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A range of different record types across the Manchester Medical Manuscripts Collection used in conjunction with one another demonstrate the development of pharmaceutical preparations and how they were used in practice to treat of various diseases and ailments. A number of volumes of materia medica, and lectures on the subject, give explanation as to the therapeutic properties of specific substances used in medicine. Pharmacopoeia (copies and extracts of which we hold in relation to the Manchester Eye Hospital, the Royal College of Physicians of London, St Thomas and Guy’s Hospitals, and one physician’s version for private practice) on the other hand go on to give detailed recipes and advice on the preparation and dosage of medicines. Finally, in the numerous case books we see how these treatments were applied in practice. Many working copies of these records contain recipes for a range of other items too, which were relevant to a physician’s daily life, with recipes for common ink, sympathetic ink, and blacking amongst them.

henbanebelladonna

A number of quite commonplace plants appear in the preparations, such as dandelion, barley, and oak bark, but the presence of what seem like more exotic plants, such as tamarind and kino gum from west Africa, show the influence of international trade on pharmacology and explain its rapid development in this period. Also notable is the common use of substances considered to be highly toxic, e.g. henbane, prussic acid, mercury, arsenic, belladonna, and hemlock, employed for their sedative, analgesic, and anti-inflammatory properties amongst others. Aside from the use of botanical and chemical substances in medical treatment, many of the case books from this period show food and alterations in diet to have formed significant part and formed the basis of many approaches.

L0002714 Use of the Seton. Credit: Wellcome Library, London. Wellcome Images images@wellcome.ac.uk http://wellcomeimages.org Use of the Seton. Armamentarium Chirurgicum Johannes Scultetus Published: 1655 Copyrighted work available under Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

L0002714 Use of the Seton. Credit: Wellcome Library, London. Creative Commons CC BY 4.0

The choice of remedy for each condition in turn reflects the logic in the medical thinking of the time. For example, a volume of John Rutherford’s (1695-1779) clinical lectures records the admission of 23 year old Robert Moubray to the Edinburgh Infirmary on 7th February 1751 suffering from epilepsy. Some of the treatments offered include Glauber’s Salts, decoction of tamarind, calomel (mercury chloride), rhubarb powder, and tartar emetic, all of which act as laxatives, the latter being described in a contemporary materia medica as “sometimes prescribed … where a brisk rousing shock is required upon the solids as in vertigoes, apoplexies, epilepsies, lethargies etc.”.  The reason this method of treatment was pursued is explained in a third manuscript written in 1792 by an unknown physician who describes epilepsy as being a result of a plethora of blood and goes on to say “we may avoid congestions in the head with laxatives or a an issue or seton on the neck”. A seton was a surgical cut kept open for a time to encourage suppuration and the evacuation of pus and was also employed by Rutherford on his epileptic patient. Both methods of treatment aimed to rid the body of the excess believed to be causing the fits.

However, Rutherford cites another possible cause of fits saying, “how the change in the moon comes to work upon the body … I cannot say but … we should endeavour before the full moon by evacuations and every other possible method to empty the already too full vessels.” In this vain Rutherford pursues his chosen course of treatment in earnest in an attempt to prevent the onset of further fits with the coming of the full moon. His attempts, however, fail and with the arrival of the full moon the patient is still experiencing fits.

Through the combined use of these manuscripts we gain an insight not only into the actual treatment of the patient but the scientific knowledge and developments underpinning the rationale behind such recipes and therapeutic treatments. In turn, it is not uncommon to see the authors of some of these works stating how they disagree with certain treatments in opposition to some of their contemporaries, showing how the profession was a long way from established and accepted forms of treatment. Whilst by simply looking back on these medicines from a modern perspective and imagining the experience of the patient, some of the proposed treatments often present themselves as more daunting than the illness itself.