This intriguing look into the medical practices of Europe some 600 years ago was written by Andrew Gaudio, a reference librarian in the Researcher and Reference Services Division.
As the world grapples with containing the COVID-19 pandemic with a range of vaccines, each with varying rates of effectiveness, it’s worth remembering that cure-alls for deadly pandemics have often proven to be more of a mirage than a reality.
The Library’s collection of medical texts from the ravages of the bubonic plague in 14th -century Europe, known as the Black Death for the color of the swollen lymph glands it caused, are an uneasy reminder of this, showing that the best practices of the era would horrify us today.
Many of these volumes are found in the Rare Book and Special Collections Division. Also, some medieval medical texts have been edited and reprinted and can be found in the Library’s general collections. They offer a window into an earlier time when even the most sophisticated doctors lacked knowledge of germ theory and microbiology. Medieval physicians had little to work with other than their own observations and past experiences in treating different illnesses; a deadly infection like the plague simply overwhelmed them. Mortality rates for the most virulent forms of the disease were reportedly as high as 95 percent.
Medical reference journals of the time show “cures” that could have helped only a little, and in some cases greatly exacerbated their patients’ suffering. Plasters made of various herbs (including, we must report, excrement) were common as treatment for buboes, as the painfully-swollen sores were called. It was thought that the technique of “bleeding” a patient in a bid to remove excess blood would restore the balance of the humors or bodily fluids of the patient to its normal state. From ancient times up to the 19th century, it was thought that the bodily fluids consisted of four humors (black bile, yellow bile, phlegm and blood) and that health could only be achieved when all humors were present in the same proportions. Bleeding a patient removed an excess amount of blood and therefore was thought to restore the humors of the body to their proper levels.
The location of bloodletting was thought to be relevant to the ailment. In one reference volume dating to about 1410 — a sort of early almanac — the authors published a rough drawing of a “vein man,” detailing where and how to bleed a patient. Each vein and location on the body was provided with instructions as to how the bleeding should be carried out, depending on the medical problem.
In their quest for a cure, some doctors reported more success than others. French physician Guy de Chauliac, who was personal physician to Pope Clement VI, claimed that he was afflicted with the plague but had cured himself.
De Chauliac’s narrative of this event is found in “Inventarium sive chirurgia magna,” Latin for “The Inventory or the Great Surgery,” published in 1363. A modern printed edition of this text is available in the Library’s general collections.
Here’s his tale. The parentheticals are mine, to help modern readers understand the text.
Regarding a cure, venesection [bloodletting], purging [most likely an emetic or a laxative] and electuaries [medicine mixed with honey] and syrupy cordials were available. The external buboes were softened with figs and cooked onions ground up and mixed with yeast and butter. Afterwards, the buboes would open and were healed. The sores were bled by applying a cupping glass, sliced open, and cauterized.
And I, to avoid defaming my reputation, did not dare to flee. With constant fear I protected myself with the preceding methods as much as I could. Nevertheless, towards the end of this mortality [the plague], I developed a continual fever with a bubo in my groin and I was sick for almost six weeks, and I was in such danger that my friends believed that I was about to die. By softening and treating the sore, as I have said, I escaped death by the command of God.
This comes from the book “Canonical medicine: Gentile da Foligno and scholasticism,” by Roger French which is in the Library’s general collections. A prominent doctor in 14th-century Italy named Gentile da Foligno was famous for treating plague patients. He ultimately died of the plague in 1348 in his quest to help the sick. That is heroic, no doubt, but some of his recommendations will cause a 21st-century reader to raise an eyebrow.
Here’s one of his mixtures for a salve: extract from an umbelliferous plant (the parsley family, including carrots and celery), the root of a lily and human excrement. It could be that of the patient. These ingredients were to be mixed together and rubbed onto the bubo. Da Foligno thought that this concoction would aid in withdrawing fluids from the sores and would therefore reduce swelling. Needless to say, this concoction actually would have worsened the patient’s condition.
The use of plants and herbs for plasters and aroma therapy were common to the era. Guidebooks on medical plants, called herbals, identified and illustrated their uses and properties. These books were prevalent in the medieval period.
In “Herbarium,” a manuscript printed in Rome in 1481, a cure for gout is offered. The text, translated from Latin: “For gout in the big toe and gout in the knee. The peridcalis plant is boiled in water and with that water you will warm your foot or knee. Next you will place on your feet or knees the crushed plant [mixed] with hog fat in a cloth. You will heal remarkably.”
That last observation, alas, is likely more hope than medical reality.
Thank you very much for your learning us
It always makes me sad to think of the many sick people who were weakened by blood-letting and then died, when they might have recovered otherwise. The story of George Washington’s death is a particular example.
Thank you for this historical perspective, proving that science is now leading the way regarding diagnosis, treatment & cures. In addition, during this devastating CoVid-19 pandemic, librarians in many different settings have played a crucial role in providing information from the most respected & trusted sources. As educational leaders, we teach that there is no room for misinformation when critical thinking skills are used to evaluate & respect information in a democratic society.
Um… maybe you should do a little more research? “Perdicalis” is supposed to have the modern scientific name “Parietaria officinalis,” common name Pellitory of the Wall.
And pellitory is supposed to be very soothing to the skin and to swellings when used externally as a compress. So it would probably make gout feel somewhat better. Not a lot, but probably better than some things.
Now, the part that’s a bit iffy is that its real power against gout is that, when taken internally, it supposedly is very good at making people urinate more, in helping the kidneys feel better, and in making them micturate out a lot of stuff like uric acid. Which is fine, if you had people taking it early enough, but probably would not help very quickly once gout set in.
But it’s possible that medieval doctors conflated the internal and external effects, and therefore thought that the external mucilage compress usefulness came from the internal kidney usefulness. That’s the only part that seems iffy. Otherwise, it’s a pretty reasonable choice of compress.
A really shockingly poor piece. Cherry-picking the most repulsive or ineffective treatments n order to promote the idea of the medieval period as ignorant while ignoring the incredibly long long list of beneficial treatments. No research done on medieval medicine- not even enough to identify the plague correctly as a bacterium, not a virus.. Perhaps consulting a medieval historian would be a good start?
Thanks for writing and pointing out the virus/bacteria error. The post has been updated. Otherwise, this short post was not intended as an academic treatise on medieval medicine. It regards treatments for the plague which, as history records by its staggering death toll, were very rarely effective.
Although bloodletting seems like low-hanging fruit when making fun of medieval medical practices, therapeutic phlebotomy (a fancy term for modern bloodletting) is scientifically established as effective for many people who suffer from too much iron in the blood (high ferritin), high hematocrit levels, or from certain hereditary diseases such as hemochromatosis and polycythemia vera. Other medieval treatments have also been found extremely effective when studied scientifically—see the Ancientbiotics project for more information on this.
The ultimate principle is not that people who lived before us were ignorant and superstitious; it’s that doctors in every age develop procedures that can be effective but are often overprescribed.