#Historical Medicine

[insipid-drivel]

Toxins, Venom, and Poisons in Historical Western Medicine: How Are We Not Extinct From Doing Some Of This To Ourselves?

This piece is an involuntary piece inspired by @writing-with-sophia's awesome post "Poison list", which is an accurate and succinct list of commonly known (and ancient!) poisons, venoms, and toxins that have been and were used for causing poisoning in ancient and recent history. I wanted to write this because what struck me by their post crossing my dash was, the sheer number of poisons listed that were - and even still are - used as mainstays for healthcare around the world throughout the ages!

OBLIGATORY DON'T BE A DUMBASS PSA: If you're planning on incorporating these poisons into your HISTORICAL-era writing, it's also important to remember that many of them were used for medicinal purposes at one time, too, and it's great you're interested in learning about the subject! And also, you shouldn't try ANY of these! I will not tell you how to do it at home if you DM me, so don't! You are not appropriately trained to do it! You will harm or kill yourself and possibly your loved ones if you fuck around with any of these and it will be 100% your fault and you absolutely should feel bad bout it! I've seen some of you idiots believe 4chan posts about making home-grown crystals using recipes for actual mustard gas and seen you being wheeled into the ER on the news! I will not feel bad if you get yourself hurt if you screw around with any of these plants, elements, or animals!

Resource blog plugs and PSA over, now for the Hilariously Poisonous Medicines:

If you're writing something that's meant to take place prior to the advent of our more modern understanding of poisons, venoms, and toxins, factoring in "this is toxic to me NOW, but what about 500 years ago?" can add a lot of opportunities for interesting plot elements to your story.

These can include someone accidentally poisoning themselves with a toxic drug or substance that wouldn't have killed them if they'd handled it properly - like tansy? Grows all over the place in Europe and England? That'll kill you if you harvest it too late in the season, but it's good for intestinal parasites when it's harvested early in the year and processed right.

Did the lady's maid really kill her mistress with belladonna? Or was she trying to secretly help her mistress get rid of an unwanted pregnancy?

The protagonist's children can't survive to make it to weaning age! Is the wetnurse a poisoner, or does the milkman hide that he sells sour milk by pouring Borax into it so no one could taste it and has no idea he's killing his clients' babies?

Nuance and cultural mores regarding historical views about poisons and toxins can make writing even more fun, dynamic, and interesting! Explore 'em!

Just... please don't try any of this crap yourself. You will poison yourself, it will hurt, you will die, and you will hurt the entire time you're dying. Using OP's master list alone, here's the flip side of these lethal beasts through the eyes of our distant ancestors who believed illness was caused by "vapors", "bad air", and "imbalanced humors":

Hemlock:

Used across multiple different cultures in history. When properly administered to treat a disease, poison hemlock was used to treat asthma, whooping cough, bronchitis, joint/bone pain, muscle cramps, and insomnia. Hemlock was most often used as a sedative and antispasmodic.

Arsenic:

Arsenic is a heavy metal, and so has been used in everything from making specialty dyes for wallpapers (Scheele's green is the most infamous arsenic-based paint; Queen Victoria once had a guestroom in her palace redone with Scheele's green wallpaper. The first dignitary to stay there had to be carried out and taken to emergency care after breathing astronomical amounts of arsenic dust from the wallpaper's paint), to medicine. Arsenic was especially commonly used in history to treat skin ailments ranging from acne, to psoriasis, to syphilis sores. It was also sometimes prescribed for menstrual cramps, upset stomachs, colic, and arthritis, among many, many other things.

Cyanide:

Uh... I have literally never found any evidence of cyanide in medicine, outside of its use in modern medicine as part of certain chemical lab tests for measuring urine ketone bodies that involve no contact with a patient whatsoever. Cyanide literally works in less than a few seconds to render your entire body incapable of absorbing OR using oxygen in your lungs or already existing in your blood. Cyanide is really only good at making things that breathe not breathe anymore.

Nightshade:

There are a lot of different "nightshades", so being specific is essential here. Potatoes are nightshades. Tomatoes are nightshades. Calling anything a "nightshade" does not inherently mean it's lethally toxic. Belladonna is probably the most notorious of the "deadly" nightshades, but to this day, is still used medicinally, and would actually be seen as a health and cosmetic mainstay in historical fiction, especially if your setting is in Italy!

Belladonna is an Italian portmanteau for "beautiful woman", because tinctures (water-based drops) of belladonna were commonly used by Italian women as eyedrops to dilate their eyes and appear more attractive, aroused, and desirable. Today, belladonna's eye-dilating effects are still used by optometrists to dilate the pupils! Belladonna has been, and still sometimes is used as an NSAID, general painkiller, motion sickness treatment, asthma medication, and even as a treatment for IBS.

Ricin:

As OP said, Ricin is derived from the toxin found in Castor Beans, and is surprisingly new as an official "the only reason this is made is to make someone dead" poison. Not only is ricin a popular "nobody would think to test for this!" choice in mystery/thriller writing, but it has been used for political assassinations in real life before. Georgi Markov, a Bulgarian anti-Communist dissenter and writer, was killed in 1978 with a 1.7mm diameter ricin-coated pellet shot into his thigh muscle by an unidentified assailant using a modified umbrella as a gun. He died 4 days later.

Historically, castor OIL has been used for medicinal purposes, especially for treating constipation, inducing labor in pregnancy, and as a topical skin moisturizer. If you've ever watched the opening scene in Disney's "Peter Pan", when the childrens' mother is trying to give them a spoonful of medicine each, she's actually giving them castor oil! Castor oil tastes really bad (so much so that flavorings like cinnamon were often added to try to muffle the taste), so the childrens' reluctance and disgust at their mom making them take their medicine is very realistic for the era the movie came out in!

Strychnine:

Another lethal poison that started life as a medicine/food additive. Strychnine is no longer used medicinally at all today, but historically, it was used to stimulate the heart, treat bladder and bowel incontinence, and limb palsy. Strychnine is a deadly-powerful muscle stimulant that, as a poison, causes horrifyingly painful full-body strictures (spasms) and destroys the cardiovascular system. (Fun fact: Strychnine and hydrochloric acid were historically mixed into cheap vodka to make knock-off gin, especially during the Georgian Era in England if the brewer didn't have or couldn't afford juniper berries!)

Snake Venom:

Seriously, do your research before you write an actual, real snake species using venom they don't produce! The Big 3 Forms Of Snake Venom are: Hemotoxic, Neurotoxic, and Cytotoxic. Specific snake species exclusively generate the same kind of venom (so a hemotoxic snake will ALWAYS produce baby snakes that also make hemotoxic venom). Aristotle himself wrote in 380 BC that certain snake venoms could be applied for treating fevers, smallpox, and leprosy, and there is even some evidence in the historical record prior to the 1800s that different cultures have experimented throughout the eons with using venom for converting into antivenom, but I've never found a source citing anyone making a successful form of antivenom until around the 1850s.

Digitalis:

OP really nailed the important thing about Digitalis, and that is it's cardiac benefits for certain people - particularly for treating congestive heart failure. Vincent van Gogh was actually prescribed epilepsy medication that likely contained Digitalis, aka Foxglove, and there are some prevailing theories about van Gogh's love of bright yellow paint as being either caused or exacerbated by the symptoms associated with digitalis use, which can cause an attraction to and increased visual sensitivity to the color yellow. In several portraits, including one of his own psychiatrist, van Gogh shows subjects presented alongside foxglove flowers. Digitalis is absolutely lethal if consumed or taken without expert guidance, however, because it's the mother ingredient of Digoxin. Digoxin isn't used as frequently as it used to be a few decades ago, but it's still used and prescribed today for certain forms of heart failure and heart disease. Digoxin was also, at one time, was also sometimes used to induce chemical abortions.

Lead:

Dear god, lead. Not only is it so slow to kill you that you'll think that the only way to manage your symptoms is with more lead, but lead poisoning can be a life-long crisis for a person who is regularly exposed to it. Humans have used lead for everything from plumbing, to paint, to our cutlery, to cosmetics, to medicine. While yes, it is very possible to ingest enough lead in a single sitting to die within hours or days, most sufferers of lead poisoning experience it for years or decades before the symptoms become obvious. Some archaeologists believe that the Romans used lead cutlery because lead has a unique reaction when we lick it: when you have lead coating your tongue, it makes EVERYTHING you eat suddenly taste 10x better. I learned this myself from going target-shooting with my mom at a gun rage as a teenager, inhaled gunsmoke (which contains lead), and went for lunch immediately after. Even though I was just eating a $5 meal from In-N-Out, my burger tasted so good I thought I was gonna have to change my pants. When I asked the rangemaster at the target place about it later, he literally said, "Oh yeah, lead makes the worst cooking taste like heaven."

The ancient Romans ate a lot of rotten, spoiled, and sour food, and so lead would've made it easier to eat it back then. But the neurological effects of lead poisoning are nightmarish. It's suspected that, in America, the #1 reason we had so many active serial killers in the country from the 1940s-2000s was because of leaded gasoline. Ever since leaded gasoline was banned? Serial and random violent crime rates have dramatically gone down, especially in metropolitan cities. Ancient Rome, too, gradually became an increasingly violent city as its population went up and its reliance on lead did. We're only just now starting to figure out how toxic lead actually is, so go nuts with using it as a plot element regarding subjects like "Why Are You Like This?"

Mercury:

Mercury is also known as quicksilver, because in spite of being a heavy metal, the temperature at which it melts into a liquid is very, very low compared to most other metals. The first Emperor of China, Qin Shi Huang, was rumored to be so obsessed with the notion of immortality that he would send his doctors on doomed voyages around the world searching for a legendary substance that would, indeed, make him immortal. Legend has it that some doctors who were tasked with the job found out about the last guys, and produced mercury before Emperor Qin Shi Huang and cried, "Here it is! I got it!" so they wouldn't end up doomed to drown at sea. Qin Shi Huang became so obsessed with ingesting and medicating himself with mercury that, when his legendary tomb was being constructed, he had a small-yet-accurate-to-scale map of China+the known world about the size of a football field with every body of water full of fountains of running mercury in his burial chamber. His tomb was rediscovered in the last couple of decades after archaeologists found suspiciously high levels of mercury in the soil on top of a "hill" that had been sitting in the countryside untouched for thousands of years. It turned out to be Qin Shi Huang's long-lost tomb.

Since those days, mercury has closely been associated in early medicine as a sort of cure-all, since it literally kills anything it touches (including people). Captain Blackbeard himself, the most notorious pirate in Western history (Western specifically; google who Zheng Yi Sao was), was known or widely believed to be a syphilis sufferer, and desperately sought infusions of mercury from ships he'd capture (and the doctors onboard) to treat it, believing like everyone did that mercury could cure syphilis. It can't. They just didn't understand back then that syphilis starts off surface-level, and then eats your brain years after the initial infection.

Aconite:

Again, ridiculously toxic outside of specific medicinal applications that still aren't safe today! Aconite, or wolfsbane, has historically been used as a heart sedative (for slowing the heart), diuretic, painkiller, and even used to induce sweating. Evidence of wolfsbane being used for medicinal purposes has been spotted here and there over thousands of years throughout the Greek, Roman, and Byzantine Empires, but its original use came about in Ancient Greece for hunting and culling wolves by poisoning bait-food with it. That form of hunting died out long before the European Middle Ages, but the name "wolfsbane" stuck. Mostly because in the Middle Ages, a lot of people believed werewolves were a huge problem, and kept wolfsbane handy to deter said werewolves.

Thallium:

Today, thallium is mostly used in the production of camera and eyeglass lenses. Before its toxicity was known about, it wasn't strange to hear of thallium being used topically to treat fungal infections like ringworm. Thallium was also sporadically used in treating typhus and tuberculosis, along with a wide array of sexually transmitted diseases.

This list doesn't even touch the tip of the toxic iceberg when it comes to the sheer quantity of hilariously dangerous toxins people have, or still continue, to use for medicinal purposes! In a Victorian-era English London middle-class townhouse setting alone, there were dozens and dozens of ways to poison or otherwise harm yourself just by going about your daily life. So, if you've got a period piece you're working on, or are just bored, you can pick an exact date and time in our history and learn just how terrifyingly comfortable our ancestors were with upsettingly dangerous substances and home remedies. You can also watch a massive docuseries, called "Hidden Killers" and hosted by historian Suzannah Lipscomb, among other historians and archaeologists, which deep-dives into the hidden and unknown dangers of living in eras from Tudor-Era England, to the Post-WWII Reconstruction Age.

As a final note: I am NOT bashing Chinese or Eastern medicinal practices here, and in fact deliberately have gone out of my way to not include any references toward culturally-sanctioned medicinal practices in Eastern and Southeastern Asia. This post is specifically related to the history of WESTERN medicines and their associated history. I am not, nor have I ever been, a doctor of any traditional Eastern medicinal practices, and do not pretend to know better. Sinophobes are unwelcome in my blog space.

[thrifted-friends]

beautiful old apothecary and bakery cabinets 🗝️

[macgyvermedical]

How about a historical ask? I was thinking about the "severe hot chocolate" you mentioned in an earlier post and wondered how people used to treat asthma attacks before the invention of inhalers and beta agonists like albuterol?

From a textbook from 1946:

Sedatives. Before about the 1960s, asthma was considered to be a condition that was partially, if not mostly psychogenic (had a mental cause like anxiety). However it did caution that if the person was already too exhausted from trying to breathe, giving them a sedative like a barbiturate (they didn't have benzodiazepines or first generation antipsychotics yet) could cause respiratory failure.

Change of scenery. It was thought that moving the person from one place to another might halt an attack. This was probably because a trigger existed in one place but not the other, and most asthma attacks are technically self-limited even without medical intervention.

Oxygen and helium. If the sedatives and change of scenery didn't work, high concentrations of oxygen and helium might keep the person alive until the attack stopped.

Epinephrine (then called adrenaline). If the patient was really struggling, injecting epinephrine into the fat under the skin could help "break" the attack. The person could also inhale epinephrine from a nebulizer-like device.

Aminophylline. This is a bronchodilator that works in a different way to albuterol. It had to be injected IV at this time in history.

If you didn't have access to any of the above, a combination of steam and the smoke from burning stramonium leaves was an older remedy but was still mentioned in this book from 1946 so I include it here.

[ghostshipglamour]

So Your Chief Surgeon Set Fire To The Dance Floor: How Fucked Are You?

a badly done summary of current and historical care by me #notadoctor

Descriptions of burns under the cut (not very graphic), historical in italics

tldr:

I: Burns primer

Burns comes in superficial, partial thickness (either superficial or deep) and full thickness (reaching the fat) (Carter, 2022)- that correspond to the older first-second-third degree classification.

Superficial burns will not scar nor blister;

Partial thickness burns (both types) will blister, leak interstitial fluid and scar; the superficial partial type is often more painful than deeper burns because well. if the nerve ending isn't there anymore, it can't relay pain

Full thickness burns look dry, comes with a loss of sensation and form thicker scars (Carter, 2022)

It can takes a few hours to a day for the real depth of the burn to be revealed. The time it takes to heal will vary depending on the depth, location and affected structures (Carter, 2022).

From Dr Ashurtst in 1862: “ if half or even one third the body surface was involved in the burn it was almost assuredly fatal.” (Hattery et al., 2015), so if your cold boy had his clothes on fire he's probably not coming to the fun walking trip ahead.

The 1800’s conception of it was different, as stated in this excerpt from (Hattery et al., 2015) :

“In the 1800s, burn pathophysiology was thought to occur in three stages. The period of congestion occurred in the first 48 hours, followed by the period of inflammation from day 2 to 14, followed by the period of suppuration. Baron Dupuytren added a fourth period: exhaustion. He advocated that burns affect different skin areas differently—severe burns were less likely on the areas of the exposed skin, pointing to the thin epidermis of the areas habitually covered. He also suggested that there were six degrees of burns, the fifth being those involving structures such as fascia and muscle. The sixth degree was described as being a carbonized, easily breakable limb […].”

II: What Does kill You

Immediately, the more deadly aspects will be shock (hypovolemic shock), suffocation and, in our case, being trampled or stabbed. The smoke combined with the crowd crush is a special hell.

Then in the near future it’s going to be the infections that does you in- you have a great door open for bacteria and delicious dead tissues for it to snack on.

Other things that may kill you are metabolic imbalances (loss of proteins, magnesium, phosphate, potassium); and hypothermia (one that’s particularly interesting for the arctic) (Carter, 2022).

Since the skin is a barrier against infection and for thermoregulation, these things will keep being an issue even further in the healing process. The deeper the burn, the greater the infection risk (Jeschke et al., 2020).

III: What you should do : comparing historical burn management to current day wilderness options (it’s unfair to compare them to hospital care when they barely have a doctor)

Get it wet. Running water or wet bandages works. Ice or ice water have worse outcomes on the healing.  The goals are to clean the wound, limit the “spread” of the burn, and limit pain. Wet bandages are the one thing that will help pain: otherwise, you want no air nor friction on it (Bitter & Erickson, 2016).

Give fluids (re: hypovolemic shock if the burn is deep/large enough). If you don’t have IV’s, drinking will do in small sips (water+salts). If the mouth is not an option you can shove it up their ass, aka proctoclysis (Jeschke et al., 2020).

In the 1800s, physicians were aware of the dehydration issue: one physician recommend giving ice chips to melt slowly, or small amounts of carbonic acid water (Hattery et al., 2015).

Dress the wound with something that lessens bacteria and retains moisture. Honey has pretty good evidence going for it!

In the 1800s, they had different recipes depending on physician’s preference: olive oil and limewater, a liniment of turpentine, a saturated solution of the carbonate of soda… (Hattery et al., 2015). It’s unclear if a dressing was applied after the solutions .

Pain management: historical options are mostly brandy and opium (Hattery et al., 2015). Hot .

As needed, someone should perform debridement, AKA cutting off dead tissue to help the rest heal.

IV: Life Took The Lemons Away -add scurvy to the mix

A burn heals in 4 overlapping phases:

Haemostasis in the first 24 hours (blood vessels shrinks and clotting happens), Inflammation in the following week/month (removal of debris and release of growth stimulants), then proliferation (new connective tissue grows) and, finally, remodeling (Jeschke et al., 2020).

BUT. IF YOU HAPPEN TO HAVE SCURVY. You can’t synthesize collagen. There is no new connective tissue created (Maxfield et al, 2023). Your burn will stagnate in the first stage. Added to that, a vitamin D deficiency weakens your immune system (Maxfield et al, 2023), so the pre-established infection risk just got that much worse. Nice!

Sources:

Carter, D. W. (2022, november 3). Burns. Merck Manual Professional Edition. https://www.merckmanuals.com/en-ca/professional/injuries-poisoning/burns/burns?query=burns

Bitter, C. C., & Erickson, T. B. (2016). Management of Burn Injuries in the Wilderness: Lessons from Low-Resource Settings. Wilderness & Environmental Medicine, 27(4), 519-525. https://doi.org/10.1016/j.wem.2016.09.001

Hattery, E., Nguyen, T., Baker, A., & Palmieri, T. (2015). Burn Care in the 1800s. Journal of Burn Care & Research, 36(1), 236-239. https://doi.org/10.1097/bcr.0000000000000112

Jeschke, M. G., van Baar, M. E., Choudhry, M. A., Chung, K. K., Gibran, N. S., & Logsetty, S. (2020). Burn injury. Nature Reviews Disease Primers, 6(1), 11. https://doi.org/10.1038/s41572-020-0145-5

Maxfield L, Daley SF, Crane JS. Vitamin C Deficiency. [Updated 2023 Nov 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493187/

[whumpbythefireside]

Terribly squeamish character in a historical setting becomes unwell and awfully feverish, meaning that a physician has to come and bleed them. Since they’re already semi-delirious, this is not a fun situation.

[mametzwood]

my favourite superhero, wound man

[whumpetywhump]

100 Days My Prince - Ep. 9, 10 + 11

[polymathkate]

I watched a few episodes of Bridgerton when the first season came out, and am now watching it through from the start. I haven't read the books. I'm currently on season 2 episode 3, and just watched the flashback scene between Anthony, his mother, and the doctor.

I've tried to put in enough tags to warn those who might find discussion of the scene triggering, because it's a very intense topic.

In short, Anthony's father, the previous viscount, has died mere weeks beforehand, leaving Anthony to be the viscount and the support of a very pregnant now dowager Vicountess Violet and all of the younger children. It hasn't been explicitly stated, but I think Anthony is about 20, and utterly overwhelmed by the whole situation and his grief.

In the scene, Violet is in labour, and things aren't progressing, so the society doctor insists on asking Anthony to decide if he should focus on saving the mother or the baby, despite Violet repeatedly telling him that it's her decision to make. Anthony doesn't even understand the question. While objecting vociferously to the very idea of her child being the one to decide such a thing, Violet also has to explain the very question to her eldest son.

The scene is played and filmed with a focus on Anthony's complete inability to manage his new responsibilities, with the doctor's complete disregard for his patient's opinion. She's a woman, and the dependent of a lord, and thus his opinion is the only one that matters, even though it's completely inappropriate to bring him into his mother's birthing chamber.

Even when Anthony refuses to make the decision and tells the doctor to listen to his mother (likely more because he didn't know what to do than because he believed it should inherently be her choice), the doctor does *not* do that, and tells Anthony (preventing him from fleeing) that he'll try to save both mother and baby, which literally wasn't an option he had presented to either Violet or Anthony previously!

What's also interesting is that even Violet doesn't say it should always have been her choice; she says it should have been her husband's, who loved her (as a spouse). She utterly rejects the idea of her son choosing for her, but not that of her husband doing so. Clearly her very raw grief at a dangerous time is a major factor here.

So far in the episode at least, we haven't been told what either Anthony or Violet would have chosen, since the doctor does take that upon himself in the end.

I feel like the answer should obviously be to save Violet, considering (in an era of high child mortality even among the rich) she already has seven grieving children, several very young, who need guidance and care, but, from experience, it's never an easy discussion, even with modern medicine and hygiene that makes saving both a much more likely outcome.

[corvidconventicle]

There’s an old remedy for snake bites (doesn’t work, don’t try) that involves holding the butt of a chicken against the snake bite to counteract the venom. They’d use a rooster if the patient was male and a hen if they were female.

[shortace]

The ancient Romans thought that rubbing onion juice into the eyes was a great treatment for someone whose sight was dimming.

[disasterhimbo]

[ID: a screenshot of body text from Wikipedia that says, “Chalmel de Vinario recognised that bloodletting was ineffective (though he continued to prescribe bleeding for members of the Roman Curia, whom he disliked), and said that all true cases of plague-” at which point the screenshot cuts off the remainder of the sentence. End ID.]

Never stop hating

[macgyvermedical]

Check out this neat diagram of the clotting cascade I found in a book from 1871!

Much easier than it is today I must say…

[kian-charles-gray-photography]

Michelangelo’s Observational Art and Early Cancer Depictions: A Historical Perspective

Michelangelo Buonarroti, celebrated for his masterful contributions to art and anatomy, remains a key figure when exploring the intersections of science and Renaissance art. His frescoes on the Sistine Chapel ceiling, painted between 1508 and 1512, are world-renowned not just for their artistic brilliance, but potentially for the subtle narratives woven into their anatomical details. One of these…

[ghostshipglamour]

This is my son he has every disease 🥰

Wound Man, from the Fasiculo de Medicina (1495)

found here

[le-loup-et-lion]

I know we've all gotten used to using broth as the default sick-fic drink, BUT! Consider the humble toast water

[thetwelvecaesars]

I love content like this.