Category: Remedies

Suffering from Colds in the Eighteenth Century

I apologise for my unexpectedly long absence from the blog, occasioned by a nasty cold followed by an even worse chest infection. But now that I’m on the mend thanks to a course of antibiotics, I have the luxury of sufficient oxygen in my blood stream to reflect on colds in days of yore.

A sick man with a cold. Coloured lithograph, 1833. Credit: Wellcome Library, London.

While nobody ever dies from the common cold, complications from colds can be debilitating or even fatal: chest infections, pneumonia, pleurisy… And these sorts of problems regularly developed in eighteenth-century patients. For fun, I trawled through the database for symptoms nearest my own to see how patients would have treated their colds. It’s not a pretty picture: lengthy and dangerous illnesses and ineffective and uncomfortable treatments.

Patients rarely consulted Sloane for recent or urgent problems, but colds often slipped into the chronic category. Elizabeth Southwell, in an undated letter,* noted that her cold had already lasted two weeks. In 1708, Elizabeth Howland referred to hers lasting three weeks. Lord Lempster, who had a chronic lung condition, had already been suffering from a cold for two weeks when his doctor James Keill wrote to Sloane on June 22, 1710. As if that wasn’t long enough, the winner of these misery sweepstakes was the Earl of Thanet who reported on July 31, 1712 that he had been taking remedies for is cold since June 12.

These weren’t just gracefully fading colds, moreover, but ones that worried sufferers. Keill had anticipated Lord Lempsters’s death, given his laboured breathing; the patient remained seriously ill when Keill wrote again on July 9. Lord Lempster, Southwell and Howland had all started to spit occasional blood in their phlegm. Southwell’s cough was so violent she had given up on taking most remedies, except diacodium (a painkiller made of poppies). The Earl of Thanet and Howland both suffered from chest pains, which can indicate the onset of a serious chest ailment, while the Earl and Southwell had sore throats. Howland was also constantly hot, which she attributed to a sharpness and heat in her blood. Colds that wouldn’t clear up might have different–and apparently hot–effects, as Dr. Keill suggested when diagnosing Lord Lempster’s problems as a stoppage of blood rather than the more serious inflammation of the lungs. Either way, these were serious complications from what started as a cold.

Although there were other remedies used, the treatments focused primarily on diet, bleeding, blistering and purging. The Earl and Howland both drank milk, then known for its healthful benefits in lung ailments. The Earl and Southwell ate fruit–possibly to keep their bowels regular. Southwell had eaten figs, while the Earl had tried and rejected oranges (proposing instead pears). All four patients were bled. Southwell, for example, had been bled twice and Lord Lempster at least three times (10 ounces, 8 ounces, and 8 ounces). Keill also suggested that Lord Lempster try blisters and purging; the Earl initially used blisters, but thought a bit of purging could also be useful. Other remedies described included powder of pearl (the Earl), chalybeates to cause vomiting (Lempster), barley water, linseed oil, sarsaparilla and China tea (Howland). The main goal of the remedies was to reduce inflammation of the lungs, break up the stoppages of the blood, or to cool the blood.

The fates of these eighteenth-century patients? Elizabeth Howland (c. 1658- 1719) and the Earl of Thanet (1644-1729) lasted many years after. Elizabeth Southwell (1674-1709) was the youngest sufferer and she died within a few years of her illness (though not necessarily related). Lord Lempster (1648-1711) was already chronically ill before he contracted his cold, and continued poorly for another year and a half before he died.

Whatever the rationale behind eighteenth-century explanations of and treatments for colds, I’m just glad that I didn’t have to suffer bleeding, purging, and blisters in addition to the misery of a chest infection!

*After 1705 when she had a son. The letter refers to visiting her young ill son.

An Eighteenth-Century Case of Hair Voided by Urine

“Honourable Sir!” wrote Thomas Knight to Sloane in February 1737 (British Library, Sloane MS 4034, ff. 34-5). He wished Sloane’s advice on an “uncommon Case”—the discovery of hairs discharged by a man who suffered from a burning pain during urinating. Knight thoughtfully enclosed the matter in a pill box for Sloane’s examination.

The patient must have been in great pain as all the adjacent parts, internal and external, were swollen and irritated. He had tried bleeding, clysters, emulsions, and opiates, all to no avail; he was only relieved when he finally passed the “hairy Substance with the gritty Matter that adheres to it”. Importantly, the patient had “kept a strict Regimen” for many years because of gout and “incontinency of urine”. As part of his regimen, he regularly drank cow’s milk.

L. Beale, Kidney diseases, uinary deposits, 1869.
Credit: Wellcome Library, London.

Knight theorized that the fine hairs had come from the skin of some animal that had gotten into the patient’s body and then circulated through the body until reaching the renal glands. “It is more possible”, he thought, “that they were extraneous, than that they were generated in the Urinary Passages”. He recognised that the veins in the body were indeed very small, but damp hairs “become very flexible, pliable and susceptible of being contorted and of assuming any Figure”. Perhaps “some of the downy-hair about the [cow’s] Udder might got along with the Milk”.

The oddity of the story is itself intriguing, but so too is the afterlife of the letter and sample. The details noted on the back of the letter by Sloane (or on his behalf) suggest the process of cataloguing in his collections.

Apr 27 1738

Ent’d in L.B.

Knight of Hair voided by Urine.


Ph. Tr. No. 460

VIII IX A letter from Mr T Knight to Sir Hans Sloane

pr. R. S. &c concerning Hair voided by Urine.

The letter and/or the sample were kept and entered into one of the collections in 1738. The letter was also passed on to the Royal Society and it was published in Philosophical Transactions no. 460.

So, what did the Royal Society make of Knight’s report? The Phil. Trans. editor in 1739, Cromwell Mortimer, remarked after the letter: “I doubt of these Substances being real Hairs; I imagine they are rather grumous Concretions, formed only in the Kidneys by being squeezed out of the excretory Ducts into the Pelvis”.

Painful enough, in any case, but at least no need to fear drinking milk!

Eighteenth-Century Ear Worms

In 1702, Mr. Hare, the Vicar of Cardington in Bedfordshire, wrote to Sloane with a “matter of fact”: a case of ear worms. Gory it may be, but this tale tells us much about domestic medical practices and popular scientific interests!

Hare reported that a young man—who lodged in the same house as him—had been suffering from some running humour and pain in his right ear, which he’d tried to treat with clean wool and honey. After several days, a maid in the house examined the lodger’s ear when she noticed it was bleeding. She “saw something working in his Ear like maggots” and promptly sent for a neighbouring woman to help. The neighbour’s remedy: an application of the steam of warm milk.

Hare took a look at the ear later that day, describing the worms inside as “large maggots in shape & Colour like those that commonly breed in putrefied flesh.” He began to pick out “a great number of Insects”, counting twenty-four. Although there were more worms in the ear, Hare could not extract them; they had burrowed in too deep during the operation. Instead, he left the patient “for about an hour in which time he was very uneasy & full of pain”, with a “thick bloody matter” in the ear. Fortunately, the remaining worms had started to work their way out and Hare “pickd out nine more” during a second attempt. The patient “found himself more at ease upon which we concluded that there were no more.” By the following day the young man had entirely recovered.

Illustrations from the English translation of Nicolas Andry’s An Account of the Breeding of Worms in Human Bodies, London, 1701 (Source: Wikimedia Commons)

Hare provided several details about domestic medical practices. The young man started off with self-treatment. A maid in the house examined his ear. A neighbouring woman and a clergyman (Hare) administered further treatments. This was typical of the process of seeking medical advice. Physicians and surgeons were seldom the first point of medical assistance—and some problems might be sorted out before their help was even necessary.

We also have some clues as to what sorts of treatments they tried. The honey and cotton wool would have been readily available and were the sort of basic application that one might try to treat an ear problem. According to the Countess of Kent’s A Choice Manual (1687), various types of simple applications for inflammations or injuries included honey. The milk steam also makes sense. In popular thought, milk was thought to draw worms out. But there were various ways this might be administered. In An Account of the Breeding of Worms in Human Bodies (1701), for example, Nicolas Andry referred to injecting warm women’s milk into the ear.

The timing of the letter suggests that the observation was offered in response to Nicolas Andry’s treatise, which had been published in English only the year before. Andry identified the different types of bodily worms, which he attributed to eggs hatching inside the body. In the human head, for example, worms might occur in the brain, nose, eyes, teeth, or ears. An Account detailed Andry’s experiments with a microscope as he explored the inner world of the human body and its many worms—including spermatozoa. Hare called his letter as a “matter of fact” (eyewitness testimony about an observation), but it was of limited scientific value and never appeared in the Philosophical Transactions. His keenness to share his account about a timely subject, however, suggests a man who was deeply interested in science and medicine.

And the account itself reveals a man who had a very steady hand…

A Curious Case of a Petrified Leg

The Sloane Correspondence contains several examples of curious medical cases, many of which were intended for publication in the Philosophical Transactions (which Sloane as secretary of the Royal Society edited for many years). One such case is that of Mrs Stevens of Maidenhead, aged 62. Surgeon Ralph Calep recounted her case in a letter to anatomist William Cowper, who in turn forwarded it to Sloane for publication.

Mrs Stevens became ill with a fever in November 1697. Within two weeks, she developed a swelling and numbness in her foot that spread up her leg. For a month, the attending physician treated her with remedies that theoretically should have helped according to early modern medical thought. The first treatment was a warm, moist compress of centaury, wormwood, and St. John’s Wort. According to the Pharmacopoia Londinensis (1702), these ingredients all had hot and dry properties and cleansed and treated wounds. Centaury might be used to treat scurvy (often seen as a skin problem) or gout, while wormwood was thought useful in resisting putrefaction. St. John’s Wort was supposed to dissolve bad blood and cure wounds. The second remedy, an oil of turpentine with galbanum, was to relieve pain, soften the skin, and reduce the tumour.

By the time surgeon Ralph Calep saw Mrs Stevens in early 1698, her foot and leg were in a bad way: brown and withered with black spots and no feeling in the leg. She was in great pain and occasionally delirium, begging Calep for help. But the only solution Calep could think of was to remove the leg, which Mrs Stevens refused. Calep thought this was best since he “did not expect any Success in the performing of it”, given her age and weakness, and left “supposing I shou’d never see her more”. He advised her friends to continue the compresses.

Amputation scene, “De gangraena et sphacelo”
Credit: Wellcome Library, London. Wellcome Images

A month later, Calep returned and was surprised to discover Mrs Stevens still alive, though with a hole in her leg that discharged black matter. Calep enlarged the opening to aid the flow. He also cut into a tumour on her knee, but was surprised to find nothing but air. He again left the patient, advising her to continue the compresses. When he returned another month later, he was not only surprised to find her still alive, but “to my admiration saw that, which thro’ the whole course of my Life I may never see again”: Nature had made a perfect separation of the mortified flesh, with the skin above looking healthy. At this point, he decided to remove the leg. Now, over ten years later, the woman was still alive! For Phil. Trans. readers, this would have indeed been a fascinating case—a peculiar physical problem, with a remedy that demonstrated the power of nature’s healing.

For the historian, the tale is intriguing for a couple other reasons. First: the surgeons’ claims to authority. Calep had one complaint after the amputation. He had hoped to take the leg for dissection, but “the Friends of the Woman deceived me”. They had promised to keep the leg for him, but then buried it in a secret location. Calep’s authority rested in his careful observation over time, as well as the verification of the story by Cowper. Cowper included a note to Sloane stating that he had also been to visit Mrs Stevens, though he had been unable to look at the thigh. Mrs Stevens was “decrepid” and the weather was too cold for her to show him. He did, however, feel the stump through her clothing and Cowper diagnosed her problem as one of petrification in the arteries. This problem, he had previously seen in “aged Persons” or cases of gangrene, and had published on it. Cowper’s authority rested in his reputation and previous scholarship.

William Cowper. Credit: National Library of Medicine and Wikimedia Commons.

But what is striking is the absence of real evidence: the amputated leg had disappeared and Cowper had not actually examined Mrs Stevens’ stump in detail. In the late seventeenth century, natural philosophers were establishing what counted as good evidence. Close observation and reputation were two of the crucial elements, but both surgeons recognised that their accounts would have been even more compelling if they had been able to examine the leg and stump. Each explained in detail why they had not done so.

The case is also interesting for what it tells us about the relationships among surgeon, patient, and patient’s friends. The “friends” (which would have included family) were important throughout, ensuring that Mrs Stevens received good care during her illness. Mrs Stevens also continued to have full control over her medical care, despite her occasional delirium. She refused the only treatment Calep could offer, amputation, until her leg started the process of separation itself. She was typical of many patients in this regard, who generally avoided surgery until it became the only option–unsurprising in an age without anaesthesia. Later, she also refused to show Cowper her stump in its entirety.

The patient’s control over the disposal of the body part appears to have been more contentious. Calep certainly wanted the leg for scientific purposes—at the very least for dissection, but possibly even intending to preserve it as a sample. He even seemed to expect that he should have it, suggesting that he’d been tricked out of having it when he called the friends deceitful. For Mrs Stevens, by contrast, there may have been some anxiety surrounding the leg’s dissection: what might happen to her body at the Resurrection? Was it shameful? By burying the leg, Mrs Stevens’ friends would have been acting on her wishes, or seeking to protect her.

A curious case, indeed, for contemporaries and historians alike!