Thanks to a program on cable TV last night about royal deaths and diseases, I was introduced to one John of Gaddesden, official court physician to Edward II (and also later worked for Edward III). In 1314 he wrote a medical treatise called the Rosa Anglica which showed the sort of medicine popular in his day. The medicinal details in the book have been ridiculed in latter centuries and Gaddesden decried as a charlatan, but this was by doctors writing from a 19th century perspective, with all of the advances that have taken place since. Hindsight is a wonderful thing! But in his day, Gaddesden was considered to be one of the best, and is even thought to be the ‘doctour of physick’ in Chaucer’s Canterbury Tales. It is possible Chaucer may have met him in his latter years, but if not then he would certainly have heard about him.
One very interesting thing about the good doctor – or physik – or leech as he would have been colloquially called – is that he saved one of Edward I’s sons from smallpox. The documentation is a little vague as to the definite identity, but it is thought to be Edward II’s half-brother Thomas of Brotherton, and the incident would have definitely taken place before 1314 when he wrote his manuscript detailing it.
Anyway, I thought I’d post a bit of the Rosa Anglica here to let you see Gaddesden at work. So here is Gaddesden on his treatment of smallpox – the case that earned him his reputation.
Some of the causes:
Herein is smallpox : little imposthumes or pustules, seen in the skin, the which are oft times of a red colour, and dig themselves into the flesh; they are produced from corruption of the catamenia, and are often preceded by continuous sanguine fever.
The cause of this sickness, as Hali says, is when nature expels towards the surface of the body, the excess of sanguine humour or [continuous fever arising from a] peccant humour, in one in whom something of the menstrual flow or corrupt boiling blood [remains]; therefrom results the sickness called variolae i.e. smallpox, and from the menstrual blood it is formed: and Averroes says there is no man who does not contract smallpox, and these are his words :—as an evacuatory force is in every member which sends its surplus from it to another member thence is formed smallpox, and measles, and therefore no man escapes them, and if any one be conceived at the time of the catamenial flow, he seldom escapes without lepra or [other] hateful disease.
Symptoms and how they relate to the four humours:
If the smallpox be caused by sanguine humour, the pustules are pointed on top and broad below, ripen at once, and escape through running; the which is a sign of health; for sanguine humour is the cause thereof, and it is subject to the digestion and is a friend of nature. If the complexion be hot and moist and the wind south in spring, it is certain that it comes from red blood.
If from choler the pustules are red in hue, turning to yellow; they are small and round with sharp heads, and prick as though it were a needle, because of the sharpness of the matter. Should there be signs of digestion in the urine, on the day of the crisis, accompanied by a lessening of the pain, fever and the violent thirst; and the pustules define themselves (open?), and liquid come therefrom, that is a [good] sign, and if the contrary [be the case] it is bad.
If it be from phlegm [the pustules] are white and broad and hard to digest, the matter corrupting under the skin, causing great itching, more especially if it be from salt phlegm. If a running begin of the colour of copper rust, accompanied by itching, and the urine be raw, that signifies death.
If it be caused by melancholy, [the pustules] are leadenhued at first [becoming] blackish thereafter, and then black; and moisture gathers not in them ; they are large and hard like large warts, the which is bad, for there is no quality in them by which they could mature; therefore they dry and split, causing heart weakness, delirium, and lack of energy, and when this happens, the leech can say, death is at hand. And sometimes two large pustules appear so that one of them is in the middle of the other, the which is bad, for it shows the amount and toughness of the matter; so if the force be weak, it is a sign of death.
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 they be evacuated, i.e. the peccant matter. Fourth: things should be applied to them to dry them, before they are entirely ripened.
If it be from the first thing mentioned, may ye know, should the body be full of humours, or excessive blood, or the force puissant, and the age and other local matters agreeing, then it is meet to let a vein at the inception of the matter, that is, the medial vein, and that at the top of the nose thereafter, (especially in the case of youths) for they preserve the upper members from the malice of the pustules. There is no danger in letting them (i.e. the veins) in children. If it come from plethora of blood, a vein may be let, from the fourth day till the seventh; then let the bowels be moved with cassia fistula and violets along with sugar of roses and their juice, and do not give a laxative there, the which is puissant, as in this case it easily turns to flux.
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, lactuca, and scariole; 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.
If it be caused by sanguine humour, violet syrup may be taken, and still more syrup of fumitory. If it be produced by choler, increase the violet syrup, and lessen that of fumitory, as [that] syrup (of fumitory) is common to them both. Sometimes these syrups are thick and hard to drink; if that be so, make this drink to digest them. [Recipe] take sorrel juice, liverwort and sampsuchine, a fistful of each; a quarter pound of fumitory juice; borage flowers, violets, roses 1 ounce (?) * of each; a quarter and a half of sugar, and a quarter of dried figs; make therefrom a syrup and use, the which digests the matter, whether it be from sanguine humour or choler.
It if be caused by phlegm, the matter may be digested with syrup of fumitory and oxysacchara, and thus it is prepared. [Recipe] take 1 ounce (?) of sugar, 8 lbs of sour apple juice, 3 drachms (?) of vinegar, and put in a tin vessel on a fire. Mix well till they come to the quantity of the sugar; then put them in a pipkin : this decoction to be used as an electuary, and is good in quotidian fever, quartan, tertian, and ague. It purges the choler in the stomach; and give it early with wine in hot water.
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. If it be, then let the air be moderated within by sally leaves, and by sprinkling water throughout the house. Tie the sick man’s hands or let him have gloves on regularly, nor let him scratch them (i.e. the pox,) 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 (?) ; or else boil fennel and smallage in water with dried figs.
And here’s the bit about his treatment of the royal smallpox:
Item 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.
* The question marks are Winifred Wulff’s, the translator and editor of the text. She observed that the scribes who copied the original or later versions seem to have used ‘the figure 3. indiscriminately for both drachm and ounce’ (the original characters for these look like a ‘3’ and a Z sitting on top of a 3 respectively – unfortunately I can’t find the original symbols to insert here!). So the question marks are because she questions whether it is the correct dosage – or pharmaceutical ingredients in other cases – quite important when this was a medical textbook!
**Although Gaddesden was going on the theory that ‘like cures like’, it is interesting to note that red light therapy is used to heal skin lesions today. I’m not convinced that light through red cloth is the same as red light from a bulb, but I may be wrong – and it’s still an interesting co-incidence that the boy healed without scarring.
*** This is the bit that confuses me, I must admit, for if he was writing this in 1314 then the King of England was Edward II, and the son would have been the future Edward III. I have done a lot of looking around on this and have not come up with any different theory to that of the boy being Thomas of Brotherton. It’s always possible that there has been a mistake in translation/transcription somewhere (in this copy) and maybe the original manuscript is a lot clearer as to the identity.
Rosa Anglica, (An early Modern Irish translation of a section of the Medieval medical text book of John of Gaddesden), Edited and translated by Winifred Wulff M.A., 1923