This image is taken from the Florentine Codex, also known as Historia de las Cosas de la Nueva España or The General History of the Things of New Spain, a monumental sixteenth-century work completed under the direction of the Franciscan monk, Fray Bernardino de Sahagún. De Sahagún conducted his research in the Nahuatl language, devising a questionnaire, employing native amanuensis (assistants who would take dictation or copy manuscripts), and spending time with informants in different parts of the country. The illustrations within the manuscript were completed in c.1575 and are attributed to Agustín de la Fuente, a native of Tlatelolco.

The image presented here is the earliest visual record depicting smallpox in the New World. Between 1520 and 1600, smallpox and other European diseases such as measles ravaged the indigenous populations of Mexico and Central and South America. Hundreds of thousands of people died, with some estimates of population loss being up to 90%. The general devastation was noted by contemporaries. In 1634, John Winthrop wrote 'for the natives, they are neere all dead of small Poxe, so as the Lord hath cleared out title to what we possess'.

The link between smallpox and skin transcended linguistic barriers and Galenic theory. The disease was immediately identifiable by the macules - pustules, lesions or boils - it caused on the skin. This image is also particularly remarkable for the careful attention it gives to the progressive nature of the disease and its successive stages. The gradual uncovering of the body in the various panels helps to demonstrate the spread of the pustules, but it also signifies the spiking and dangerous fever for which the disease was well known. While few visual accounts of smallpox survive, those that do display similar attention to the progressive nature of the disease. They remind us that while skin was often the subject of artistic scrutiny, the way in which it signified what was more difficult to represent (in this case delirium, fever, and death) was the cause of its scrutiny.

HM

The Florentine Codex is found in the Medicea Laurenziana Library in Florence.

A digital edition has recently been made available at The World Digital Library.

The treatment of canine skin afflictions was a core component of early modern texts that dealt with hunting with hounds. Many of the pharmaceutical preparations were empirically based, although dogs (as all animals) shared with man the same humeral framework in their bodies. Thus, care was to be taken to keep their bodies in balance. If out of sorts, overheated, or too cold, techniques such as bloodletting, cupping, and purging were applied to the canine patient.

George Gascoigne’s The Noble Art of Venerie or Hunting (1576), a translation of Jacques du Fouilloux’s La Venerie (1561), dealt with a number of subjects, including: mange, ringworm, scabies, animal bites (from vipers, serpents, boars, bears, wolves, ‘or such like’), ear cankers, plasters for sore feet, and preparations for sore ears, along with removing fleas, lice, and other vermin. A careful and detailed surgical operation involving incisions and tying up veins with thread was required to treat the ‘Wolfe, which is a kernel or round bunch of flesh, which groweth and increaseth, until it kill the dogge’.

There were four kinds of canine mange. Red mange was considered to be the most dangerous. Caused by overheating, it would make a dog’s legs swell. The excess of heat could be due to variety of causes, such as running in water while hot, lying in cold and wet places without being ‘well dryed or rubbed’, or being a butcher’s dog, where the blood of oxen and other beasts might cause this overheating. Scaly mange grew in patches (‘as broad as the palme of a mans hande’) and removed the skin. Black mange ‘lyeth under the skinne’ and caused the shedding of hair. Common mange was a result of either a dog lacking fresh drinking water or due to ‘foule and filthy lodging and kennelling’, for example in a pig sty or simply lying on the straw on which a dog with mange had slept. Unlike the other three types of mange a decoction of herbs could affect a cure.

For red, black, and scaly mange the following treatment was to be applied. The dog had to first be purged then bathed and then the next day be bled of two ounces or more of blood. Within the next two days, the dog had to have a special ointment applied to its skin. In preparation for this, the dog would be washed and rubbed all over with a mixture of water and salt. The ointment was made of walnut oil, juniper oil, worm oil, honey, vinegar, rosin, pitch, new wax, sulphur, iron sulphate, and verdegris (copper carbonate). After anointing the dog with this ointment, which promised to ‘kill and heale all maner of manges and itches’, the patient would be tied up by a fire to promote a healthy sweat for an hour and a half (water would be provided to drink during this time). Once warm, the dog should be fed with a mutton broth that contained herbs and a bit of sulphur, eating this diet for eight days to complete the cure.

KWM

Further Reading:

• George Gascoigne, The Noble Art of Venerie or Hunting (1576), reprinted in 1908 as Tuberville’s Booke of Hunting (Oxford, 1908)
  

Main image: From George Gascoigne The Noble Art of Venerie or Hunting (1576), reprinted in 1908 as Tuberville’s Booke of Hunting (Oxford, 1908), Chapter 79: 'Receipts, to heale sundrie diseases and infirmities in houndes and dogges', p.221

Some of the main sources of information about skin in early modern Europe are medical texts written on disease. The most famous of these, On Skin Disease (1572) written by Girolamo Mercuriale, is often described today as 'the first dermatological treatise'. Yet skin was a focus in many texts on disease, long before Mercuriale ever wrote his treatise. Rashes, ulcers, lesions, boils, the temperature of skin, and its colour, were all common signs a physician looked for and took into account when diagnosing disease (as indeed did apothecaries, barber-surgeons, midwives, family members, or the patient).

 

How these diseases were dealt with in the literature was not straightforward. The dominant physiological paradigm for rashes was dictated by the Galenic humoral system. In this model, as the historian Michael Stolberg has described, a rash was understood to be the body ridding itself of morbid or dangerous matter. Thus a rash was part of the process of disease, rather than a disease in its own right. Moreover, a rash was seen as necessary and so not to be suppressed; in some cases it was even promoted. Stolberg writes how 'Patients and, in the case of children, relatives felt relieved when a rash appeared'.

 

From the literature we can see that from the earliest days of print there were a number of conditions that were understood to be skin diseases. Their symptoms on the skin were not only regarded with great fear, but also provoked specific action across a number of different spheres. First and foremost was leprosy. By 1500, there were many hospitals and charities dedicated to providing care specifically for this disease. The most notorious of all diseases was undoubtedly the plague, identified by historians and contemporaries alike by the colour and quality of lesions or marks on the body. From the 1490s, the spread of syphilis (variously referred to as 'pox', the 'French Disease', 'the Italian Disease' and other terms) saw new attention paid to skin. At the same time, there was a mobilisation of printing and artistic techniques used to illustrate and conceptualise skin disease. Albrecht Dürer's broadsheet (as illustrated here) was one of the earliest texts to deal with syphilis. The illustrations show that even in its very origin, efforts made to identify and treat pox were intertwined with efforts to represent it. The iconography of French pox was rapidly established and repeated elsewhere, as reflected by the author in this piece on the Florentine Codex. The epidemic nature and contagion associated with such terrifying illnesses caused great fear and panic, but they also contributed to changing conceptions of disease, treatment, and the role of skin in each.

 

Aside from leprosy, plague, and pox, there were other skin conditions which frequently appeared in medical texts. Within Book IV of Avicenna's canon, Diseases Not Specific to Certain Organs, are sections on smallpox (De variolis), measles (De morbillo), and a huge number of inflammatory conditions most of which took place on the skin, including 'Persian Fire' or anthrax (De pruna et igni persico). Other ailments less well known by historians today were frequently dealt with by sixteenth-century medical practitioners. So we find erysipelas (red murrain or Rotlauf) detailed in sixteenth-century medical compendia by Theodor Zwinger, as well as in later veterinary books. The sixteenth century also saw the identification of 'new' diseases, such as scurvy by the physician Johann Weyer. Although today diseases such as this are not recognised as skin afflictions, they were nevertheless identified by their chroniclers for the extreme effects they had upon the surface of the body.

 

Future posts will examine some of these individual ailments in greater depth. But for now it is important to recognise that, despite the apparent hegemony of Galen and a general consensus on the physiology of skin (evident as we have already seen in the commonly cited metaphor of the fisherman's net), in the first half of the sixteenth century, there were multiple ways of approaching skin and its disorders, within and outside of learned medicine. Skin disease did exist. The potential for conceptual tension within Galenism is one more example of the pliancy of early modern medical thinking more generally, as a framework for explanation as well as a field of practice.

HM

Further Reading: 

• Michael Stolberg, Experiencing Illness in Early Modern Europe (Palgrave Macmillan, 2011). See, in particular, the section on skin and rashes, pp.105-114.
  
• Luke Demaitre, Leprosy in Pre-Modern Europe: A Malady of the Whole Body (Johns Hopkins University Press, 2007)
  
• Jon Arrizabalaga, John Henderson, Roger French, The Great Pox: The French Disease in Renaissance Europe (Yale, 1997)
  
• Claudia Stein, Negotiating the French Pox in Early Modern Germany (Ashgate, 2009)

Image: Broadsheet: text and woodcut of a syphilitic by Albrecht Dürer. Credit: Wellcome Collection CC BY

Girolamo Mercuriale (1520-1606), the foremost physician teaching in Italy in the second half of the sixteenth century, lectured on the subject of pimples at the University of Padua in the 1580s. Notes on the lectures were collected and organised, along with notes relating to other afflictions to facial beauty, by his student Giulio Mancini (1559-1630), who would later gain fame as a physician and art critic in Rome. The collection was first published as De decoratione in 1585, with multiple editions appearing in the following decades. The chapter on pimples (de varis) follows the humanist medical approach that Mercuriale applied to all of his work. He begins by explaining the nomenclature of the Greek and Latin terms for this affliction, followed by a long discussion on how pimples are created and develop, paying careful attention to ancient medical authorities. According to Mercuriale, pimples were most prevalent in young people (see image), due to their warm and damp complexions.

As most skin afflictions were considered to have been caused by a humoral imbalance (in the case of pimples, an excess of thick and raw blood around the face), the physician was required to start from the 'inside out’ when treating their patient. Firstly, the physician should identify the pustules as pimples. They could be recognised by the little lump being slightly hard to the touch and the top being briefly red. If squeezed, they would expel ichor crassissimus (a thick discharge). A regimen of health was then advised for the future: avoiding too much sun, exercise, salty or spicy food, or an excess of wine. Some blood would be let and then the body purged. The stomach and humours would be prepared before being purged and detailed recipes are supplied for each step of this process. Once purged, the physician should then examine the pimples and squeeze out the pus with either a needle or finger. Once squeezed, the pimples could be softened with a variety of recipes. One suggestion was to wash the face with honey and vinegar. These softening recipes should be sufficient to remove the pimples, but if they still remained and were hard ammoniac, frankincense, and Gaulish soup could be applied. This last remedy is the subject of a brief discourse by Mercuriale, who mentions that one version - a soap made of ashes, salt, and oil - was still in use in Germany.

Read translation of chapter 20 'On pimples':

On pimples

KWM

Image: Lorenzo di Credi, Bust of a Boy Wearing a Cap, c. 1480. Musée du Louvre, Paris

Cleaning the body by expelling waste material through its surface was key in the Galenic system. As Sandra Cavallo and Tessa Storey have recently shown, in both learned medical theory and popular practices, personal hygiene was closely associated to the purification and purging of the body. Different kinds of waste were produced in the process of transforming foodstuff into blood, and then expelled from the body. 'Insensible transpiration' and 'perspiration' were the names given by physicians to the process of involuntary waste expulsion from the skin's pores. Being clean and being healthy were closely aligned.

 

Within this mentalité, bathing had a crucial function in the opening up or closing of the skin's pores. This was facilitated by the use of cold water, hot water, and water vapours. By the sixteenth century, thermal baths had long been the focus of medical literature with increasing numbers of the population seeking wellness and health in thermal stations. Humanist intellectuals praised the classical Roman tradition of public bathhouses, also lauding the ingenuity of the ancients in their ability to build such technologically complex systems of heating baths and steam baths.

 

In his famous 1585 encyclopaedia, Tommas Garzoni devotes a chapter to steam bath attendants. This gives a clear sense of what he considered to be changing – in his eyes, for the worse – in the world of public bathing. He explains that the profession had a rather dignified history. In the Latin language, these attendants were known as balneatores, meaning 'all those who work as attendants for whatever kind of bath'. Things began to change in the fifteenth century, when humanists such as Lorenzo Valla made a distinction between thermal baths and regular baths: thermal baths were those warmed up by nature; baths, or steam baths, were warmed by humans with the use of fire. Garzoni noted that in the strictest sense, thermal baths in ancient Rome and in contemporary Germany were places where people went to sweat. In this respect, this made them proper medical spaces and Garzoni then refers the reader back to authorities such as Arnau of Vilanova (c. 1238-1311) and Michele Savonarola (1385-1468). For Garzoni, sixteenth-century baths were different:

German towns were famous for hosting many such public baths, as Murphy discusses elsewhere on this site. In fact, Bartolomeo Della Rocca (also known as Cocles), author of a 1504 book on physiognomy and chiromancy, wrote his description of the physiognomic traits of a prostitute after being in such a place. He recalled: 'When I was in a steam bath, as the Germans do, I noticed a prostitute, whose body I inspected after gaining consensus from her and her pimp'. (See Bartolomeo della Rocca ‘Cocles’, Chyromantie ac Physionomie anastasis (Bologna, 1504), book VI, chapter 74.

 

A clean skin with unobstructed pores granted health, and this went hand in hand with the pleasures of the flesh.

PS

Further Reading:

• Richard Palmer, '"In this our lightye and learned tyme": Italian Baths in the Era of the Renaissance', Medical History, 34/S10 (1990): 14–22
  
• Sandra Cavallo and Tessa Storey, Healthy Living in Late Renaissance Italy (Oxford, 2013)
  
• Valeria Finucci, The Prince’s Body: Vincenzo Gonzaga and Renaissance Medicine (Cambridge, Mass., 2015)

Image: A representation of a Roman public bath from De balneis omnia quae extant apud Graecos, Latinos, et Arabas, ed. by Tommaso Giunta (Venice, 1553)

Giambattista della Porta’s Magia naturalis (Naples, 1558) was a hugely popular printed book of secrets. This particular genre of writing details technical, medical, cosmetic, and alchemical ‘experimental’ recipes that cover a huge variety of subjects, from setting up your own distillation still to perfuming your gloves. Della Porta's text, Natural magick, sought to understand the secret properties of all natural beings: animal, vegetable, and mineral. In addition to multiple Latin editions, the work was also translated into French, Dutch, and English. The 1658 English version has been quoted here.

The whole of Book IX is devoted to cosmetic recipes that deal with a broad range of subjects, including removing wrinkles, warts, ringworm scabs, pimples, spots, sun-burn, or redness in the face; cleaning one's teeth; the dying of hair and eyebrows; and the preparation of lead paint, mercury water, and talc. The final chapter of the book (ch.XXX) is entitled ‘Adversus mulieres ludicra’ ('Games against women'). It is in stark contrast to the book's title - 'On adorning women and making them beautiful' - for the goal of each of the five recipes is now one of mockery: 'Thus far I have shewed how to beautifie women, now I shall attempt some things against their decking of themselves, and make some merriment after those things that I seriously discovered to adorn them'.

The first experiment allows the practitioner to ‘spot’ if a woman has used face paint or not, claiming that a painted face will change colour due to the action of either saffron or brimstone: 'If you would know a painted Face, do thus: Chew Saffron between you Teeth, and stand neer to a woman with your mouth: when you talk with her, your breath will foul her Face, and make it yellowish; but if she be not painted, the natural colour will continue. Or burn Brimstone in the room where she is: for if there be Ceruss or Mercury sublimate on her Face, the smoak will make her brown, or black. The painted Women that walk at Puteoli, in the Mountains of Phlegra, are made so black, as Silver-money is, shut up in bags.' The next experiment has a similar aim - to discern if the lady has used a rouge: 'Chew Grains of Cummin, or a Clove of Garlick, and speak close by her; if it be natural, it will remain; but counterfeit with Ceruss or Quick-silver, it presently decays'.

After these two diagnostic experiments, the following three cause a change in the skin itself (although two of them include instructions to rectify the damage caused by the prank). Two recipes affect the face, with the third concerning hair. Animals feature in each of these recipes: a stellio (lizard), a chameleon, and a salamander. The use of animals in cosmetic recipes was not out of the ordinary. Della Porta gives recipes for black hair dye that involve a tincture of wine-infused leeches, while another involved boiling a green lizard in oil which was then applied to the hair.

The first of these recipes causes a female face to be covered in red pimples. Averting red pimples was an aim of experiments covered earlier in the ninth book of Magia naturalis often involving eggs, with one recipe suggesting the application of an oil of burnt paper to the pimple. The ‘prank’ recipe caused the appearance of those ill-desired red pimples that were so detrimental to contemporary ideals of beauty of smooth, soft, and white skin. Directly referencing Pliny the Elder's Natural History for this, Della Porta writes 'Of a Stellio is made an ill Medicament: for when he is dead in Wine, all the Faces of those that drink of it, will be red-spotted Wherefore, they that would disfigure Whores, kill him in an Oyntment. The Remedy is, the yelk of an Egg, Honey and Glass. Pliny.'

The next recipe relates to the changing of skin colour and it uses an animal famed for its ability to change the colour of its skin: the chameleon. The chameleon had been an animal of wonder for millennia, alleged to subsist on a diet of air like the mythical bird-of-paradise and able to turn into a variety of colours. In line with Aristotelian thinking, it was thought that the chameleon could not change its skin tone to white, in early modern cosmetics a colour which when accompanied by some redness on the cheeks was the ideal tone for the perfect sanguine complexion. The chameleon recipe was designed to make the face green and it cites Avicenna: 'Avicenna saith, That the Decoction of Chamaeleon, put into a bath, will make him green-coloured that stays long in that bath; and then by degrees he will recover his former colour'.

The final recipe within this chapter is to make hair fall off from either the head or the beard. Despite appearing in a section of tricks ‘against women’, this last experiment seems clearly aimed at men: 'Touch any part of mans body with a matter white as milk, that the Salamander vomits up out of its mouth, and the Hairs will fall off; and what is touched is changed into the Leprosie. Pliny.'

However strange it might seem to end a long discussion on beautification with recipes against such a goal, prank recipes abound in Della Porta, so the ones detailed above must be considered within this tradition. Book XIV deals with culinary recipes but ends with a chapter on 'How to drive Parasites and Flatterers from great mens Tables’, which includes a recipe to turn a man's hands black when he wipes them with a napkin and one to make meat at a meal appear bloody and worm-ridden so that it is not eaten. Book XX is formed of a series of recipes listed in no particularly ordered way and includes some that are similar to the cosmetic pranks of Book IX. So, there are those to make a man’s face swell up, or to make a face appear extremely pale and lean, or even to allude to the likeness of 'Blackmores’. All of these recipes should be considered in the same vein as those that explain how to make women take off their clothes or coins turn around.

KWM

Further Reading:

• William Eamon, Science and the Secrets of Nature: Books of Secrets in Medieval and Early Modern Culture (Princeton, N.J., 1994)
  
• Giambattista della Porta, Magia naturalis (Naples, 1558) [available digitally at Internet Archive. The 1658 English translation, published as Natural magick, is available at Early English Books Online]
  

Image: Frontispiece of the English translation of Della Porta’s Magia naturalis (1658).

In early modern Europe, the essence of femininity was understood primarily in medical terms in line with contemporary humoral theories that conceptualised the body as a mixture of four fluids. Women’s phlegmatic complexions were believed to render them moist and cold, whereas their male counterparts were taken to be naturally hot and dry. Moreover, the bones and internal structure of a female body were considered inherently weaker and unstable, subjected as they were to the nefarious influences of a 'thirsty womb'.

 

Rest and movement together constituted one of the six non-naturals (i.e. factors not determined by the innate complexion) that acted upon an individual's disposition. In virtue of their clamminess and weakness, women were recommended in particular to exercise. In fact, activity was crucial to disperse the natural excess of moisture which was thought to be at the root of female idleness and dull-wittedness. Yet on the other hand, vigorous exertion brought women dangerously close to the 'hot' behaviours of a male complexion. Internal distempers also challenged physiological boundaries, since sexuality in this period was considered fluid and could constantly shift according to humoral changes. The increase in heat generated by corporeal exercise was thought to trigger such changes and – in extreme cases – generate a radical mutation of sex.

 

Women were therefore aware that they treaded an extremely fine line as they strove to achieve that delicate balance between rest and movement that ensured their physical wellbeing. A widely recommended solution was for them to indulge exclusively in passive or gestational forms of exercise, also thought suitable for the convalescent or the elderly. Commonly referred to as 'agitation', this kind of activity referred to all instances in which the body was moved or carried. Typically, that meant for women to be taken out on a litter or, in more recent times, being driven in an open chariot.

In his influential 1569 treatise on medical gymnastics, the Italian physician Girolamo Mercuriale commended being carried around as 'the most peaceful and gentle of exercises', for it had the advantage of naturally balancing movement and rest for a long period of time without inducing a sense of tiredness. A vigorous carriage ride, however, was endowed with a 'heating and thinning property' that could help reduce weight. Moderate walking was also thought to be suitable for women, and Mercuriale prescribed in particular taking a stroll in a dewy meadow. The watery droplets absorbed through thin or woollen garments were supposed to possess a 'colliquative power', able to consume all excess of flesh.

A final endorsement from Mercuriale was the use of the skimpodium, a type of oscillating cradle or seat that features frequently in classical sources. Swinging on these structures, the author affirmed, had been considered suitable for women since Antiquity. The Persian physician Avicenna had praised the refreshing effect derived from being constantly thrust into the air, thus preventing excessive heating and perspiration. Swinging was clearly singled out as a quintessentially feminine activity in the 1573 illustrated edition of Mercuriale’s De arte gymnastica. Drawing inspiration from Roman medals, the painter and antiquarian Pirro Ligorio depicted three women exercising on a skimpodium (see image), with one seated and the others pushing and pulling the ropes on both sides. Tellingly, this is the only female scene out of the 22 plates that adorn the volume. 

Valerio Zanetti

Further Reading:

• Alessandro Arcangeli, 'Exercise for Women' in Rebecca Von Mallinckrodt and Angela Schattner (eds.), Physical Exercise in Early Modern Culture: New Perspectives on the History of Sports and Motion (London and New York, 2016), pp. 147-63
  
• Sandra Cavallo and Tessa Storey, Healthy living in Late Renaissance Italy (Oxford and New York, 2013)
  
• Katherine Crawford, European Sexualities, 1400-1800 (Cambridge, 2007)
  
• Girolamo Mercuriale, De arte gymnastica, trans. Vivian Nutton (Florence, 2008) [View digitised copy of the 1573 edition]
  
• Gail Kern Paster, 'The Unbearable Coldness of Female Being: Women’s Imperfection and the Humoral Economy', English Literary Renaissance 28 (1998): 416-40
  

Image: Plate designed by Pirro Ligorio and included in Girolamo Mercuriale, Hiernonymi Mercurialis De arte gymnastica libri sex (Venice, 1573), p. 164. By permission of the Master and Fellows of Trinity College, Cambridge.

Valerio Zanetti is a Cambridge Trust and AHRC-funded History PhD candidate at St. John’s College, University of Cambridge. His thesis investigates female horse riding in early modern France, considered both as political strategy and embodied experience.

Leonard Mascall (d. 1589) authored many books (often translations and adaptions of other works) on subjects as diverse as grafting, angling, medical recipes, removing stains from fabrics and catching mice, rats and polecats. His first book on animal husbandry was devoted to chickens (The Husbandlye Ordring and Gouernmente of Poultrie, 1581). His second book on animal care had a wider scope and was titled The first booke of cattell wherein is shewed the gouernment of oxen, kine, calues, and how to vse bulles and other cattell to the yoake, and fell. It was published in London, 1587. Addressed to the ‘husbandman’, so that it could ‘bee understood of the unlearned husband man, as of the learned gentle man’, the book intended to cover the ‘government’ (care) and presented remedies for cows, horses, sheep, dogs, pigs, and goats (all domesticated animals covered under the generic term ‘cattle’). It was a volume of just over three hundred pages, in a portable octavo size. Mascall collected material from various sources, both contemporary and classical. The first book is dedicated to cows, the second to horses, and the third to ‘the ordering of sheep and goatees, hogs and dogs.’ Regarding sheep, a wide variety of ailments were covered, from fevers, lice, maggots, pestilence, and intestinal worms, along with advice for breeding sheep, building a sheep pen, and buying the best breeds (sheep with long, soft, white fleeces).

Sheep were considered to be more prone to the ‘scabbe’ than any other animal, caused by their exposure to cold weather and rain, with Mascall quoting a translation of Virgil’s Georgics:

 

When sheepe are greatly beaten with raine,

Then frost and cold encreaseth their paine:

Whereby the scabbe, will then encrease,

Which ye may kill, with tarre and fresh grease.

 

As a general prophylactic against the scab sheep should not be put on grass covered with dew or frost, as this was considered a major source of the ‘scabbe’. Being thin also made sheep more prone to the scab, as did putting them in a horse stable. Scratches from briers and thorns could also turn into scabs.

Regarding the ‘itch’, an ointment made of goose grease, pitch, and boiled young broom stalks should be rubbed onto the animal. Scabs and the ‘itch’ could be prevented by dipping the sheep in salted rain water right after shearing.

Other remedies for ‘common scab’ involved mixing powdered sulphur, cypress roots, camphor, wax and white lead (blancht rasis) and rubbing the scab with the ointment three times. The affected area would then be washed with wine lees (sediment at the bottom of the vessel) and salt water, followed by a wash with plain water. Mascall commented that the common shepherds tended to use a simpler ointment of tar and grease. In his work however, he provided assorted recipes to cure the scab including: a wash of boiled bear's-foot herb with milk thistle; a wash of elecampane roots; an ointment of olive oil and sulphur; hemlock juice seasoned with salt and placed in a dunghill a year; and, human urine (quenched on ‘hotte burning tilestones’ or boiled) mixed with henbane juice, cinnamon, salt and the powder of tiles.

 

Darters was a term for scabs on a sheep’s chin, mouth, and lips. Like the ‘common scab’, it was said to be caused by shepherds negligently allowing sheep to graze on dew-covered grass. The recommended treatment involved rubbing the area with a mixture of vinegar and hyssop, followed by washing it with vinegar, and finally applying an ointment of pig-grease and tar. Other recommended remedies included a mixture of verdigris and old grease, or an infusion of cypress leaves. Mascall emphasised the need to act rapidly with all forms of scab, as it was highly contagious and ‘if they be not holpen in time, one sheepe wil infect all the rest in short space’. Similarly, lambs could catch ‘scabbiness’ from adult sheep, which could be cured with a mixture of tar and grease or cow-foot oil (although goose grease was considered the best). Another type of scabbiness that affected sheep’s mouths was blamed on them eating the tops and flowers of furze or gorse. This was best treated with rubbing the area with fresh butter, but an ointment of boiled plantain juice and grease could also be used.

 

Side effects of the scab were bald patches on a sheep’s fleece. To make the wool grow again, Mascall suggested various shepherd’s recipes for ointments, such as a mixture of butter, oil, goose grease (or just ‘fresh grease’). Another involved mixing tar and oil with burnt daffodil bulbs, water-lily root or burdock. Cress mixed with mustard could be used too, as could crow’s foot (the plant) with oil, all with the same aim of encouraging wool growth again.

 

‘Scabby’ sheep could be spotted by bits of their fleece hanging loose on their backs, and it was incumbent on any shepherd to check his flock daily for the scab or the ‘pocks’, which were recognisable on the skin by a profusion of red or purple pimples, the size of ‘farthings’ (a very small coin fragment). The sheep’s behaviour also provided clues, as an animal scratching, biting or rubbing their bodies, either with their mouths, feet, horns or rubbing themselves against a tree, causing the scratched skin to redden, were likely to have either the scab or lice.

 

The moment a sheep was spotted with scabs, it should be removed from the flock and placed in fresh pasture.  The aim was to make sure that the sheep was ‘sodeinly remedied, to the end that al the rest be not infected with the same.’ The rest of the flock should be monitored. If any displayed signs of scabbiness a wash with water might be helpful (although to be avoided in a frost). Mascall suggested more ointments including nightshade juice mixed with grease, garlic mixed with tar, a wash of artichoke juice or Spanish chamomile (‘pelitory of spain’) and vinegar.

 

Finally, as a treatment for dried scabs (‘tetters’) as opposed to the open sores of the common scab, Mascall recommended either sorrel roots, hazel wort or the gum of cherry trees soaked in vinegar to rub on the dried scab. The area could also be anointed with a mixture of soap and Armenian bole (a red clay from Armenia, containing iron oxide).

 

Further reading:

·         Leonard Mascall, The first booke of cattell wherein is shewed the gouernment of oxen, kine, calues, and how to vse bulles and other cattell to the yoake, and fell (London, 1587) [available on EEBO]

·         Louise Hill Curth, The Care of Brute Beasts: A Social and Cultural Study of Veterinary Medicine in Early Modern England (Leiden, 2009)

KWM

Extending the conversation in ‘Skin and Material Metaphors in Sixteenth Century Texts’, this post examines animal metaphors for skin. The skin of quadrupeds and humans was usually understood to have the same formation, layers (cutis and cuticula), and function (as a means of eliminating bodily wastes).  However, regarding metaphors, animal skin is usually connected with diseased skin, to exemplify rough, broken, or swollen human skin. The names of many diseases point to how a disease was understood to manifest itself on the skin of the afflicted. The swollen lymph nodes of the neck of a scrofulous patient were thought to resemble the mammary glands of a pregnant pig (scrofa/scrofula). 

Cancer (Latin, crab) was applied to the disease by Roman Celsus (1^st century AD), translating directly the Hippocratic term karkinos for a malignant tumour. By the late medieval period the analogy not only depended on the tumour’s resemblance to the animal, but also its behaviour as a hungry beast eating the surrounding flesh. Thus in 1597 the surgeon Peter Lowe wrote that apart from looking like crabs, cancers ‘gnaweth, eateth and goeth like this fish’ and the physician Philip Barrough (1584) emphasised the crab’s resolute nature as cancer ‘verie hardly pulled awaie from those members, which it doth lay holde on, as the sea crabbe doth, who obstinately doth cleave to that place which it once hath apprehended’.

This ravenous animal might have to be literally fed to assuage its hunger. The surgeon Guy de Chauliac (d. 1368, still very influential in the early modern period) commentated how some people would ‘feed’ the tumour with hen’s flesh to avoid it eating the person. The surgeon Daniel Turner (1667-1741), author of De Morbis Cutaneis (1714), when discussing worms in cancers (a long-standing early modern medical belief) asserted that ‘perhaps the Progress of the Corrosion is sometimes stopt, by applying the Flesh of a Chick, to which these Animals stick, leaving the coarse for the finer Food’. The practice of ‘feeding’ a cancer was still attested in the 19^th century by the French surgeon Anthelme Richerand (d. 1840) who described how a female patient with breast cancer who applied a large piece of veal to her breast to “appease (she said) the hunger of the monster which was devouring her”.

The first references to a disease called ‘The Wolf’ (lupus) appear in the tenth century and for the twelfth century Salernitan surgeon Rogerius Frugardi, who wrote a Practice of Surgery, the term lupus was used to describe corrosive facial lesions and lesions on the lower limbs. On the face it was noli me tangere (touch me not), and on the thighs, it was a type of cancer (his student, Roland of Parma called these thigh lesions lupula, little she-wolf). Overtime the term was gradually replaced in many medical texts with herpes estiomenus, a snake analogy replacing the wolf. This name had been used in Classical texts for a corrosive skin disease, herpes from the Greek term to “slither like a serpent,” as the disease appeared to creep across skin, and estiomenus, for “eating”. However, the ‘wolf’ was still used in the early modern period to designate some cancers and also appears in veterinary medicine. The Noble Arte of Venerie or Hunting (London, 1575), George Gascoigne’s translation of Jacques du Fouilloux La vénerie (Poitiers, 1561) discusses it in detail in two entries, the first of which is titled: ‘A Receipt to heale the disease called the Wolfe, which is a kernell or round bunch of flesh, which groweth and increaseth, vntill it kill the dogge’.

Drawing on ancient, Arabic, and medieval (primarily from Salerno and Montpellier) sources, the early modern medical classification of leprosy was completely based on the resemblance of the leprous patient’s skin to a particular animal’s skin and behaviour. Elephantia was caused by an excess of black bile and the accompanying signs were thick, rough skin of a blackish colour, covered in tuberosities and nodes. Like an elephant the disease was strong both regarding cause and cure, with a slow increase (and a slow cure). The second form, leonina, was blamed on an excess of yellow bile, with symptoms resembling a lion: loss of eyebrows, wrinkles a bulging forehead, accompanied by yellow skin and urine (for Avicenna it made the patient look terrifying and was the form of leprosy most common in lions themselves). Regarding behaviour, the disease was considered to be both ferocious and swift.   The third form was tyria which had the characteristics of a snake. It was named for the highly venomous tyrus snake, which lived in the region around Jericho. A patient suffering with tyria (caused by an excess of phlegm) would have a very pale face, with white scaliness and urine. Descriptions of this form often emphasised the snake-like shedding of skin, with the patient often rubbing or scratching themselves to shed their skin. The final form was considered the mildest: alopecia, caused by an excess of blood, and ascribed to the fox, with patients affected by hair loss and a red face and eyes.

These animals were not the only ones used as analogies for leprosy. The Basel physician Johann Jakob Huggelin (d. 1564), following Galen, discussed how a leprous patient’s face resembled that of a satyr, and that they would imitate the creature’s lecherous behaviour. The Portuguese physician Velasco de Tharanta (fl. 1418) claimed Galen was not referring to satyrs with the use of the word ‘saton’, but instead to the badger (‘taxus’).

Animal metaphors were not restricted to classical or medieval archetypes. The Jesuit José de Anchieta (1534 – June 1597) described an epidemic of smallpox (viruelas) affecting the indigenous population in São Vicente in Southern Brazil. Observing the sores on the patients’ bodies, Achieta divided them into benign (dulces), known (acostumbrados) and ‘horrible’ new ones which covered the entire body. The latter sores caused the sufferer’s skin to resemble the skin of the dogfish (cuero de cazón), sharks of the Squalidae family.

Apart from these metaphors for diseased skin, other animals abounded in medical texts in connection with skin, such formica (the sensation of ants crawling under one’s skin) or the use of verbs of biting or devouring. For example, the Latin verb corrodere (to gnaw to pieces) was used to describe the effect of tissues being eaten away; the destruction of humours, ulcers, and wounds; or the corrosive or destructive effects of medicines, poisons or caustics. All these metaphors point to the multiple ways medical authors attempted to explain the complex nature of skin through beasts familiar to their audience. 

KWM

Further reading

• Luke Demaitre, Leprosy in Premodern Medicine: A Malady of the Whole Body (The John Hopkins University Press, Baltimore: 2007)
• Alida C. Metcalf, Go-betweens and the Colonization of Brazil: 1500–1600 (University of Texas Press, Austin: 2013) [on Anchieta]
• Marie Christine Pouchelle, The Body and Surgery in the Middle Ages, trans. Rosemary Morris (Rutgers University Press, New Brunswick, New Jersey: 1990)
• Alanna Skuse, Constructions of Cancer in Early Modern England: Ravenous Natures (Palgrave Macmillan,  Baskingstoke: 2015
• Kathleen Walker-Meikle, ‘Animals’ in A Cultural History of Medicine: The Middle Ages, ed. Iona McCleery (Bloomsbury, London, forthcoming)

 

Image

Credit line:  Land crab, leaf from a volume (now consisting of 113 leaves of drawings), after John White, 1585-1593. Museum number: SL,5270.16. © The Trustees of the British Museum

The medical care of pets is a lacuna in medieval and early modern sources. Specialist texts on animal care focused overwhelmingly on horses, with a small portion devoted to livestock (sheep, cattle, pigs and the like) and hunting hounds.  We know that companion animals were widely kept in the period, evidenced, from letters, account-books, iconography, poetry, among the wide array of available sources. Nevertheless, their health care remains a mystery as we do not even have one source devoted to the subject, even though there were volumes available at the time devoted solely to chickens (The Husbandlye Ordring and Gouernmente of Poultrie in 1581).

Horses dominate the field, with many available farrier’s manuals and learned equine treatises, and unsurprising in a world where many of these would be high status and expensive animals, worthy of paying someone when they fell ill or having someone to hand at the stables who could provide medical care.  Small animal practice was frowned upon as rather unworthy for a trained professional, and this would continue to the case until the twentieth century (see Alison Skipper’s recent article on Edwardian elite veterinarians catering to the ‘dog fancy’).

Sources regarding the care of dogs do appear in hunting manuals, which often include sections on how a kennel master should care for the hound pack. For example, George Gascoigne’s The Noble Art of Venerie or Hunting (1576) [bit.ly/2LoHHUo] discusses in one chapter (79):

'Receipts, to heale sundrie diseases and infirmities in houndes and dogges' after the bulk of the text, which deals with how to train your hounds for a variety of prey, such as deer, hares, foxes and badgers. Unlike learned equine treatises, there is almost no theory in this manuals, only simple preparations to cure common ailments such as rabies, fleas, mange, and sore paws. We do not know if this material was appropriated for the care of small household pets.'

Household recipe collections present a similar problem. While they are replete with medicines for the reader to prepare and administer to sick household members, we do not know if this extended to household pets. Would a recipe for a human with an upset stomach be given to a pet suffering from the same complaint? There are occasionally prescriptions for animals in these collections, such as one for a ‘Horse sick of the Plague in the guts’. However, even when there is a rare reference to a dog, how can we tell that these was for household pet? (the vast majority of recipes regarding dogs are for preparations against dog bites, rather than curing them!).

A rare glimpse of specialist care for pet dogs can be found in the seventeenth-century recipe-book of Johanna St John in the Wellcome Library, Ms 4338. Johanna St John collected and tested both medical and culinary recipes, as evidenced in her large correspondence (see Elaine Leong’s Recipes and Everyday Knowledge). The two recipes of interest specially refer to a ‘little dog’. Diminutive size was one of the characters of pet dogs kept by ladies, which could be carried or placed on laps, cushions, or beds. Given the female authorship, I believe that both of these recipes are specifically meant for small pet dogs that would have been kept in the house, rather than the larger hunting specimens outside in the kennels. Both are recipes to cure mange, which in the seventeenth century was understood to be caused by intemperate choleric or sanguineous humours inside the body that would manifest themselves on the surface of the skin. This was the prime cause of mange (and scabies, considered to be the same disease in humans), although the contagious nature of the disease was also recognised.

The first recipe is on f. 1r of Ms 4338 and is not in Johanna’s own hand. It states:

'For the Itch in man or woman or mange in a Dog: Half a pound of flower of Brimston or sulphur & a quart of white wine put together give a wine glasse to a man or woman a very night to a little dog 2 spoonfule a nott lys expenen’. The same ingredients (wine and sulphur) are used for both humans and the ‘little dog’. This is not unsurprising as the disease (called here ‘itch’ for the human sufferers) was considered to be the same. The only difference is in the quantity of the medicine and the mode of administering it. The humans get the mixture in a wine glass while spoonfuls are given to the pet dog.'

The second recipe is in Johanna’s own hand and appears on f. 271v of the manuscript:

'For a mang in a Dog: As much as a nut meg of uenes Turpentine & as much as a gray peas of quicksilver beat them together tel you cannot se the quicksilver then role it up in Butter and give it fasting & let the dog fast 4 howers or more you need giv it but ones this is for a little dogg tried it to two of mine.'

This second recipe is an excellent example of household testing strategies that appear in so many of these recipes, where evidence is attested of trials (and any modifications) of recipes on family members and servants to test efficacy. Here Johanna states that she has tested it on two of her pet dogs. Both recipes, apart from the rarity of involving pet dogs, are unusual in the fact that the preparation is to be ingested, either as a liquid or in pill form. Nearly all preparations to cure this disease, whether suggested by physicians, surgeons or farriers, emphasise the need to use a topical preparation as the main cure. These would be ointments, which in the early modern period were most frequently made from sulphur and/or mercury (often with animal fat as the base).

Johanna St John’s recipes for her little dogs illuminate how early modern pet owners might have treated their sick animals.

 

KWM

 

Further reading

• Elaine Leong, Recipes and Everyday Knowledge: Medicine, Science, and the Household in Early Modern England (University of Chicago Press, 2018)
• The Recipes Project – Food, Magic, Art, Science, and Medicine https://recipes.hypotheses.org/
• Alison Skipper, ‘The ‘Dog Doctors’ of Edwardian London: Elite Canine Veterinary Care in the Early Twentieth Century’, Social History of Medicine, , hkz049, https://doi.org/10.1093/shm/hkz049
• Kathleen Walker-Meikle, Medieval Pets (Boydell & Brewer, 2012)

 

Image: Johanna St John (1631–1705), painted by Godfrey Knelle (1646–1723) with one of her little dogs

Photo credit: Lydiard House Art UK 

While early modern European physicians and naturalists were notoriously fascinated by monsters, such creatures elicited curiosity and wonder only when they were confined to their own specific spaces in books, paintings, museum collections, or freakshows. Everyday monstrously disfigured faces would certainly cause horror. Horror and repugnance formed a mixed reaction in the beholder who happened to come across disfigured people. The disfigured person was similar to a monster, but not quite like it, since its status was the product of injury or illness, and not of congenital defects or its belonging to strange, exotic “races.”

Fortunio Liceti (1577-1657) – polymath, antiquarian, physician, natural historian and natural philosopher – was one of the key figures of early modern teratology. Liceti had studied arts and medicine in Bologna, and then moved to Padua, where he became professor of theoretical medicine. His book on monsters was first published, without illustrations, in 1616; a second, beautifully illustrated edition came out in Venice in 1634. Liceti is often credited as being one of the first thinkers who naturalized monsters, and indeed he made a systematic effort to classify monsters by following a naturalistic definition. According to Liceti, a monster was: “a being under heaven which provokes in the observer horror and astonishment by the incorrect form of its members, and is produced rarely, begotten, by virtue of a secondary plan of nature, as a result of some hitch in the causes of its origin … [monsters are] faults of nature when she does not proceed in the right way.” And he added: “It is in this [monstrous births] that I see the convergence of both nature and art, because one or the other not being able to make what they want, at least they make what they can.”

Liceti’s book made reference to grafting and monstrosities in plants and humans. He made use of Gaspare Tagliacozzi’s surgical procedure  as a tool to clarify the status of monsters caused by “an excess of matter.” While discussing the tenth cause of monstri excedenti, which is some kind of “violent consussion of the body of the mother,” Liceti described the case of a pair of twins, “already formed,” who suffered from a blow to the pregnant woman’s body. The skin of the twins could be excoriated and coalesce through the union of blood – acting as glue – in unnatural shapes. “While we were students in Bologna, we have seen several times our master Tagliacozzi re-making human noses by excoriating the scars on the nose, and then attaching the skin of the arm to the face in the space of a few days. This can be seen even in trees when, once the bark has been removed from different parts and tied together, they are glued together thorugh the action of the nourishing juices which flows through both parts.” Liceti used his former teacher’s surgical procedure as an analogy to explain the status of human monsters as preternatural entities. Monsters emerged through a blind assemblage of natural causes giving way to unprecedented and singular outcomes.

There is more. In his discussion of “monsters with a double nature” Liceti mentioned the disturbing example of man-made monsters. These were either made unintentionally by poorly skilled empirics and barber-surgeons, or intentionally by the art of people seeking to make money with freak shows. The seventh cause of such monstri ancipiti consisted in “an imitation of nature’s faults by art, not without the help of nature.” Liceti could not fail to notice that “art can produce monsters.” Indeed, all the works of nature were carried on either by nature alone or with some kind of cooperation. There were cases “when art, if it is able to fashion some kind of monster, cannot help the workings of nature to this end: in fact, the origin of a monster properly depends upon nature. Indeed, the active action of the art can only apply itself to the natural things which are passive: so monsters made with the cooperation of art are to be considered as natural products. Awe can observe another benefice of the art, or in some respect a misdeed, in plants: here, living monsters can be produced; even if farmers disagree on that, they can produce one single species starting from differentt trees through grafting and ligations, and in this way they obtain living beings which have a monstrous nature.”

Liceti used Tagliacozzi’s principle of grafting to illustrate the monstrous potential of the combination of human shapes, also alluding to artificially created monsters made through the human art of grafting. For example, Liceti reported a 1466 case of two boys in France who were struck by lightning and found attached together in one single body through their burning parts. Patients with burnings who were not treated properly could assume monstrous shapes too. Skin was both the material and the means through which unusual body shapes could come into being.

PS

Image: Fortunio Liceti, De caussis (1634): monstrous twins.

Further readings:

• Lorraine Daston and Katharine Park, Wonders and the Order of Nature, 1150-1750 (New York: Zone Books, 1997).
• Paolo Savoia, “Nature or Artifice? Grafting in Early Modern Surgery and Agronomy,” Journal of the History of Medicine and Allied Sciences 72, 1 (2017): 67–86.
• A.W. Bates, “The De Monstrorum of Fortunio Liceti: A Landmark of Descriptive Teratology,” Journal of Medical Biography 9, 1 (2001): 49–54.

This blog has addressed the issues of early modern scabies/mange regarding sixteenth-century scabby sheep, canine mange in hunting treatises and treating your mangy pet dogs.

 

Scabies, termed mange in mammals, is an infestation of the skin by parasitic mites. The itchy rash is caused by the female of the species (sarcoptes scabiei) burrowing under the first layer of the epidermis to lay her eggs.  For early modern medicine, the initial outbreak of the condition was due however not to mites, but an humoreal imbalance. An abundance of blood was usually alleged to be the prime causative factor, although other humours (black bile salty phlegm, choler) could also cause the condition. Although Galen himself in the second century AD listed scabies as a prime example of contagious disease (along with ophthalmia and phthisis), understanding the individual’s humoreal complexion was still essential when diagnosing and treating early modern scabies. Its highly contagious nature is more commonly discussed in agrarian and equine treatises and is rather rare in medical works dealing with human patients.

 

Traditional histories of medicine often point to Giovanni Cosimo Bonomo’s late seventeenth-century ‘discovery’ of the scabies mite as a watershed in understanding the causes of this affliction. Bonomo examined samples of skin from several itchy people and spotted under his microscope the scabies mite. He recounted these observations, complete with a drawing of the culprit, in a letter to Francesco Redi (printed as Osservazioni intorno a' pellicelli del corpo umano, Peitro Matini: Florence, 1697). However, the scabies mite was not broadly accepted by the medical community as the cause of scabies until the mid-nineteenth century.

 

However, this is not to say that mites were ignored, merely that their presence on the skin was not connected to scabies. The mite, not distinguished by species, was called acarus in Latin, ciron in French, seur in German, hand-worm in English, and in Italian a pedicello, among other terms. A reference to their small size appears in William Shakespeare’s Romeo and Juliet (Act 1 Scene 4) when Mercurio describes Queen Mab’s petite wagoner as “a small gray-coated gnat, Not half so big as a round little worm Pricked from the lazy finger of a maid.”

 

Mites, like fleas and lice, were believed to spontaneously generate on the surface or just under the first layer (cutis) of the skin. Like all such vermin, they were caused by a noxious mix of humours that caused putrid excrements to be pushed up through the pores to the skin’s surface, on which they would be created. There could confusion between all of these small annoying creatures. The twelfth-century Trotula (texts on women’s medicine) has recipes to remove worms or mites (titled vermes, formicaciones and syrones) that affect the hands and feet and those that appear on the body, especially the face. The same term for mites (syrones) was also used for little animals that eat the hair, which is more likely a reference to lice. In his 1363 Chirurgia magna the fourteenth-century French surgeon Guy de Chauliac spoke of mites (syrones) that lived between the flesh and skin (carnem et cutem), particularly on the hands. The mites’ prediliction for hands is emphasised in their name in the English vernacular: hand-worm. The exact location of the mites on the skin was further specified by Guillaume Rondelet (1507-1566), regius professor of medicine at Montpellier, who stated that cyrones lived semper intra cutim et cuticulam (always between the dermis and epidermis) and were extracted by women with the aid of a needle. Other early modern medical authors, such Daniel Sennert (1572-1637), mention needles being used to remove them. Although they might not have considered as causes of scabies in particular, mites, like fleas or lice, were one of the many causes of an itchy body in the early modern period.

KWM

 

Further reading

•  H.M. André, ‘The true identity of Pascal’s mite and the diachronic use of ciron’, Acarologia, 59:2 (2019), pp. 261-278
• Green, M. ed. and trans. The ‘Trotula’: a medieval compendium of women’s medicine, (Philadelphia: University of Pennsylvania Press, 2001).
• M. Ramos-e-Silva, 1989. ‘Giovan Cosimo Bonomo (1663-1696), discoverer of the etiology of scabies.’ International Journal of Dermatology,  37 (1998),  pp. 625–630

In January 1699, Willem ten Rhijne (1647–1700), a physician in the services of the Dutch East India Company, received a letter from his correspondent Georg Joseph Kamel (1661–1706), a Jesuit pharmacist stationed in Spanish Manila. In the letter, Kamel thanked his colleague for the advice on how to treat Asiatic leprosy with a remedy prepared from snake bile. Whilst leprosy had been receding in Europe throughout the early modern period, this ancient biblical disease continued to wreak havoc on colonial practitioners. Its Asiatic form was considered particularly severe and, even worse, it was largely unfamiliar to European physicians.

Having devoted more than two decades of his life to studying this terrible disease, ten Rhijne was a leading authority on Asiatic leprosy. Some ten years prior to his exchange with Kamel, he published a ‘Treatise on Asiatic Leprosy’ (Verhandelinge van de Asiatise Melaatsheid, 1687), which provides rich insights into seventeenth-century colonial medical care and skin diseases in southeast Asia. Although ten Rhijne had written all his previous works in Latin, he chose his vernacular Dutch for this treatise. Indeed, he was addressing a wider audience, including colonial officials, rather than just men of letters. With the disease “having in a few years’ time spread to such a degree that one would fear this evil growing even more grave” (p. xi), ten Rhijne was writing in direct response to the growing fear of the spread of Asiatic leprosy in Java. Difficult to diagnose correctly and even harder to cure, ten Rhijne offered a detailed discourse on its nosology, symptoms, causes and treatment, including non-European observations and therapies. His understanding of the disease was Galenic and, at every step, ten Rhijne invoked his rich direct experience with the disease.

In that respect, he had plenty to draw on. In 1677, he was appointed a regent in the leprosy house of Angké, located just outside the Batavia walls, and he later became the chief inspector of leprosy control in the capital, where he was charged with diagnosing people suspected of carrying the disease. It was also ten Rhijne who designated the island of Purmerend in the Batavia bay as the new site of isolation in 1679, when the Angké leprosarium was found too close for comfort to the city walls. In ten Rhijne’s words, “this [Asiatic] form is very infectious and hideous” and posed serious health risks to the colony (p. 22). As it had long been customary with infectious diseases, isolation was the main solution and also a necessity: to “protect and save the healthy,” the sufferers were to be “sent far out of sight of the uninfected” (p. xii). Ten Rhijne described the disease explicitly as “frightful to see and hear,” with the lepers increasingly covered in ill-smelling ulcers and hampered in their speech as the decay progressed (p. 34). Such unpleasant sensory perceptions could have had medical consequences too, polluting the air with corrosive vapours and provoking shock and fear in the onlookers. This would pose a particular threat to pregnant women. According to the idea of maternal imagination, anything a pregnant woman saw could be imprinted on her unborn child and lead to a monstrous birth. The stigma that accompanied the disease was indeed severe and, out of compassion, ten Rhijne chose to protect the anonymity of his patients. It was not only leprosy sufferers who were removed to Purmerend for the greater good of the colony: anyone found ‘unsightly’ enough, including those infected with different skin and venereal diseases, could fall victim to the Dutch policy.

 

Just as with other forms of leprosy, ten Rhijne ascribed the origins of the Asiatic strain to poisonous vapours, which would build up in the entrails, before beginning to affect the skin and its excrements (hair and nails) and progressively pervade and destroy the entire body. Ten Rhijne speculated that “even a simple constipation may lead to leprosy,” yet the exact cause of the disease remained shrouded in mystery (p. 16). Ten Rhijne named several factors that increased the risk of infection, including poverty and the associated lack of hygiene, as well as the consumption of certain foods. He advised avoiding eating too much fish and seafood, sharp spices and meat. Overindulgence in sexual intercourse, especially with menstruating women and leprosy sufferers, was also deemed to be particularly perilous. All the worse, in the early stages of the disease, some sufferers were found to “have excellent appetite and be very sensual, of which we have seen deplorable and offensive examples” (p. 30). Ten Rhijne offered a strongly moralising and sexualised portrayal of the disease, which he associated explicitly with non-Europeans and slaves, among whom he found the affliction to be particularly prevalent. Such cases were subject to strict isolation; however, Dutch colonists – at least those better off – could simply move outside the city walls or even return home to receive treatment in Europe. This was the case for the Dutch surgeon, Pieter van Campen. Having been diagnosed with the illness, he was allowed to continue his work at Purmerend until the next ship took him and his entire family back to Europe.

When discussing the remedies against this ‘great evil’, ten Rhijne expressed his dissatisfaction with standard methods of treatment. This was perhaps the reason behind his experiments with local remedies, including snake bile; after all, local substances were commonly considered to be specific to local diseases. Animal bile was a staple ingredient in Chinese and Japanese medicine: Li Shizhen’s renowned ‘Compendium of Materia Medica (Bencao Gangmu, 1578) mentioned more than thirty different kinds, from domesticated animals, such as the ox and pig, to larger beasts including the elephant, tiger and shark. In addition to snake bile, horseshoe crab bile was also recommended for leprosy. It was probably no accident that both of these animals shed their skin, unlike any other source of bile listed. Here, we can see how analogies between the human and the animal world were reflected in the method of medical treatment. Ten Rhijne may have learned of this remedy during his stay in Dejima (1674–1676), the Dutch trading post in the Nagasaki bay, or perhaps from a Chinese or local colleague in Batavia. Just as the Europeans, the Chinese considered “inner or malignant vapours to be the real originators” of leprosy and explained the disease in causal terms (p. 20). Whilst it is important to remember that commensurable ideas did not necessarily guarantee a shared understanding, these overlaps may have facilitated ten Rhijne’s decision to test and adopt the remedy. In colonial contexts, different medical traditions could easily become entangled, especially with death and contagion looming in the air.

 

SK

Title Image: Ten Rhijne’s elaborate handwriting (British Library, Sloane MS 4083A: 129v). Reproduced with permission of the British Library Board.

 

Primary sources used

• Willem ten Rhijne, Verhandelinge van de Asiatise Melaatsheid na een naaukeuriger ondersoek ten dienste van het gemeen, Amsterdam: Abraham van Someren, 1687.
• For an English translation of the introduction and the first two chapters, see: Opuscula selecta Neerlandicorum de arte medica, vol. 14, 1937, pp. 32–113.
• Li Shizhen, Compendium of Materia Medica: Bencao Gangmu, ed. Xiwen Luo, Beijing: Foreign Languages Press, 2003.
• Letter from Willem ten Rhijne to Georg Joseph Kamel, Batavia, 29 August 1699 (British Library, Sloane MS 4083A: 130r–131v).

 

Further Reading

• Luke Demaitre, Leprosy in Premodern Medicine: A Malady of the Whole Body, Baltimore, MD: The Johns Hopkins University Press, 2007.
• Leo van Bergen, Uncertainty, Anxiety, Frugality: Dealing with Leprosy in the Dutch East Indies, 1816–1942, Singapore: NUS Press, 2018.
• Harold J. Cook, Matters of Exchange: Commerce, Medicine, and Science in the Dutch Golden Age, New Haven, CT: Yale University Press, 2007.