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JOHN OF GADDESDEN
Although little is known of John of Gaddesden – so we can’t be sure – it is a fair guess that today we would label him a polymath and a prodigy. Going to Oxford University, he became there a Master of Arts, a Bachelor in Theology, and a Doctor in Medicine. A student at Oxford had to spend two years studying grammar, then four years as a student to gain his licence to study for his Arts course.
It would then be three years course to gain his Masters, followed by six years
to become a Doctor.
So… if – as Wikipedia says – he started writing Rosa Anglica in 1304 and was born in 1280, he must have gone to Oxford aged nine, started his degree aged 15, and started writing the book that became the go-to textbook for the next 400 years as soon as he qualified aged 24!!
In medieval England, you could qualify as a doctor without ever meeting a sick person.
Rosa Anglica is not based on Gaddesden’s personal experience. It
is – as many of the medical textbooks of the day – a compendium of known
knowledge, with quotes from dozens of authorities including Galen, Avicenna,
Gilbertus Anglicus and the famous Persian doctor Al Rhazes. The Rosa is full of “all the recipes he had ever met with or heard of … the best History of what medicines were in use, not only among the Physicians of that time, but among the common people of England, both in the practical and superstitious way”, as one 18th century Physician commented,
..
Gaddesden’s famous ‘red cloth’ cure for smallpox, with which he claimed to have
healed the King’s son, was pinched from Gilbertus Anglicus’s record of a
provincial old women’s cure. It is, as one translator termed it, "a a hotch-potch of medical teaching, genuine or fabulous", and the famous 14th century French physician and surgeon Guy de Chauliac declared it
"that fatuous Rosa Anglica",
full of "fables" I have included accounts of Gaddesden’s passages on Oedema, Tuberculosis and Smallpox below. You will see that although his explanations and causes are way off the mark, the treatments he
records are sensible, and many of the herbs and remedies he prescribed have been found to contain medicinal substances. They represent the result of thousands of years of trial and error.
Having said that, Gaddesden also included superstitious and magical charms, a
few of which I have added at the end (note the sympathetic magic in the last one
about epilepsy).
The Rosa also includes recipes for cosmetics, and
prescriptions for depilatories, hair dyes, face washes, and applications to
remove wrinkles – everything your everyday medieval doctor might find himself
being consulted about.
Gaddesden became a famous London Physician, and doctor to members of the Royal Household. He was also a priest, and in 1342 was appointed a Prebendary of St Paul’s Cathedral in London. In the
Rosa he boasts of his achievements, of his secret cures, and of the
large sums his medicines – particularly one involving green tree-frogs which
extracted teeth painlessly – earned him. He was a contemporary of Chaucer,
and it has been suggested that Gaddesden was the target of Chaucer’s description
of the Doctor of Physick.
Dropsy
What we call nowadays ‘oedema’ is fluid retention, usually caused by heart failure, liver or kidney problems.
Today, the symptoms are treated with diuretics, in severe cases with a surgical
drain … along with medication, diet and exercise to treat the underlying cause.
Gaddesden called the disease ‘Hydrops’. He includes
detailed descriptions of the disease in its various forms.
Cause:
Like many physicians, Gaddesden believed that food was digested in the liver, and thereby sent in the blood to the limbs to be burned up as fuel for the muscles. The cause of Hydrops, he said, was a ‘hot liver’, leading to “a change of the digestive power in the liver”, so that the nutriment did not cleave (bind) to the muscles, but overflowed into the ‘empty spaces’ of the body. Sometimes the cause was “phlegm penetrating with blood into the limbs … as if the water stood under the flesh”, and this could be caused by cold.
Other causes included retention of excreta, haemorrhoids, or food which was too
salted, flavoured, fried or overcooked.
Cure:
“The cure of hydrops is of two kinds, common and proper. The proper is by means of various appropriate medicines and by local measures.
The common, as says Avicenna, is by extraction of the watery humidity and its
drying up, and this extraction may be carried out in four ways, as Constantine
lays down in the seventh book of his Practice.
The first method is by diuretic medicines which provoke a
flow of urine such as spikenard, cassia and the like.
The second method is to purge out the yellow fluid by means of sweating and discharge from the bowels. For this latter effect use purging drugs such as mugwort and spurge laurel. Emetics and enemas can also be used.
Sweating can be brought about by sulphur bath or sea baths, or by fumigations
with water in which have been boiled such roots or herbs as pellitory or
loveage, together with bran; or with a rub of hot oil, with laurel bark or a hot
ointment...
The third method is for the patient to drink his own urine….
The whey of goat's or cow's milk also purges.
The fourth method is by means of an incision three fingers' breadth below the umbilicus, and a deep perforation made therein, or by a perforation made in the testicles, or by scarifications under the skin between the joints of the feet, or above the feet or round the ankles. Incision, however, is dangerous, and must not be performed unless the patient is very strong. Avicenna says, ‘when the belly is full of water and the strength is well maintained, then make an incision and let out the water, but little by little and not all at once’.”
Gaddesden does not mention surgery often but, where it was needed, he gives detailed instructions
and, in this case, he describes where and how to make the incision, insert a
canula, and draw off the fluid, finishing:
“Then feel the patient's pulse, and if he be weak take out the canula and give medicine or dressing made of down dipped in wine or white of egg.
Make the patient lie down and give him chicken broth with spicey medicines, or
food of easy digestion such as partridge, kid, or lamb.
On the second day take off the dressing, replace the canula, and draw off some more water, and do this three or four times.”
Comment: Excepting the measures to purge his patients, and that he used diuretic herbal medicines, and – although it is indeed a diuretic – modern doctors would never ask a patient to drink urine, these cures are fairly much how we treat the symptoms of oedema nowadays.
Note however, that Gaddesden treated the SYMPTOMS … because he did not
understand the true cause of the malady, he could not treat the underlying
cause.
Note, however, the dependence of Gaddesden’s ideas about the
cause on the Theory of the Four Humours (eg the reference to a ‘hot liver’ and
penetrating phlegm due to cold) and cures which therefore rebalance the humours
by diuretics, purging and draining the fluid.
Tuberculosis
Tuberculosis of the lungs is a contagious disease caused by bacteria. It spreads through the air when an infected person coughs or sneezes.
Common symptoms include a terrible cough, coughing up blood, tiredness, night
sweats, fever (particularly in the afternoon), loss of appetite, and weight
loss.
Gaddesden called the disease ‘phthisis’. He includes detailed descriptions of the disease in its various forms. He warns that it can only be cured if caught early, “before the pus-filled ulceration
. . . and before its stench and the descent of water to the
depth [of the lungs]’.
Cause:
The cause of phthisis, stated Gaddesden, was “the flow of mental humour from the head to the underlying and neighbouring parts” in the form of catarrh [ie phlegm].
This was, he said “the mother of all diseases”, causing, in addition to
phthisis: deafness, tinnitus, blindness, conjunctivitis, polyps in the nose,
angina, pleurisy, cerebral haemorrhage and arthritis.
Cure:
Gaddesden provided a vast list of drugs and remedies, with
instructions to:
“keep in check the catarrh and phlegm
... cleanse the body ... strengthen the chest and the head so that they do not take up the matter
... cleanse and dry up the ulcers ... restrain and cure the cough by using demulcent drinks with ointments and poultices
... assist the patient to sleep ... strengthen and bring back the appetite ... keep in check the spitting of blood
... do what can be done to make the breathing more easy and to remove the asthma and the hoarseness.”
Then:
“As to food, the best is the milk of a young brunette with her first child, which should be a boy; the young woman should be ‘well-built’, and should eat and drink in moderation. Failing a wet nurse, the milk of other animals might be used in the following order of choice: the ass, the goat, and the cow. If the patient liked, he could take his milk straight from the udder; if not, it was to be boiled with a little salt and honey, so that it should not coagulate in the stomach, for in that case it was a very poison.”
Plus, if possible, the patient should go to live in a dry,
clear and still atmosphere on a high mountain.
Comment:
With the exception of the wet-nurse, and the fact that he used available herbal
medicines, this is EXACTLY how TB patients were treated before antibiotics,
right up to the 1930s.
Note, however, the dependence of Gaddesden’s ideas about the
cause on the Theory of the Four Humours (eg the reference to a ‘mental humour’
and phlegm due to cold) and cures which suggested a ‘dry’ atmosphere and breast
milk (a ‘warming food’) to rebalance the
humours.
Smallpox was an acute contagious disease caused by the variola virus. It was accompanied by a high fever, and a rash of pustules which left permanent disfiguring scars. About 1 in 3 people who got smallpox died.
It was eradicated through vaccination by 1979.
Gaddesden called the disease ‘Variolae’. He includes
detailed descriptions of the disease in its various forms.
Cause:
Smallpox, stated Gaddesden, occurred:
“when nature expels towards the surface of the body, the excess of sanguine humour or continuous fever arising from a corrupted humour, in one in whom something of the menstrual flow or corrupt boiling blood remains. Avoiding customary exercise sometimes causes smallpox…. [Smallpox] occurs oftener in a hot moist complexion than in a hot dry one, and in little children and youths, rather than in maturity, or old age; for it is not produced in old age but through strength, and in a hot moist land.
So we understand there are two kinds of smallpox proper and improper. Smallpox proper is produced by the blood that boils, and this form occurs principally in children, and youths. Improper smallpox is caused by foods which strong heat draws outward from the inner members to the extremities, and this can occur at any age….
If the breathing be good, and the fever lightening, it is a good sign, but should the fever and thirst be acute, with constriction of the chest, it is a sign of death. If weakness of the heart supervene, it is a sign of death….
If the matter go to the lungs, it is an indication that death is approaching;
and if it go to the eyes, it takes away the sight; and if [the patient] be cured
badly, it leaves ugly pits on the body.
Cure:
As to a cure, Gaddesden commented:
“Many things are sought for the cure
hereof, but first the matter must be purged by [letting] a vein, and with a
little laxative that softens, but not one that draws or dissipates.
Second : the matter must be
surrounded and changed internally with acids, unless tightness of the chest
prevent it.
Third: it is meet to give
comfortatives that relieve the sick man, so that [the pustules] be evacuated.
Fourth : things should be applied to them to dry [the pustules], before they are entirely ripened….”
After which:
“The diet of smallpox patients should be increasingly cold, composed of barley and oats; and let the sick man take [milk of] almonds. If the fever be strong, make this pottage, wherein is put liverwort and lettuce; and if the bowels be relaxed, mix with a little plantain.
Then a pottage of bugloss may be made, which cleans the blood well, and he may
eat figs and almonds, on removing their skins….
The following expel the matter to the surface of the body, fennel, smallage [with] sugar, and their juice, roots and seed, together with scented saffron and elm, wherein are boiled dried figs.
Then take a scarlet or other red cloth, and put it about the pox; as I did to
the King of England's son when this disease seized him, and I permitted only red
things to be about his bed, by the which I cured him, without leaving a trace of
the smallpox pustules on him….
It is necessary to take care not to apply ointments to them, as these would clog the pores; nor to let cold air get at them, unless the weather be warm…
Tie the sick man's hands or let him have gloves on regularly, nor let him scratch [the pustules], nor touch them with his nails, for that makes the skin ugly. Then take smallage and fennel, warm them by the fire, dip a linen cloth therein, and wrap it round the whole body, for that draws all the matter out and consumes it.”
Comment: Until it was eradicated by vaccination, and excepting the bloodletting, purging and blistering agents, this was how smallpox was treated into the 20th century: treating the fever, keeping the patient comfortable and well-fed, drawing the pustules … and not letting the patient scratch the spots.
It is of interest that, at the beginning of the 20th century, doctors found that
using only red light in the patient’s room – although it did not affect recovery
– did prevent those patients who recovered being left with potmarks.
Note, however, the dependence of Gaddesden’s ideas about the cause on the Theory of the Four Humours (an excess of sanguine humour, in hot moist lands) and therefore his cures (bleeding, purging and blistering agents and ‘cold’ foods and cooling plants and herbs such as lettuce, plantain, liverwort and bugloss.
Fennel, counterintuitively, was a warming herb, but Gaddesden was using it to
help the body draw out the harmful humours into the pustules).
Other ‘Cures’
A Cure for Weakness of Sight
Gaddesden recommended oxide of zinc soaked 15 times in the
urine of a virgin youth, rose water, balsam, and white wine, mixed with
marjoram, fennel, spikenard, long pepper, and aloes. To this was to be
added the gall of a crow, swallow or hen, and the whole mixed with honey.
The patient was to take it partly as a food and partly as an eyewash and,
Gaddesden adds:
"It will make him see small letters to the end of his life, and the contents in urine, and the veins in the arms.
And therefore it is of great value to all barber surgeons”.
Simple Precautions against Pestilenital Air
“If the air is hot or foul smelling, then let the wayfarer smell camphor or roses or violets, and in very hot weather let him smell musk or wood sage {ambrosia), laudanum, camomile, laurel leaves or marjoram. Let him hold his nose if a fetid smell is present, and on rising let him eat a toast in aromatic wine or chestnuts roasted with the same.”
A Hangover Cure
“If anyone have drunk too much, if it be a man the testicles should be washed with salt and vinegar, and if it be a woman, the breasts, also let them eat the leaf or the stalk or the juice of a cabbage with sugar.”
“The root of parsley, hung on the neck, relieves toothache. The root of Hawkweed, and the root of Fraxinella do the same.”
“Again, write these words on the jaw of the patient: In the name of the Father, the Son and the Holy Ghost, Amen. + Rex + Pax + Nax + in Christo Filio, and the pain will cease at once as I have often seen.”
“Again, if the many-footed ‘worm’ which rolls up into a ball when you touch it is pricked with a needle, and the aching tooth is then touched with the needle, the pain will be eased.”
“Again, some say that the beak of a magpie hung from the neck
cures pain in the teeth.”.
A Cure for Epilepsy
Gaddesden recommended that a cuckoo be roasted until it could be powdered, and the powder then blown up the nose of the patient during a fit. Also, the patient should wear the head of a cuckoo round his neck, which will save him from harm if he falls.
Gaddesden writes:
“ I have tried this remedy”, , “with success in many cases of children who could not take medicine.
And the reason for this doing good is that the cuckoo suffers from epilepsy
every month, and therefore, according to some, it has a peculiar property of
attracting the epileptic ‘materia’ to itself, just as rhubarb attracts the
jaundice”.
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