Alcohol as medicine through the ages

Ancient Origins

While no one knows exactly when alcohol was first produced, it was presumably the result of a fortuitous accident that occurred at least tens of thousands of years ago. However, the discovery of late Stone Age beer jugs has established the fact that intentionally fermented beverages existed at least as early as the Neolithic period around 10,000 years ago, and it has been suggested that beer may have preceded bread as a staple. Wine clearly appeared as a finished product in Egyptian pictographs around 4,000 BC, and residues of wine samples in Greece date to the same period. But alcohol was not consumed in the same way as it is today. In fact, in ancient times, alcohol was seen as an important medicinal ingredient and as an essential part of the diet.

From the moment the first alcoholic beverages were discovered, man has used it as a medicine. Apart from the stress relieving, relaxing nature that alcohol has on the body and mind, alcohol is an antiseptic and in higher doses has anesthetizing effects. But it is a combination of alcohol and natural botanicals, which creates a far more effective medicine and has been used as such for thousands of years. It is the origin of the most famous toast, “Let’s drink to health”, which exists in many languages around the world.

One of the earliest signs of the use of alcohol as a medicine dates back around 5,000 years to a jar found in the tomb of one of the first pharaohs of Egypt, Scorpion I. With extremely sensitive chemical techniques, bioarchaeologists were able to identify the different compounds within the residue left in the jar. They found that the remnants contained wine, as well as a number of herbs known to have medicinal properties Wine was also a frequent component of ancient Roman medicine. As is well known nowadays, alcohol is a good means of extracting the active elements from medicinal plants.

Wine was the only form of alcohol known to the Romans as distillation wasn’t discovered until the middle ages. Herbs infused in wine were a regular medicinal stratagem which would have a degree of effect given the alcohol’s ability to extract the active compounds of a number of herbs.

 One of the most famous practitioners of alcohol-based herbal remedies was the father of modern medicine, Hippocrates, whose own special recipe for intestinal worms was known as Hippocraticum Vinum. Hippocrates was making a crude form of vermouth in approximately 400BC using local herbs in wine, but herbal infusions took on a whole new level of potency once distillation was discovered.

The spread of Christianity with the crusades from 1095 onwards brought knowledge about the art of alchemy and distillation from the early Arab scholars. The ‘Water of Life’ was being refined all over Europe (known as such due to it being safer to drink than disease-ridden water) and soon commercial apothecaries grew from the spread of the knowledge of distillation and botanical extraction selling both raw ingredients and herbal tinctures. Throughout antiquity, available water was polluted with dangerous microbes, so drinking alcohol, which involved the liquid being boiled or subjected to similarly sterilising treatments, was seen as being healthier and safer.

One of the earliest records of medicinal alcohol dating to this period comes from Roger Bacon, a 13th Century English philosopher and writer on alchemy and medicine. According to the translation (published in 1683) Bacon suggests wine could: "Preserve the stomach, strengthen the natural heat, help digestion, defend the body from corruption, concoct the food till it be turned into very blood." But he also recognises the dangers of consuming in excess: "If it be over-much guzzles, it will on the contrary do a great deal of harm: For it will darken the understanding, ill-affect the brain... beget shaking of the limbs and bleareyedness."

Alcohol as medicine in the Middle Ages ( public domain )

European colonisation during the 15 th and 16 th centuries gave the apothecaries an abundance of exotic herbs, spices, barks, peels and berries to add to their medicine cabinets and from this point until relatively recently, a large percentage of medicines were made with an alcoholic base.

Gin is a good example of a spirit which was originally designed to be used as a medicine; the use of Juniper as a diuretic was believed to be able to cleanse the fevers and tropical diseases that the Dutch settlers were suffering from in the newly colonized West Indies. Many of today’s brands such as Chartreuse and Benedictine were born in the monasteries of Europe designed as stomach tonics and general elixirs.

However, by the 18 th century, there were growing concerns about the more harmful effects of alcohol, including drunkenness, crime, alcoholism and poverty. In 1725, the first documented petition by the Royal College of Physicians expresses fellows' concerns about "pernicious and growing use of spirituous liquors". By the 19th Century, temperance movements began to emerge in Britain - at first some advised restrictions on certain drinks only, but over time their stance shifted to call for total abstinence.

An 1820 engraving warning of the dangers of alcohol ( public domain )

The irony is that we now live in an age where although alcohol is socially acceptable, classing it as ‘good for you’ is frowned upon and is a notion which seems to have been born from the development of modern medicine.

 Old-fashioned pharmacies with their jars of coloured macerations died out in the early part of the 1900’s when science was able to synthetically reproduce the key properties of nature therefore no-longer needing alcohol as a base. Drug companies have also been keen to brush over the fact that organic-based medicine is free whereas tablets are not. You can’t patent nature, but you can patent pills.

By April Holloway

10 Facts About Healthcare in the Middle Ages

Made from History

 BY TOM CROPPER


 Medicine in the Medieval period was imprecise and mixed with superstition. The advances made in Antiquity by the Greeks, Romans and Egyptians were scarcely built upon and in some societies, much was forgotten.

 Although by the 14th century medical education was growing in Western Europe, Church domination of all aspects of life naturally extended to medicine, further impeding any advanced understanding of the workings of the human body.

 Here are 10 facts about medicine and healthcare in medieval times.

 1. Eye surgery was conducted with a needle
 Cataracts surgery was carried out with a pretty basic needle, which would make more than a few eyes water. This didn’t change until more advanced medical techniques arrived from the Arab world.

 2. A surgeon might choose to bore a hole in your head
 If you were unwell doctors would occasionally bore a hole in your skull. This was thought to alleviate pressure and was believed to be a cure for many conditions including epilepsy. Needless to say this procedure often proved fatal.

 3. Doctors thought too much blood could be bad for you

A painting depicting the letting of blood.

 Doctors believed in things called humours – fluids held within the body such as phlegm, bile and blood. Having too much or too little of these, they believed, could make you ill. This is why they often bled patients to relieve an excess of blood.

 4. Sheep dung was a form of birth control
 It was a long way from the morning after pill, but sheep dung was popularly used as a form of contraceptive.

 5. Ill people were thought to be evil
 In the Middle Ages much of what happened to us was thought to be down to the way we lived our lives. So people who contracted diseases were often believed to have been guilty of a sin.

 6. Going on pilgrimage could cure disease
 If you were ill one option could be to go on a long pilgrimage to a holy site.

 7. The King’s hands could heal

Edward the Confessor was said to have healing hands. English and French monarchs claimed to be able to heal the sick just by laying their hands on them. Edward the Confessor is the first King said to have this power, but Henry I was the first King to try and use it for political purposes.

 8. Spiders had medicinal properties

Spiders and cobwebs held the cure for many diseases.

 Cobwebs, for example, were said to be a good cure for warts.

9. Rosemary was a form of toothpaste
 In order to brush your teeth the best option was to put burned rosemary into a cloth.

 10. Binge drinking was a bigger problem than today
 As the Black Death raged across Europe, another plague was following in its wake – drunkenness. People mistakenly believed that alcohol would protect against the disease. Some followed this medicine so completely that they drank themselves to death.

9 weird medieval medicines

History Extra

Anatomical chart of the human body, from 15th-century Tractatabus de Pestilentia (Treatise on Plague) © The Art Archive / Alamy

Medicines in the medieval period were sometimes homemade, if they weren’t too complicated. Simple medicines consisted of a single ingredient – usually a herb – but if they required numerous ingredients or preparation in advance, they could be purchased from an apothecary, rather like a modern pharmacist.
Although some medical remedies were quite sensible, others were extraordinarily weird. They all now come with a health warning, so it’s probably best not to try these at home...

1) St Paul’s Potion for epilepsy, catalepsy and stomach problems

Supposedly invented by St Paul, this potion was to be drunk. The extensive list of ingredients included liquorice, sage, willow, roses, fennel, cinnamon, ginger, cloves, cormorant blood, mandrake, dragon’s blood and three kinds of pepper.
Although this sounds like a real witch’s brew, most of the ingredients do have some medicinal value: liquorice is good for the chest – it was and continues to be used to treat coughs and bronchitis; sage is thought to improve blood flow to the brain and help one’s memory, and willow contains salicylic acid, a component of aspirin. Fennel, cinnamon and ginger are all carminatives (which relieve gas in the intestines), and would relieve a colicky stomach.
Cormorant blood – or that of any other warm-blooded creature – would add iron for anaemia; mandrake, although poisonous, is a good sleeping draught if used in small doses, and, finally, dragon’s blood. This isn’t blood at all, and certainly not from a mythical beast! It is the bright red resin of the tree Dracaena draco – a species native to Morocco, Cape Verde and the Canary Islands. Modern research has shown that it has antiseptic, antibiotic, anti-viral and wound-healing properties, and it is still used in some parts of the world to treat dysentery – but I’m not sure it could have done anything for epileptics or cataleptics.

2) A good medicine for sciatica [pain caused by irritation or compression of the sciatic nerve, which runs from the back of your pelvis, all the way down both legs]

A number of medieval remedies suggested variations of the following: “Take a spoonful of the gall of a red ox and two spoonfuls of water-pepper and four of the patient’s urine, and as much cumin as half a French nut and as much suet as a small nut and break and bruise your cumin.
Then boil these together till they be like gruel then let him lay his haunch bone [hip] against the fire as hot as he may bear it and anoint him with the same ointment for a quarter of an hour or half a quarter, and then clap on a hot cloth folded five or six times and at night lay a hot sheet folded many times to the spot and let him lie still two or three days and he shall not feel pain but be well.”
Perhaps it was the bed rest and heat treatments that did the trick, because I can’t see the ingredients of the ointment doing much good otherwise!

3) For burns and scalds

“Take a live snail and rub its slime against the burn and it will heal”
A nice, simple DIY remedy – and yes, it would help reduce blistering and ease the pain! Recent research has shown that snail slime contains antioxidants, antiseptic, anaesthetic, anti-irritant, anti-inflammatory, antibiotic and antiviral properties, as well as collagen and elastin, vital for skin repair.
Modern science now utilises snail slime, under the heading ‘Snail Gel’, as skin preparations and for treating minor injuries, such as cuts, burns and scalds. It seems that medieval medicine got this one right.

4) For a stye on the eye

“Take equal amounts of onion/leek [there is still debate about whether ‘cropleek’, as stated in the original recipe, in Bald’s Leechbook, is equivalent to an onion or leek today] and garlic, and pound them well together. Take equal amounts of wine and bull’s gall and mix them with the onion and garlic. Put the mixture in a brass bowl and let it stand for nine nights, then strain it through a cloth. Then, about night-time, apply it to the eye with a feather.”
Would this Anglo-Saxon recipe have done any good? The onion, garlic and bull’s gall all have antibiotic properties that would have helped a stye – an infection at the root of an eyelash.
The wine contains acetic acid which, over the nine days, would react with the copper in the brass bowl to form copper salts, which are bactericidal. Recently, students at Nottingham University made up and tested this remedy: at first, the mixture made the lab smell like a cook shop, with garlic, onions and wine, but over the nine days the mixture developed into a stinking, gloopy goo. Despite its unpromising odour and appearance, the students tested it for any antibiotic properties and discovered that it is excellent. The recipe is now being further investigated as a treatment against the antibiotic-resistant MRSA bug, and it looks hopeful.
The ancient apothecary was right about this remedy, but it was one that needed to be prepared in advance for sale over the counter.

_{The apothecary's shop. From Johannis de Cuba Ortus Sanitatis, Strasbourg, 1483. © Pictorial Press Ltd / Alamy}

5) For gout

“Take an owl and pluck it clean and open it, clean and salt it. Put it in a new pot and cover it with a stone and put it in an oven and let it stand till it be burnt. And then stamp [pound] it with boar’s grease and anoint the gout therewith.”
Poor owl! I can’t think that this would have helped the patient very much either…

6) For migraines

“Take half a dish of barley, one handful each of betony, vervain and other herbs that are good for the head; and when they be well boiled together, take them up and wrap them in a cloth and lay them to the sick head and it shall be whole. I proved.”
Betony [a grassland herb] was used by the medieval and Tudor apothecary as an ingredient in remedies to be taken internally for all kinds of ailments, as well as in poultices for external use, as in this case. Modern medicine still makes use of the alkaloid drugs found in betony for treating severe headaches and migraine.
Vervain’s glycoside [a class of molecules in which, a sugar molecule is bonded to a ‘non-sugar’ molecule] derivatives too are used in modern treatments for migraine, depression and anxiety, so once again the apothecary knew what he was doing with this recipe!

7) For him that has quinsy [a severe throat infection]

“Take a fat cat and flay it well, clean and draw out the guts. Take the grease of a hedgehog and the fat of a bear and resins and fenugreek and sage and gum of honeysuckle and virgin wax. All this crumble small and stuff the cat within as you would a goose. Roast it all and gather the grease and anoint him [the patient] with it.”
With treatments like this, is it any wonder that a friend wrote to Pope Clement VI when he was sick, c1350, to say: “I know that your bedside is besieged by doctors and naturally this fills me with fear… they learn their art at our cost and even our death brings them experience.”

8) To treat a cough

“Take the juice of horehound to be mixed with diapenidion and eaten”
Horehound [a herb plant and member of the mint family] is good for treating coughs, and diapenidion is a confection made of barley water, sugar and whites of eggs, drawn out into threads – so perhaps a cross between candy floss and sugar strands. It would have tasted nice, and sugar is good for the chest – still available in an over-the-counter cough mixture as linctus simplex.

9) For the stomach

“To void wind that is the cause of colic, take cumin and anise, of each equally much, and lay it in white wine to steep, and cover it over with wine and let it stand still so three days and three nights. And then let it be taken out and laid upon an ash board for to dry nine days and be turned about. And at the nine days’ end, take and put it in an earthen pot and dry over the fire and then make powder thereof. And then eat it in pottage or drink it and it shall void the wind that is the cause of colic”
Both anise and cumin are carminatives, so this medicine would do exactly what it said on the tin – or earthen pot. The herbs dill and fennel could be used instead to the same effect – 20th-century gripe water for colicky babies contained dill.
This remedy would have taken almost two weeks to make, so patients would have bought it from the apothecary, as needed.

Toni Mount is an author, historian and history teacher. She began her career working in the laboratories of the then-Wellcome pharmaceutical company [now GlaxoSmithKline], and gained her MA studying a 15th-century medical text at the Wellcome Library. She is also a member of the Research Committee of the Richard III Society.

Her books, all published by Amberley, include Everyday Life in Medieval London: From the Anglo-Saxons to the Tudors; The Medieval Housewife & Other Women of the Middle Ages and her latest book, Dragon’s Blood & Willow Bark: The Mysteries of Medieval Medicine, which is out now.

7 surprising facts about the history of medicine

History Extra

Ancient Egyptian childbirth scene: the mother is helped by her handmaidens and the midwife. Reconstruction of a Theban painting from the Dynasty XIX. (Photo by DeAgostini/Getty Images)

Maintaining a comfortable state of health is a goal shared by much of the world's population past and present, thus the history of health and medicine weaves a thread connecting us with our ancestors' human experiences. Yet it's easy to assume that studying it involves either celebrating the ‘eureka moments’ of well-known heroes or laughing at outdated therapies. But, as I set out to show in my new book, medicine's past features plenty of lesser-known but equally fascinating episodes…

 1) Some of the earliest named doctors were women

Saqqara is a huge archaeological site about 20 miles south of present-day Cairo. Five millennia ago it was the necropolis for the ancient Egyptian city of Memphis, and remains home to one of the oldest surviving buildings in the world – the step pyramid of Djoser.
A nearby tomb reveals the image of Merit Ptah, the first female doctor known by name. She lived in approximately 2,700 BC and hieroglyphs on the tomb describe her as ‘the Chief Physician’. That's pretty much all that's known about her career, but the inscription reveals that it was possible for women to hold high-status medical roles in Ancient Egypt.
Some 200 years later another doctor, Peseshet, was immortalised on a monument in the tomb of her son, Akhet-Hetep (aka Akhethetep), a high priest. Peseshet held the title ‘overseer of female physicians’, suggesting that women doctors weren't just occasional one-offs. Peseshet herself was either one of them or a director responsible for their organisation and training.
Although the barriers of time and interpretation make it difficult to reconstruct the day-to-day practice of Merit Ptah and Peseshet, female doctors appear to have been a respected part of ancient Egyptian society.

  2) Cataract surgery was possible in the sixth century BC

One of the oldest known medical textbooks is the Sushruta Samhita, written in Sanskrit in India. Its exact date is tentative, as no original version survives and it is only known from later copies, but the current consensus is that it was written in around 600 BC. Sushruta is thought to have been a physician and teacher working in the North Indian city of Benares (now Varanasi in the state of Uttar Pradesh). His Samhita – a compilation of knowledge – provides detailed information on medicine, surgery, pharmacology and patient management.
Sushruta advises his students that however well read they are, they are not competent to treat disease until they have practical experience. Surgical incisions were to be tried out on the skin of fruits, while carefully extracting fruit seeds enabled the student to develop the skill of removing foreign bodies from flesh. They also practised on dead animals and on leather bags filled with water, before being let loose on real patients.
Among its many surgical descriptions, the Sushruta Samhita documents cataract surgery. The patient had to look at the tip of his or her nose while the surgeon, holding the eyelids apart with thumb and index finger, used a needle-like instrument to pierce the eyeball from the side. It was then sprinkled with breast milk and the outside of the eye bathed with a herbal medication. The surgeon used the instrument to scrape out the clouded lens until the eye “assumed the glossiness of a resplendent cloudless sun”. During recovery it was important for the patient to avoiding coughing, sneezing, burping or anything else that might cause pressure in the eye. If the operation were a success, the patient would regain some useful vision, albeit unfocused.


_{Roman civilization, a relief portraying an ophthalmologist examining a patient. (Photo By DEA/A DAGLI ORTI/De Agostini/Getty Images)}

3) A ‘tree of life’ tackled scurvy

Trapped in ice near Stadacona (the site of present-day Quebec City) in 1536, Jacques Cartier's ships weren't going anywhere. The crews, holed up in a makeshift fort with little access to fresh food, came down with a disease so gruesome that “their mouth became stincking, their gummes so rotten, that all the flesh did fall off, even to the rootes of the teeth, which did also almost all fall out.” They had scurvy, now known to result from a deficiency of vitamin C. Cartier had no idea what to do.
During his first voyage to Stadacona in 1534, Cartier had kidnapped two young men, Dom Agaya and Taignoagny, taking them back to France as proof that he had discovered a new territory. Now that they were home, the men and their community had every reason not to trust Cartier – an attitude that he interpreted as “treachery” and “knavery”.
In spite of this tension, Dom Agaya showed Cartier how to make a decoction from a tree called Annedda and, although the Frenchmen wondered if it were a plot to poison them, a couple of them gave it a go and were cured within days. After that, there was such a rush for the medicine that “they were ready to kill one another”, and used up a whole large tree.
The identity of Annedda is not certain but there are several candidates including eastern white cedar and white spruce. Whatever it was, its nutritional benefits resulted in the sailors' complete cure.
Cartier repaid Dom Agaya by kidnapping him again along with nine other people. By the time of Cartier's next voyage – to Canada in 1541 – most of the prisoners were dead, but Cartier informed their relatives that they were living in style in France. The scurvy cure did not gain widespread recognition and the disease continued to claim the lives of sailors for more than 200 years.

 4) If you want a cure for everything, try theriac

Being a king in ancient times was exhaustingly dangerous; there was always someone plotting to get rid of you. So, according to legend, Mithradates (aka Mithridates) VI of Pontus (on the shores of the Black Sea in Turkey) attempted to become resistant to poisons by taking gradually increasing doses. He was also reputed to have conducted toxicological experiments on condemned prisoners, culminating in the creation of mithridate – a medicine that combined all known antidotes in one potent formula.
It didn't work against Roman armies, however, and when Mithradates was defeated by the military leader Pompey in 66 BC, the recipe supposedly arrived in Rome. Emperor Nero's physician Andromachus developed it into a 64-ingredient composition, which became known as theriac. Most of the ingredients were botanical (including opium), but viper's flesh was a notable component.
In spite of early scepticism, theriac took off as a prized (and expensive) cure-all. By the 12th century Venice was the leading exporter and the substance had a high profile in European, Arabic and Chinese medicine alike. Its fortunes waned after 1745, however, when William Heberden debunked its alleged efficacy and suggested that enterprising Romans had exaggerated the Mithradates story for their own gain.
Even so, theriac remained in some European pharmacopoeias until the late 19th century.

_{Tin-glazed Italian pharmacy jar (or albarello) from Rome or Deruta, used by the Jesuits and intended for storing theriac, 1641. (Photo by SSPL/Getty Images)}

5) General anaesthesia helped cancer patients at the beginning of the 19th century

Kan Aiya, a 60-year-old woman, had lost many loved ones to breast cancer. She had seen her sisters die of the cruel disease, so when a tumour formed in her left breast she was well aware of the likely outcome. For her, however, there was a chance of survival – an operation. It was 1804 and she was in the best possible place for surgery – feudal Japan.
Seishu Hanaoka (1760–1835) studied medicine in Kyoto and set up a practice in his hometown of Hirayama. He became interested in the idea of anaesthesia owing to stories that a third-century Chinese surgeon Houa T'o had developed a compound drug enabling patients to sleep through the pain. Hanaoka experimented with similar formulae and produced Tsusensan, a potent hot drink. Among other botanical ingredients it contained the plants Datura metel (aka Datura alba or ‘devil's trumpet’), monkshood and Angelica decursiva, all of which contain some potent physiologically active substances.
Tsusensan had quite a kick and if you glugged it down willy-nilly you would probably die, but in the correct dosage it rendered patients unconscious for between six and 24 hours, allowing ample time for surgery.
On 13 October 1804, Hanaoka excised Kan Aiya's tumour while she was under general anaesthesia, going on to operate on at least 150 more breast cancer patients and people with other conditions. Sadly, Kan Aiya is thought to have died of her disease the following year, but had been spared the agony that still characterised surgery in the West.

  6) A ‘leech craze’ hit 19th-century Europe

The medicinal leech has been in use for thousands of years, and is even today considered to be a way of restoring venous circulation after reconstructive surgery. But it was in the early 19th century that the leech really soared in popularity. Led by French physician François-Joseph-Victor Broussais (1772–1838), who postulated that all disease stemmed from local inflammation treatable by bloodletting, the ‘leech craze’ saw barrels of the creatures shipped across the globe, wild leech populations decimated almost to extinction, and the establishment of prosperous leech farms.
Leeches had advantages over the common practice of bloodletting using a lancet – the loss of blood was more gradual and less of a shock for those of delicate constitution. And because Broussais's followers used leeches in place of all the other medicines at the 19th-century physician's disposal, patients were spared some harsh remedies that might otherwise have made them feel worse. In 1822, a British surgeon called Rees Price coined the term sangui-suction for leech therapy.

 7) Ugandan surgeons developed life-saving caesarean operations

In 1884, the caesarean section was not a new idea. It dated from the time of the Caesars, for a start, when Roman law required the procedure to be carried out in the event of a woman's death in childbirth.
Over the centuries, reports occasionally surfaced of caesarean sections saving the lives of both mother and baby, but even after the introduction of antiseptic methods and anaesthesia, caesareans remained a dangerous last resort. So Edinburgh surgeons were surprised to hear a lecture by Robert Felkin, a missionary doctor, about a successful operation that he had witnessed in the African kingdom of Bunyoro Kitara five years earlier.
The operation, Felkin reported, was carried out with the intention of saving both lives. The mother was partially anaesthetised with banana wine. The surgeon also used this wine to wash the surgical site and his own hands, suggesting awareness of the need for infection control measures. He then made a vertical incision, going through the abdominal wall and part of the uterine wall, before further dividing the uterine wall enough to take the baby out. The operation also involved removing the placenta and squeezing the uterus to promote contraction.

_{The first surgical treatment of breast cancer performed under general anaesthetic by Seishu Hanaoka (1760-1836) in 1804 (colour litho), Japanese School (19th century). (Private Collection/Archives Charmet/Bridgeman Images)}
The means of dressing the incision was also highly developed: the surgeon used seven polished iron spikes to bring the edges of the wound together, tying them in place with bark-cloth string. He then applied a thick layer of herbal paste and covered this with a warm banana leaf held in place with a bandage. According to Felkin's account, the mother and her baby were still doing well when he left the village 11 days later.
Although caesarean operations had been performed in Africa by white surgeons before this date, the procedure appeared to have been developed independently by the Banyoro people – a somewhat discomfiting realisation for a British audience familiar with colonial tales of ‘savages’.

Caroline Rance blogs at www.thequackdoctor.com about the history of medical advertising and health fraud. Her latest book, The History of Medicine in 100 Facts (Amberley Publishing, 2015), explores medicine's history in bite-sized topics, from prehistoric parasites to the threat of antibiotic resistance.

When did medical practitioners start to be called ‘doctor’?

History Extra

Illustration by Glen McBeth

Anyone with a doctorate can be called ‘doctor’. The doctor’s degree was a product of the medieval universities; this higher degree simply conferred the right to teach.
It could be in law, theology, philosophy or medicine (and other disciplines now). The medical hierarchy of practitioners was physician, surgeon and apothecary, and each had defined functions. Physicians, who had gone to university, were the real ‘doctors’, and surgeons and apothecaries, who trained by apprenticeships, were ‘mister’.
But the verb ‘to doctor’ is also very old, and has meanings outside medicine too: to change something, whether in a human body or an inanimate object. This ‘doctoring’ verb made it easy to call medical practitioners ‘doctors’. The rise of the surgeon-apothecary from the mid-18th century consolidated this shift in address. This new group, the ancestor of the modern GP, took care of the whole family: diagnosing, delivering babies, compounding and dispensing drugs, and other surgical tasks.
Edward Jenner, pioneer of vaccination against smallpox and a medical practitioner, would have been called ‘Dr’ Jenner, whereas his teacher, the famous John Hunter (1728–93), would, as a pure surgeon, have been addressed as ‘Mr’ Hunter. Neither Jenner nor Hunter had doctorates, unlike university-trained physicians at the time.
Answered by: William Byrnum, professor emeritus, University College London

9 weird medieval medicines

Anatomical chart of the human body, from 15th-century Tractatabus de Pestilentia (Treatise on Plague) © The Art Archive / Alamy

History Extra

Just as we do today, people in the medieval period worried about their health and what they might do to ward off sickness, or alleviate symptoms if they did fall ill. Here, historian Toni Mount reveals some of the most unusual remedies commonly used…

Medicines in the medieval period were sometimes homemade, if they weren’t too complicated. Simple medicines consisted of a single ingredient – usually a herb – but if they required numerous ingredients or preparation in advance, they could be purchased from an apothecary, rather like a modern pharmacist.
Although some medical remedies were quite sensible, others were extraordinarily weird. They all now come with a health warning, so it’s probably best not to try these at home...

1) St Paul’s Potion for epilepsy, catalepsy and stomach problems

Supposedly invented by St Paul, this potion was to be drunk. The extensive list of ingredients included liquorice, sage, willow, roses, fennel, cinnamon, ginger, cloves, cormorant blood, mandrake, dragon’s blood and three kinds of pepper.
Although this sounds like a real witch’s brew, most of the ingredients do have some medicinal value: liquorice is good for the chest – it was and continues to be used to treat coughs and bronchitis; sage is thought to improve blood flow to the brain and help one’s memory, and willow contains salicylic acid, a component of aspirin. Fennel, cinnamon and ginger are all carminatives (which relieve gas in the intestines), and would relieve a colicky stomach.
Cormorant blood – or that of any other warm-blooded creature – would add iron for anaemia; mandrake, although poisonous, is a good sleeping draught if used in small doses, and, finally, dragon’s blood. This isn’t blood at all, and certainly not from a mythical beast! It is the bright red resin of the tree Dracaena draco – a species native to Morocco, Cape Verde and the Canary Islands. Modern research has shown that it has antiseptic, antibiotic, anti-viral and wound-healing properties, and it is still used in some parts of the world to treat dysentery – but I’m not sure it could have done anything for epileptics or cataleptics.

2) A good medicine for sciatica [pain caused by irritation or compression of the sciatic nerve, which runs from the back of your pelvis, all the way down both legs]

A number of medieval remedies suggested variations of the following: “Take a spoonful of the gall of a red ox and two spoonfuls of water-pepper and four of the patient’s urine, and as much cumin as half a French nut and as much suet as a small nut and break and bruise your cumin.
Then boil these together till they be like gruel then let him lay his haunch bone [hip] against the fire as hot as he may bear it and anoint him with the same ointment for a quarter of an hour or half a quarter, and then clap on a hot cloth folded five or six times and at night lay a hot sheet folded many times to the spot and let him lie still two or three days and he shall not feel pain but be well.”
Perhaps it was the bed rest and heat treatments that did the trick, because I can’t see the ingredients of the ointment doing much good otherwise!

3) For burns and scalds

“Take a live snail and rub its slime against the burn and it will heal”
A nice, simple DIY remedy – and yes, it would help reduce blistering and ease the pain! Recent research has shown that snail slime contains antioxidants, antiseptic, anaesthetic, anti-irritant, anti-inflammatory, antibiotic and antiviral properties, as well as collagen and elastin, vital for skin repair.
Modern science now utilises snail slime, under the heading ‘Snail Gel’, as skin preparations and for treating minor injuries, such as cuts, burns and scalds. It seems that medieval medicine got this one right.

4) For a stye on the eye

“Take equal amounts of onion/leek [there is still debate about whether ‘cropleek’, as stated in the original recipe, in Bald’s Leechbook, is equivalent to an onion or leek today] and garlic, and pound them well together. Take equal amounts of wine and bull’s gall and mix them with the onion and garlic. Put the mixture in a brass bowl and let it stand for nine nights, then strain it through a cloth. Then, about night-time, apply it to the eye with a feather.”
Would this Anglo-Saxon recipe have done any good? The onion, garlic and bull’s gall all have antibiotic properties that would have helped a stye – an infection at the root of an eyelash.
The wine contains acetic acid which, over the nine days, would react with the copper in the brass bowl to form copper salts, which are bactericidal. Recently, students at Nottingham University made up and tested this remedy: at first, the mixture made the lab smell like a cook shop, with garlic, onions and wine, but over the nine days the mixture developed into a stinking, gloopy goo. Despite its unpromising odour and appearance, the students tested it for any antibiotic properties and discovered that it is excellent. The recipe is now being further investigated as a treatment against the antibiotic-resistant MRSA bug, and it looks hopeful.
The ancient apothecary was right about this remedy, but it was one that needed to be prepared in advance for sale over the counter.

_{The apothecary's shop. From Johannis de Cuba Ortus Sanitatis, Strasbourg, 1483. © Pictorial Press Ltd / Alamy}

5) For gout

“Take an owl and pluck it clean and open it, clean and salt it. Put it in a new pot and cover it with a stone and put it in an oven and let it stand till it be burnt. And then stamp [pound] it with boar’s grease and anoint the gout therewith.”
Poor owl! I can’t think that this would have helped the patient very much either…

6) For migraines

“Take half a dish of barley, one handful each of betony, vervain and other herbs that are good for the head; and when they be well boiled together, take them up and wrap them in a cloth and lay them to the sick head and it shall be whole. I proved.”
Betony [a grassland herb] was used by the medieval and Tudor apothecary as an ingredient in remedies to be taken internally for all kinds of ailments, as well as in poultices for external use, as in this case. Modern medicine still makes use of the alkaloid drugs found in betony for treating severe headaches and migraine.
Vervain’s glycoside [a class of molecules in which, a sugar molecule is bonded to a ‘non-sugar’ molecule] derivatives too are used in modern treatments for migraine, depression and anxiety, so once again the apothecary knew what he was doing with this recipe!

7) For him that has quinsy [a severe throat infection]

“Take a fat cat and flay it well, clean and draw out the guts. Take the grease of a hedgehog and the fat of a bear and resins and fenugreek and sage and gum of honeysuckle and virgin wax. All this crumble small and stuff the cat within as you would a goose. Roast it all and gather the grease and anoint him [the patient] with it.”
With treatments like this, is it any wonder that a friend wrote to Pope Clement VI when he was sick, c1350, to say: “I know that your bedside is besieged by doctors and naturally this fills me with fear… they learn their art at our cost and even our death brings them experience.”

8) To treat a cough

“Take the juice of horehound to be mixed with diapenidion and eaten”
Horehound [a herb plant and member of the mint family] is good for treating coughs, and diapenidion is a confection made of barley water, sugar and whites of eggs, drawn out into threads – so perhaps a cross between candy floss and sugar strands. It would have tasted nice, and sugar is good for the chest – still available in an over-the-counter cough mixture as linctus simplex.

9) For the stomach

“To void wind that is the cause of colic, take cumin and anise, of each equally much, and lay it in white wine to steep, and cover it over with wine and let it stand still so three days and three nights. And then let it be taken out and laid upon an ash board for to dry nine days and be turned about. And at the nine days’ end, take and put it in an earthen pot and dry over the fire and then make powder thereof. And then eat it in pottage or drink it and it shall void the wind that is the cause of colic”
Both anise and cumin are carminatives, so this medicine would do exactly what it said on the tin – or earthen pot. The herbs dill and fennel could be used instead to the same effect – 20th-century gripe water for colicky babies contained dill.
This remedy would have taken almost two weeks to make, so patients would have bought it from the apothecary, as needed.
Toni Mount is an author, historian and history teacher. She began her career working in the laboratories of the then-Wellcome pharmaceutical company [now GlaxoSmithKline], and gained her MA studying a 15th-century medical text at the Wellcome Library. She is also a member of the Research Committee of the Richard III Society. 

Forget Folk Remedies, Medieval Europe Spawned A Golden Age of Medical Theory

Does your bad humour ail thee? Credit: Wellcome Library Collection View full size image

This article was originally published at The Conversation. The publication contributed the article to Live Science's Expert Voices: Op-Ed & Insights.
It’s often said that there was no tradition of scientific medicine in medieval times. According to the usual narrative of the history of progress, medicine in the European Middle Ages – from around the 5th to the 15th centuries – was a formless mass of superstition and folk remedies; the very antithesis of science.
And those who look in medieval medicine for precursors of modern pathology, surgery, antibiotics, or genetics will of course find it a failure. But if we’re looking for a coherent medical system that was intellectually and emotionally satisfying to its practitioners and patients, and based on written authorities, rational enquiry, and formal teaching, then medieval Europe produced one of the most influential and scientific medical systems in history.
Medieval medicine did take many forms. Some of it was non-literate and based on inherited traditions, some on the use of simple herbs, while other remedies were based on blaming elves or demons or sin for sickness. Sometimes it was practised by women for their families and servants.
But if we are careful with our definition of “science”, and use it to mean not (as often happens) what we now think is correct but rather a rationally organised body of knowledge about the natural world, then medieval medicine did use scientific methods.
And it was in the 11th century that Europe witnessed a medical revolution. Scholars and physicians in southern Italy, especially in the city of Salerno, began to study and teach ancient medical texts after a hiatus of 500 years or more. We know this from surviving 11th and 12th-century manuscripts that are only now being collectively studied, especially those of a little known medical textbook called the Articella.

The Articella

How we view medieval medicine, at the expense of alternate forms, is partly due to the nature of the surviving evidence we have. Apart from rare archaeological finds, this comes mostly from manuscripts primarily from the second half of the Middle Ages (c.1000-1500AD). Many of these manuscripts are copies of medical texts written much earlier, between about 400BC-1000AD. Some of these were in Latin, and had long sat ignored in monastic libraries. Others were in Arabic or Greek and were traded or carried across the Mediterranean to be translated into Latin.
These texts didn’t just appear; they were actively sought, translated and edited by newly curious medical teachers and practitioners. And they are how we know about a revolution in 11th-century European medicine.
By about 1100AD, an international body of philosophers and physicians, stretching north from Salerno to England, and east from Iberia to the German empire, had organised five Latin texts into a textbook called Ars Medicinae (“The Art of Medicine)” and later nicknamed the Articella (“The Little Art”). The five texts were the Isagoge (or “Introduction”) of Johanittius (an Arab Christian), the Aphorisms and Prognostics of Hippocrates, On Urines by Theophilus, and On Pulses by Philaretus. After about 1150, many copies of the Articella also include Galen’s Tegni (or Ars medica).
This may seem an overwhelming syllabus, but the entire Articella is shorter than any modern medical textbook. Each text served a different function in the classroom. The Isagoge was a brief introduction to medical theory. And through Hippocrates' Aphorisms and Prognostics, students learned brief and useful statements on medical practice by this father of medicine. The Byzantine Greek texts by Theophilus and Philaretus were the most practical, giving instructions for making diagnoses and prognoses with a patient’s urine and pulse. The Tegni encompassed and surpassed the first five texts, and so served as the basis of university exams and commentaries for centuries to come.
By 1200 the Articella was accepted throughout Europe as the foundation of medical education. Medieval university faculties of medicine made the Articella required reading along with the Canon of Medicine by Avicenna, first translated into Latin in the 1170s.

Articella, still going in 1534.
Credit: Wellcome Images, CC BY-NC

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And after the invention of printing, the book appeared in at least 16 editions to 1534, surviving well beyond the usual dates for the Middle Ages.
It’s obvious that the Articella was popular, but why does it matter so much? The vast number of healers, men and women, had never read it. But the widespread acceptance of the Articella set the bar for medicine across Europe.
Every doctor, especially itinerant male healers in search of a wide clientele, had to know (or at least pretend to know) the rational medicine taught in the schools.
Knowledge of this distinctly medieval medicine, which was built on Greek and Arabic foundations but developed by generations of medical teachers and students into something new, was expected of any proper physician. Even those not directly involved in medicine, such as philosophers, lawyers, and theologians, began to incorporate learned medicine into their writings.

Corruption of the humours

By the 12th century and up to the 16th, the majority of people in the noble, mercantile, and clerical classes of European cities agreed on a specific form of medical learning, generally known as scholastic medicine. Ideally, this medicine was practised only by Christian men and written in Latin. It was a highly literate science that was taught in the universities, and was based on the writings of ancient Greek and medieval Arabic physicians, especially Hippocrates (5th century BC), Galen (c.130-200AD), and Avicenna (the Latinised name of Ibn Sina, 980-1037AD) – one of the foremost thinkers in the Islamic world.
These authors and their medieval Latin followers created a medicine that was thoroughly holistic: sickness was explained by the imbalance or corruption of the four humours (blood, phlegm, yellow bile, black bile), the four principal liquids of the body. And health was achieved by the balance and proper cultivation of the humours. Each was necessary to human nature, but each could also grow too abundant or corrupted.
Physicians used these humours to explain every complaint – medical or psychological. The dominant pattern or mixture of humours determined a person’s complexion, a term referring not to the skin but to one’s entire bodily and mental constitution. And everyone’s complexion was slightly different, especially between the sexes, and also changed as one aged.
A physician’s course of treatment had to be tailored to the individual patient, or at least to their age group and gender. Diagnosis and prognosis took into consideration the whole person – using a system developed by Arab physicians out of Galen’s writings and called the “six non-naturals” – by which the physician ideally examined his patient’s food and drink, air and environment, sleep and wakefulness, motion and rest, evacuation and repletion, and emotions.
So before undertaking treatment, a physician trained in Galenic medicine took into consideration a wide range of factors, including complexion, environmental and personal “non-naturals”, and symptoms of the disease.
By the end of the Middle Ages, an educated physician might also look to the stars and cast horoscopes of his patient to determine prognosis and course of action. And treatments were generally conservative, tending toward advice on diet, exercise or bathing. When medicines were prescribed they were based on local herbs and alcohol for the average client or exotic spices and sugar for the wealthy – the former available from any village herbalist and the latter from apothecaries in urban areas.

Placebo action

Most of the regimens and prescriptions in surviving manuscripts would not have cured any condition, apart from improving the patient’s mood, but neither would they have done any harm. If their condition improved, credit could be given to the physician. If their did not improve, blame could be applied to anyone from the patient, the spouse, or children, or servants, the physician, or even the apothecary.
Therein lies part of the durability of medieval medicine: it offered a satisfactory explanatory system for disease in the absence of anything better, and the physician was not expected to work wonders, since he bore only part of the responsibility for treatment and cure.
The science of medieval medicine was centuries in the making: Arab physicians and teachers of the 10th to the 12th centuries, and Latin ones after the 11th worked and reworked the complicated inheritance of ancient medicine into a convenient, flexible, and rational system.
Despite its failure (by modern standards) to identify or cure most diseases, the medieval medicine of the Articella satisfied patients and practitioners for half a millennium, surviving even the Black Death and the Renaissance, to last well into the early modern era.
Winston Black does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.
This article was originally published on The Conversation. Read the original article. Follow all of the Expert Voices issues and debates — and become part of the discussion — on Facebook, Twitter and Google +. The views expressed are those of the author and do not necessarily reflect the views of the publisher. This version of the article was originally published on Live Science.
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