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Absent Friends: Oh True Apothecary!

An old and dear friend of mine, too early gone from the world, once worked in Boston’s Massachusetts General Hospital, the greatest teaching hospital in New England, as an authoritative and much-consulted surgeon. He hated the subway with a passion only someone once forced to rely on it as a student could muster; he knew Red Sox statistics to the fourteenth decimal; but about the history of his own profession he knew nothing at all and cared less. What makes it all the more ironically telling is that when I asked him one afternoon to comment on a hypothetical patient vaguely complaining of stomach pains, he instantly offered a comment which, though flippant, yet stands as the perfect amalgam of the old world and the new: “Give me two hours of exploratory surgery on somebody, and I’ll know every one of their sins in alphabetical order.”

It would never have occurred to this thoroughly modern skeptic that he was speaking a virtual parable on the progress of Western science, and yet it was so: the medieval sins, thickly and wetly ensconced in the mortal flesh, but discoverable by the surgeon’s scientific scalpel in all of their entirety. Such is the world we live in, these days in the West, when every bored college undergraduate has watched enough episodes of ER or Scrubs to disdain the learning of the dark ages (which, for medicine, extended roughly to Machiavelli’s day, if not to Eisenhower’s). The average intelligent denizen of Chappaqua or Topeka can tell you without hesitation, for instance, that your brain is the seat of your consciousness, that your stomach undertakes the digestion of your food, and that genetics plays a large role in your physical makeup.

In previous ages, this was not so. The urgency of illness was no less great; a man with a deep, persistent cough or a hard growth in his lower abdomen will be every bit as desperate for a cure whether he lives in the tenth century of the twenty-first. But in the twenty-first, webmd.com is just a mouse-click away, and the phone book’s listing of doctors runs to dozens of close-packed pages. Each of those doctors has access to diagnostic software, X-rays, ingestible dyes, and full-body scanners. Each of their patients, whether afflicted with kidney stones or an inguinal rupture, not only desperately wants but also confidently (and even impatiently) expects complete relief.

400 years ago, Nicholas Culpeper (1616-1654) would have been such a patient. Plagued all his life with poor vision, headaches, bad back teeth, ulcers, and a generally nervous disposition, Culpeper had no choice but to focus his attentions on the field of human health. After studying at Cambridge, he focused not only his attention on the ailments of the flesh but also his enormous industry, which enabled him to produce one lengthy work after another of medicinal lore and learning, works which were printed and reprinted in vast numbers and consulted by innumerable sufferers in houses great and small. In candlelit small spaces of agony all across England and in many places beyond, someone worrying over a poor sufferer (just-delivered young wife still copiously bleeding? 4-year-old child burning with fever? Elderly grandfather sweating through his clothes?), the hushed sentence was always some variation on ‘what does Culpeper say?’ Some heavily-greased, well-thumbed edition of The Complete Herbal or The English Physician was pulled from a modest bookshelf (often containing a Bible, a book of sermons, and nothing else) and paged through urgently for some hint of salvation

This trust was not misplaced: The Complete Herbal is a vast, hugely detailed description of every single herb and flowering shrub in the whole of the realm of England, each one described carefully (Linnaean classification lay in the future, and it wouldn’t do to have a reader mistake a deadly poison for a much-needed analgesic), its healing properties plainly laid out, and the directions for its preparation and use meticulously given. This is no airy philosophical tract but a practical manual, meant to be sold and used. Air does enter into it, however. Culpeper classifies each herb not only according to the physical ailment it alleviates but according to which planet governs its exercise. These planets influence specific humors at work in every human body, so knowing the celestial patrons of the medicines in question only makes sense to Culpeper, scientifically speaking.

Here the modern Western reader will be tempted to scoff, and here – right at this point – such a reader should be slapped down hard for being spurious, spoiled, purblind, arrogant, and ignorant. Nowhere is the past more vulnerable to the scorn of the present than in the realm of medicine – indeed, that scorn is enshrined in popular entertainment everywhere from Star Trek to Black Adder to every episode of House, in which some once-definitive study is ridiculed out of consideration. This trend is snottily vindictive and has no place in intelligent discourse, if for the simple human fact that those who indulge in it would have been the first to reach for a volume of Culpeper, had they been suffering a toothache in his age instead of their own. In his time and place, what else was a pained, inquiring soul like Nicholas Culpeper to have thought, or believed, or written, or done? From his apothecary shop in Spitafields, next door to the Red Lion tavern, he spent the 20 years of his professional life studying herbal lore and anatomical data, dispensing carefully-measured concoctions (free, to the poorest in need), and writing books that became household names in his day and for his immediate posterity – and that have now the dubious fate of looking silly to modern Western eyes (it’s significant to point out that Culpeper’s work would certainly not look silly to the roughly four billion humans on Earth whose medical awareness hasn’t yet advanced beyond his own).

 
Part of this is Culpeper’s own fault, of course. In addition to being a persevering student of human well-being, he was also (perhaps understandably) a worry-wart and a bit of a ninny. His books make curiously delightful reading, but they habitually overreach, and they possess throughout their length a slightly febrile quality that inadvertently lends itself to ribaldry. Foremost along these lines must certainly be his urgent author’s introduction to the definitive printing of The Complete Herbal and English Physician Enlarged (no snickering now), surely the only author’s note ever to warn readers that buying older or pirated editions of the work in hand might actually kill them. These editions, he writes,

Are very falsely printed: There being twenty or thirty gross mistakes in every sheet, many of them such as are exceedingly dangerous to such as shall venture to use them.

One wonders if such a strategy helped Culpeper’s sales, and if so, what’s keeping the PDR from giving it a try.

His agitations notwithstanding, Culpeper’s passion is lambent. The millennial limitations of the physician’s art chaffed at him as surely and as sharply as they must have chaffed at Galen, or Hippocrates himself. We read his words, and we feel the Enlightenment clamoring to be born, straining at the bars of the past:

All other Authors that have written of the nature of Herbs, give not a bit of reason why such an Herb was appropriated to such a part of the body, nor why it cured such a disease.
I cannot build my faith upon Author’s words, nor believe a thing because they say it, and could wish everybody were of my mind in this, — to labour to be able to give a reason for every thing they say or do.
They say Reason makes a man differ from a Beast; if that be true, Pray what are they that, instead of reason for their judgement, quote old Authors? Perhaps their authors knew a reason for what they wrote, perhaps they did not, What is that to us? Do we know it?

Here indeed is the Northern Renaissance’s Erastian cry of ‘ad fontes’ in full voice, made all the more singularly courageous by virtue of the fact that it calls for the casting aside of tradition, when tradition was the only prop 15th century medicine had supporting it.

It certainly did not have practical success, unlike all the other ancient arts. Architects could build, as it were, on the work of their illustrious forebears; writers could always choose to learn from the glories of their predecessors, or to subvert them. But medicine, prior to the 19th century, knew almost nothing of what it was about. True, in all those earlier centuries there were fewer ailments to combat – mankind in the last 150 years has dumped so many and such diverse toxins into Earth’s environment that nowadays allergies, cysts, tumors, retrofitted viruses, and cancers are rife enough for a staggering one in three to encounter them. The ancient world knew nothing of this poisonous muck, but it had plenty to contend with nonetheless. The human body is a biological grab-bag, stuffed to the fetlocks with innumerable physiological faultlines. A granule too small to be readily seen by the naked eye, if it travels one pathway instead of another, can reduce a brawny athlete to a puddle of tears through agony alone. A routine movement, done imperceptibly different just once, can throw a back out of alignment for a month. The very cord through which a fetus receives sustenance from its mother can strangle it as it tries to reach the outside world.

Into this soupy chaos apothecaries like Culpeper ventured as well-armed as they could manage. In Culpeper’s case, as he smarmily mentions, he had help:

I consulted with my two brothers, Dr. REASON and Dr. EXPERIENCE, and took a voyage to visit my mother Nature, by whose advice, together with the help of Dr. DILIGENCE, I at last obtained my desire; and being warned by Mr. HONESTY, a stranger to our days, to publish it to the world, I have done it.

Evidently, Dr. TEDIOUS was also on call. But then, our apothecary is quite unabashedly a bit of a wag, as for instance here, when he’s discoursing on the benefits of cotton-thistle:

Mars owns the plant, and manifests to the world, that though it may hurt your finger, it will help your body; for I fancy it much for the ensuing virtues. Pliny and Discorides write, That the leaves and roots thereof taken in drink, help those that have a crick in their neck; whereby they cannot turn their neck but their whole body must turn also (sure they do not mean those that have got a crick in their neck by being under the hangman’s hand).

Or here, when he’s writing about St. John’s Wort:

It is under the celestial sign Leo, and the domination of the Sun. It may be, if you meet a Papist, he will tell you, especially if he be a lawyer, that St. John made it over to him by a letter of attorney.

But although our diligent apothecary will have his little joke, his endeavor is deadly serious. The section of The English Physican which details the preparation of preserves and concoctions is a marvel of exactitude – even by modern scientific standards, instructions could not be made clearer or more methodical. It’s important to remember that in addition to compiling a great deal of first-hand investigation, Culpeper was also synthesizing centuries of country lore, all of it midwife-derived and much of it trial-tested.

True, errors abound. The Papistical St. John’s Wort, for instance, will do you none of the good it’s advertised in the case of snakebite, any more than the powdered head of a viper, applied to the bite site, will draw the venom. The juice of the Cuckow-Point may ease an earache or it may not, but gout will be unaffected by the application of those crushed berries – with or without the added ‘hot ox-dung’ Culpeper prescribes.

He’s surely right that tobacco, taken in a pipe, “easeth weariness and takes away the sense of hunger and thirst,” but one may doubt his subsequent claim that it also “provokes the stool.” Likewise it’s doubtful the ashes of a burnt sheep or goat’s bladder, “taken internally,” will do much for somebody suffering from diabetes. And while it may be true that a concoction of ambergris “eases the pain of the head and strengthens the brain exceedingly” (especially if taken in the suspiciously ubiquitous draught of wine), it’s certainly not a benefit shared by the whale whose head must be split open to obtain the substance. Sometimes, Culpeper’s credulousness strains the patience of even the most forgiving modern reader, but every so often a sly humor will gleam through and make you wonder just how much of the joke is on us:

Eels, being put into wine or beer, and suffered to die in it, he that drinks it will never endure that sort of liquor again.

It becomes faintly possible that our apothecary is having a bit of fun in the midst of his great endeavors, and if so, we can hardly begrudge him. He’s surely writing about some of his more trying patients when he prescribes the concoction Pleres Arconticon:

It is exceedingly good for sad, melancholy, lumpish, pensive, grieving, vexing, pining, sighing, sobbing, fearful, careful spirits….

This was an age groping fearfully in the dark for some aid against the legion of maladies flesh is heir to; a savage, stabbing pain will make a gambler out of the sanest man, and Culpeper, we should remember, was no stranger to pain himself, living with it his entire life and dying quite young. He never explicitly refers to himself in any of his prescriptions, but there’s an almost heartbreaking note of personal experience in his entry on laudanum:

It was invented (and a gallant invention it is) to mitigate violent pains, stop the fumes that trouble the brain in fevers (but beware of Opiates in the beginning of fevers) to provoke sleep, take not above two grams of it at a time, going to bed; if that provoke not sleep, the next night you may make bold with three. Have a care how you be too busy with such medicines, lest you make a man sleep to doom’s-day.

Given the state of medicine in his day – given the virtually unimpeded triumph of disease and its attendant miseries – we can forgive our apothecary if he gained his knowledge of laudanum with first-hand experimentation. Likewise with substances like tobacco: it’s for an age and culture with far more options to raise the subject of addiction. Culpeper was pitting what slender biological knowledge he possessed against evils that had stalked mankind since the dawn of the species – he’s allowed what weapons he can find.

And perhaps in the final accounting his knowledge wasn’t all that slender. Recall all those nameless midwives toiling in fields and helping the suffering in all the long centuries between the fall of Rome and the birth of Pasteur: these were wise women, and their invisible oral tradition was immense and constantly self-correcting. Bookstores across the country now have ‘alternative medicine’ sections filled with herbal prescriptions – many of which Nicholas Culpeper would have recognized instantly.

Of thyme he wrote “it is excellent for gout, hip and loin-pain – taken internally, it comforts the stomach much and expels wind.” Thyme, it turns out, is an antispasmodic and expectorant with hypotensive and cardiotonic properties – in other words, it’s an excellent painkiller and will sure as Hell expel any wind you’ve got lying around.

Common horseradish? Of it he writes that the juice is “held very effectual for the scurvy.” Culpeper knew nothing of Vitamin C, the scourge of scurvy, but it turns out horseradish is stuffed with it – it would, in fact, be just the ticket for a touch of scurvy.

Earth chestnuts, our author tells us, are “under the dominion of Venus, they provoke lust exceedingly, and stir up those sports she is mistress of; the seed is excellent good to provoke urine.” Earth chestnuts are, all the new alternative medicine books will tell you, extremely powerful stimulants, full of anti-oxidants. They’ll certainly provoke your urine, and if Venus rejoices in any other side-effects, well, that would be a private matter, wouldn’t it?

The Complete Herbal and The English Physician have long been out of print, and given this era’s hyper-litigious culture, what publisher would dare to bring these prescriptions before a public no less gullible than the one Culpeper served? Wouldn’t want anybody breaking out the hog’s suet, now would we?


Steve Donoghue worked for most of his life as a mule-driver along the Erie Canal, during which time he composed hundreds of ballads and chanteys inspired by the territory. When his job was rendered obsolete by the steam tug he turned to the study of history and today he hosts the literary blog Stevereads.

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