Part 13

The ancient idea that earth, air, fire, and water were the elements of Nature was held by chemists in the 18th century. Empedocles appears to have been the author of this theory, which was adopted by Aristotle. Some speculative philosophers, however, taught that all of these were derived from one original first principle; some held that this was water, some earth, some fire, and others air. Paracelsus, who does not seem to have objected to this idea, contributed another fantastic one to accompany it. According to him everything was composed of sulphur, salt, and mercury; but he did not mean by these the material sulphur, salt, and mercury as we know them, but some sort of refined essence of these. These three essentials came to be tabulated thus:--

SALT. SULPHUR. MERCURY. Unpleasant and bitter. Sweet. Acid. Body. Soul. Spirit. Matter. Form. Idea. Patient. Agent. Informant or movent. Art. Nature. Intelligence. Sense. Judgment. Intellect. Material. Spiritual. Glorious.

This is taken from Beguin, who explains that the mercury, sulphur, and salt of this classification are not those “mixt and concrete bodies such as are vulgarly sold by merchants. Mercury, which combines the elements of air and water, Sulphur represents Fire, and Salt, Earth.” “But the said principles, to speak properly, are neither bodies; because they are plainly spiritual, by reason of the influx of celestial seeds, with which they are impregnated: nor spirits, because corporeal, but they participate of either nature; and have been insignized by Phylosophers with various names, or at the least unto them they have alluded these.”

Instances of the combination of these principles are given. If you burn green woods, you first have a wateriness, mercury; then there goes forth an oleaginous substance easily inflammable, sulphur; lastly, a dry and terrestrial substance remains, salt. Milk contains a sulphurous buttery substance; mercurial, whey; saline, cheese. Eggs: white, mercury, yolk, sulphur, shell, salt. Antimony regulus, mercury, red sulphur conceiving flame; a salt which is vomitive.

Nowhere do you get these principles pure. Mercury (the metal) contains both sulphur and salt; so with the others.

Becker, the predecessor of Stahl, was not quite satisfied with the orthodox opinion, and improved upon it by limiting the elements to water and earth; but he recognised three earths, vitrifiable, inflammable, and mercurial. The last yielded the metals. Stahl was inclined to go back to the four elements again, but he had his doubts about their really elementary character. He, however, concentrated his attention on fire, out of which he evolved his well-known phlogiston theory. This substance, if it was a substance, was conceived as floating about all through the atmosphere, but only revealing itself by its effects when it came into contact with material bodies. There was some doubt whether it possessed the attribute of weight at all; but its properties were supposed to be quiescent when it became united with a substance which thereby became phlogisticated. It needed to be excited in some special way before it could be brought again into activity. When combined it was in a passive condition.

The amusing features of the phlogiston theory only developed when it came to be realised that when the phlogiston was driven out of a body, as in the case of the calcination of a metal, the calx remaining was heavier than the metal with the phlogiston had been. The first explanation of this phenomenon was that phlogiston not only possessed no heaviness, but was actually endowed with a faculty of lightness. This hypothesis was, however, a little too far-fetched for even the seventeenth century. Boerhaave thereupon discovered that as the phlogiston escaped it attacked the vessel in which the metal was calcined, and combined some of that with the metal. This notion would not stand experiment, but Baume’s explanation of what happened was singularly ingenious. He insisted that phlogiston was appreciably ponderable. But, he said, when it is absorbed into a metal or other substance it does not combine with that substance, but is constantly in motion in the interstices of the molecules. So that as a bird in a cage does not add to the weight of the cage so long as it is flying about, no more does phlogiston add to the weight of the metal in which it is similarly flying about. But when the calcination takes place the dead phlogiston, as it may be called, does actually combine with the metal, and thus the increase of weight is accounted for.

HUMOURS AND DEGREES.

The doctrine of the “humours,” or humoral pathology, as it is generally termed, is usually traced to Hippocrates. It is set forth in his book on the Nature of Man, which Galen regarded as a genuine treatise of the Physician of Cos, but which other critics have supposed to have been written by one or more of his disciples or successors. At any rate, it is believed to represent his views. Plato elaborated the theory, and Galen gave it dogmatic form.

The human body was composed not exactly of the four elements, earth, air, fire, and water, but of the essences of these elements. The fluid parts, the blood, the phlegm, the bile, and the black bile, were the four humours. There were also three kinds of spirits, natural, vital, and animal, which put the humours in motion.

The blood was the humour which nourished the various parts of the body, and was the source of animal heat. The bile kept the passages of the body open, and served to promote the digestion of the food. The phlegm kept the nerves, the muscles, the cartilages, the tongue, and other organs supple, thus facilitating their movements. The black bile (the melancholy, Hippocrates termed it) was a link between the other humours and sustained them. The proportion of these humours occasioned the temperaments, and it is hardly necessary to remark that this fancy still prevails in our language; the sanguine, the bilious, the phlegmatic, and the atrabilious or melancholy natures being familiar descriptions to this day.

The humours had different characters. The blood was naturally hot and humid, the phlegm cold and humid, the bile hot and dry, and the black bile cold and dry. Alterations of the humours would cause diseased conditions; distempers was the appropriate term. There might be a too abundant provision of one or more of the humours. A plethora of blood would cause drowsiness, difficulty of breathing, fatty degeneration. A plethora of either of the other humours would have the effect of causing corruption of the blood; plethora of bile, for example, would result in a jaundiced condition, bad breath, a bitter taste in the mouth, and other familiar symptoms. Hæmorrhoids, leprosy, and cancer might result from a plethora of the melancholic humour; colds, catarrhs, rheumatisms were occasioned by a superabundance of the phlegm.

It must not be supposed that Galen or any other authority pretended that the humours were the sole causes of disease. Ancient pathology was a most complicated structure which cannot be even outlined here. The theory of the humours is only indicated in order to show how these explained the action of drugs. To these were attributed hot, humid, cold, and dry qualities to a larger or less extent. Galen classifies them in four degrees--that is to say, a drug might be hot, humid, cold, or dry in the first, second, third, or fourth degree. Consequently the physician had to estimate first which humour was predominant, and in what degree, and then he had to select the drug which would counteract the disproportionate heat, cold, humidity, or dryness. Of course he had his manuals to guide him. Thus Culpepper tells us that horehound, for example, is “hot in the second degree, and dry in the third”; herb Trinity, or pansies, on the other hand, “are cold and moist, both herbs and flowers”; and so forth. Medicines which applied to the skin would raise a blister, mustard, for example, are hot in the fourth degree; those which provoke sweat abundantly, and thus “cut tough and compacted humours” (Culpepper) are hot in the third degree. Opium was cold in the fourth degree, and therefore should only be given alone to mitigate violent pain. In ordinary cases it is wise to moderate the coldness of the opium by combining something of the first degree of cold or heat with it.

An amusing illustration of the reverence which this doctrine of the temperatures inspired is furnished by Sprengel in the second volume of his History of Medicine. Dealing with the Arab period, he tells us that Jacob-Ebn-Izhak-Alkhendi, one of the most celebrated authors of his nation, who lived in the ninth century, and cultivated mathematics, philosophy, and astrology as well as medicine, wrote a book on the subject before us, extending Galen’s theory to compound medicines, explaining their action in accordance with the principles of harmony in music. The degrees he explains progress in geometric ratio, so that the fourth degree counts as 16 compared with unity. He sets out his proposition thus: _x_ = _b_^{_n_-1}_a_; _a_ being the first, _b_ the last, _x_ the exponent, and _n_ the number of the terms. Sprengel has pity on those of us who are not familiar with mathematical manipulations, and gives an example to make the formula clear.

Medicament. Weight. Hot. Cold. Humid. Dry. Cardamoms ʒi 1 ½ ½ 1 Sugar ʒii 2 1 1 2 Indigo ʒi ½ 1 ½ 1 Myrobalans ʒii 1 2 1 2 --- ----- ----- --- --- ʒvi 4½ 4½ 3 6

This preparation therefore forms a mixture exactly balanced in hot and cold properties, but twice as dry as it is humid; the mixture is therefore dry in the first degree. If the total had shown twelve of the dry to three of the humid qualities, it would have been dry in the second degree. When it is remembered that in addition to these calculations the physician had to realise that drugs adapted for one part of the body might be of no use for another, it will be perceived that the art of prescribing was a serious business under the sway of the old dogmas.

THE ROSICRUCIANS.

It has never been pretended, so far as I am aware, that the Rosicrucian mystics of the middle ages did anything for the advancement of pharmacy. They are only mentioned here because they claimed the power of curing disease, and also because it happens that the fiction which created the legends concerning them was almost contemporaneous with the not unsimilar one (if the latter be a fiction) which made a historical figure of Basil Valentine. Between 1614 and 1616 three works were published professing to reveal the history of the brethren of the Rosy Cross. The first was known as Fama Fraternitatis, the second was the Confessio Fraternitatis, and the third and most important was the “Chymical Marriage of Christian Rosencreutz.” The treatises are written in a mystic jargon, and have been interpreted as alchemical or religious parables, though vast numbers of learned men adopted the records as statements of facts. It was asserted that Christian Rosencreutz, a German, born in 1378, had travelled in the East, and from the wise men of Arabia and other countries had learnt the secrets of their knowledge, religious, necromantic, and alchemical. On his return to Germany he and seven other persons formed this fraternity, which was to be kept secret for a hundred years. The brethren, it is suggested, communicated to each other their discoveries and the knowledge which had been transmitted to them to communicate with each other. They were to treat the sick poor free, were to wear no distinctive dress, but they used the letters C.R. They knew how to make gold, but this was not of much value to them, for they did not seek wealth. They were to meet once a year, and each one appointed his own successor, but there were to be no tombstones or other memorials. Christian Rosencreutz himself is reported to have died at the age of 106, and long afterwards his skeleton was found in a house, a wall having been built over him. Their chief business being to heal the sick poor, they must have known much about medicine, but the books do not reveal anything of any use. They acquired their knowledge, not by study, but by the direct illumination of God. The theories--such as they were--were Paracelsian, and the fraternity, though mystic, was Protestant.

The most curious feature of the story is that the almost obviously fictitious character of the documents which announced it should have been so widely believed. Very soon after their publication German students were fiercely disputing concerning the authenticity of the revelations, and the controversy continued for two hundred years. Much learned investigation into the origin of the first treatises has been made, and the most usual conclusion has been that they were written by a German theologian, Johann Valentin Andreas, of Württemberg, b. 1586, d. 1654. He is said to have declared before his death that he wrote the alleged history expressly as a work of fiction.

THE DOCTRINE OF SIGNATURES

was at least intelligible. It associated itself, too, with the pious utterances so frequent among the mediæval teachers and practitioners of medicine. The theory was that the Creator in providing herbs for the service of man had stamped on them, at least in many instances, an indication of their special remedial value. The adoption of ginseng root by the Chinese as a remedy for impotence, and of mandrake by the Hebrews and Greeks in the treatment of sterility, those roots often resembling the male form, have been often cited as evidence of the antiquity of the general dogma.... But isolated instances of that kind are very far from proving the existence of systematic belief. Hippocrates states that diseases are sometimes cured by the use of “like” remedies; but he was not the founder of homœopathy.

It is likely that the belief in a special indication of the virtues of remedies grew up slowly in the monasteries, and was originated, perhaps, by noticing some curious coincidences. It found wide acceptation in the sixteenth century, largely owing to the confident belief in the doctrine expressed in the writings of Paracelsus. Oswald Crollius and Giovanni Batista Porta, both mystical medical authors, taught the idea with enthusiasm. But it can hardly be said that it maintained its influence to any appreciable extent beyond the seventeenth century. Dr. Paris describes the doctrine of signatures as “the most absurd and preposterous hypothesis that has disgraced the annals of medicine”; but except that it may have led to experiments with a few valueless herbs, it is difficult to see sufficient reason for this extravagant condemnation of a poetic fancy.

The signatures of some drugs were no doubt observed after their virtues had been discovered. Poppy, for instance, under the doctrine was appropriated to brain disorders, on account of its shape like a head. But its reputation as a brain soother was much more ancient than the inference.

It is only necessary to give a few specimens of the inductive reasoning involved in the doctrine of signatures as revealed by the authors of the old herbals. The saxifrages were supposed to break up rocks; their medicinal value in stone in the bladder was therefore manifest. Roses were recommended in blood disorders, rhubarb and saffron in bilious complaints, turmeric in jaundice, all on account of their colour. Trefoil “defendeth the heart against the noisome vapour of the spleen,” says William Coles in his “Art of Simpling,” “not only because the leaf is triangular like the heart of a man, but because each leaf contains the perfect icon of a heart and in the proper flesh colour.” Aristolochia Clematitis was called birthwort, and from the shape of its corolla was believed to be useful in parturition. Physalis alkekengi, bladder wort, owed its reputation as a cleanser of the bladder and urinary passages to its inflated calyx. Tormentilla officinalis, blood root, has a red root, and would therefore cure bloody fluxes. Scrophularia nodosa, kernel wort, has kernels or tubers attached to its roots, and was consequently predestined for the treatment of scrofulous glands of the neck. Canterbury bells, from their long throats, were allocated to the cure of sore throats. Thistles, because of their prickles, would cure a stitch in the side. Scorpion grass, the old name of the forget-me-not, has a spike which was likened to the tail of a scorpion, and was therefore a remedy for the sting of a scorpion. [The name forget-me-not was applied in England, until about a century ago, to the Ground Pine (Ajuga Chamœpitys), for the unpoetical reason that it left a nauseous taste in the mouth.]

Oswald Crollius, who describes himself as Medicus et Philosophus Hermeticus, in his “Tractatus de Signatures,” writes a long and very pious preface explaining the importance of the knowledge of signatures. It is the most useful part of botany, he observes, and yet not a tenth part of living physicians have fitted themselves to practise from this study to the satisfaction of their patients. His inferences from the plants and animals he mentions are often very far-fetched, but he gives his conclusions as if they had been mathematically demonstrated. Never once does he intimate that a signature is capable of two interpretations. A few illustrations not mentioned above may be selected from his treatise.

Walnuts have the complete signature of the head. From the shell, therefore, a salt can be made of special use for wounds of the pericranium. The inner part of the shell will make a decoction for injuries to the skull; the pellicle surrounding the kernel makes a medicine for inflammation of the membrane of the brain; and the kernel itself nourishes and strengthens the brain. The down on the quince shows that a decoction of that fruit will prevent the hair falling out. So will the moss that grows on trees. The asarum has the signature of the ears. A conserve of its flowers will therefore help the hearing and the memory. Herb Paris, euphrasia, chamomile, hieracium, and many other herbs yield preparations for the eyes. Potentilla flowers bear the pupil of the eye, and may similarly be employed. The seed receptacle of the henbane resembles the formation of the jaw. That is why these seeds are good for toothache. The lemon indicates the heart, ginger the belly, cassia fistula the bowels, aristolochia the womb, plantago the nerves and veins, palma Christi and fig leaves the hands.

The signatures sometimes simulate the diseases themselves. Lily of the valley has a flower hanging like a drop; it is good for apoplexy. The date, according to Paracelsus, cures cancer; dock seeds, red colcothar, and acorus palustris will cure erysipelas; red santal, geraniums, coral, blood stones, and tormentilla, are indicated in hæmorrhage; rhubarb in yellow bile; wolves’ livers in liver complaints, foxes’ lungs in pulmonary affections, and dried worms powdered in goats’ milk to expel worms. The fame of vipers as a remedy was largely due to the theory of the renewal of their youth. Tartarus, or salt of man’s urine, is good against tartar and calculi.

Colour was a very usual signature. Red hangings were strongly advocated in medical books for the beds of patients with small-pox. John of Gaddesden, physician to Edward II, says, “When I saw the son of the renowned King of England lying sick of the small-pox I took care that everything round the bed should be of a red colour, which succeeded so completely that the Prince was restored to perfect health without the vestige of a pustule.”

METALS AND PRECIOUS STONES.

It will be noticed that parts of animals are credited in the examples just quoted with remedial properties. This was a natural extension of the doctrine. Metals, too, were credited with medicinal virtues corresponding with their names or with the deities and planets with which they had been so long associated. The sun ruled the heart, gold was the sun’s metal, therefore gold was especially a cordial. The moon, silver, and the head were similarly associated. Iron was a tonic because Mars was strong.

“Have a care,” says Culpepper, “you use not such medicines to one part of your body which are appropriated to another; for if your brain be overheated and you use such medicines as cool the heart or liver you may make mad work.”

But it was not quite so simple a thing as it may seem to be to select the proper remedy, because there were conditions which made it necessary to follow an antipathetical treatment. For instance, Saturn ruling the bones caused toothache; but if Jupiter happened to be in the ascendant, the proper drug to employ was one in the service of the opposing planet. Modern astronomy has removed the heavenly bodies so far from us that we have ceased to regard them in the friendly way which once characterised our relations with them. To quote Culpepper again: “It will seem strange to none but madmen and fools that the stars should have influence upon the body of man, considering he being an epitomy of the Creation must needs have a celestial world within himself; for ... if there be an unity in the Godhead there must needs be an unity in all His works, and a dependency between them, and not that God made the Creation to hang together like a rope of sand.”

SYMPATHETIC REMEDIES.

Among the strange theories which have found acceptance in medical history, mainly it would seem by reason of their utter baselessness and absurdity, none is more unaccountable than the belief in the so-called sympathetic remedies. There is abundant material for a long chapter on this particular manifestation of faith in the impossible, but a few prominent instances of the remarkable method of treatment comprised in the designation will suffice to prove that it was seriously adopted by men capable of thinking intelligently.

The germ of the idea goes back to very early ages. Dr. J. G. Frazer, the famous authority on primitive beliefs, traces the commandment in the Pentateuch, “Thou shalt not seethe a kid in its mother’s milk,” to an ancient prejudice against the boiling of milk in any circumstances, on the ground that this would cause suffering to the animal which yielded the milk. If the suffering could be thus conveyed, it was logical to believe that healing was similarly capable of transference.

Pliny (quoted by Cornelius Agrippa) says: “If any person shall be sorry for a blow he has given another, afar off or near at hand, if he shall presently spit into the middle of the hand with which he gave the blow, the party that was smitten shall presently be free from pain.”

Paracelsus developed the notion with the confidence which he was wont to bestow on theories which involved far-fetched explanations. This was his formula for “Unguentum Sympatheticum”:--

Take 4 oz. each of boar’s and bear’s fat, boil slowly for half an hour, then pour on cold water. Skim off the floating bit, rejecting that which sinks. (The older the animals yielding the fat, the better.)