Thursday, June 08, 2006

The Wilder Shores of Arthritis: Fit the Second


Rev Stone and his predecessors adhered to the old Doctrine of Signatures, which said that every plant, being created for man's use (cf The Book of Genesis), had in its appearance or habitat something to guide one to its use. Willow, growing and flourishing in damp conditions, would naturally be a specific for diseases associated with such conditions. Felix Hoffmann later independently developed acetyl-salicylic acid for the Bayer Drug Company in 1899: aspirin. This is a synthetic form of the substance which naturally occurs in willow-bark, which had been recommended by physicians for its analgesic properties as far back as Hippocrates. A substance might be used for the wrong reasons; but the fact that it kept on being used might suggest that it did have some efficacy. Only now, driven by the need for new treatments, are medical researchers studying folk usages with an objective instead of a dismissive approach.

When looking at this early medicinal advice, it's important to remember also the Doctrine of Humours. This was a theory, going back to Hippocrates at least, formalised by Galen and still surviving unconsciously today in folk remedies. It's similar in essence to Chinese and other eastern medical theory: the body contains certain elements (the humours in this case) that can get out of whack for one reason or another; one comes to dominate over the others; disease results, and the treatment must consist of restoring balance and harmony. In Western medicine the humours were held to be: black bile, yellow bile, phlegm and blood, and each would have the qualities of cold/heat and moist/dry. So plants and, later, post Paracelsus, chemicals with these qualities were the ones to be used to sort things out. We are now drifting well into the realm of abstract philosophical theorising and to hell with what actually was wrong with or helped the patient.

Back to the story. In medieval times the situation wasn't much changed. A MS of the reign of Henry VII contains a recipe "ffor all maner ache yn senos [sinews] or juntys [joints]" which suggests that you boil thyme in wine to a concentrate, in which you then boil a red cloth. Then wash yourself with the hot herb water and cover the affected parts with the cloth. As a matter of fact, red flannel was supposed to have protective properties - the flannel certainly would be very insulating, although the colour choice is probably down to sympathetic magic - and petticoats made of it were in use well into the twentieth century in Britain.

(A propos sympathetic magic, I can't resist quoting two instances from Frazer's The Golden Bough: if your fingers are stiff, collect some long-legged spiders and roast them, then rub your fingers with the ashes. The suppleness and nimbleness of the spiders will be transferred to your fingers. Again, for a case of gout or rheumatism, rub Spanish pepper into the fingers and toes of the sufferer: the pungency of the pepper will be too much for the gout or rheumatism, which will then depart in haste.)

Our anonymous medieval scribe has a cure for sciatica also: "Take a sponnefulle of the galle of a rede oxe and ij sponnfull of the wat[er] of Culerage [water pepper] and iiij of his owne water [urine] and as moche comyn [cumin] as half a french note [nut] and as moche sewet [suet] as a small notte and breke and bruse thy cumyn then boyll all thes together tyll they be grewell [gruel]." The patient then warmed his bottom against the fire and the concoction was rubbed in and he was sent to bed in heated sheets. I don't think the heat treatment would do much for the sciatica but it would help the patient to relax and, if he had arthritis and muscle spasm, heat and massage would help those. The contents of the spice cupboard I'm not so sure about; maybe they were local skin irritants.

Nicholas Culpeper (1616-54) was an astrologer-physician (the disciplines were not mutually incompatible then) who wrote a hugely influential Herbal, firmly based in the Doctrines of Signatures and of Humours, and with the astrological qualities of the herbs conveniently specified. By which we learn that All-Heal (aka Self-Heal, Prunella vulgaris) is "under the dominion of Mars, hot, biting, and choleric.... helps all joint aches." While also effective against "the bite of mad dogs and venomous beasts", hence the name, I suppose. Oil of chamomile (Anthemis nobilis), which he says "is much used against all hard swellings, pains or aches, shrinking of the sinews, cramps or pains in the joints", is still much prized by herbalists today as an anti-inflammatory . Comfrey (Symphytum officinalis), similarly, has been investigated and found to have therapeutic qualities, particularly in wound and ulcer healing; Culpeper suggests a poultice of the fresh leaves applied to painful or gouty joints.

Ground Pine (Ajuga chamæpitys) is, apparently, another martial plant, and is to be prescribed for palsy, gout, sciatica, rheumatism, scurvy, and all pains of the limbs. Palsy and scurvy are presumably in there because both of them can include joint and/or muscle pain in their symptoms. The root of horseradish (Cochlearia armoracia) (Mars again) is also recommended as a poultice for sciatica and joint-ache; I wonder if this would be yet another capsaicin-like counter-irritant? Raw horseradish certainly is, as is rue (Ruta graveolens) (under Leo, the sun, this time); rue causes extremely painful blistering of the skin, if gathered in sunlight. Tea made from tansy (Tanacetum vulgare) (Venus), a known, if drastic, vermifuge, if it didn't help the sciatica and joint-aches at least provided an urgent distraction.

The gardener's foe, Ground Elder (Ægopodium podagraria) (Saturn) is also significantly known as Goutweed; "it heals the gout and sciatica; as also joint-aches, and other cold pains."

Of course, Culpeper was a professional, licensed, physician. Thousands of amateurs, housewives, wise men and women of all sorts, had their own private recipes concocted in their stillrooms up till the end of the eighteenth century at least. One such, from Essex, is "Sir George Horseyes Green Ointment for Aches proceeding from a Cold Cause for Shrunke Sinews in Man, or Beast, & for Strains it's incomparably good & holds Perfection 40 years." It should; collecting the list of ingredients alone would take long enough: mallow, groundsel, strawberry, cotton lavender, birch leaves, chickweed, comfrey, parsley, sage, bay leaves, chamomile, adders' tongue [a fern], ox-eye daisy. But you haven't finished: roses, frankincense, pork lard, butter made in May and clarified in sunlight, salad oil, turpentine, verdigris. Blend and boil this lot, decant into closed containers and bury them three-feet deep in a pile of horse manure [I swear I am not making this up] for three weeks. Then boil them up again, strain, and add spike lavender oil. Apply to the affected place gently warmed. Well, it might smell nice.

This recipe illustrates what a pickle medicine had got itself into by the dawning of the nineteenth century. The professionals were increasingly distanced from reality into theories, while the laity were piling Pelion on Ossa in vain attempts to make sure that something worked, even if it was only the application of local heat and massage. Meantime the nineteenth-century arthritis sufferer found more emphasis placed on inorganic and less on herbal treatments, although the principles of heat and counter-irritant remained basically unchanged: "Rheumatic Plaster. Take one-fourth pound of resin and a like quantity of sulphur; melt by a slow fire, and add one ounce of cayenne pepper and one-fourth of an ounce of camphor gum; stir well until mixed, and temper with neatsfoot oil."

Those who rejected "chemical drugs", then as now, tended to retreat into a dream of "natural" remedies, like Sir William Withey Gull, Queen Victoria's personal physician (and one-time candidate for the rôle of Jack the Ripper); he wrote Rheumatism Treated by Mint Water, though whether he tried it on his Royal patron I don't know. She, by all accounts, preferred whisky, laudanum and cocaine. (How unlike, how very unlike, the home life of our own dear Queen.)

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