Toothaches, Anesthesia, and Fertility Control – pre-1600s European Medicines

by Mecia Raposa

A TOOTHACHE REMEDY: ITALY 1514

Introduction

Giovanni Da Vigo was an Italian physician who published a text in 1514 that was translated into English in several editions – I used the edition from 1550. I have analyzed one of his toothache remedies and recreated it.

“Sometyme there chaunceth a certeyn dormitation in the teeth, by holding cold thinges in the mouth, a stupefaction… medicines in the mouth, for the remotion werof, they shal use the medicine under wrytten, comaundiyng it to be holden in the mouth warme…:

English translation of the text

Theory of Toothaches

Prior to learning about bacteria, tooth pain not related to an obvious injury was believed to be due to unbalanced humors or tooth worms living inside the tooth. Most herbal remedies sought to balance the humors – tooth worms were chased out by more extreme methods.

Ingredients

Odiferous wine

This refers to wine vinegar. Vinegar was a common ingredient in toothache remedies as it was thought to be strong enough to carry the other ingredients into the structure of the tooth.

Aqua vite

Otherwise known as distilled liquor. This may be another carrier like the vinegar since simmering would cause most of the alcohol to evaporate.

Rosemary

Required warm according to Dioscorides, warm and dry according to Banckes.

“The distilled water of the floure of Rosemary being drunke at morning and evening first and last, taketh away the stench of the mouth and breath, and maketh it very sweet….”

John Gerard

Sage

Should be hot in the first degree and dry in the second.

“Of sage there are two manners, sage of the garden and wild sage. If thou will have sage for medicines, take the leaves of garden sage….”

Banckes

Chamomile

Should be warm. “The roots, flowers, and herb have a warming, relieving strength.” Dioscorides

Clove

Hot. A topical numbing agent especially useful in the mouth and used to relieve sinus pressure. “If one suffers in his head, so that his head is stuffy, and it is as if he were deaf, he should eat cloves often, and the stuffiness in his head will diminish.” – Hildegard von Bingen

Nutmeg

Hot and dry in the second degree according to Banckes.

Mandrake

A plant that depresses the central nervous system and is also associated with the human body due to the shape of the root.

Mandrake is a powerful pain reliever and was used extensively in European medicine for a wide variety of ailments.

“The wine within the root hath been boyled or infused provoketh sleepe and asswageth paine.” – John Gerard “Twenty grains of the juice…. expel phlegm…”

Dioscorides

Analysis

At the beginning of this chapter Da Vigo states that teeth “are wont to be vexed” due to matter descending from the brain. My theory is that this remedy is for toothache caused by sinus congestion which would include phlegm (which is the cold and wet humor) dripping down from the sinuses (matter “descending from the brain”). This would also explain the ingredients which are a mixture of hot/dry and pain relievers. Sinus congestion puts pressure on the nerves going to the roots of the upper molars which can cause general pain in those teeth.

Recipe

Da Vigo uses common apothecary symbols of the time.

My Redaction

of odiferous wine, half a pound

of aqua vitae, an ounce

of rosemary, sage, and chamomile each a half ounce

of clove and of nutmegge each, a scruple

):( – this symbol means to pound in a mortar

of mandrake, a dram and half a pound

“Let them all sethe together until the third part be consumed, then straine them” Simmer until reduced by 1/3, strain the solids. Hold in the mouth while it is still warm.


SURGICAL ANESTHESIA IN PRE-MODERN EUROPE AND THE NEAR EAST

Pain is a complication that interferes with all of our treatments of abcesses, wounds, and their complications… We may have to use dangerous medicines to save a life. Then we will use the stupefacients.”

– Guy de Chauliac, 1363

Intro

Prior to the invention of modern anesthetics, pain control during surgery was not expected to be significant. Many surgical manuals describe the proper way to strap down the patient to the operating table depending on the surgery to be performed. Some sedation was, however, possible and it seems to have been mostly unchanged from the earliest medical texts through until the 19th century.

Theory and Application of Pain Mitigation

They do not attack the cause for the pain; they effect only the symptoms… Stupefacients are potent contraries, rather than sedatives. They are cool and contrary-to-nature…”

– Guy de Chauliac

In humoral theory, pain occurs due to the humors being significantly out of balance. Most pain relievers were meant to rebalance them, but some pain control was purely sedative. Pain control during surgery was mostly by the use of “somniferous herbs” – plant compounds known to effect consciousness. A small sponge was soaked in a decoction of the herb (what you are left with after boiling the plant – a well-known method of extracting the active compounds) and then dried in the sun so that it could be stored for future use. To activate, the sponge was soaked in hot water and held under the patient’s nose so that they inhaled the active compounds in the herb. Waking the patient after surgery involved holding a sponge soaked in hot vinegar under the nose.

“Somniferous herbs”

Throughout the premodern era, world wide, surgical anesthesia was mostly accomplished by the application of various plants known to effect consciousness, the most widely written about being:

Mandrake

A potent central nervous system depressant. Not recommended for use during oral surgery because it often causes the patient to vomit. “They use a winecupful of it for those who cannot sleep, or are seriously injured, and whom they wish to anesthetize to cut or cauterize.” – Dioscorides

Poppy

The original source of opioid drugs that are still used today for potent pain relief, first discussed in writing by Sumerians. Several varieties were recommended for encouraging sleep but the most potent and probably most often used for surgical anesthesia is Turkish poppy (Papaver somniferum).

Henbane

first documented use is by the Babylonians, it was used throughout the premodern period for pain relief especially for tooth pain. Three varieties were recommended, with black henbane being the most potent. “These both cause delirium and sleep, and are scarcely useable.” – Dioscorides

Datura/Thornapple

A genus of plants that cause delirium. There is disagreement whether this genus was exclusively New World and therefor only known in Europe in the 16th century and later.

Aconite/Monkshood/Wolfsbane

A genus of plants native to most of the northern hemisphere, it was not very popular because it depresses the central nervous system in a potentially deadly way.

Sweet oil of vitriol: Ether

Ether became the surgical anesthesia of choice from the mid-19th century until the invention of modern injectable anesthetics. It may have been discovered earlier but the first definite mention of it for medical purposes was by Paracelsus (1493-1541) for use in veterinary surgery. The only person to describe it’s manufacture and use prior to 1600 was Valarius Cordus (1515-1544) in a posthumously-published text De Artificiosis Extractionibus. Ether is a compound made from sulpheric acid and ethanol. In our time period, sulpheric acid was known as “oil of vitriol” and was widely manufactured in the process of alchemy, as early as the 8th century.

Vitriol was widely considered the most important alchemical substance, intended to be used as a philosopher’s stone. Highly purified vitriol was used as a medium to react substances in. This was largely because the acid does not react with gold, often the final aim of alchemical processes. The importance of vitriol to alchemy is highlighted in the alchemical motto Visita Interiora Terrae Rectificando Invenies Occultum Lapidem(‘Visit the interior of the earth and rectifying (i.e. purifying) you will find the hidden/secret stone’), found in L’Azoth des Philosophesby the 15th Century alchemist Basilius Valentinus, which is a backronym. “

history of sulpheric acid.

Valarius Cordus gave detailed instructions on the distillation of ether from sulpheric acid and wine. Ether is stable enough to be stored for months in a sealed glass jar. In excessive quantities it can cause respiratory paralysis but in lesser quantities it produces sedation or unconsciousness in a way that is easier to control than when plants are used.



Contraceptives and Abortifacients in Europe and the Near East Prior to 1600

Introduction

We have documentation that humans have sought to control their fertility from the very beginning of recorded history.

Methods used varied in their effectiveness but modern scientific studies have confirmed that many historical methods were effective at either preventing pregnancy or terminating it in the early months.

The Greek and Roman medical authors wrote extensively about pregnancy control, and the knowledge continued to be written down and added to over the centuries.

Contraception vs Abortion

Humans have had a fairly accurate understanding of how pregnancy occurs since the earliest records – they understood that “seed” from both parents was required.

Prescriptions were sorted according to their action: contraceptive (mostly inhibiting ovulation, but a few affected sperm count), emenagogues (a menstrual stimulant or method of ejecting a dead fetus after a miscarriage), or abortifacient.

These were either administered orally, vaginally via a pessary, or applied to the head of the penis. I have focused on orally administered prescriptions.

Common Herbs and their Effectiveness

Silphium

The most effective contraceptive herb of all time was the Great Century Plant (Silphium, in the same family as Giant Fennel and Wild Carrot which are proven to be effective at pregnancy control). Modern studies done on plants in the same genus confirm that they are extremely effective at preventing ovulation in humans with minimal side effects.

The Romans used the plant so extensively that they made it extinct, which gives us a good idea of how acceptable contraception was in that culture.

Many plants that were written about over and over through the centuries are very effective at pregnancy prevention or very early term abortion.

Some plants are hard to definitively identify and not all have had modern studies done, but many of the most commonly referenced have a measurable effect on fertility.

The vast majority of these prescriptions are simples: a single ingredient, not blended with anything else other than “some water or a little wine” which I believe were just to wash down the herb since no further instructions are given.

Since many of these plants were either common culinary herbs or weeds, they would have been available to most if not all of the population. They also would have been easy to take without attracting attention.

Other Commonly Used Herbs and their Efficacy

COMMON NAME/LATIN NAMEEFFECTIVENESS RATE (at clinical dosage)
Rue (Ruta graveolens)50-100% depending on when in pregnancy it is taken (earlier is more effective)
Thyme (Thymus vulgaris)Results vary but is documentably effective to some extent
Pennyroyal (Mentha pulegium)Up to 100%, also used as a menstrual stimulant
Wild Carrot/Queen Anne’s Lace (Daucus carota)100% when taken within the first week after intercourse
Coriander (Coriandrum sativum)“Significant” reduction in fertility when taken up to 20 days after intercourse
Ferula (the entire genus including Giant Fennel)99% when taken within 3 days of intercourse
Juniper (Juniperus communis)70% effective at blocking implantation
Birthwort (Aristolochia clematitis)100% effective up to midterm
Squirting cucumber (Ecballium elaterium)100% prevention of ovulation
Rubus (entire genus – blackberry, raspberry, etc)70-90% effective at blocking implantation

Legal and Religious Considerations

I have not dug deep into the religious or legal opinions on pregnancy control but what I have read thus far indicates that in the Abrahamic faiths, the parents were allowed to do as they chose for themselves mostly.

Different cultures had differing opinions on when a fetus received a soul, but all of them believed that there was a period of time between conception and when the fetus gained a soul. In Judaism it was either 8 or 40 days after coitus, depending on the author. The Koran says it gains a soul after 120 days. Various Christian cultures largely considered a fetus to gain a soul at “the quickening” – the first time the pregnant person felt the fetus move, at the earliest this is at 16 weeks post-coitus.

Various texts support the idea that pregnancy prevention or termination were the choice of the parents. The Torah says that any man who causes another man’s wife to miscarry must pay a fine but does not mention abortion chosen by the parents. The Koran states that an unhealthy woman may be given contraceptives or abortifacients to preserve her health. Medieval Christian laws have phrases that could either be interpreted as “don’t give a pregnant person an abortifacient that would risk their life” or “don’t give a pregnant person an abortifacient without consent”. The common thread in all of this is the idea that the parents of the fetus decide whether pregnancy continues. As Europe urbanized throughout the late 15th and 16th centuries, it became more popular to have a smaller family and that’s what occurred, which indicates that pregnancy control methods must have been in wide use.

Harvesting Simples for Medicinal Use

“If we gather of them to soon or too late, they lose their best virtue. Roots must be plucked up in the fall of the leaf, for then they are fullest, both of moisture and virtue, their being at that season gathered. Flowers must be gathered in the Spring, because then they have most virtue. And leaves must be gathered in the Summer. The like we must observe in other things. Know also, that some things lose their virtue quickly, others keep it a long time, as experience and the rules of Physic teach us, that some things may be kept many years, others being long kept, are good for nothing… But there are certain peculiar times to gather them in… where the heavenly constellations bestow upon them some singular virtue, proceeding from the most excellent nature and quality of the stars in which times if the be gathered, they are exceedingly operative.” – John Baptista Porta

Citations

(n.d.). Retrieved July 04, 2020, from https://textcreationpartnership.org/docs/dox/medical.html?fbclid=IwAR0B6s3QtA_4XPXAi8-TNpzVP2ZSSTNX0QG-L8tNjrqbmwnKBZ8lL4mtgU4

(n.d.). Retrieved July 04, 2020, from https://www.cs.mcgill.ca/~rwest/wikispeedia/wpcd/wp/s/Sulfuric_acid.htm

Arano, L. C. (1979). Tacuinum sanitatis. Milano: Electa.

Arikha, N. (2008). Passions and tempers: A history of the humours. New York: Harper.

Brunschwig, H. (1973). The virtuose boke of distyllacyopn of the watrs of all maner of herbes .. Amsterdam: Theatrum Orbis Terrarum.

Davis, Scott L. “Omar,” 1997, Natural Magick By John Baptista Porta (Giambattista della Porta) (1537-1615) A NEAPOLITANE: IN TWENTY BOOKS (1584 A.D.) Wherein are set forth All the Riches and Delights Of the NATURAL SCIENCES, Edited by Scott L. “Omar” Davis omard1@tscnet.com, 12207 Crossridge NW, Silverdale WA 98383

Eustachius, B., Chernin, D. A., & Shklar, G. (1999). Bartholomaeus Eustachius: A little treatise on the teeth: The first authoritative book on dentistry (1563). Canton: Science History Publications.

Fisher, G. J. (1880). Gabriello Fallopio: 1523-1562. Place of publication not identified: Publisher not identified.

Fuchs, L., Dobat, K., & Dressendörfer, W. (2016). The new herbal of 1543 = New Kreüterbuch. Köln: Taschen.

Gerard, J., & Woodward, M. (1994). Gerard’s herbal: The history of plants. London: Senate.

Guerini, V. (2010). A history of dentistry, from the most ancient times until the end of the eighteenth century. U.S.: Nabu.

Guy, Nicaise, E., & Rosenman, L. D. (2007). The Major surgery of Guy de Chauliac: Surgeon and master in medicine of the University of Montpelier. Philadelphia: Xlibris Corporation.

Hildegard, Saint & Throop, Priscilla, 1946-, (translator.) & Jacobsen, Mary Elder, (illustrator.) (1998). Hildegard von Bingen’s Physica : the complete English translation of her classic work on health and healing. Healing Arts Press, Rochester, Vt

History of Anesthesia. (n.d.). Retrieved July 04, 2020, from https://www.woodlibrarymuseum.org/history-of-anesthesia/

Hæger, K. (1990). The illustrated history of surgery. New York: Bell Pub.

Larkey, S. V., & Pyles, T. (1979). An Herbal. Delmar, NY: Scholar’s Facsimiles and Reprints.

Paré, A., & Keynes, G. (1984). The appologie and treatise of Ambrose Pare: Containing the voyages made into divers places and with many of his writings upon surgery. Birmingham, Ala.: Classics in Medicine Library.

PDR for herbal medicine. (n.d.). Montvale, NJ: Thompson Healthcare.

Pedanius, D., Osbaldeston, T. A., & Wood, R. P. (2000). De materia medica: Being an herbal with many other medicinal materials: Written in Greek in the first century of the common era: A new indexed version in modern English. Johannesburg: IBIDIS.

Riddle, J. M. (1994). Contraception and abortion from the Ancient World to the Renaissance. Cambridge, MA: Harvard University Press.

Vigo, G. D., & Godin, N. (1520). Practica copiosa in arte chirurgica .. Venetiis.

Weights. (n.d.). Retrieved July 04, 2020, from https://www.nottingham.ac.uk/manuscriptsandspecialcollections/researchguidance/weightsandmeasures/weights.aspx

13 Replies to “Toothaches, Anesthesia, and Fertility Control – pre-1600s European Medicines”

  1. I so enjoyed visiting with you last year, and I love this exhibit this year! This was a great read! Thank you so much!

    1. I have samples of most of these plants but haven’t organized them into a chest yet, they currently live in glass jars in a box. Sadly I got my poppy, datura, and monkshood seeds into the ground too late for them to sprout this year, hoping they pop up next spring.

  2. I LOVE THIS!!!

    I hope I get to chat with you!

    I might have to borrow that measurement chart! I really like that one!

    I love the way you broke down the treatment, described the ingredients, and gave the thoughts about what caused the ailment.

  3. I have really enjoyed your research, and I can’t wait to get a chance to hear you present about it, as I know this is just the tip of the ice burg. I love that you have been delving into these topics for years, that so often get overlooked and have approached it with a scientific mind. I look forward to seeing you teach, and potential co-teaching with you at some point in the future.

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