallpox (147-8). Measles could also become malignant, or as we’d call it today, develop complications. The fever would last longer than four days and the spots would erupt much more slowly. Worse yet, diarrhea and peripneumonia occurring afterwards could prove fatal (149-150). At this point, Fuller included excerpts from Thomas Sydenham’s observations of measles outbreaks during the 1670s (151-7).

Death carries off a child on his back. Etching by Stefano De Credit: Wellcome Library, London.

Death carries off a child on his back. Etching by Stefano Della Bella, Credit: Wellcome Library, London.

It is Sydenham’s references to the personal devastation from the illness that caught my attention. In 1670, measles “seiz’d chiefly on Children; but spar’d none in any House they enter’d into” (151). By day 8, the spots cleared up, as was typical, but that is when the cough set in: “we are to observe, that at this Time the Fever, and Difficulty of Breathing are increased; and the Cough grown so cruelly troublesome, as to hinder Sleep Day and Night”. The cause of the children’s terrible coughs, Sydenham suggested, was poor management of the disease; they had “been kept too hot, and have taken hot Medicines, to drive, or keep out the Measles” (153). As we know now, complications are more likely to happen in people who have chronic conditions, the very young or elderly, and the malnourished.

So, how did Sydenham and Fuller treat measles? With “much the same Method of Cure with the Small-pox”. Not surprising, given that they were both classed as venomous diseases. Above all, “hot medicines and regimen are extreamly pernicious”. The patient should “eat no flesh”, only water-gruel, barley-broth and roasted apples (sometimes). To drink, the patient was allowed small beer or watered down milk. The patient was to remain in bed for two to three days during the eruption, so the morbose particles would leave through the skin (155-6).

The cough should be treated with a pectoral decoction, linctus and diacodium (poppy syrup): “Very rarely, if ever, will any one that useth this Method die”. If the cough continued, it could “bring great Danger”. Bleeding was the clear choice in that case. “I have (with great Success)”, Sydenham promised, “order’d even the youngest Infants to be let Blood in the Arm; and where the Case requir’d it, I have not fear’d to repeat the same.” This rescued “truly many Children that have been at Death’s Door”. As a bonus, bleeding treated the diarrhea by ridding the body of sharp humours (156-7).

No wonder measles was so feared, with Sydenham declaring that the pneumonia “is so fatal commonly after the Measles, that it may well be reckon’d the chief Minister of Death, destroying more than even the Small-Pox itself” (157). They didn’t know yet about the potential for brain damage or deafness! In the West, we’ve forgotten the real horror of epidemic diseases that killed children.

For some other historical discussions of measles, see The Wellcome Trust Blog on the development of vaccination programmes and Historiann on the early eighteenth-century treatments proposed by Cotton Mather.

On Asses’ Milk

Donkey, from Buffon, Histoire naturelle des mineraux, 1749-1804. Credit: Wellcome Library, London.

Donkey, from Buffon, Histoire naturelle des mineraux, 1749-1804. Credit: Wellcome Library, London.

It’s not often that I have an a-ha moment when reading a Daily Fail article. And it chokes me to even admit that I had one on Boxing Day as I perused “Could DONKEY MILK be the elixir of life?”.

The Sloane Letters have several references to eighteenth-century patients drinking asses’ milk. It was never held up as an elixir of life, but was thought to be particularly useful in treating lung ailments (as with the Viscount Lymington in 1722), blood problems (in the case of Catherine Henley) and emotional troubles (the Duchess of Beaufort’s hysteria in 1705). But one thing that always intrigued me was the lengths to which patients would go to get asses’ milk; why, I wondered, did it seem like such a faff to find a lactating donkey?

In 1723, Robert Holdwsorth reported that Lady Middleton had provided his wife with a goat and an ass so she could drink milk, as per Hans Sloane’s prescription. Mrs Holdsworth had stopped drinking the milk, though, as it disagreed with her. (A common complaint!) On its own, this might just seem like an act of kindness on Lady Middleton’s part—but it was likely darned helpful for the Holdsworths to have a friend in high places who could help in finding an ass.

The Duke of Bedford, for example, wanted to drink asses’ milk in 1724, as Sloane had recommended for an eye problem. Unfortunately, the Duke had been unable to procure an ass in the country and had needed to send to Streatham (another family holding) for one. As the letter was sent from his seat at Woburn Abbey in Bedfordshire and Streatham is over fifty miles away in Surrey, the ass came from quite a distance.

Asses suckling children.  From: Infant feeding by artificial means : a scientific and practical treatise on the dietetics of infancy By: S.H. Sadler. Credit" Wellcome Library, London.

Asses suckling children.
From: S.H. Sadler, Infant feeding by artificial means : a scientific and practical treatise on the dietetics of infancy, 1895.
Credit: Wellcome Library, London.

As Sally Osborn tells us at The Recipes Project, there are lots of eighteenth-century recipes for artificial asses’ milk. One version included snails boiled in milk with eringo root and brown sugar. Yum.

Donkey milk is good stuff, by several counts, being the closest in composition to human milk. Although early modern people wouldn’t have known these details, Sloane and other physicians prescribed it regularly and patients were often curious to try it. Mrs Reynolds wondered in 1725 whether Sloane might recommend that she try asses’ milk to help her general weakness. He did, as he scrawled “lact. asen.” on her letter.

It turns out that asses’ milk is still hard to get today. Across Europe, the average price is over £40 per litre. Female donkeys produce only a litre of milk per day for about half they ear and can only produce milk when its foal is nearby. Not the easiest of milk to acquire… The eighteenth-century demand, it seems, outstripped supply. No wonder patients struggled to find lactating asses and settled for unappealing substitutes!

The Twelve Days of Christmas

Inspired by the season, I started playing with my database of Hans Sloane’s correspondence to see how many items from The Twelve Days of Christmas to my wondering eyes should appear. Although some substitutions were required, all twelve days are represented—and, in turn, hint at the breadth of Sloane’s collections, medical practice and epistolary network.

Above, a partridge (perdix californica); below, a pigeon (columba cruenta). Engraving by Manceaux after E. Traviès. Credit: Wellcome Library, London.

Above, a partridge (perdix californica); below, a pigeon (columba cruenta). Engraving by Manceaux after E. Traviès. Credit: Wellcome Library, London.

On the first day of Christmas, my true love gave to me… an account of the King hunting partridge from 8 in the morning until four in the afternoon in August 1724. It is unspecified whether any partridge was also in a pear tree. In a stunning twist for the song, George was also hunting rabbits and the trip had to be cut short because of a storm. Safety—and partridges—first, everyone. In any case, the King and his party were very tired after such a long day.

For the second day of Christmas, I found no turtle doves, but there are pigeons. And they are just as good, maybe even better, since I’ve never heard of anyone eating dove. Thomas Hearne, in an undated letter, reported that he was coughing up blood and receiving medical help from the Duchess of Bedford. All he was able to eat was milk and pigeon. Not my usual choice of dinner, but to each one’s own.

For the third day of Christmas, I was unable to locate any foreign hens. There was, however, an odd pheasant hen sent by John Hadley in 1721. He thought that Sloane might enjoy dissecting the hen because her feathers had changed several years previously from the usual hen colours to that of a cockerel.

I hoped to find collie birds (blackbirds) or calling birds (song birds) for the fourth day of Christmas—and I found several of each in one letter! In 1721, Richard Richardson sent Sloane the eggs and nests of several types of birds, including larks, thrushes, crows and blackbirds. Thank you, Mr. Richardson for being so obliging.

Gold ring with container, supposedly--but unlikely--held poison. Swiss; undated, possibly 16th or 17th century. Credit: Wellcome Library, London.

Gold ring with container, supposedly–but unlikely–held poison. Swiss; undated, possibly 16th or 17th century. Credit: Wellcome Library, London.

But what about five gold rings? I happily settled for one with a fancy, though indecipherable, inscription from Charles Preston in 1699. One ring to rule them all?

The geese, laying or otherwise, posed the greatest trouble. Goose does come up in the database, but only as a description. Mark Catesby in 1724 compared another bird specimen to a goose in size and Emelyn Tanner in 1727 described a deformed baby as having down like a goose.

The only swans mentioned in the letters are pubs, though the drinkers may or may not have been swimming in their drink. For example, Richard Richardson (1729) referred to a carrier from Preston who would be staying at the Swan in Lad Lane, London. Or Antony Picenini stayed at the Swan Tavern in Chelsea, hoping that a change of air would benefit him while he recovered from (unspecified) surgery on his thigh.

There were some maids mentioned in relation to milk, but only one maid doing any milking—in this case, drinking milk rather than fetching it. In 1725, Matthew Combe was treating Sophia Howe, Maid of Honour to Queen Caroline, for a bad cough. The patient had been drinking asses’ milk, commonly given to people suffering from chest troubles.

Akan drum owned by Sloane and acquired beyween 1710 and 1745. Made in West Africa and collected from Virginia. Credit: British Museum, London.

Akan drum owned by Sloane and acquired beyween 1710 and 1745. Made in West Africa and collected from Virginia. Credit: British Museum, London.

Although there were no drummers drumming, there is at least a drum. In 1729, Elizabeth Standish of Peterborough was planning to send Sloane “a Negro drum”. No other details were given, such as where the drum came from or how Mrs Standish had acquired it. Could this be the same Akan drum still held at the British Museum?

Travelling smoking set, Europe, 1815-1820. Credit: Science Museum, London, Wellcome Images.

Travelling smoking set, Europe, 1815-1820. Credit: Science Museum, London, Wellcome Images.

There is only one reference to a piper actually piping. In 1723, Timothy Lovett reported that he had been treating his long-standing phlegmatic cough (forty years) by smoking a pipe: “I have used my selfe to smoking several years about 5 pipes a day but it is ready to make me short breathed. I find it opens and loosens ye body.” Smoking as a cure… it worked until it didn’t, apparently.

Now, the Lords and Ladies were apparently too dignified to mention their leaps and dances to Sloane, but the subject of their exercise does occasionally come up. I offer you one Lord, the Earl of Derby, and one Lady, Lady Clapham. Derby suffered from swelling and bad breathing in 1702. He was “most pusled what to do about exercise, which is so necessary, but the least causes my legs to swell so”. Lady Clapham was also ill in 1702 and her regular physician despaired of the elderly woman’s skin disorder, hard swellings all over her body. He wasn’t sure if “the cause of this disease may proceed from a great stomach & little exercise or a great surfeit of cherries in London”. Tough one…

St. Giles is in the background of Hogarth's "Noon", from Four Times of Day (1736).

St. Giles is in the background of Hogarth’s “Noon”, from Four Times of Day (1736).

Since I clumped Lords and Ladies together, I’ll end with an 1842 version of Twelve Days which has twelve bells ringing.  After Sloane was elected President of the Royal Society in 1727, the bell-ringers of St. Giles-in-the-Fields honoured him by ringing the bells. St. Giles only has eight bells today and, in 1727, would only have had four bells. But no matter, it’s the thought that counts and a four-bell honour is pretty darned fine!

And on that (ahem) note, I wish a Merry Christmas to all.

Strange Pigs

There are strange pig tails in the midnight sun
From men who moil for hog’s stones
The science trails have their secret tales
That would make monstrous piglets groan;
The English nights have seen queer sights
But the queerest they ever did see
Was that marge on the note of Stephen Gray
Concerned with porcine impersonation.(1)

Pig tales occasionally show up in the Sloane Correspondence, and they are inevitably crackling good fun. But what do pigs have to do with the history of science? A while back, Samantha Sandassie (@medhistorian) wrote a fascinating post on the role of pigs in early modern medical history: besides providing a useful addition to one’s diet, pigs were often the subject of wondrous stories. By the eighteenth century, they were also the subject of Royal Society interests: classifying strange objects from animal bodies, understanding the development of fetal deformities, and analysing the composition of food stuffs.

John Morton, a naturalist who described fossils and wrote The Natural History of Northamptonshire, wrote to Hans Sloane about an extraordinary hog’s stone in April 1703. Morton thanked Sloane for his friendship and promised his service in return; this included sharing his work in progress on fossils. The description of the hog’s stone was, presumably, a taster for Sloane, but Morton also mentioned the possibility of sending it as a gift to the Royal Society. Sloane’s patronage was desirable, but even more so was attracting the interest of the Royal Society, and Morton was successful in both.

On the 30th of November 1703, Morton—nominated by Sloane’s rival, John Woodward—was accepted as a Fellow of the Royal Society. By June 1704, Morton had gifted the stone to the Royal Society after they had favourably received his account of it. A seemingly small offering, perhaps, but one that helped to establish a correspondence that continued for over a decade.

Sloane’s family members also sent him objects of interest. On Sloane’s birthday in 1711, his stepson-in-law John Fuller sent “a Couple of Monstrous Piggs, one of them was farrowed alive the other dead, the sow had six Piggs beside, all of them as they should be”. A quick perusal of the Philosophical Transactions of the Royal Society reveals that monsters remained a source of fascination to the Society throughout the eighteenth century.

Disability and deformity were frequently explained in terms of the influence of maternal imagination: that the pregnant woman either had cravings or had been subjected to extreme emotions, either of which could shape an unborn child. (See, for example, Philip Wilson’s article on maternal imagination and disability.) Fuller’s piglets would have been especially intriguing, given that only two of the sow’s litter had been monstrous. What might the study of deformity in animals mean for the medical understanding of human reproduction? And why, moreover, were traits only passed on to some offspring? Food for thought: a fine gift, indeed, for Sloane!

But the strangest pig tale in the correspondence is from Stephen Gray, who was better known for his work on electricity than porcine expertise. Even so, in the summer of 1700, Sloane requested that Gray send further details about the fat of some pork that he had sent to the Royal Society. Gray denied all knowledge of the pork sample, insisting that either someone had the same name or was impersonating him. A fairly random occurrence that raises so many tantalizing questions: was there another Stephen Gray who was a pork expert? Was this a practical joke? And if so, was it intended for the Society or Gray? And what was its point? In any case, the Society clearly wanted to find out more about the chemical composition of pigs.

These three little pig gifts may seem like small tokens, but reflect the roles of patronage, reputation and curiosity in early eighteenth-century medical and scientific knowledge. Now, if only the joke or insult behind Gray’s impersonation could be deciphered: any thoughts?

[1] With apologies to Robert Service and my father, whose favourite poem is Service’s The Cremation of Sam McGee. I’d started this post in time for Father’s Day post, but was otherwise occupied at the time and unable to finish it.

Image: Eight pigs on a meadow near a wallow with a thatched barn in the background. After E. Crété after W. Kuhnert. Credit: Wellcome Library, London.

Bethlem Bed Shortages in the Eighteenth Century

I just read an excellent post by Jennifer Evans (@historianjen) over at earlymodernmedicine on a sad case of madness from Hans Sloane’s correspondence. Go read the post in full, but to sum it up: over several months in 1714, the Earl of Derby was attempting to care for John Getting, who was in clearly declining mental health. The Earl wondered about the possibility of committing Getting to Bethlem, as the case had become too difficult to manage. Although the outcome can’t be traced, Evans wonders if Getting was admitted to Bethlem Hospital (also known as Bethlehem or Bedlam).

Maybe. Getting doesn’t appear in the letters again–but being admitted to Bethlem was not easy, nor did it provide long-term care.

We regularly complain about hospital bed shortages, but the situation was even more complicated in the eighteenth century! Mental health care primarily occurred in the home, although Bethlem Hospital and private care were an option for more difficult cases. There were few charitable hospitals overall and a chronic shortage of space. The early eighteenth-century Bethlem, for example, had only just over 100 places.[1] (The population of London in 1715 was around 630,000, but to make matters more complicated, Bethlem patients like Getting might come from outside of London.)

The Hospital of Bethlem [Bedlam] at Moorfields, London: seen from the south, with three people in the foreground. Etching by J. T. Smith after himself, 1814. Image Credit: Wellcome Library, London.

The Hospital of Bethlem [Bedlam] at Moorfields, London: seen from the south, with three people in the foreground. Etching by J. T. Smith after himself, 1814. Image Credit: Wellcome Library, London.

Bethlem was able to remain a charitable hospital largely through its fundraising: it doubled as a tourist attraction for rich and poor alike, with visitors expected to leave donations. Frenchman Cesar de Saussure, for example, described his tour of Bethlem. On the first floor, visitors could look in the little windows of cells at “these poor creatures” or, in the big gallery, pass by the “many inoffensive madmen” allowed to walk around. Cells on the second floor held “dangerous maniacs, most of them being chained and terrible to behold”. The building may have been grand, but it was a “melancholy abode”.

Patients being assessed could stay at Bethlem, but that did not always result in admission, as this fascinating case from Bethlem Blog suggests. Admission into most early eighteenth-century English hospitals was granted through patronage or—in the case of the Foundling Hospital (founded 1741)—by lottery. As a physician for Christ’s Hospital (1694-1730) and on the Board of Governors for St. Bartholomew’s, Sloane was frequently asked for assistance in obtaining admission for patients. But as the post on Getting reveals, admission to Bethlem could be helped by a charitable donation—and, perhaps, the assistance of important patrons like Sloane and Derby.

Another case from the Sloane correspondence, however, suggests the difficulty of finding long-term care for those in dire need. Ambrose Godfrey, a chemist well-known to Sloane for his analysis of the properties of stones and waters, wrote a distressed letter to Sloane in July 1724 on behalf of Mr. Steiger (an engraver).

Godfrey had known Mrs. Steiger and her brother well for nearly forty years, but the brother “had lost his understanding” and the family hoped to have him admitted to Bethlem. The Bethlem physician, however, “refuses it, alledging that there is no roome”. Godfrey hoped that a letter from Sloane might help. The situation was, indeed, dire.

He has been already been ones before in Bedlem & was sent out as cured. But being now as bad as ever & Threatning to stab them, haveing done already very dangerous things, it would be great charity good S’r if you could be instrumentall to get him in again, the dangerous prancks he has played will else be the ruin of my friend who has already the Burthen & care of 3 of this mad mans children upon his back.

It’s clear that in helping the Steiger family, Godfrey was asking Sloane for a very personal favour: “I am deeply concerned for them”, he wrote, and “it would be as much satisfaction to me see their request fulefilled, as if they ware relations of my own”. In the event that personal recommendation was insufficient, Godfrey also pointed out the brother’s good reputation. He had “ben a man of much credit & served all the offices in ye parish of Gracion’s street”.

Statues of "raving" and "melancholy" madness, each reclining on one half of a broken segmental pediment, formerly crowning the gates at Bethlem [Bedlam] Hospital. Engraving by C. Warren, 1808, after C. Cibber, 1680. Image Credit: Wellcome Library, London.

Statues of “raving” and “melancholy” madness, each reclining on one half of a broken segmental pediment, formerly crowning the gates at Bethlem [Bedlam] Hospital. Engraving by C. Warren, 1808, after C. Cibber, 1680. Image Credit: Wellcome Library, London.

So why the stickiness over admissions and the insistence in discharging an obviously ill patient? A charitable hospital like Bethlem needed to show that it was successful in curing people in order to attract patronage. To that end, according to Bethlem Blog, those patients accepted into Bethlem were most likely to be easily treatable within a year or two. It was not until the late 1720s that Bethlem opened an “incurable” ward—and that was only available to patients already in the hospital. After a year of treatment and assessment, severely ill patients might be transferred to the ward.

Might. The waiting list to enter the ward was long.

It’s hard to say what happened to either Getting or Mrs. Steiger’s brother, but their sad cases predated the incurable ward. At best, if the men were admitted to Bethlem, the Steiger family and Earl of Derby might have had a couple years respite; in the brother’s case, this might even have coincided with the opening of the new ward. At worst? Well, the Earl had the inclination, money and assistance to continue helping Getting. As for the Steiger family, however, I dread to think. Mrs Steiger’s brother was a danger to the family: the costs of caregiving for a family could be high, indeed.

[1] Christine Stevenson, “Robert Hooke’s Bethlem”, Journal of the Society of Architectural Historians 55, 3 (1996): 254–275.

Looking after your family until the end: the cost of caregiving in historical perspective

A very old man, suffering from senility. Colour stipple engraving by W. Bromley, 1799, after T. Stothard. Image credit: Wellcome Library, London.

A very old man, suffering from senility. Colour stipple engraving by W. Bromley, 1799, after T. Stothard. Image credit: Wellcome Library, London.

Another day, another governmental exhortation that families just aren’t doing enough to keep society going… This time, it is Simon Hughes (the UK coalition’s justice minister) who suggested that British people had lost a sense of duty to care and were neglecting the elderly. Caregivers regularly bear the brunt of governmental disparagement, especially at a time when an ageing population puts increasing stress on limited resources. The solution, Hughes proposes, is that we look to immigrant cultures who understand the necessity of sacrifice for the good of elderly family members.

Gee, that’ll do the trick… (There’s a thorough dissection of Hughes’ statements  over at (Dementia Just Ain’t) Sexy.) But what I want to discuss here is the problematic view of the past underpinning Hughes’ assertions. He ignores the daily experience of modern caregivers and instead assumes that British family responsibility was much more important back in the halcyon olden days.

Let me introduce you to the Meure family in the early eighteenth century, whose case suggests the high costs of caregiving at a time when there were no other options. The Meures were naturalized Huguenot immigrants who had moved to London shortly after Louix XIV had revoked the Edict of Nantes in France. The family’s immigrant status is worth noting, given that the myth of dutiful families relies on the belief that they remained in one place.

The location of the French Academy, where a different sort of dancing now takes place. Image source: my own photograph.

The location of the French Academy, where a different sort of dancing now takes place. Image source: my own photograph.

Abraham Meure (senior, hereafter “Meure”) established a boarding school for French Protestants in Soho, but the school—which taught fencing, dancing, drawing and languages—quickly attracted of the English nobility. Times must have been good for the family, as Abraham Meure (junior, hereafter “Abraham”) styled himself as “Gent.” when he married Elizabeth Newdigate in 1707.

Somewhere around 1708, Meure’s son-in-law Moses Pujolas wrote to Hans Sloane. Sloane had previously acted as a legal witness on behalf of Meure who suffered from dementia and senility. The father’s need for care was not disputed within the family; rather, this was a matter of ensuring that Abraham could take over his father’s interests. Unsatisfied with the facts of the case, the jury at the Court of Chancery wanted Meure to attend court. Moses worried that ‘he isn’t in a fit state to conduct himself without embarrassment’ and hoped that Sloane would attest to treating Meure’s senility over time.[1] The family appears to have been protecting Meure by preserving his dignity. The Court treated the debility as temporary, but then removing Meure’s power irrevocably wasn’t the family’s goal, either. The Meures delayed three more years before seeking a permanent ruling.

Meure’s last will dates from 1703 and was proven in 1716.[2] Although it’s hard to know when exactly Meure’s dementia began, the will makes it clear that his daughter Magdalene Pujolas and her family were living with him. According to the will, Abraham received the bulk of his father’s estate, but was to pay Moses £500 as specified in the marriage articles and, within six months of Meure’s death, Magdalene would receive a further £500. Meure declared:

Further, I give my daughter Magdalen Pujolas her board for all the time she lived with me since her marriage, and for three months after my decease, as alsoe the Board of her Husband Moses Pujolas his Children, and servants, and I doe prohibite my Eldest son or his Executors ever to make any demand thereon upon any amount whatever.

In addition, Moses could take back everything in his two furnished chambers and any Pujolas possessions elsewhere in the household. There were bequests to other family members: Robert Pujolas (Magdalene’s son), £500; Andrew Meure (son), £450; and Magdalin Meure (Andrew’s daughter), £100. The particularly generous bequests to the Pujolas family hints that Meure expected them to remain with him indefinitely and that they may already have been providing him with domestic assistance. The Meure family was not wealthy, although the school provided a sufficiently comfortable living to remunerate the Pujolas family for their long-term assistance.

The evidence is, admittedly, patchy. No family records or other letters to Sloane refer to Meure’s deteriorating state, though Moses’ reference to Meure’s likely embarrassment in court suggests that he was in a bad state a mere five years after writing the will. It must have been agonizing for those closest to him who continued to care for him until his death circa 1714, which was when Abraham took over as ratepayer for the property.

Moses and Abraham for many years had a friendly relationship. For example, Moses was Abraham’s guarantor in his marriage settlement of 1707. Not long after Meure died, there were growing tensions within the family. And it is these letters that suggest what the real cost of long-term caregiving was for Magdalene.

In 1719, Abraham wrote to Sloane to question Moses’ treatment of his sister:

I beg the favour of you to lett me know when you saw my sister Pujolas last, and how you found her, her husband saith that he locked her up by your advice.

Sloane replied that he had not treated Mrs Pujolas for several years, but had looked into the matter for Abraham. Magdalene had, apparently, ruined her health, by ‘coveting and drinking large quantities of hott liquors’.

The case must have been severe. Sloane was concerned enough to advise Moses to consult a lawyer about locking Magdalene up in order to limit the quantities of alcohol that she consumed.

Coincidence?

[1] British Library, Sloane MS 4060, ff. 142-3. Pujolas thanked Sloane for an affidavit in BL MS 4060, f. 141,

[2] London Metropolitan Archives, PROB 11: Will Registers – 1713-1722 – piece 554: Fox, Quire Numbers 173-208 (1716), Will of Abraham Meure.