Читать книгу The Greatest Benefit to Mankind: A Medical History of Humanity - Roy Porter - Страница 59

Pharmacy underwent significant change as the range of remedies was extended, thanks to the retrieval of classical drugs, the discovery of new vegetable products from America and the Indies, and the increasing use of chemical substances. Herbs – understood in the widest sense as the leaves, seeds or fruits, bark and roots of plants, shrubs and trees – had always been the prime ingredients of medical remedies. If used individually, apothecaries called them ‘simples’; combined into a compound drug, perhaps with animal and mineral ingredients, they would be called ‘Galenicals’. Herb gathering (simpling) and preparation of remedies were domestic skills practised in the family, but there was also a commercial side to herbal medicine.

With the Greek revival, physicians became concerned that the remedies then in use were inferior, and sought to recover the original materia medica used by the ancients. This required the reform of botany, since there was no uniform nomenclature, leaving plant identification chancy. Botany enjoyed its own humanist renaissance: medieval authors were denounced for their barbaric language and for corrupting ancient texts, and there was a call for pure editions of classical botanical works. The great scourge of the pharmacists was the Paris humanist Symphorien Champier. About 1513 he issued his Myroel des Apothecaires, whose subtitle reveals his position: The Mirror of the Apothecaries and Druggists in Which is Demonstrated How the Apothecaries Commonly Make Mistakes in Several Medicines Contrary to the Intention of the Greeks … on the Basis of the Wicked and Faulty Teachings of the Arabs.

Around the mid fifteenth century manuscripts of Theophrastus’ Historia plantarum [The History of Plants] and De causis plantarum [On the Causes of Plants] were brought from Constantinople and translated into Latin by Theodore Gaza. Galen’s De simplicium medicamentorum facultatibus [On the Powers of Simple Remedies] had been used in the medieval universities, but in 1530 a new Latin translation was published, corrected by reference to ‘old manuscripts’. More important, however, as a vehicle for medical botany was the De materia medica of Dioscorides (fl. AD 50–70), which galvanized the botanical revival. The work had been known in Latin to the Middle Ages, but humanists collected Greek manuscripts, and the Aldine Press published a Greek edition in 1499.

With the Dioscorides revival, herbals themselves changed. The earliest printed ones were compiled from medieval sources, but later works by William Turner (c. 1510–68), Leonhart Fuchs (1501–66) and others became more naturalistic, both verbally and pictorially, mirroring the Renaissance anatomy atlases. The first to abandon the old stylized pictures was the Herbarum vivae eicones (1530) [Living Images of Plants] of Otto Brunfels (d. 1534), town physician of Bern. The artist Hans Weiditz (d. c. 1536) (school of Durer) gave this herbal its innovative look. When his plants did not tally with Dioscorides’, Brunfels tried to force identifications.

He described 258 different plants; ninety-seven years later, Caspar Bauhin’s (1560–1624) Pinax theatri botanici (1627) [A Catalogue of Botanical Theatre] included around 6,000 specimens. This stupendous increase was achieved through individual and collaborative efforts. The first chair in botany was established in Padua in 1533; botanical gardens were created in Pisa and Padua in 1544–5, with other universities following: Bologna, Leiden, Leipzig, Basel and Montpellier. Plants, however, were not always available and altered with the seasons; this made the artificial or dry garden (hortus siccus) an invaluable invention, allowing rare plants to be preserved or exchanged, and providing teaching material and draughtsmen’s models.

A great boost was provided by Pier Andrea Mattioli (1500–77), who in 1542 became physician to the province of Gorizia, where he worked on a commentary of Dioscorides. Published in 1544, his edition of De materia medica became the spur for botanical and pharmacological research, earning its author European celebrity. Like Linnaeus later, Mattioli had a gift for inspiring collaborators to travel, collect and send him specimens. Expanding with each edition, the work culminated in the version of 1565, a lavishly illustrated Latin folio running to nearly 1500 pages, bejewelled with full-page illustrations.

As the entrepôt of the Mediterranean, enjoying close links with the Middle East and the overland spice trade from the Indies, Venice was the natural centre for the humanist goal of recovering classical medicaments. Not least, the Venetian Republic controlled Crete and Cyprus, the herb gardens of the ancients. Drugs unknown to the latin West – balsam and myrrh for instance – were rediscovered. Famous for its purging powers, rhubarb had entered Europe through the overland trade routes from the East; by the early seventeenth century, seeds from Bulgaria allowed one medically valuable type of rhubarb (Rhaponticum, from the Pontus or Black Sea) to be grown in Europe, while search continued for the ‘true’ rhubarb which Marco Polo had reported in 1295 as deriving from China. Theriac, that panacea of the ancients, composed of up to a hundred herbal, animal and mineral ingredients, seemed in the 1540s quite impossible to compound; many of its ingredients were unknown and more than twenty substitutes were needed. But by 1566 the Veronese botanist-pharmacist Francesco Calzolari (1522–1609) was using only three proxies. Physicians grew confident that the remedies of the ancients had been recovered.

Thanks to Iberian voyages of discovery, new drugs filtered in, together with foodstuffs like potatoes. Cocoa came back with Cortés in 1529, becoming a favourite drink, a specific for ‘wasting diseases’, a stimulant, and even the basis of cocoa-butter suppositories. Meanwhile the Portuguese had rounded the Cape of Good Hope in 1487–8 and reached India in 1499. By 1512–13 they landed in the legendary Spice Islands, the Moluccas, whose spices had traditionally arrived in Europe via the overland route.

Remedies from distant parts entered into scholarship, particularly through the writings of Nicolas Monardes (c. 1493–1588) and Garcia d’Orta (1501–68). Educated at Seville, Monardes commented that New World drugs were inferior to those of Spain (pharmaceutical chauvinism was strong), but he later changed his mind, enthusiastically praising their powers in his Dos Libros (1565–74). The book followed a standard format, giving for each plant its place of origin, appearance, colour, properties and uses. New World plants posed problems, for their virtues were uncertain. This led him to concentrate on the distinguishing marks of the new plants and to describe how they were processed by the American Indians. Together with coca, jalap, sarsaparilla and sassafras (these latter famed for blood-cleansing), one of his best-known descriptions was that of tobacco, which he praised for curing head pains, toothaches, bad breath, chilblains, worms, joint pains, swellings, poisoned wounds, kidney stones, carbuncles and fatigue. Its efficacy derived from its heating and drying qualities. Despite King James I’s strictures against ‘this filthy custom’, tobacco enjoyed a high medicinal reputation in the seventeenth century.

In the face of the terrifying syphilis epidemic, imported plant remedies might appear godsends, for treatment with mercury was almost worse than the disease. In the Caribbean the Spaniards saw syphilis (more probably yaws) treated by decoctions made from guaiac wood (Guaiacum officinalis); by 1508 this was being imported into Spain and its use became widespread. Also known as ‘holy wood’, guaiac was obtained from evergreens indigenous to the West Indies and South America. The folk belief that God planted cures where diseases arose reinforced the conjectural New World origin for syphilis. Shiploads of guaiac were imported into Europe, organized by the Fuggers of Augsburg, the mercantile and banking family who monopolized the trade and profited mightily. The German humanist and soldier Ulrich von Hutten (1488–1523) experienced the horrors of the mercury treatment; he went through eleven mercury cures in nine years, then he heard of guaiac, and after repeated infusions believed he was cured. Von Hutten’s De guaiaci medicina et morbo gallico (1519) [On the Guaiac Remedy and the French Disease] was translated into German and French, but by the time Monardes wrote in 1565 guaiac was losing support.

One key remedy from the East was opium, largely imported from Turkey. It had been in use in Egypt in the second millennium BC, and Avicenna called it ‘the most powerful of stupefacients’. Ever the queen of drugs, it was profusely used in western medicine from the sixteenth century, and Thomas Sydenham (1624–89) later proclaimed that ‘among the remedies which it has pleased the Almighty God to give to man to relieve his sufferings, none is so universal and so efficacious as opium.’ It seemed the wonder drug; not just a pain-deadener, it also stopped dysentery and relieved respiratory disorders.

India supplied new remedies. In 1563 Garcia D’Orta published Coloquios dos simples, e drogas he cousas mediçinais da India [Dialogues on Simples and Drugs and Medical Matters from India] which described such eastern products as aloes, camphor, sandalwood, ginger, asafoetida and betel, and new fruits such as mangoes. Like the Italian humanist botanists, he had to confront identification problems. (Was modern cinnamon the ‘canella’, ‘cinnamon’ or ‘cassia’ of the ancients?) Other eastern drugs filtered to the West later, including Chinese rhubarb and ginseng, introduced in the eighteenth century by the Jesuits.

Thanks in part to the labours of the botanists and the importation of new drugs, the apothecary’s trade boomed, though for many (witness Romeo’s remarks) the apothecary remained a wretch vending poisons:

I do remember an apothecary

And hereabouts he dwells – whom late I noted

In tatter’d weeds, with overwhelming brows,

Culling of simples; meagre were his looks,

Sharp misery had worn him to the bones;

And in his needy shop a tortoise hung,

An alligator stuff’d and other skins,

Of ill-shap’d fishes …

Like other branches of medicine, apothecaries organized themselves. In England, James I recognized them as a special body in the Grocers’ Company in 1607, and ten years later they gained their independence, organizing as the Masters, Wardens, and Society of the Art and Mystery of the Apothecaries of the City of London.