Category Archives: medicine

Ancient medicine

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We know the Ancient Greeks had medicine. Examples of the diseases that afflict us now, such as cancer and TB, and diseases we have managed to conquer such as smallpox, are found in their writings.

What do we know of medicine in Bronze Age Crete? Not very much. We know they used herbal remedies. An examination of Egyptian dynasties contemporary with Crete suggest other possible medical treatments. Papyri and scenes inscribed on walls depict medical instruments. The purpose of some of them, however, are still a mystery. Instruments from later dynasties have been found as well.

Papyri, and clay tablets from Mesopotamia, show that a huge feature in medicine was divine intervention. Prayer and animal sacrifice, which we know were also employed in Bronze Age Crete, were important features. Amulets, to keep demons and bad outcomes at bay, were commonly used. Astral medicine, i.e. using the stars to predict the best time for the best outcomes, was also very important. The zodiacal calendar was used to predict the most propitious times for medical treatments.

I want to add that seers were used to predict the best times for all important activities. The flights of birds was one method. The sacrifice of a sheep and the reading of the organs was another.

Our current medical system certainly has flaws. I am very glad, though, that a surgery appointment does not depend on how a flock of birds fly through the sky!

Medical care in 1802 – Pain management

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To modern eyes, health care 200 years ago was primitive at best, lethal at worse. A recent knee replacement inspired me to consider medical care and pain management. (A friend of mine told me that a knee replacement is essentially an amputation of one’s leg.) However, it is described, it is a painful procedure.

The choices for treating pain were limited. I think we have all heard the story of the wounded man being treated with a glass of whiskey and a stick clamped between the teeth. Alcohol was used to help the patient into insensibility as well as a disinfectant.

Another choice was salicylic acid, the active ingredient in aspirin. Of course, it wasn’t aspirin. yet; the distilling of salicylic acid did not take place until late in the nineteenth center. No, it had to be used in its natural state. The leaves of the willow tree was steeped into a tea which was given to the patient as an analgesic. As a blood thinner and an anti-inflammatory, it is given to surgical patients and heart attack patients alike. It is still one of the most widely used medications in the world.

Finally, there were the opiates. The sap of the opium poppy has been used for millennia to treat pain. Of course, none of the stronger extracts had been distilled from the poppy until 1820 (morphine) and beyond.

One of the early methods of gaining the analgesic effects of the opium was to steep the straw into a tea. (I allude to this in Death in Salem with a character addicted to ‘straw tea’.) But the most common method of ingesting opium was as laudanum, a tincture of opium and alcohol. A reddish brown liquid, it was extremely bitter. By the early eighteen hundreds, laudanum was common and during the eighteen hundreds it became an ingredient in many patent medicines. It was frequently prescribed to women for menstrual cramps and various aches and pains. As might be expected, addiction was prevalent. Mary Todd Lincoln, Abraham Lincoln’s wife, was an addict. Another fun fact: nurses would spoon feed laudanum to the infants in their care to help them sleep. And if that doesn’t make your hair curl, I don’t know what will.

Laudanum is still available by prescription.

Our world of Tylenol and Ibuprofen seems almost like paradise in comparison.

Epidemics – Tuberculosis

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In my Will Rees mysteries, he meets people who are ill with tuberculosis several times. The frequency of deaths from this disease in my fiction in not an accident. It was a pandemic that still has not been eradicated. In 2017, there were more than 10 million cases of active TB which resulted in 1.6 million deaths; it is therefore the number one cause of death from an infectious disease. Most of these deaths, and most of the new infections, occur in the developing world.

I was mostly familiar with TB as ‘consumption’, a disease that afflicted Victorian poets. Although TB was common in both the poets, the upper classes and the slum-dwellers, it was not a new disease during Victorian times. It has been around for millennia. Bison remains from 17,000 years ago display the effects of the disease.  (No one is sure if TB jumped to humans from the bovine like smallpox or whether it developed independently.) TB scars have been found on Neolithic skeletons and on the spines of Egyptian mummies.

So, it has been around a very long time. Despite that, it was not identified as a single disease until 1820 and the bacillus that caused it was not discovered until 1882 (by Robert Koch. He received the Nobel prize but failed to recognize that one of the transmissions of TB was via infected milk.)

Before the advent of antibiotics, and even with the best care in the sanatoriums set up for this purpose, 50% of the patients died within five years. In 1815, one in four died of the illness in England.

Antibiotics beat back the disease, but new drug resistant strains raise the possibility of a new epidemic. Even now, in modern times, about one quarter of the world’s population is infected with TB.

The white plague

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In my Will Rees mysteries, he meets people who are ill with tuberculosis several times. The frequency of deaths from this disease in my fiction in not an accident. It was an epidemic and still has not been eradicated. In 2017, there were more than 10 million cases of active TB which resulted in 1.6 million deaths; it is therefore the number one cause of death from an infectious disease. Most of these deaths, and most of the new infections, occur in the developing world.

 

I was mostly familiar with TB as ‘consumption’, a disease that afflicted Victorian poets. Although TB was common in both the poets, the upper classes and the slum-dwellers, it was not a new disease during Victorian times. It has been around for millennia. Bison remains from 17,000 years ago display the effects of the disease.  (No one is sure if TB jumped to humans from the bovine like smallpox or whether it developed independently.) TB scars have been found on Neolithic skeletons and on the spines of Egyptian mummies.

 

So, it has been around a very long time. Despite that, it was not identified as a single disease until 1820 and the bacillus that caused it was not discovered until 1882 (by Robert Koch. He received the Nobel prize but failed to recognize that one of the transmissions of TB was via infected milk.)

 

Before the advent of antibiotics, and even with the best care in the sanatoriums set up for this purpose, 50% of the patients died within five years. In 1815, one in four died of the illness in England.

 

Antibiotics beat back the disease, but new drug resistant strains raise the possibility of a new epidemic. Even now, in modern times, about one quarter of the world’s population is infected with TB.

Diabetes circa 1800

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As Rees investigates murders, he invariably meets people who are ill. Illness and death was a constant companion. Illnesses: measles, mumps, diphtheria carried off infants and children; about one in five. Tuberculosis was epidemic. Women succumbed to childbirth. Simple accidents caused death, if not by the accident itself by sepsis.

Diseases we think of as modern, such as cancer or diabetes were present but not identified by name.

How do we know diabetes existed. About 3000 years ago the Egyptians described an illness with excessive thirst, urination and weight loss, the symptoms of Type I diabetes. In India they discovered they could use ants to detect the disease because the ants were drawn to the sweetness. And the Greeks called the disease diabetes mellitus ; diabetes for siphon or pass through and mellitus for sweet.

Early treatments included a diet of whole grains, milk and starchy foods, rancid animal meat, veal and mutton, green vegetables. Other treatments recommended exercising, reducing stress, wearing flannel – seriously. As one might expect, the true causes of Diabetes and possible treatments were not identified until modern times. In 1889, Joseph von Mering and Oskar Minkowski found that removing the pancreas from dogs led them to develop diabetes. In 1910 Sir Edward Albert Sharpey-Schafer named the missing chemical, without which the body could not survive, insulin. That means island because the cells in the islets of Langerhans in the pancreas produce it.

The first human subject took an insulin injection in 1922. So, although this illness has been with us a long time, its identification and the treatment is recent.

Why am I so interested in diabetes? Read Simply Dead and find out.

The Shakers and Herbs – Part 2 – Medicinal Weeds

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Many of the plants we despise as weeds actually have qualities that render them useful as medicines, dye plants or more. Take the humble dandelion, for example. First of all, it is not native to North America but was brought over by the first colonists. The leaves are edible and I’m sure most people have heard of dandelion wine. Using it as a dye produces a reddish color. I’ve also read, although never tried it, that if a woman who believes she might be pregnant urinates on the leaves and they change color, she will know she is expecting.

Medicinally, the dandelion is recommended for diseases of the liver, constipation and uterine obstructions. It should be collected when the plant is young. A freshly dried root can be used as a tonic for stomach troubles.

Broadleaf dock root, a common visitor in my yard, can be used as a purge and a tonic. The Shakers shipped great quantities of this root. In 1889, some forty four thousand pounds was shipped to one firm in Lowell Mass from Enfield, New Hampshire. Since at that time the root was selling for about 50 cents a pound, the community must have made quite a bit.

Skunk cabbage was another plant used successively as a treatment. A stimulant, the root was used for nervous irritability (not sure what this means) and whooping cough, asthma, chronic rheumatism and spasms.

Burdock leaves were used as a cooling poultice.

I’m sure you get the idea. Some of the other weeds they harvested and sold are: Butternut bark (the hulls of the nuts make a yellowish gray dye), elder flowers (tasty as well as medicinal), Yarrow, hoarhown, bugle, crosswort (or boneset) and many more.

They also made combinations as lozenges and syrups. Their cough medicine included wild cherry bark, seneca snakeroot with rhubarb and a tiny amount of morphine. (The Shakers also grew the opium poppy and sold the raw opium at tremendous prices.) Another popular offering was Tamar laxative. Among other ingredients it included Tamarind, prunes, fruit of cassia and sugar. The resulting paste was dried and cut into lozenges.

Interestingly, they also sold concentrated sarsaparilla syrup. Sarsaparilla is also known as wild licorice.

Although the Shakers were a religious community, they were also canny – but honest – businessmen and women. Next up, the marketing and selling of the herbs.

Folk Medicine

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Herbal remedies are certainly part of folk medicine. Tonics were a regular part of the health regimen and reading the ingredients explains why. Willow and poplar bark, spearmint, wormwood and ginseng – all used in various ways now.

But there is a lot more to it. Beech leaves (astringent and used for skin injuries) might be boiled down into a poultice, but other parts might be added to the remedies. For example, regular nose bleeds might be treated by a mixture of alum, red bath root and blood root mixed together into a powder that can be inhaled. The blood root and the red bath root symbolize the blood. Many folk medicine relied on both sympathetic and contagious magic. So a knife might be placed under an expectant mother to cut the pain of childbirth.

Or, in contagious magic, items that were in contact with the body would have special powers. Sailors relied on the caul (the membrane covering a new baby) as protection against drowning. A sore throat would be cured by applying camphor to a sock (that had been work on the right foot) and wearing it around the neck. While we still use the camphor, we no longer expect it to be smeared over a dirty sock.

Incantations or blessings were also said over the cure or affected person.

To us, folk medicine is suspect, partly because of some of the farm ingredients. Cow manure might be used as a poultice of sheep manure strained with cider and drunk. Ugh. Croup might be cured with a spoonful of skunk oil.

There were also people reputed to have special powers. Blood stoppers were credited with the power to stop bleeding (kind of like the dowsers who find water.) Some of them could find lost things. The seventh son was especially powerful.

Modern medicine has moved away from most of these old remedies although faith healing is still practiced in certain sects. However, progress to current medicine has a down side. We have lost touch with nature and the natural remedies found in herbs and tree bark.

Next up: The Shakers and Herbs.

Herbal Remedies

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Herbal remedies have been used for thousands of years and are still used today – although frequently the active ingredient has been removed and transformed into a pill. The examination of Neanderthal remains, for example, reveals traces of poplar bark and willow bark (bark which contains high levels of salicylic acid – otherwise known as the active ingredient in aspirin – as well as the kind of mold that is used for penicillin.  Lavender is still commonly used as are the culinary herbs. Many of them were used in the past for their medicinal properties. Lavender, for example, was used for flatulence and fainting.

But well into the 1800’s, before the advent of antibiotics, herbal remedies were the only choice. Remedies were passed down orally and usually kept secret.  Many people did not visit a doctor until adulthood if in fact they ever did. It is fortunate that many of these remedies were efficacious. Many of the male doctors of the time accepted women with herbal knowledge but would not share their medical knowledge. Women were the ‘weaker vessels’ and so should be restricted to the garden variety remedies. But the doctors were not above borrowing these remedies; many of the tonics and teas and poultices were effective. In the early 1700’s a Mrs. Feeld (a midwife) had a ‘green’ ointment which contained such herbs as sorrel, bay leaves, sage, lettuce, camomile and violets. (The Shakers sold herbal remedies and sage, used in tonics, was an astringent and sorrel, also in tonics, was an antiseptic.) Early colonists used sage to treat everything from gray hair to yellow teeth to failing memory. It does not do all of that BUT it is found in some treatments for the throat and also for cognitive issues. Lettuce was used as a mild narcotic. Who knew?

As mentioned above, midwives frequently treated many illnesses.

My mother always grew a flower – Calendula – which has pale yellow to orange flowers. It looks like of like marigolds. Well, this was used for topical ointments for burns and cuts. Neither of us knew its medicinal properties. Another plant, which I consider a weed and eradicate whenever I can, is St. Mary’s thistle. It can also be used topically. Other culinary herbs, such as rosemary, was used in a tonic for coughs and colds and the oil was used as a liniment. Thyme was used for stomach aches.

Many of the midwives were Indians or part-Indians. (In Vermont and Maine, they were frequently from the Abenaki tribe.) Their use of herbs was extensive and many Colonists learned from them. More about this in a future post.

Herbal remedies were also part of a larger topic – folk medicine. Some of these treatments, although they sound very odd, actually work. Next week, folk medicine.

Women’s Health in the 1700s

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Pregnancy took an enormous toll on women. Besides the tremendous – and physical work – of running a household, women helped in the fields when needed. Childbirth was dangerous and it was not uncommon for a farmer to bury three wives.

We think that midwives handled the lying-in and birth for the mothers. Not exactly. Both Ministers and doctors attended. (I suspect male doctors were already moving into this sphere, although it is usually assumed that did not happen until the mid-1800s. But why the Ministers? A review of some of the early diaries indicates that a significant number of men were both Ministers and Doctors. What about the ones who weren’t?)

But I digress.

In any event, from the writings of these men, it is clear that they treated women for a variety of ailments. From the 1700s the Commonplace Book of Thomas Robie of Salem reveals that as a physician he stepped into to prevent and promote abortion (!) and to speed and ease delivery of the baby. Because many women experienced soreness of the breasts after childbirth (and this is still true), he recommended a concoction of “Millepedes with the heads off, stampt in white wine or beer” to be taken every morning and evening. (Can I say yuck now?)

Another male healer,  parson, also treated complications of pregnancy and menstrual disorders. His cure for cramps? “. . .every night you goe to bed smell your fingers after you have picked the stinking sweat that is between your toes.” Ugh!

Many of these men did consult with female healers when unsure what to do. Although these women, relying on herbal medicines and lore passed down orally from mother to daughter, were frequently illiterate, a survey of diaries show that the men regularly borrowed recipes from the them.

For all that women were legally dependent, unable to inherit without express willed instruction from her husband, she nevertheless was extremely important in the house. Her illness or death devastated the household. She was a major player in the economy of the family besides caring for children and performing the household tasks that were essential for survival. Perhaps because mortality was so high, every life was precious.

Next up: Herbs and remedies.

Shelby – and Snow

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Snow – and Shelby

This winter has been more like living in the Arctic than the Northeast, and more like living in the Arctic than living in the Arctic. We’ve broken all kinds of records, both for cold and snow. This past week we had three storms, small ones in comparison to some of the ones we’ve had, but the snow still added up to a foot.

Even Shelby is beginning to get tired of it all. But it doesn’t stop her from going out on the trail and making sure no squirrel or rabbit has come on to her territory.

shelby snow two

 

shelby snow