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Venereal Diseases in the Golden Age of Piracy, Page 11

Treating VD During the GAoP: Second Stage (Confirmed Pox) - Cure

Surgeons Working, From De Recta Curandorum Vulnerum Ratione,
By Franciso de Arce (1658) There were basically two treatment regimes used when dealing with a Confirmed Pox during the golden age of piracy. Sea surgeon John Moyle outlines them succinctly: "The one is by Purging and Sweating. The other is by Salivation and Sweating."¹ While sweating was used in a variety of health problems at this time, salivation was primarily used during this time to treat a Confirmed Pox. Both procedures were humor-based, with the desire being to purge the humors brought in by the venereal taint out of the body.

Moyle goes on to explain when he feels each of these procedures were most appropriate. "If the Disease be confirmed, yet recent and mild, it may be Cured by Purging and Sweating. But if it be inveterate and stubborn, it must be Cured by Salivation and Sweating."² Other procedures were employed as part of salivation and sweating although they were basically incidental to the primary objectives. Only the three methods discussed by Moyle are discussed here.

Since one of the primary symptoms identified for a Confirmed Pox was the appearance of gumma ulcers on the body, the doctors from this time discussed medicines and procedures for handling them. These will be discussed as well, although that will be confined to a different section since they were handled separately from those employed to stop the pox.

¹ John Moyle, Chirugius Marinus: Or, The Sea Chirurgeon, 1693, p. 143; ² Moyle, p. 143-4

Treating VD During the GAoP: Second Stage (Confirmed Pox) - Using Purges

While purges were not typically the primary treatment used when dealing with a Confirmed Pox, they were used by some period authors in conjunction with both salivation and sweating, including after the treatment had been completed to eject the mercury in the patient's body.

Sea surgeon John Atkins explains when using salivation to cure a Confirmed Pox that "two or three
Photo: B. Navez - Tamarindus Indica Pods Purges are to precede: And the Reason of this is that besides preparing the Body for succeeding Mercurials, they leave an Astringency that makes a Patient less apt to it after wherefore those of them that leave more [astringency] than other [medicine]s of that Property behind best suit the Purpose [of removing the Confirmed Pox]; as the Potio Communis Purgativa Sydenham."¹

Atkins is referring here to a potion described by English physician Thomas Sydenham in his works: "Take of Tamarinds half an Ounce, of Sena two Drams, of Rhubarb one Dram and an half; boyl them in a sufficient quantity of Water; to three Ounces of the strained Liquor add of Manna, and Syrup of Roses Solutive, each one Ounce; mingle them, make a Potion to be taken early in a Morning."²

Atkins also recommends giving purges (among other things) after the operation is finished, explaining that if they weren't used, salivation or sweating "might continue an inconvenient length, if the Humours were not diverted, and the Ulcerations dried in the end, by Enema's, Catharticks and Gargles."³ He then makes up for his suggesting only a single purge before the salivation by suggesting three purges which may be used after it. Many of the ingredients in these medicines should now be fairly familiar to those who have read through the purges used to treat a first stage Clap.

Photo: Flickr User Lalithamba - Senna Alexandrina, Found in India

Rx. Pil. Coch[iæ]. [Pil.] Extr[act]. Rud[ii]. {of each 15 grains} rez[in] Jalap. {4 grains}, Ol. Carui [oil of caraway] {2 drops} f. Pil. [make into a pill] no. v. [5 each] deaurand. [gilded] ad sex vices repetand. alternis diebus [given six times on alternate days].
Rx. Fol. Sennae Alex[andrina]. {1 dram} Zinzib[er]. [ginger] Sal Tartar. [potassium carbonate] {of each, a scruple} Infunde tepide per noctem Colatur. [pour in warm at night to nurture] {3 ounces} adde Ol. Anisi {1 drop} Syr[up]. Rosar[um]. Solutiv[e]. {6 drams} M. [mix]
Rx. Manna opt. {1 ounce} dissolv[e]. in {1 gallon} Aq. Strethamens. [water from the Stratham fountain] & superbib. [drink] {3 gallons} Aquae ejusdem singulis diebus. [the same water, every day.]⁴

German military surgeon Matthias Gottfried Purmann also cites Sydenham as one of his sources for treatment of a confirmed pox. He orders his readers to "first give a good Purge" before causing a patient to salivate with mercury⁵, although he doesn't go into any more detail. He does add that one way to stop the patient from salivating is to "give the Patient a gentle Purge" after the salivation is finished⁶, presumably to wash the mercury out of his system. He also says that once the patient has completely stopped salivating,
The Four Temperaments or Body Types, From
Ohysiognomische Fagmente, By J. C.
Lavaters (1792) "the Patient must be purged well afterwards, and sweated four or five times in Balneum Laconicum [a sweating room] with Spirit of Wine, that none of the Mercury or the Disease may remain behind."⁷ He again fails to give a suggestion for which purging medicine to use here.

Like Atkins and Purmann, sea surgeon John Moyle mentions using purges for salivation. He says, "you must prepare his Body for Salivation, with such Catharticks [purges] as are proper to his Temperament or Habit."⁸ Temperament refers to the patient's dominant humoral trait. Just as there are four humors - blood, phlegm, black bile and yellow bile - there were four temperaments - sanguine, choleric, melancholic and phlegmatic. The belief was that medicines had to be selected which best matched the patient's temperament. (See this page for more information on the four temperaments.).

For the purges themselves, Moyle recommends a variety of possible medicines, among them: "Pil. Rudii, or Electuar. Cathol[icon]. or Syr. Ros[arium]. solute. cum Senna, in decoct. Senna Gerconis [decoction of sena - a purging compound medicine containing sena, polypodium, ginger and a variety of fruits and flowers]."⁹ He goes on to detail the amounts to be administered for each of these medicines, noting that "there is scarcely that Humour or Constitution [referring to temperament], but one or other of these occurs with"¹⁰. The purges were to be given every other day for a week before inducing salivation, alternating them with a diet of "warm
Photo: Wiki User Daderot - A Posset Dessert Pot Grewel, or (if ashore) Posset drink between each motion."¹¹ A posset drink is cream-based, often being combined with sugar, ales or wines and other flavor enhancers like cinnamon or ginger and rose-water. It was thought to have healing properties. Because it is cream-based, it would be difficult to keep from spoiling on a ship for more than a day or two which is why Moyle advised only employing posset drinks when on land.

Moyle also suggests using purges to stop salivation, referring to these as 'checking Catharticks'¹². He explains that "very commonly the Salivation works off of it self, but when you would have it off sooner, give the Patient a Purge or two, and those will carry it off quickly. That of Syr. Rosar[um]. in decoction of Senna is usual; or Syr. de Spin. Cerv. [syrup of buckthorn] {1 ounce} in Posset-drink or Barley water, is excellent."¹³

Moyle adds another purging drink which he says will work as a purge for both the mercury and the venereal taint, calling it "one of the best things in the world in this case", although it would again be difficult to obtain on a ship due to its ingredients: "Rx. Aq. lactis [a compound based on milk], Alexiteria [Water for resisting poison - containing juniper berries, white tumeric, myrrh, angelica seeds, dittany of Crete (Origanum dictamnus), virginia snakeweed root and saffron in wine] {of each, 3 ounces} Epidem. [plague water] {1 ounce} Manna opt. {2 ounces} misce f. Haustus [mix into a haustus]."¹⁴

Photo: Sten Porse - Common Sea Buckthorn (Hippophae) Berries In a case study contained in his book Memoirs: Of many Extraordinary Cures, Moyle provides a nice broad outline of the medicines used before salivation, adding a few not included in his other books. He notes that he started the cure of a patient with a Confirmed Pox

with Lenient Cathartics [easy purging drugs], to make Preparation for Salavating. It was the Infusion of Senna and Rhabarb. [rhubarb] in the Dose of which I mixed Syr. de Spin. Cervin. [syrup of buckthorn] {1 ounce} it was taken in the Morning Fasting, and it work’d well, and another like Dose he had the second Morning after, and drank a Dish or warm Tea after each Motion.¹⁵

Moyle also mentions the use of purges to treat patients when a sweating cure is used. In his book
Photo: Eitan F. - Scammony (Convolvulus scammonia)
Chiurgius Marinus, Moyle advises the use of:

Rx. Pulv. Rasin. Julap. [powdered jalap resin – distilled with spirit of wine] [powdered] Scamo[ny]. [mercury sublimate] dulc. {of each, one ounce} Tartar. Vitriol. [potassium sulfate] {2 drams} Terebinth. Chio. [turpentine from the Greek island Chios] q.s. [a sufficient quantity] f. mass pro Pilulæ. [make into a lump for a pill]
Let the Patient take of these Pills {1 dram} at a dose, each other day, for five times taking; keeping to the Sanative [healthy] Diet... without Flesh.
Or Pil. Balsamic. doth the same thing, given in the same dose and order.¹⁵

According to George Bates' pharmacopoeia, the 'Pil Balsamic' (balsamic pill) is: "Rx. Extractum Eustachii [extract of the justica eustachiana flower] {5 drams} Troches Alhandæ {1 dram} Saffron {1 scruple} Crude Mercury strained thro' Leather {1 ounce} Venice Turpentine, [a sufficient quantity] mix and make a Mass, [according to art]."¹⁶
Artist: James Gillray
"Taking Physic" [Medicine] (1800) Moyle probably didn't make this pill, instead purchasing it pre-made with an eye towards treating the pox. After the patient had been sweated, Moyle advised giving him a few days to rest then "fall to Purging again as before; letting him take [the purges] but three times each other day"¹⁷.

In Moyle's first book, Abstractum Chirurgæ Marinæ, he says to treat a Confirmed Pox, "the same purging [treatment] likewise must be used as in a Clap: Purge six or seven days first, and then desist; and sweat two or three days, and so to purging again"¹⁹. This comment ties the purges used here to those used to treat first stage of the Universal Venereal Disease. This suggests that the same purges might be used here as in a Clap, although none of those he specifically mentions are identical to those discussed in the section on purges used to treat a Clap. These remedies do employ a lot of the same basic ingredients, however, and it can readily be seen how the purges previously discussed could be used here.

In one of his case studies, Moyle explains that when the 'Siphylitic humor' causes tumors in the mouth which would make salivation difficult, "I am willing to avoid Salivating, then by Purging I carry it downward [using laxatives to purge 'down'], and so cure by the desultory Tergiversate [sporadically evasive], way, using both means (vicissim) [purging upwards with emetics and downward with laxatives] as the intention requires, and at length the deorsum [downward] manner only till this Cathartic [purging] course is accomplished"²⁰. This is an unusually wordy explanation for Moyle, but it basically means he uses laxative and emetic medicines to attempt to purge the body of the venereal humors if he can't salivate the patient. Among other interesting things, he refers to the Confirmed Pox as being syphilis in this case study, somewhat unusual for the period.

¹ John Atkins, Lues Venerea, not dated, p. 40; ² Thomas Sydenham, The Whole Works of that Excellent Practical Physician Dr. Thomas Sydenham, 3rd ed., 1702, p. 409; ^3,4 Atkins, Lues Venerea, p. 45; ⁵ Matthias Gottfried Purmann, Churgia Curiosa, 1706, p. 194; ^6,7 Purmann, p. 195; ⁸ John Moyle, Chirugius Marinus: Or, The Sea Chirurgeon, 1693, p. 146; ^9,10,11 Moyle, Chirugius Marinus, p. 144; ^12,13 Moyle, Chirugius Marinus, p. 150; ¹⁴ Moyle, Chirugius Marinus, p. 151; ¹⁵ Moyle, Chirugius Marinus, p. 144; ¹⁶ George Bates, Pharmacopœia Bateana, edited by William Salmon, 1713, p. 652; ¹⁷ Moyle, Chirugius Marinus, p. 145; ¹⁸ John Moyle, Abstractum Chirurgæ Marinæ, 1686, p. 24; ¹⁹ John Moyle, Memoirs: Of many Extraordinary Cures, 1708, p. 106

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