Category: History of Medicine

The Sir Hans Sloane Birthday Collection: Giants’ Shoulders #70

Posted on April 16, 2014 by - Blog Round-up, History of Medicine, History of Science

Sir Hans Sloane, collector and physician, was born on 16 April 1660. To celebrate his 354th birthday, I’m hosting the history of science carnival: Giants’ Shoulders #70. Sloane collected stuff of all kinds, from curiosities (natural and man-made) and botanical samples to manuscripts. He was very thorough… So what does one give the man who had (nearly) everything for his birthday? The gift of knowledge! Hosting Giants’ Shoulders follows–in a small way—in the footsteps of Sloane, who edited the Philosophical Transactions of the Royal Society for two decades.

Newspaper recipes pasted into a manuscript recipe book. Wellcome, WMS 7366, p. 78. Image Credit: Wellcome Library, London.

Newspaper recipes pasted into a manuscript recipe book.
Wellcome, WMS 7366, p. 78. Image Credit: Wellcome Library, London.

Being a physician was central to Sloane’s identity, so it’s fitting to start off with a round-up of history of medicine links. I must, of course, include a painful seventeenth-century medical case: that of “Samuel’s Stone-induced suffering”. Sloane, like many other eighteenth-century physicians, was no stranger to proprietary remedies; he even had his own special eye remedy. This month, we have “Proprietary Panaceas and Not-So-Secret Recipes”, “Newspaper Remedies and Commercial Medicine in Eighteenth-Century Recipe Books” and “The Business of Medicine”. Sloane was particularly interested in finding useful remedies and would, no doubt, have approved of our modern interest in reviving old treatments or exploring non-Western ones (“Under the Influence”). He was equally intrigued by indigenous knowledge (as was “A Pirate Surgeon in Panama) and older popular treatments (as was Thomas Scattergood in the early nineteenth century, here and here).

As President of the Royal College of Physicians from 1719, Sloane also would have been familiar with medical disputes and prosecutions against irregular practitioners, such as “Master Docturdo and Fartado: Libellous Doctors in Early Modern Britain”. A post on “The Return of Nicholas Culpeper” finds the traces of Culpeper’s career around London. I’ve often wondered whether Sloane would simply have seen Culpeper as an irregular practitioner, or appreciated what they had in common–botanical interests and willingness to treat the poor.

Photograph of a telescope that belonged to Caroline Herschel. Image Credit: Geni, 2008, Wikimedia Commons.

Photograph of a telescope that belonged to Caroline Herschel. Image Credit: Geni, 2008, Wikimedia Commons.

A driving factor in Sloane’s career was his insatiable curiosity. A teacher tells us why the history of science “is essential to engage students”, while “Hydra meets Handel” shows children participating in early modern science by gathering “duck pond detritus”. Sloane also encouraged curiosity in others, including women; for only two examples, he exchanged letters and botanical samples with the Duchess of Beaufort and Cassandra Willughby. There were lots of early modern women who practiced science—and this month, there were posts on Margaret Cavendish, Emilie du Chatelet and Caroline Herschel. Women could also be important patrons of science, such as Angela Burdett-Coutts. (Sloane certainly benefited from the patronage of women early in his medical career, particularly that of the Duchess of Albemarle.)

In his botanical research, Sloane catalogued and classified his specimens. Language was increasingly important in describing experiments and specimens, and was being developed and refined out of necessity. Robert Hooke, for example, coined sixty-eight words including (my favourites) “splatch” and “punk”. Over at Evolving Thoughts, a series on speciation outlines the origins of “speciation”, Linneaus’ contribution and late eighteenth-century developments. There are lots of posts this month about curiosities that might have appealed to Sloane, which I’ve divided into man-made and beautiful objects. Under man-made (and sometimes horrifying) objects, we have Holler’s copper plate, Dead Men’s Teeth (a.k.a. dentures), a Time-Traveling, Vote-Gathering Miraculous Acousticon, Brunel’s Atmospheric Railway and the plutonium box. Under beautiful objects, we have the Salagrama Stones, the Vessels of Hermes, a triangular book about alchemy, Nathaniel Wallich’s specimens, and a colourful atlas.

T. Rowlandson, 1787. A fashionable dentist's practice: healthy teeth are being extracted from poor children to create dentures for the wealthy. Image Credit: Wellcome Library, London.

T. Rowlandson, 1787. A fashionable dentist’s practice: healthy teeth are being extracted from poor children to create dentures for the wealthy. Image Credit: Wellcome Library, London.

One of the reasons that Sloane was so well-known for his botanical expertise is that he had actually travelled to Jamaica early in his career, gathered local knowledge and tried out local remedies. On behalf of the Royal Society, he also requested that some explorers bring back specific items or look into particular issues. In 1700, Edmond Halley returned to St. Helena and reported on the area. Halley’s travel descriptions weren’t intended for the Royal Society, but his travels would certainly have been of interest. Explorers have also been the mappers of new and old areas. There is a series of posts on “A Concise History of Geological Maps”, which highlights the many uses of mapping beyond the geographical (2, 3 and 4). The newest areas are sometimes very far away, such as Martian canals or the centre of the Earth. Getting to some places might have been impossible in the nineteenth and early twentieth centuries, though astronomical photography might help to span the distance. But in the end, the question remains: we can take humans out of their usual lands, but can we take the terrestriality out of the humans?

Experimentation, itself a way of exploring the universe, became increasingly important from the early eighteenth century. This month, I read about Isaac Newton’s experiments as instances of special power, the most famous failed science experiment, the lack of religious barriers to the practice of early modern science, experimental self-asphyxiation and experimental embryology in China. The secrets of the universe, however, are often invisible to the naked eye—perhaps more so than early eighteenth-century people even would have guessed. What about trying to study “the unfashionable ether”, magnetism and light rays, quantum physics… or medieval multiverses and modern cosmic conundrums? And that’s before we even get to time! Sloane would have been familiar with the attempts to measure time and longitude, but less so the pervasiveness of modern standardised time, the ancient methods of measuring the movements of the sun or a twentieth-century physicist’s obsession with time and existence.

Sloane would have been no stranger to scientific disputes (especially since he sometimes played mediator). Recently, there has been much lively discussion among historians of scientists about the T.V. series Cosmos. By and large, historians of science have been highly critical of the choices made: the focus on Giordano Bruno, the inaccuracies in the story of Bruno, frustrating omissions and outright misrepresentations. Other historians were a bit more sympathetic, with suggestions that historians of science need to tell more compelling stories and that we need to provide better alternatives to the Cosmos style of history.

Pieter Bruegel the Elder, Hunters in the Snow (Winter), 1565. Source: Wikimedia Commons, from Kunsthistoriches Museum.

Pieter Bruegel the Elder, Hunters in the Snow (Winter), 1565. Source: Wikimedia Commons, from Kunsthistoriches Museum.

To end the Sloane birthday edition, I offer some book reviews. Sloane, of course, was constantly adding to his library, as do most historians. You might be interested in acquiring Everyday Renaissance Astrology, The Book of Trees, Ice Time (especially for those of us suffering from this never-ending winter in North America), or Books and Readers at the Dawn of the Victorian Age.

Happy reading! See you next month over at The Renaissance Mathematicus, where Thony Christie will be hosting Giants’ Shoulders #71. His contact details are here, if you want to start sending in nominations for May.

An Eighteenth-Century Case of Cotard Delusion?

Posted on March 3, 2014 by - Early Modern History, History of Medicine, Patients, Religion

Recently, I found myself doing a little seat dance in the British Library when I came across a fascinating series of letters (Sloane MS 4076) from 1715, written by apothecary William Lilly about the Countess of Suffolk, Henrietta Howard. Historians of medicine, of course, are generally loathe to engage in retrodiagnosis, but sometimes it’s just too tempting… What Lilly seemed to be describing was a case of Cotard Delusion!

Cotard Delusion, or Walking Corpse Syndrome, was first described as a cluster of symptoms by Jules Cotard in the 1880s. The symptoms include insensitivity to physical pain, a preoccupation with guilt and despair, and the belief that one is already dead, damned or possessed (or, conversely, immortal). Cotard was not the first to observe this sort of case, but he categorised it as a syndrome: hypochrondriac delusion and anxious melancholy, or lypemania—drawing on an earlier classification from Jean-Étienne Dominique Esquirol (1772-1840).

The corpse of a lady wearing a ruff and an elaborate head-dress. Credit: Wellcome Library, London.

The corpse of a lady wearing a ruff and an elaborate head-dress.
Credit: Wellcome Library, London.

According to modern studies, Cotard Delusion starts off with a sense of general anxiety that could last weeks or years, but increases over time until the patient believes s/he is dead and is preoccupied with guilt and despair. Sometimes this is accompanied by muteness or paralysis. In some cases, the disorder might be accompanied by physical problems, such as a brain tumour or injury, multiple sclerosis, or Parkinson’s disease.

So what were Lady Suffolk’s symptoms? In a letter dated 20 July (ff. 7-8), Lilly noted that Lady Suffolk was taking little rest, but

“when she waked from her slumber call’d out in a frightfull manner for half an hour that she was deceased and a great deal of such Language”.

Once this “raveing fitt” ended, she became profoundly drowsy and “lay still without any motion”. She needed help with the bedpan, even “though she walk’d severall turns in her Bed Chamber yesterday”. Lilly bled her nine or ten ounces, which he hoped would prevent worse lethargy. Lady Suffolk’s blood was viscous and sizy. Lilly thought it suggested, along with her stopped urine, a “phrenites [acute inflammation of the mind and body] with the Mania”. Lilly also applied blisters on her legs to draw the bad humour down and out, laid pigeons to her feet (sometimes used to treat headaches and migraines) and shaved her head to relieve the excess heat in the head.

Four days later, Lilly had administered Sloane’s prescriptions “without the desired effect” (f. 9). Lady Suffolk no longer had a fever, but her other symptoms continued and she was drowsy, “which made me fear her turning lethargical or some other distemper on her Braine which I perceved to be already affected”. Lilly gave Lady Suffolk a glister, inducing her to flow in several ways. She produced a large stool and plenty of urine and spoke more than she had in two days.

On 26 July, Lilly reported that Lady Suffolk had vomited phlegm and choler, as well as had three stools. She could walk around her chamber, but “still continues very melancholy and silent and seldom speaks without being importuned to it”. Lilly was deeply worried. He hoped that Lord Suffolk would take his wife to London “where you may see her oftener”, as her “present indisposition will not quickly be removed”. Lilly again suggested that it might be an affectio hypochondrica [melancholy] or mania, and provided details about Lady Suffolk’s conversation:

“for what she sayes is that she is undone in soul and body that she is sure she will be damned at other times when I urge her to speaks she tells me she is dead and has been so for some time”.

After M. de Vos, A woman beleaguered by demons, death and deceiving angels; representing faith resisting the evils of the world. Source: Wellcome Library, London.

After M. de Vos, A woman beleaguered by demons, death and deceiving angels; representing faith resisting the evils of the world. Source: Wellcome Library, London.

In an undated letter that seems to come at this point in the series (ff. 12-13), Lilly listed Lady Suffolk’s symptoms as diarrhoea, fever and head pain and insisted again that the disorder was hysterical, not feverish. Given Lilly’s repeated attempts to persuade Sloane that the real problem was hysterical, it’s not clear that Sloane initially trusted Lilly’s diagnosis.

But by late July, Sloane had started prescribing anti-hysterical medications, including cordials and drops (29 July, ff. 10-11). Even so, Lady Suffolk “is more than usually melancholy” and complained of heart palpitations and swimming in the head: more symptoms of hysteria. Since Lady Suffolk’s fever had not returned, Lilly hoped that the danger had passed.

This sort of delusion was distressing to observers, including Lilly who was uncertain of his ability to help, but Lady Suffolk’s disorder was readily classified as hysteria or hypochondria—ailments that were as much physical as mental. The diagnosis and treatment for Lady Suffolk was humoral in nature, treating her emotions as fluids and using remedies to make her body and mind flow.

Although retrodiagnosis is tempting in Lady Suffolk’s case, eighteenth-century medicine already had a place for her religious delusions. Robert Burton, for example, included a lengthy section on religious melancholy in his famous Anatomy of Melancholy  (1621). Eighteenth-century books on hypochondria also emphasised the often religious nature of sufferers’ fears, such as despair and damnation, especially in women (e.g. Nicholas Robinson, A New System of the Spleen, Vapours, and Hypochondriack Melancholy, 1729).

Retrodiagnosis is unhelpful in another way. Lady Suffolk was ill with problems besides the delusion, which had even lessened toward the end. In particular, Lady Suffolk’s ailments progressed rapidly in less than a month.

Lady Suffolk never made it to London to see Sloane in person. The danger had not passed: she died on the 10th of August.

 

References
G.E. Berrios & R. Luque, “Cotard’s Delusion or Syndrome?: A Conceptual History”, Comprehensive Psychiatry 36, 3 (1995): 218-223.

Hans Debuyne, Michale Portzky, Frédérique Van den Eynde, Kurt Audenaert, “Cotard’s Syndrome: A Review”, Current Psychiatry Reports 11, 3 (2009): 197-202.

An Eighteenth-Century Love Story

Posted on February 13, 2014 by - Early Modern History, Gender History, Hans Sloane, History of Medicine, Patients

The Newdigate family became Hans Sloane’s patients around 1701, starting with Lady Frances Sedley (née Newdigate), her husband, and father-in-law. By 1705-6, Sloane was treating Elizabeth Newdigate (b. 1682) for colic, hysteria and fever (BL Sl. MS 4076, 1 July 1705, f. 173; 4077, 21 December 1706, f. 164). But Elizabeth’s complaints went far beyond the medical.

A letter of 1 November 1706 detailed her illness, penury, and unhappy family situation. Specifically, she blamed the “distruction of my health if not to the loss of life” on her brother and sisters who were “miserably unkind” to her. This was partly financial, as her brother Dick

wou’d not help me to one peny of money when I was sick in London but forsed me to borow of strangers.

Dick had apparently even written to “all my Relations [that] I unjustly demanded mony of him when he was not in my debt”.

But the siblings were being unreasonable in another way, too. They had dismissed her illness, telling everyone “that I was distracted and had no illness but that of being in love”. She swore innocence in the matter, insisting that she had not even really spoken to the man.

Theodore Lane, A young woman escapes down a rope of sheets, intending to elope with her lover, n.d. Credit: Wellcome Library, London.

Theodore Lane, A young woman escapes down a rope of sheets, intending to elope with her lover, n.d. Credit: Wellcome Library, London.

Of course, she must have done… or perhaps her siblings had put the idea of an unsuitable match into head. A year later, she married Abraham Meure, the son of a Huguenot schoolmaster–self-styled a “Gent.” in the marriage contract of 3 September 1707 (Warwickshire County Record Office, CR 136 C2734).

For a woman from a good gentry family, this was a bad choice of husband. A torn-out page from the family Bible makes clear that Elizabeth had “married herself” (WCRO, CR 136/B830). Her father made the point again in the marriage settlement, promising “That for and notwithstanding the consent and good likeing of the said Sr Richard Newdigate is not obtained”, he would still pay her portion. Abraham, nonetheless, does appear to have been a man of some means. Not only did he renounce his claim on and interest in Elizabeth’s portion, “out of the great love and affection” he had for her, but he would provide an annuity of £300.

Elizabeth’s letter reads like a cry for pity.  Perhaps, by playing upon her defenselessness, she hoped to persuade Sloane to mediate on her behalf. Given her eventual success in marrying Abraham, it is entirely possible that Sloane did help. Sloane certainly continued on as physician to the Newdigate and Meure families. And over time, Abraham became a close member of the family, helping his brother-in-law William Stephens during financial difficulties.

Unfortunately, Elizabeth and Abraham’s match was short-lived. Elizabeth died on 9 July 1710, just two weeks after giving birth to their son John.

The Problem of Mad Dogs in the Eighteenth Century

Posted on January 27, 2014 by - Early Modern History, Environment History, Hans Sloane, History of Medicine, Philosophical Transactions

Surgeon John Burnet shared “a very strange account” with Sir Hans Sloane in March 1720. The tale, sent to the French Académie des Sciences, had come straight from the Czar of Muscovy (Peter the Great) himself. Apparently,

a Man was bitt by a Mad-dog & that he lay with his wife the same night & after three fitts dyed, but that his wife was brought to bed nine weeks afterwards of five puppies.

Curious, indeed. Did this mean that rabies (or hydrophobia, as it was called) might be spread like a venereal disease? Or that the dog-bite had transmitted canine qualities into the infected man, which he then passed on to his offspring? Burnet was sceptical about account, noting “how far this is true, I know not”, but similar stories could be found in the Philosophical Transactions.

Rabies: Slaying a mad dog. From Dioscordes, Acera de la materia medicinal y de los venenos, 1556. Credit: Wellcome Library, London.

Physician Martin Lister, for example, wrote “An Observation of Two Boys Bit by a Mad Dog” (1698). Back in 1679, two boys aged nine and ten washed the head wounds of a dog that had been bitten by a mad dog. The injured dog was saved, but several months later, the boys became ill with stomach pains and convulsions.

What suggested a diagnosis of hydrophobia was that, by August 1680, the boys feared the water and had become, well, a bit dog-like. They regularly went into simultaneous fits that would last an hour, during which time “the Eldest especially, snarled, barked and endeavoured to bite like a Dog”. By September, “they became more wild” and, even after the fits had passed, could not endure the company of people. They had become more animal than human. The case seemed dire, but the boys were on the mend by the end of September.

Clergyman and antiquary, Abraham de la Pryme, wrote to Sloane in 1702 about a 1695 case from his brother’s household (see also Phil. Trans. 23, 1702-3). De la Pryme noted the regularity of timing in several cases, but was particularly intrigued by the way that tiny “Particles of this Poyson” could spread to infect a “mass of particles millions of times bigger”.

This case started with a “pretty grey-hound Bitch that had Whelps” being bitten by a mad dog. Three weeks later, the greyhound also went mad and had to be put down. The puppies appeared well and were looked after, but (again) three weeks later, “all pull’d out one anothers throats except one”. This one continued to eat, but would drink no liquid. Two servants caring for the puppy stuck their fingers into its mouth to check for a blockage, but there was none. The puppy soon went mad.

Three weeks later, both servants became ill. One, “a most strong and laborious Man”, managed to sweat off his symptoms: acute headache, tightened throat and red eyes (which makes me think of Black Shuck’s fiery eyes). But the fourteen-year old apprentice was much sicker. He became so savage that it took four adult men to hold him down

and all his discourse was of fighting, and how if that they would but let him alone, he would leap upon them, and bite, and tear them to pieces.

He soon lost his ability to speak altogether (one of the marks of humanity), then died.

The economic problem of the disease was obvious, as it could easily spread to livestock. In George Dampier’s recipe for rabies (published in the Phil. Trans.), Dampier reported that his remedy “did [his neighbours] a Hundred Pound’s Worth of Good” during a local outbreak when it saved their cattle.

But the social consequences of transmission was even more worrying. Rabies was, after all, considered a type of poison (see here and here), but so too was venereal disease, which could also be passed to one’s offspring. The real fear? That the mad animal’s qualities might be passed on to the human—or, worse yet, the victim’s children.

As De la Pryme concluded in his account, it was a pity “that the most Noble of creatures lyes at the Mercy of the most ignoble of particles”, but a wonder “that a few Atoms should be able to destroy a whole world”.

Recording Dr. Sloane’s Medical Advice

Posted on January 9, 2014 by - Collecting, Early Modern History, Hans Sloane, History of Medicine, Patients, Remedies

Sir Hans Sloane might have collected recipe books in search of knowledge, but patients in turn might record his medical advice for later reference. The Arscott Family’s book of “Physical Receipts”, c. 1730-1776 (Wellcome Library, London, MS 981), for example, contains three recipes attributed to Sloane, which provides snippets of information about his medical practice.

Although Sloane was best known for his botanical expertise and promotion of treatments such as Peruvian Bark or chocolate, the Arscott family recipes show a mixture of chemical, animal and herbal remedies. The treatment for worms (f. 129), for example, combined a mixture of elixir proprietatis and spirit. salis dulcis in either white wine or tea. Together, these aimed to sweeten the blood, strengthen the nerves and fortify the stomach.

A woman is carrying a tray with a cup of chocolate [or maybe the pleurisy remedy?] and a glass on it. Credit: Wellcome Library, London.

A woman is carrying a tray with a cup of chocolate [or maybe the pleurisy remedy?] and a glass on it. Credit: Wellcome Library, London.

The pleurisy remedy (f. 156) included pennyroyal water, white wine and “2 small Balls of a sound stone horse”—or, dung from a horse that still had its testicles. This was to be steeped for an hour, then strained. (Apparently this weakened the taste of the dung.) This delicious liquor would keep for three days. Are you tempted? Because the dose was a “large Chocolate Dish fasting in the morning and at 4 in the Afternoon”. “If the Stomach will bear it” (and whose wouldn’t?), the patient was to take the remedy for four to six days in a row. In this remedy, the dung was the most powerful ingredient, as it was considered a sudorific (causing sweat) and resolvent (reducing inflammation) that would aid asthma, colic, inflamed lungs, and pleurisies.

Sloane, of course, was also famed for his eye remedy, which he made public knowledge in 1745 when he published An Account of a most efficacious medicine for soreness, weakness, and several other distempers of the eyes. But how close to the published remedy was the Arscott version?  Fortunately, the most detailed of the three recipes is “Sr Hans Sloane’s Direction for my Aunt Walroud in ye Year 1730–when she perceiv’d a Cataract growing in one of her Eyes” (ff.79-80).

Sloane's remedy would have been preferable to being couched for a cataract. Heister, Operation for cataract and eye instruments, 1757. Credit: Wellcome Library, London.

Sloane’s remedy would have been preferable to being couched for a cataract. Heister, Operation for cataract and eye instruments, 1757. Credit: Wellcome Library, London.

Although there are measurements and preparation details, just like a recipe, it was also a summary of Sloane’s successful medical advice to Mrs Walroud. Of course, what early modern patients deemed success in a treatment differs from our modern concept. For Mrs Walroud, it was enough that after she started the treatment at the age of 67, her eyes did not get any worse for ten years and “she could write & read tolerably well”. When she died at the age of 83, she still had some of her sight.

The Arscott instructions begin by recommending that the sufferer have nine ounces of blood taken from the arm and a blister applied behind the ears. Next, take a conserve of rosemary flowers, pulvis ad guttetam (ground human skull mixed with various herbs), eyebright, millipedes, fennel seed and peony syrup. Last, the patient was to drink a julap (medicine mixed with alcohol) of black cherry water, fennel water, compound peony water, compound spirit of lavender, sal volat oleos and sugar. Mrs Walroud took both twice daily and kept a “perpetual Blister between her shoulders”.

One crucial difference between Sloane’s published remedy and the Arscott one is that no mention is made in Mrs Walroud’s treatment of using an ointment made of tutty (oxide of zinc), lapis haematites, aloes, prepared pearl and viper’s grease. Three possibilities for the ointment’s absence occur to me.

  • The Arscott family may have simply assumed that the listed directions were intended to accompany the purchase of Sloane’s ointment and didn’t specify something so obvious.
  • The reference to using the ointment was lost when the instructions had been passed between family members.
  • Or, Sloane did not always prescribe the ointment.

The remaining directions, though, do have overlaps. In his Account, Sloane prescribed drinking a medicine that also contained rosemary flowers, pulvis ad guttetam and eyebright—though he included more ingredients: betony, sage, wild valerian root and castor. This was to be followed by a tea (rather than julap) with drops of compound spirit of lavender and sal volat oleos. In this case, it was the Arscott version that included extra ingredients.

The type of bleeding in the Account was also slightly different than Mrs Walroud’s, with the recommendation that six ounces of blood be taken either from the temples using leeches or by cupping at the shoulders. Sloane’s eye remedy was supposed to be useful for many types of problems, he did not prescribe it exactly the same each time. Variations were possible, according to the patient and the problem.

The Arscott recipes suggest not only what advice from Sloane the family had found most useful, but what sorts of remedies Sloane might prescribe to his patients. But whatever Mrs Walroud’s rave review, the next time I suffer from eye strain at the computer, I won’t be reaching for Sloane’s drink with pulvis ad guttetam and millipedes in a hurry.

Mary Davis, the horned woman

Posted on December 2, 2013 by - Collecting, Hans Sloane, History of Medicine, Postgraduate Research, Specimens

By Felicity Roberts

Mary Davis by an anonymous artist. Credit: British Museum.

Mary Davis by an anonymous artist. Credit: British Museum.

At the British Museum, near the centre of the Enlightenment Gallery in wall press 156, there is a portrait in oils of a woman with what appear to be horn-like growths coming from the side of her head.  The woman has an arresting, impassive facial expression.  She wears no cap, so her head is exposed to the viewer, but she is demurely dressed, with her left arm drawn up and across her body so that her hand rests firmly on her collar. She seems to wait patiently for our observation of her to end.

The inscription on the painting reads:

“This is the portraiture of Mary Davis, an inhabitant of Great Saughall near Ches[ter.]  Was taken Ano. Dom. 1668, Aetatis 74 when she was 28 years old an excrescence rose uppon her head which continued thirty years like to a wen then grew into two hornes after 5 years she cast them then grew 2 more after 5 years she cast them. These uppon her head have grown 4 years and are to be seen […cropped]”.

Today we would say that Mary Davis had developed cutaneous horns.  It is a relatively rare condition in which a lesion or lesions develop on the skin, usually around the face or neck, sometimes protruding several centimetres.  Such lesions occur more frequently in older people and on commonly exposed parts of the body. Although their cause has been linked with sun exposure, underlying skin tumours has also been suggested.  Even with these medical explanations, a person who develops cutaneous horns today may still be the subject of news reports likening their appearance to that of the devil.

In the seventeenth- and eighteenth-centuries, such persons were treated as both wonders and anomalies of nature [1].  That is to say, their condition was interpreted as both a religious portent and a natural phenomenon.  Davis herself was, as an aging widow, exhibited at the Swan pub on the Strand where members of the public could come to see “such a Wonder in Nature, as hath neither been read nor heard of […] since the Creation” [2].  Yet her portrait was also collected by natural philosophers, and the horns she shed entered various cabinets of curiosity, including, it seems, the Ashmolean Museum and the British Museum. Both these specimens are now lost [3].  The interest shown in Davis’ condition is a good example of the overlap that existed between popular and scientific culture in London at the turn of the eighteenth century.

Sir Hans Sloane certainly had an interest in curious objects, especially ones which seemed to transgress the boundaries between human and animal, natural and monstrous.  He owned a horn shed by a Mrs French of Tenterden which he entered as specimen 519 in his Humana MS catalogue [4].  He also apparently owned the Mary Davis portrait.  In a letter of August 1709 Sloane’s friend Dr Richard Middleton Massey wrote:

“I have been in Cheshire & Lancashire, where I think I have mett with a curiosity, tis an originall picture in oil paint of Mary Davis the Horned Woman of Saughall in Cheshire”

Sloane must have indicated an interest in the portrait to Massey, because in a follow up letter of October 1709 Massey wrote:

“I will send up ye picture the first opportunity if you please call upon Mr Dixon at the Greyhound in Cornhill”

This must be the portrait which now hangs in the Enlightenment Gallery.  Did Sloane also own Mary Davis’ horn, which also entered the British Museum but was subsequently lost?  I have found no evidence for this in the letters as yet!

The provenance of the British Museum’s painting of Davis has long been shrouded in mystery.  Its Collection Online entry states it could have come from either Dr Richard Mead or Sloane.  But I think these Sloane letters suggest that the painting was Sloane’s before it became the Museum’s.

 

[1] For further information, see Lorraine Daston and Katherine Park, Wonders and the order of nature 1150-1750 (New York: Zone Books, 2001).

[2] J. Morgan (ed.), Phoenix Britannicus: being a miscellaneous collection of scarce and curious tracts […] collected by J Morgan, Gent (London, 1732), 248-250.

[3] Jan Bondeson, ‘Everard Home, John Hunter and cutaneous horns: a historical review’, American Journal of Dermatopathology 23 (2001), 362-369.

[4] Natural History Museum, Sloane MS Catalogue of Fossils, 6 vols. Vol 1, f. 344r.

A Welsh Doctor, Sir Hans Sloane, and the disappearing catheter

Posted on November 14, 2013 by - Hans Sloane, History of Medicine, Patients, Remedies, Surgery

By Alun Withey

Editor’s note: Alun would like to warn all readers that this post contains some graphic description of a particularly uncomfortable surgical technique…

Woodcut preparatio of patient for lithotomy, 1628. Credit: Wellcome Library, London.

Woodcut preparatio of patient for lithotomy, 1628. Credit: Wellcome Library, London.

In 1720, Dr. Alban Thomas was something of a high-flyer. The son of a Pembrokeshire cleric and poet, Alban first matriculated from Oxford in 1708, became librarian of the Ashmolean museum, assistant secretary of the Royal Society and, if that wasn’t enough, obtained his doctorate in medicine from Aberdeen in 1719. At a time when Wales was still a largely rural country, with no medical institutions of its own and fairly poor transport and road infrastructures, these were exceptional achievements for a boy from Newcastle Emlyn.

Also unusual was that Alban appears to have returned to Wales to set up his medical practice; many Welsh practitioners who had trained in Oxford or London chose not to return, choosing the potentially more lucrative market of the larger English towns. Nonetheless, especially in and around the growing Welsh towns, there was still a relatively wealthy Welsh elite to cater for and some, like Alban, positioned themselves to serve the denizens of large estates and houses.

It is clear, though, that Alban still had connections. One of his correspondents was no less a luminary than Sir Hans Sloane, the Irish physician to the fashionable and, indeed, the royal and, later, president of the Royal Society. Surviving letters from Alban Thomas to Sloane suggest that theirs was a fairly regular correspondence, with Sloane acting in an advisory role for particular cases. It is one particular case that interests us here.

In November 1738, Alban Thomas wrote to Sloane regarding a patient, Sir Thomas Knolles of Wenallt, Pembrokeshire, who was causing him concern. Knolles, although “a person of great worth, candour and humanity” was also

a person of very gross habit, of body an unusual size and make and about 20 stone weight with an appetite to his meat but very moderate in his drinking.

Knolles enjoyed exercise but, due to his size, this was often done on horseback.

At some stage, Knolles had become ‘dropsicall’ and suffered from swollen legs. The doctor used a combination of diuretics and tight, laced stockings to countermand this with, he reported, some success as Knolles returned to health, requiring only the odd purge as a ‘spring clean’. About four years previously however Knolles had begun to complain of a swelling in his scrotum, which Alban Thomas assumed to be hydrocele–a condition causing grossly swollen testicles (sometimes treated by injecting port wine into the testicles). After drawing off “about a quart of limpid serum” from the stoic Knolles’ testicles followed by the application of a dressing, and strict recovery routines, the doctor hoped that he had cured the condition for good. This proved to be premature.

When Knolles began to complain sometimes of not being able to pass urine at all, at others a few drops and occasionally losing his bladder control entirely, he took it upon himself to get a second opinion from an unnamed doctor in nearby Haverfordwest. This physician prescribed a ‘Turbith vomit’ which wrought well and even caused Knolles to void a stone about the size of a kidney bean. Rather than being put off by this occurrence, Knolles was encouraged and began to pester Dr Thomas to give him more of these treatments. Unimpressed and undeterred, Thomas decided on a more proactive course. After putting Knolles on a course of diuretic medicines, liquors and balsams for a week he brought in to his consulting room. What happened next highlights the particular horrors of early modern surgery.

Left, Raw's grooved catheter; right, bladder of a male. Engraving with etching. Credit: Wellcome Library, London.

Left, Raw’s grooved catheter; right, bladder of a male. Engraving with etching. Credit: Wellcome Library, London.

When Knolles arrived, Dr Thomas first applied a Turbith vomit, hoping that “so rugged a medicine” would clear the blockage without the need for more invasive procedures. It didn’t. In fact, the symptoms grew worse. It was at this point that Dr Thomas reached for his catheter and introduced it into the unfortunate Sir Thomas’s member. Expecting some resistance, he was surprised to find that the catheter went in without resistance.

On the contrary it seemed to force itself out of my fingers after passing the neck of the bladder as if it was sucked in, which I thought was owing to the pressure of his belly, the crooked end was now upward.

Yes, you read it right. The catheter was ‘sucked’ out of the doctors fingers and upwards further into the bladder! Now, any male readers may want to cross their legs!

In an attempt to probe for the stone that he feared was lurking in the bladder, and to release some water, Dr Thomas decided to turn the catheter around. At this point, the poor patient “cryed out with some violence…TAKE IT OUT I CAN BEAR IT NO LONGER”. Happily for Knolles the catheter came out “with as much ease as it went in without one drop through it or immediately after it”.

Three months later, the patient was still suffering, with the addition of great pain, defying all attempts for his relief. Despite being a “hail, hearty man having good lungs but lyable to hoarseness” and the occasional cold, Alban Thomas perceived him to be a healthy man. His efforts to treat Knolles had so far failed and he appealed to the eminent Sloane to help him “form a right judgement in this case”.

And so we leave the story there. What happened to Knolles is unclear, but the pain of his condition can only have been matched by the pain of his treatment. Suffering a succession of violent vomits, pills, electuaries and, finally, a wandering catheter, it is almost amazing to think that he ever went near Dr Alban Thomas again. Such (uncomfortable) cases remind us of the situation facing patients in the early modern period. For some the decision to see a doctor must have been a balancing act between bearing their illness or facing treatment.

(This post originally appeared on Alun Withey’s blog http://dralun.wordpress.com. Thank you to Alun for cross-posting his Sloane story here!)

Checking Tongues in the Eighteenth Century

Posted on October 23, 2013 by - Early Modern History, History of Medicine, Patients

A bored physician looks at the tongue of an old lady; suggesting the waste of physician's time by hypochondriacs. Credit: Wellcome Library, London.

A bored physician looks at the tongue of an old lady; suggesting the waste of physician’s time by hypochondriacs. Credit: Wellcome Library, London.

Miley Cyrus must, by now, have the most photographed tongue in history. My friend Jennifer Marotta recently  sent me this link about the diseases that Miley might pick up or spread by licking sledgehammers, mirrors and so forth. Although Jennifer had asked whether there were any nasty early modern equivalents, I became mesmerized by the sight of Miley’s tongue… and the secrets that it might reveal. Checking the tongue was a crucial part of diagnosis in early modern medicine.  

One of Hans Sloane’s correspondents, Giorgio Baglivi, was an Italian physician known for his work on medical practice. Baglivi, like Sloane, believed in the importance of bedside observation. In The Practice of Physick (1704), Baglivi outlined what a full medical examination should entail: “the Sick Persons Excrements and Urine, his Tongue and his Eyes, his Pulse and his Face, the Affections of his Mind, his former way of living, and the errors he has been guilty of in the way of Conduct” (30).

Physicians, of course, had no way to see or hear inside the human body. Examining the tongue was perhaps the best tool available, as it would provide

“a more certain and naked view of that state of the Blood than any other Sign”.

This included the taste, colour, “and other qualities of the Tongue” (157). In their letters to Sloane, several patients mentioned the state of their tongues.

Tongues were variously described as moist, clammy, or dry. Mrs Conyers, who had stomach pain, wheezing and shivering, apparently had a moist tongue and hands. In 1710, William Derham wrote that his wife had a “moist, & not very white” tongue, but by the following morning the tongue had become drier. Thomas Isted, according to his doctor, suffered from a clammy tongue, as well as sweating and sizy (viscous) blood.

Taste was also an important detail. Mr Campbell, who “had indulged his palate and rarely exercised as his business was very sedentary”, suffered from a foul and dry tongue. This was in addition to terrible urine (“thick and muddy”, “foul and turbid, gray, ropy and tough”) and a “muddy complexion”. The foulness had spread throughout his body.

The colour of tongues was most often described as black or white. In 1720, Dr Allen had several chest and stomach problems that were on the mend, but he also had a “slow fever, a brown but afterwards black Tongue” and low spirits. A “young gentleman” in 1725 had a violent peripneumonick fever accompanied with a “dry black tongue”; his strength was failing so rapidly that the physician did not want to try bleeding the patient. Sir William Thomson, in 1739, had a dry throat and “soon after the edge of the tip of his tongue grew hairy, white and almost transparent”. The physician believed “that an aphthous [blister] crust would creep down the throat and probably pass as a thorough thrush to the anus”. Unpleasant.

These details revealed the body’s interior. As Baglivi noted,

“if the Tongue is moist, so is the Constitution of the Blood; if dry, than the Blood is of a dry inflammatory Nature”.

An acidic taste, for example, revealed an acidic blood, or a salty taste meant salty blood (296). A canny physician could also make a prognosis, based on the evidence. For a patient delirious with an acute fever and a parched tongue (signs of inflamed viscera), the physician should avoid applying blisters, otherwise the patient would likely be “seiz’d with Convulsions before they die” (424). In malignant fevers, “a foul Tongue and trembling Hands are always dangerous in acute Diseases” (165). Black tongues were a bad sign. When a patient had an acute disorder, “a black Tongue is almost always followed by a Delirium” (88). Worst of all, though was a cold tongue: “Death follows soon after” (174).

Although displaying the body is part of the act for many female pop stars, the visibility of Miley’s tongue allows us to see inside her body in a surprisingly intimate way. The good news is, she is at present no danger of a mortal distemper.

The bad news is, her tongue does appear a little white. (Others have provided modern diagnoses here and here.) Baglivi did not mention white tongues specifically, but white-coated blood suggested inflammation of the internal organs. In any case, I sincerely hope that Miley doesn’t develop Sir William Thomson’s creeping thrush.

A Death by Unicorn Horn in 1730

Posted on August 19, 2013 by - Collecting, Early Modern History, Hans Sloane, History of Medicine

On the 28th of August 1730, Joseph Hastings died after receiving “several mortal Bruises with an Unicorn’s Horn”, wielded by John Williams of St. Andrew’s Holborn eleven days earlier. The assault occurred on a Holborn skittle-ground, witnessed by several local men.

Robert Linsey deposed that Joseph Hastings arrived at the skittle-ground “with the Horn in his Hand, and some old Clothes”. According to the defendent, he had been on his way for a pint of beer when he met a friend who encouraged him to drink a pint of gin instead (to help with his ague). While passing through the skittle ground, Williams picked up the horn and “ask’d the Deceas’d, what he would have for it?” When Hastings replied “it was worth more Money than he had in his Pocket”, Williams contemptuously offered three pence.

Narwhal tusk. These tusks could grow to several metres in length and were often traded as unicorn horns. Powdered unicorn horns had medicinal uses. Credit: Science Museum, London, Wellcome Images.

Narwhal tusk. These tusks could grow to several metres in length and were often traded as unicorn horns. Powdered unicorn horns had medicinal uses. Credit: Science Museum, London, Wellcome Images.

Hastings unsurprisingly refused, demanding that Williams return the horn. Witnesses testified that Hastings bragged that he had “been bid more Money for that Horn, than any Man at the Ground had in his Pocket”—by no-one other than Sir Hans Sloane himself. Williams called Hastings “a fancy Son of a B – h, and if he spoke two Words more he would knock him down with it”.

At this point, things are a little unclear. According to the defendant, Hastings swore at him “and lifted up his Hand with the Bowl in order to throw it at him”. Williams claimed that he merely pushed Hastings off in self defence and that it was an accident that Hastings fell back onto the stump.

But some witnesses saw Williams as the aggressor. John Drew saw Williams strike Hastings in the stomach with the horn, then push “him on on the Jaw with the end of it”. After Hastings fell onto a stump, Williams again hit him with the horn until someone took it away. Williams then kicked Hastings “upon his Breast, Belly, and Members”. Hastings was unconscious for at least two minutes.

Charles Wentworth, added “That he had never seen so vile and barbarous a Thing done in his Life”. The other men at the skittle ground held Williams back to keep him from following Hastings, who “went away in a very bloody Condition”. Wentworth visited Hastings several times after the attack: his “Head had been broke, and his Head and Face bruis’d in five places” and his genitals “look’d like a piece of Neck-Beef”.

Much of testimony considered whether or not Williams could be responsible for Hastings’ later death. Apothecary Richard Buckley attended the patient on 27 August, noting that the scrotum was discoloured. He thought the cause of death was probably an apoplexy. The autopsy after Hastings died was inconclusive. Although surgeon Mr Smith believed that the injuries were the cause of death, both Noah Sherwood and Henry Hildip did not think that the injuries were severe enough. The deceased had a rupture in his scrotum, but minor bruises and no skull fracture. The real clincher, perhaps, was that several people saw Hastings walking around after his injuries.

For those close to Hastings, Williams’ guilt was obvious. Mrs Hastings provided the sad testimony that her husband had left home in perfect health and returned with a broken head, “the Mark of a Foot on his Face, and a Bruise the side of his Neck and Throat”. Her neighbours, Mr and Mrs Waller, and brother-in-law spoke about Hastings’ continual pain and insistence that, if he died, it was because of Williams’ attack.

The jury acquitted Williams.

In many ways, this is an ordinary tale of a brutal assault with terrible consequences. The case itself, though, gives us a tantalizing glimpse into daily life in Holborn: neighbours who witnessed the attack or helped to nurse the patient, the importance of the skittle-ground in local social life, the use of any weapon that came to hand, the prickliness of each man’s sense of honour, the use of gin as a remedy for ague…

But it is the unicorn horn and reference to Sloane that captures my attention. The fact that Hastings possessed a unicorn horn is intriguing: from where did he get it and for what price? It was clearly valuable to him—and of interest to others, such as Williams. Had he taken the horn out that day with the intention of showing it off to friends, or (perhaps for a small price) to people down at the local tavern? Sloane’s fame, moreover, even extended to skittle-ground skuffles. His name, it appears, was readily identifiable in popular culture with the trade in curiosities, possibly enhancing the value of an asociated object.

A fascination with curiosities was not only for the educated, but was widespread in eighteenth-century society. The unicorn horn tale is just the tip: people eagerly paid to see wild men or bearded ladies and other wonders. But the story also reveals that the wealthy were not the only ones who might have a prized collection of curiosities; those lower down the social scale could, too—even if it was just a single, and singular, unicorn horn.

You can read the records from the trial at The Proceedings of the Old Bailey Online.

Timing is Everything

Posted on August 12, 2013 by - Family, Hans Sloane, History of Medicine, Letter-writing, Networks, Patronage, Undergraduate Research

William Cadogan, 1st Earl Cadogan. Credit: Wikimedia Commons.

William Cadogan, 1st Earl Cadogan. Credit: Wikimedia Commons. Uploaded by: Materialscientist.

By Matthew De Cloedt

Hans Sloane received many gifts from myriad places and numerous people. The two books that Edmund Gibson, the Bishop of Lincoln, sent on 24 July 1722 were different. The titles might not have been noteworthy, or even mentioned in his letter, but the thanks they represented were deeply personal. Edmund’s uncle, Dr Thomas Gibson, had recently passed away and Sloane had been the attending physician during his final days. The care and treatment made an impression on the family and they greatly appreciated his service.

But before Sloane had a chance to read Edmund’s thank you letter, he had three requests for recommendation letters to respond to: all wanting to replace Dr Thomas Gibson who had been the physician to William Cadogan, 1st Earl Cadogan.

As both a court physician and the President of the Royal College of Physicians, Sloane ordinarily attracted a great number of such recommendation requests. In this case, however, Sloane was an even better connection than unusual; his daughter Elizabeth had married the Earl’s younger brother Charles in 1717. The post was prestigious, for Earl Cadogan had served with distinction during the War of the Spanish Succession under John Churchill, 1st Duke of Marlborough. This was the opportunity of a lifetime and the competitors wasted no time in petitioning Sloane for support.

The applicants for the position were strong and each was aware of the need to secure Sloane’s assistance first. Philip Rose urgently wrote: “Dr Gibson being dead… I thought it improper to loose time”. Frank and to the point, Rose assured Sloane that he was worthy of the post and would forever remember whose patronage secured the job for him. Unfortunately, he had a black mark on his record–an outstanding debt with the Royal College of Physicians. It was not until 1728 that the debt was settled and this no doubt hindered his chances of preferment.

John Woodward was a noted physician, natural historian, antiquary, and active member of the Royal Society and Royal College of Physicians. He hoped to see Sloane at a dinner in Greenwich with apothecaries, where they might discuss the job, among other things. Woodward’s chances might have been hampered by the fact that he and Sloane had a spat over a decade before. During an argument over the nature of plant physiology and respiration Woodward insulted Sloane, refused to apologize, and then attempted to remove Sloane from his post at the Royal Society. This bad blood between the two led to Woodward’s absence from actively engaging in the Royal Society business. It, perhaps, would have taken a considerable amount of charm and interesting table talk to overshadow their previous conflict. (That said, Woodward–himself a collector–did write Sloane several other letters about their mutual interests after the dispute of 1710!)

Sir Richard Manningham, the celebrated man mid-wife, claimed to be embarrassed to ask Sloane for his support because of the “Considerable salary” attached to the post. He asked Sloane to “forgive this rash weakness and folly” on his part. Manningham was well qualified. He was elected a Fellow of the Royal Society and licentiate of the Royal College of Physicians in 1719, then was knighted in February 1722. There were no significant blemishes on his record to this point in his career, save his self-confessed boldness in contacting Sloane in the hopes of his support.

Each of the hopefuls vying to replace the late Dr Thomas Gibson recognized the importance of reaching Sloane first. The competitiveness of the medical profession required well-connected contacts like Sloane to gain the positions with the most prestige and largest remuneration. It is not clear whether or not any one of them got the job, but a cursory vetting of the candidates nearly three hundred years later suggests some had more faults than others. As Sloane was the late Dr Gibson’s physician, it might have helped their chances to lament the fact he had passed away instead of immediately requesting Sloane’s backing.