Posts by atepperm

Doctoral candidate at the University of Florida, Department of History. Part-time Ro-Man.

Medieval Drugs III: How Do I Drug Thee? Let Me Count the Ways.

This is my third and final post about medieval drugs. A big “thanks” to Joe Gabriel for recommending Points to me and to Trysh Travis for giving me a soapbox for sharing some of my interests and original research with the Points community!

Among the favorite stock images of modern medicine are the scientifically dosed drug, measured in identical pills or graduated syringes, and the thermometer. While both are modern inventions, the hypodermic syringe and thermometer reflect a tendency, shared by later medieval Islamic and European physicians, to quantify drugs, their qualities, and medicinal actions. The tendency to quantify drugs, common by the end of the Middle Ages, is the third stage in the process I proposed in my first post, by which herbal medicines were transformed into “drugs” by physicians, pharmacists, and patients who began to look at their medicines in new ways. That transformation took a number of forms and for a variety of reasons, which I’ve grouped under the themes of individualism, exoticism, and scholasticism in these three posts.

The accurate measurement of drugs, in terms of both their strength and quantity, is central to modern medicine, and began in the High Medieval universities.

By “scholasticism” I mean the intellctual processes of subjecting pharmaceutical remedies to the philosophy and science taught in the schools and universities, especially mathematics and Aristotelian physics. Universities were an invention of the High Middle Ages, a way of organizing the already present schoolmasters and students into corporations with more effective legal, economic, academic, and even spiritual powers. By about 1225 the cities of Paris, Oxford, Cambridge, Bologna, Padua, Salamanca, and Montpellier all had thriving universities. These universities provided the social and economic foundations for novel thinking about matter and physics in general, and about drugs in particular.

One of the most important developments in the medieval university, and one with a direct impact on modern science and medicine, was the practice of applying mathematics to non-spatial concepts, like heat or speed. Before the universities, these concepts could only be measured qualitatively (that pot is hotter, that horse is faster), and not quantitatively. Since Aristotle had considered quantity and quality different categories of definition, and not to be mixed, it took a huge mental leap for mental scholars to make the connection as step out of Aristotle’s shadow. If you want to quantify speed or heat, you need to develop the idea of velocity or temperature, respectively. This may sound downright modern and “scientific”, but medieval physicists took the idea of quantification and ran with it. Masters in Oxford, especially, tried to quantify non-spatial concepts that have no place in modern science: one tried to measure doubt on a sliding scale, another to measure the amount of charity in a man, and another even the amount of Christ in the Eucharistic host (yes, these are all real).

The “modernity” of medicine is often depicted by quantification, as in dosage, or body temperature.

These are extreme examples, but they’re indicative of a broad trend in Western society outlined by Alfred W. Crosby in his book The Measure of Reality. He identifies quantification as one of the most important changes in Europe in the period 1250-1600. He doesn’t really touch on medicine, but quantification changed that field as well. In this context, it’s hardly surprising that scholars of pharmacy would also want to measure exactly the amount of hot, cold, wet, or dry (Aristotle’s four elemental qualities) in a medicinal substance.  Continue reading →

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Medieval Drugs, Part 2: The Drugstore in Paradise

Welcome to the second instalment on Winston Black’s excellent Points series on medieval drugs. To read the first post in this series, check out ‘Turning Herbs Into Drugs in the Middle Ages‘.

Where do quality and health come from? Apparently only from jungles and primitive tribes.

One of the favorite advertising gambits of the alternative medicine industry is to promote the exotic nature of a cure. This is done with images of rain forests or Tibetan monasteries, hard-to-pronounce names (ylang-ylang or acai berry), or by dressing up a homely remedy (cornflower becames echinacea). This industry plays on fears of or hostility to modern, chemical pharmaceuticals, and popular beliefs that a plant sourced from an unsullied, non-Western locale, and preferably used by “primitives” must necessarily be better than our local weeds.

Such beliefs about exotic, natural remedies (whether genuinely believed or used deceptively) are not new. The favorite drugs of the High Middle Ages were advertised as coming from far away, in the lands of Arabs and Indians, or from Paradise itself. Our modern paradises tend to be jungles or hidden valleys, the farther from Europe or America, the better. Medieval people didn’t need new paradises; they had the real thing in the Garden of Eden, never seen by sinful humanity but firmly believed in. Everyone knew it was the best place on Earth, and most agreed it lay far to the East. (Want to know more? Try Jean Delumeau’s History of Paradise).

Exotic materia medica laid out neatly on a shelf, including sapphires, coral, mercury, a squid, and mumia, a secretion of the spinal column in Egyptian mummies. From Robinet Testard’s lavishly illuminated edition of the Livre des Simples Médecines, a French adaptation of Matthaeus Platearius’ Circa instans.

In last week’s post, I put forward the idea—as a historical exercise—that drugs were an invention of High Medieval culture. This applies not to the contents of the drugs, but how they were understood, sourced, packaged, and sold—drugs as a cultural construct, representing new attitudes toward medical practice and herbs that had been used for centuries. The transition from herbs to drugs included a change in where philosophers and pharmacists thought the best drugs came from, or at least in where they claimed they had come from. Ideas about the nature of Paradise were central to this change: even if we can’t enter Paradise any more, so the argument ran, we can still obtain its healing plants and craft the very best drugs. But like modern websites, which can deliver health secrets from the deepest jungle to your door by UPS, exotic medieval drugs also had to be made accessible (if only to the wealthy) through pharmaceutical manuals and urban apothecaries.

One of the main aspects of Paradise was abundant spices, valuable in commerce, cuisine, and medicine. Clear lines were drawn between “spices” and “herbs”, even if we now find all of them on the spice rack. In the seventh century St. Isidore, archbishop of Seville, made the distinction: “Spices are whatever India or Arabia or other regions produce that have a fragrant scent”. The herbals of Macer Floridus and Henry of Huntingdon both have separate sections for herbs and spices. Macer’s twelve spices were pepper, pellitory, ginger, cumin, galangal, zedoary, cloves, cinnamon, costus root, spikenard, frankincense, and aloe. Henry added several dozen more spices, but both authors were right: these spices did come from central and east Asia. As European knowledge of Asia grew, the spices moved farther away. In the fourteenth century the travel writer John Mandeville claimed that farther east than Eden itself is the land of Java where “there grow all manner of spices more abundantly than anywhere else, such as ginger, cinnamon, nutmegs, cedar and mace”. (For more on medieval spices, I recommend Paul Freedman’s 2008 book, Out of the EastContinue reading →

Turning Herbs into Drugs in the Middle Ages

We here at Points are delighted to welcome a new guest blogger for the next few weeks: Winston Black, an intellectual historian of medieval England and France who has published several essays on medical and religious education, and an edition, translation, and study of Henry of Huntingdon’s Anglicanus Ortus: A Verse Herbal of the Twelfth Century (Toronto and Oxford, 2012). He is currently the Haslam Postdoctoral Fellow in the Marco Institute for Medieval and Renaissance Studies of the University of Tennessee.

A recent essay in The Guardian compares modern cough medicines to the medieval cure-all theriac. The picture painted of medieval medicine is not so patronizing as usually found in the press: according to the author, neither ‘drug’ actually cures anything, there was a vigorous market for both, and both possessed some sort of placebo effect. The similarities end there. Whereas most modern cough medicines rely on sweeteners, affordability, and easy access for their appeal, the lure of theriac lay in its exotic, even repulsive content (viper’s flesh as the main ingredient), its cost (exorbitant), and the supposed difficulty in preparing it. Arnald de Villanova, a professor at the medical school of Montpellier around 1300, wrote an entire treatise on the topic, “On the dosage of theriac medicines” (De dosi tyriacalium medicinarum).

A copy of the “Tacuinum sanitatis” (‘Tables of Health’) from Vienna, ca. 1400, uses a well-stocked apothecary shop to illustrate the description of triacha, theriac.

Theriac is frequently held up as the medieval drug par excellence, and it probably was by the fourteenth century, but there were centuries of drug therapy before theriac was rediscovered. There was, in fact, an intellectual and economic gulf between the herbal pharmacy of much of the Middle Ages and the mature drug culture of the Later Middle Ages. How did this change occur? How did herbs become ‘drugs’?

Albarello vase for theriac; Italy, 1641.

There are several problems in discussing medieval drugs. The main problem is one of definition. The word ‘drug’ was not used until the very end of the Middle Ages to refer to medicine (droge meant ‘supply’ or ‘barrel’). Moreover, most of the substances we call ‘drugs’ didn’t exist or were rarely used then, such as refined or synthesized chemical compounds, legal stimulants like caffeine or nicotine, or illegal recreational drugs derived from marijuana or opium poppies. But if we use ‘drug’ in the broadest sense not as a substance that has by its nature a medicinal or intoxicating effect on an organism but rather as one that the user or provider thought would have such effects, this allows us to consider as ‘drugs’ a huge range of natural substances used in medieval medicine. For God, in a popular medieval view, provided the entire world for the benefit of mankind, and drugs could therefore be found everywhere, potentially in any animal, vegetable, or mineral. Continue reading →

It’s Official! Dr. Bob’s Home and Stepping Stones are National Historic Landmarks

It’s official!  Ken Salazar, the Secretary of the Interior, has formally designated a new round of National Historic Landmarks (NHL), including Stepping Stones, the longtime home of Bill and Lois Wilson in Katonah, New York, and Dr. Bob’s Home, the residence of Dr. Bob and Anne Smith, in Akron, Ohio.  As I have written previously, I had the privilege of working with a team of graduate students from the University of Michigan on the NHL nomination for Dr. Bob’s Home.  Last May, we traveled to Washington, D.C., to present the nomination to the Landmarks Committee of the National Park Service, one step in the process.  Now, we are thrilled to learn that both nominations have cleared the final hurdle with the Secretary’s signature.

Kudos to the NHL staff for coordinating the nominations of Dr. Bob’s Home and Stepping Stones.  The two sites together illustrate the genesis of Alcoholics Anonymous in Akron with Dr. Bob, Anne, Bill, and a small circle of others; and its later explosive growth as an organization, as well as the development of Al-Anon, under the stewardship of Bill and Lois.  In this way, the designation process itself provides an interpretive framework for understanding the evolution of the Alcoholics Anonymous fellowship.

National Historic Landmark status is reserved for places that “possess exceptional value and quality in illustrating or interpreting the heritage of the United States.”  Perhaps the most important aspect of this designation is that it gets the story of Alcoholics Anonymous into the mainstream of American history, where it belongs.

Weekend Reads: Lance Armstrong Edition

Viewed from the outside, many proponents of the War on Drugs seem intransigent in their views simply because they find it difficult to allow any new argumentation or evidence to affect what they’ve deemed a moral issue. Much as temperance was in the 1920s, those who support the American government’s battle to retain strict drug laws with severe punishments are undoubtedly engaged in a symbolic crusade (to borrow a term from Joseph Gusfield). Essentially, their support exists in the name of continuing counterproductive and often irrational public policies because, to many, such laws and strictures symbolize something more, something deeper. Many Americans don’t see the loosening of drug laws as a utilitarian means of harm reduction, but as a retreat from the “traditional” values from a morally cohesive age that never really existed.

To be fair, moral crusades regarding drug use are far too complex to be simply be reduced to the simplistic regressive, anti-modernist picture I just provided without heavy qualification. While it is true that the struggle over the meaning of drug laws remains largely politically partisan in American society, one need only look to the news to see how the issue of drugs, government oversight, and moralism can be reframed in a much more complex way. With the recent investigations of Lance Armstrong’s doping and illegal prescription drug muling coming to a close this week, one finds no clear political delineation among the cyclist’s supporters and opponents. Positions on drugs within the Livestrong Industrial Complex vary, as liberals, libertarians, conservatives, and independents struggle to disentangle the implications of L’affair Armstrong.

For those not yet aware, the Plano, Texas-born Armstrong is perhaps the most celebrated road cyclist in history, having famously won the Tour De France seven times, six times after having contracted cancer in his testicles, lungs, abdomen, and brain. Armstrong parlayed his seemingly superhuman ability to perform astounding athletic feats whilst struggling with a life-threatening illness into the multi-billion dollar Livestrong charity, which works as an awareness-raising (though not really a money-raising) foundation on behalf of cancer research. As one might expect, Lance’s combination of non-partisan do-goodery and athletic acumen – not to mention his celebrity romancing – made him an enormously popular and powerful fellow in the worlds of cycling and politics.

Because it seems counterintuitive that someone should not only recover from cancer to win a prestigious endurance race, but should do so without the use of performance enhancing drugs (PEDs) within a sport rife with said drug use, Armstrong has also spent much of his adult life under suspicion. He is undoubtedly the most famous and divisive longtime target of both national and international anti-doping agencies. Despite numerous allegations and investigations, however, Armstrong has never (publicly) tested positive for PEDs and has vigorously defended, in both the courts and the press, his personal reputation as a “clean” racer. Nonetheless, fans and journalists have continued to widely (and openly) suspect Armstrong’s use of non-detectable PEDs, including “The Clear.”  Continue reading →

Historical Hooters; Or, What I Did on My Summer Vacation

Ye Olde Alaska

I didn’t expect that a trip to Alaska this past summer would become an ongoing tour of brothel museums, but it did.  Along with spectacular scenery, bountiful wildlife, and delicious food, Alaska tourism served up plenty of quirky history.  Casting prostitutes and madams of the gold rush era as heroic female entrepreneurs who purveyed both sex and alcohol, which were scarce and valuable leisure commodities, these museums demonstrate how the act of deeming behaviors or practices “historic” can sanitize them for present-day audiences.

My first stop was Dolly’s House Museum, located on Creek Street in Ketchikan, Alaska, where the former red-light district has been reimagined as a tourist attraction.  Women in period garb stood outside the building, inviting passers-by to come in.  Although my two young sons have accompanied me on many museum tours, this time I let them stay with other family members and went inside by myself.  The tour guide provided an orientation in the “men’s waiting room,” emphasizing how prosperous Dolly Arthur, the proprietor of the house, became from selling both her favors and bootleg liquor.  Her rate was $3, with an additional $1 charge for a half shot of alcohol and $2 for a full shot.  The tour guide contrasted these amounts with the daily wage of $1 earned by most miners at that time.  The tour was self-guided through the remaining rooms, where video screens and accompanying text recounted Dolly’s life story and other details about prostitution and local history in Ketchikan.

Dolly’s House

Although there were no hands-on activities or interactive exhibits, the museum had a certain liveliness, showcasing Dolly’s personality and witticisms, and exhibiting cases were full of her clothing, hats, and other artifacts. Dolly’s House came to be known as the place “where you could get hammered and nailed.”  Dolly is also quoted as having said, “If I ain’t in my house, I ain’t making no money.” Even the tagline for the house museum today –  “Dolly’s Little Place of Business Where Both the Men and the Salmon Came up Stream to Spawn” – is highly suggestive. The gift shop sells T-shirts with that slogan, as well as postcards with a portrait of a glamorous Dolly in silhouette and the declaration, implicitly attributed to her, “If you can’t find your husband…He’s in here!”  The overall tone of the museum conveyed respect for Dolly’s business acumen and determination, leavened by sexual humor, as when the tour guide told me to make sure to notice the rosettes on the shower curtain, sewn by Dolly from French condoms because why waste silk? Continue reading →

Weekend Reads: Micro Edition

Early October is a special time on the college calendar. Undergrads grit their teeth in anticipation of mid-term exams, the Seminoles experience their yearly swoon, and frosh throughout the nation finally realize – not a moment too soon – that laundry machines exist for a reason. The most predictable of early autumn college rituals, however, may be the annual media panic over alcohol abuse.

This year, “butt-chugging” has titillated the media. University of Tennessee student Alexander Broughton has become something of a minor celebrity, having given himself alcohol poisoning – a .45 blood-alcohol content upon his arrival at the University of Tennessee Medical Center – through…*ahem*…anal infusion. Mr. Broughton vehemently denies providing himself with an alcohol enema. According to recent reports, he is planning on suing someone because, you see, he’s a Christian and being accused of “butt-chugging” implies that he’s gay. Or something. For their part, police are skeptical, having found a plastic bag of wine (a rose, for the record) beside pools of Broughton’s blood in the frat’s bathroom.

Does this story of alcohol poisoning, self-abuse, suspended fraternities, thinly-veiled homophobia, and frivolous lawsuits really constitute news? Probably not. You probably couldn’t find a better slice of 2012 fraternity life, though.