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Venereal Diseases in the Golden Age of Piracy, Page 8

Treating VD During the GAoP: First Stage (The Clap) - General Gonorrhea Cure

Like other aspects of venereal diseases, the sort of cure used to treat gonorrhea depended on the symptom being addressed during the golden age of piracy. The period sea-based medical authors focus their treatment recommendations on the two primary gonorrheal symptoms: the gonorrhea discharge cure (pus running from the urethra) and the painful urination cure (disuria).

Treating VD During the GAoP: First Stage (The Clap) - Gonorrhea Discharge Cure

Not surprisingly, most of the treatment for pus running from the urethra employs medicines. While each surgeon has his own particular choices, nearly all of them use compound medicines, first using purges to eject poisons from the body and reduce the running (sometimes using mercury-based medicines) then to contract the body tissues with astringents and finally to heal urethral passage with balsamics.

Specific Purging Compounds to Cure Gonorrhea

Sea surgeon John Moyle recommends a variety of different types of medicines which are used based on each patient's ability to tolerate them. In his first book, he starts with a pill and moves on to an electuary (a sort of glutinous paste which he refers to as a bolus) and then finally suggests a liquid medicine.

Ipomoea Purga Plant, Source of Jalap, From
Edwards Botantical Register (1847)

Rx. Pil Rudii {1 scruple} resina Jalapi & Calomelos [calomel, refined mercury dulcis] ana {of each 10 grains} f. pilula [make into a pill],
If he cannot take Pills then,

Rx. Electu. Pro morb. Gal. Salmon. [William Salmon's Electuary for the pox] {2 scruples}
Or if a Bolus will not down with him, then,

Rx. Decoctum Colocynthidos Salmon. [juice of Citrullus colocynthis, a 'rough purger'] two spoonfuls in a glass of Wine.

If he can take any of these, you may interchange them, as you see fit, because the too often taking of the same thing cloys the patient.¹

In his next book, Moyle drops the two non-pill prescriptions originally recommended by physician William Salmon in favor of the pill, modifying the recipe for it slightly. "Rx. Pil. rudii {1 scruple} radix Jalep. [jalap root,a purging medicine] {5 grains} [Mercury] dulc. [sweet mercury sublimate] {10 grains} misce f. Pilulæ [mix and make into a pill], for one Dose."²

Moyle advises that such purging medicines "must be taken in the Morning fasting, and he [the patient] must be ordered as to purge; when he has purged sufficiently, for four or five days, the running will cease; only some small gleeting 'tis possible will remain."³ His later book suggests spacing the medicine doses out a day or two.
Artist: David-Teniers the Younger
Making medicines, From A Flemish surgeon treating a foot (17th c.)
In one of his case studies, Moyle used "Rx. Pil. ex duob. {2 scruples} Calomel. {12 grains}"⁴. Finding two doses of this medicine administered two days apart didn't work, he switched to straight calomel pills.

For gonorrhea, Atkins felt that treating patients with mercury-based medicines "may suffice for their Defence in general."⁵ However, he separates this from purges, noting that when the surgeon's treatments have prohibited nature from performing the cure, "I repeat the Mercurial Bolus, and purge no oftner than Reason tells me their Strength will admit, without a Hypercatharsis [excessive purging] Fainting, or Loathings; (which is with some every other Day; with others twice a Week, or less;)..."⁶. From this, it can be seen that Atkins feels whatever purging results from administering mercury, it is less significant that that caused by using purging medicines.

Where purging is concerned, Atkins prefers "a single quick Purge", particularly in fit men⁷, when treating gonorrhea. The medicines he defines as purges all contain mercury, often combining it with the laxative ingredients. He lists three such mercury-based medicines:

Photo: Kelly Nash
Amber Calomel and Yellow Terlinguaite

Rx. Mer. Dul. [sweet mercury sublimate] {12 grains} Cons. Ros. [conserve of roses] q. s. f. bolus [a sufficient quantity for a bolus] hora somni sumend. [taken at bedtime] purging it off next Morning with an Infusion of Senna [senna is a 'gentle' laxative]. After the first or second time, I increase the Mercury in the Bolus, and give stronger Catharticks [laxatives].

Rx. Pil. ex duobus {1 scruple} rez Jelap. [Jalap resin - a purging medicine] Bals. Peruv. [balsam of Peru] Ana [of each] {2 grains} Calomel. {6 grains} fiat Pil. [make into a pill] Not. v. mane vorandus [note, take on an empty stomach, early in the morning].

Vel [or], Rx. Pil. Cochiae [a purging pill] {half dram} Calomel. {10 grains} Ol. Junip. [oil of juniper - a diuretic] {3 grains} f. Pil. deaurand. [make into a pill, gilded]

Vel [or], Rx. Elect. Lenitiv. [a laxative electuary] {2 drams} Mer. dul. {10 grains} rez Scammon. [Scammony resin, a purge] Jalap. [Jalap resin] an. [of each] {4 grains} Ol. Carui [Oil of Caraway] {2 grains} M. [mix]⁸

Atkins goes on to note that purging medicines are given following the administration of mercury-based medicines in an attempt to remove 'vicious Humours'. He also says that they can help prevent mercury poisoning, by keeping "too great a Quantity of Mercury remaining at once in the Body."⁹

Naval physician William Cockburn first explains that purges do not, or at least should not, work as we have already seen. He then goes on to list several medicines which he grudgingly admits "have been proved, to be of some Use in the Cure of a Gonorrhœa; as is likewise manifest by Experience"¹⁰.

Photo: Karel Jakubec - Senna Alexandrina Plant

Rx. Folior. Scrophular. aquatic. [leaves of Scrophularia aquatica or water figwort] Sen. virent. [green senna leaves] {of each, 2 scruples} Immittantur in aq. bullient [put into boiling water], {one pound} et Infundant. ab igne remota [and remove it from the fire]. Colaturam hauriat duobus vel tribus vicibus [strain and drink two or three times].

Rx. Tamarindor. {2 ounces} aq. commun. [common water] {4 gallons} Coquant. ad [cooked down to] {3 gallons} In Colatura [strain] infunde frigide [pour cold on] per noctem  Senn. mund [purified senna, left overnight], semin. Coriandr. [coriander seeds] Liquirit et rosar. rubrar. [red rose water] {of each, 2 scruples} Capiat Cyathum unum mane, una hora ante pastum. [Take one cup in the morning, one hour after eating.]

...Rx. Conserv. Malv. [conserve of mallow] rhab. Elect. [rhubarb electuary] Pulverat. [powdered] {of each, 1 dram} terebinth. venet. [Venetian turpentine] {2 scruples} M. F. Bol. [make into a bolus] primo mane deglutiendus. [drink early in the morning.]

For the same Purpose this Apozem [decoction] was devised.
Rx. Radic. Alth. [mallow roots] {1/2 ounce} folior. Malv. [mallow leaves] Bismalv. [malva alcea – hollyhock mallow leaves] {of each, half a handful} Fic ping. [figs] {2 ounces} aq purgant. [a compound purging water, probably containing senna] {2 gallons} Coq. ad 1/4 consumptionem [cook until ¼ is consumed]. Colaturam [strain] hauriat Æger debitis intervallis. [let the sick drink at appropriate intervals]¹¹

Cockburn also lists several mercury-based medicines which have a purging function. He introduces the mercury-based prescriptions noting "Mercurial Medicines are very frequently mix'd in
Photo: Jim Conrad
Cassia Fistula Leaves and Flowers with Cassia [fistula]; both on the Account of its being a soft and easy Purgative; as also, that it is thought particularly Useful to the Bladder, and Urethra."¹² He then lists three such compound medicines:

Rx. Cass[ia]. recenter extract. [fresh extract of cassia fistula] {1/2 ounce} pulver. rad. rhabarb. [powdered rhubarb root, a purgative] el. {1/2  dram} Mercur. d. [sweet mercury sublimate] {1/2 scruple} (vel [or] Lacert. virid. [lacerta viridis - green lizard, thought to be a sudorific] {4 grains} M. F. Bol. [make into a bolus] mane vorandus. [swallow early in the morning]

Rx. Ocul. Cancror pptor. [prepared crab's eyes] {1/2 dram} Gum. Guaiac. [guaiac resin] diagrid. [scammony] {of each, 3 drams} Sal. prunell. [crystal mineral] G[ummi]. Tragacanth[a]. {of each, 1 dram} Calomelan. [Calomel] {2 scruples} Solution. gum. Tragac. [solution of gummi trangacantha] q. s. M. F. pilular. Massa [a sufficient quantity to make a mass for pills], de cujus singulis drachmis forment. pil. x.  æquales pondere.  [of which, use one drachma to form 10 pills of equal weight] Harum.  [arum – Indian turnip] {5 ounces} indies accipiat. [take daily]

Rx. Lacert. virid. [green lizard] {2 drams} G[ummi]. guaiac [guaiac resin] nativ. Stib[ium]. diaphoretic. [diaphoretic antimony] {of each, 1 dram} Scammon[y]. sulphurat. [scammony prepared with sulfur] Alo. succotrin. [aloes succus - Arabian or Egyptian aloe plants] {of each ½ dram} solut. gum. Tragacanth. q. f. M. F. s. singulis drach. pil. [as much as is sufficient to make a single 12 dram pill] quarum. iv. [make four pills from this] primo Mane 6 hora Somni deglutiat. [swallow every six hours from morning until bedtime]¹³

It is interesting that the different authors' prescriptions show quite a bit of overlap in ingredients. This is true not only between the different authors, but also between the various prescriptions recommended by the same author.

¹ John Moyle, Abstractum Chirurgæ Marinæ, 1686, p. 90; ² Moyle, Chirugius Marinus: Or, The Sea Chirurgeon, 1693, p. 139; ³ Moyle, Abstractum, p. 90-1; ⁴ John Moyle, Memoirs: Of many Extraordinary Cures, 1708, p. 119; ⁵ John Atkins, The Navy Surgeon, 1742, p. 233; ⁶ Atkins, Navy Surgeon, p. 234; ⁷ Atkins, Lues Venerea, p. 30; ^8,9 Atkins, Navy Surgeon, p. 233; ¹⁰ William Cockburn, The Symptoms, Nature, Cause and Cure of a Gonorrhoea, 1713, p. 106; ¹¹ Cockburn, p. 106-7; ^12,13 Cockburn, p. 108

Specific Astringent Compounds to Cure Gonorrhea

The primary role of astringent medicines here seems to be to prevent the pus from flowing or at least to decrease it and modify it so that it does not run so thick. Navy physician William Cockburn is the only author to specifically separate astringent medicines from purges and healing medicines. Cockburn includes sixteen different prescriptions, many reprinted from other authors. He strikes a very cautionary note with regard to their use, explaining that while they function by thickening the flow of pus and slow it down, they don't always work. When they do, they can cause the venereal poison to flow back into the body and poison the blood.¹ We will look at some of the prescriptions he gives, focusing on those which use the ingredients more likely to be found in period sea surgeons' medicine chests.

Photo: Universite de Bourgogne
Crab's Eyes, Actually Crayfish
Calcium Deposits, Located In Their
Heads (Not Actually Eyes)

(Powders.) …Rx. Fol. Menth. [mint leaves] Mumiæ [mummy] Coral. rub. [red coral] Agn. Cast [leaves of Vitex agnus-castus tree], Carab. [amber] {of each, 1 dram} M. F. Pulvis. [make into a powder] Hujus {1 dram} ex Ovo tremulo [of which, shake 1 dram with an egg] primo Mane deglutiat. [swallow in the morning]

Claud. Deodatu [physician Claudius Deodatus] greatly commends the Sacchar. Saturn [sugar of lead].

(Electuary.) …Rx. Semin. Lactuc. [lettuce seeds] Agn. Cast. [leaves of Vitex agnus-castus tree] Sang. Dracon. [dragon’s blood resin] Myrrh. Ocul. Cancr. pptor. [prepared crab’s eyes] Terr. sigillat. [sealed earth] Irid. [iris, probably the root] {of each, 2 drams} Conserv. rosar. rubr. [conserve of red roses] {1/2 ounce} Syr. Menth. [mint syrup] q s. M. F. Opiata de qua Magnitudin. Nuc. Moschat. major. [a sufficient quantity to make an opiate about the size of a large nutmeg] bis vel ter in die accipiat. [to be given two to three times a day]

(Bolus.) Rx. Mastich. [mastic] Coral. rubr. ppti. [prepared red coral] Succ. Alb. Sach. Saturn. [white sugar of lead] {of each 15 grains} Cons. Cynosbat. [conserve of rosa sylvestris hips] q. s. M. F. Bol. ij. [a sufficient quantity to make two boluses] quorum a num hora somni capiat, alterum proximo Mane [one given when the patient goes to sleep and another in the morning].

Photo: Mike Chong
Horsetail or Equisetum telemateia

…(Apozem.) Rx. Rad. Consolid. major. [comfrey root] {1/2 ounce} Plantagin. [plantane root] Equiset[um]. [Horse tail root]  Bellid. [belladonna] minor. poligon. [polygonum minimum – broadleaf knotweed] {of each, a handful} Acetos. [sorrel] {1.5 handfuls} Semin. plantagin. [plantane seeds] {1 dram} Acetos. [sorrel seeds] Malv. [mallow seeds] {of each, ½ ounce} Fl. ros. rubr. [red rose petals] {a pinch} Uvar. passar. [raisins] {1/2 ounce} Glyciriz. [licorice] {3 drams} Coq in aq pynt. ix. [boil in 9 pints of water] Colatur. [strain] add. Syr. portulac. [add syrup of purslane] Myrtin. [and syrup of myrtles] {of each 1.5 ounces} M. F. Apozema [make into an apozem] pro tribus dosibus. [for three doses.]

Rx. Semin. Alkekeng. [winter cherry seeds] Quatur frigid. major. [the four major cold seeds – citrullus, gourd (cucubita), cucumber and muskmelon] papaver. alb. [white poppy seed] Lactuc. [lettuce seed] plantagin. [plantain seeds] {of each, ½ ounce}, rhab. elect. [rhubarb electuary] {2 drams} Mastich. {1.5 drams} Gum. Arabic. bol. Armen. [Armenian earth] Succin. Tragacanth. [Tragacantha juice] Amyl[um]. [white starch] {of each, 1 dram} Semin. Agni. cast [seeds of Vitex agnus-castus tree], ros. rubrar. [seeds of red roses] {of each ½ dram} Solut Gum. Tragacanth. q. f. M. F. pilular. Massa. [a sufficient quantity of gum tragacanth to make a pill]

Photo: Wiki User Geolina - Verdigris

 (Injections.) Rx. Siliquar. fabar Cineres [bean pod ash], Aq. plantagin. [plantane water] q. s. M et injiciantur. [a sufficient quantity to be injected]

…Rx. Virid æris [verdigris] {1/2 dram} Aq fontan [spring water] {2 gallons} Stent simul quousqe coloretur aqua [let stand until the water be strained]; decanta [decant the liquid], & in decantata disolve Mercur. meteorizat. [dissolve mercury vapor in the decanted liquid] {3 grains} Filtra pro Injectione. [filter for injection]

…Rx. Aq. plantagin. [plantane water] {5 ounces} Vitriol. roman. [blue vitriol – copper sulfate] {1/2 dram} Croc. mart. astring. [astringent saffon of iron] {2 scruples} M. bene & filtra [mix well and fileter]. Liquor est rubicandus. [The liquid is red.]²

John Atkins also includes some astringent medicines in his list of purges which appear to belong in this list rather than the list of purging medicines. He does explain that purges "will turn Astringent, and dry up the Liquor of the Glands"³. In fact, many of the ingredients in these medicines are more astringent than purging. When listing his purges, he notes that the medicines are "in their Order of Healing and Astringency"⁴.

Rx. Bol Arm. [Armenian earth] {1 dram} Bals. Capiv. [balsam of Capivi] {3 ounces} capiat uniciam semis quotidie. [take ½ ounce every day] Semel vel bis, alvos promovet. [once or twice promotes digestion.]

Photo: Rod Waddington
Dragons Blood Tree, Dracaena Draco, Socotra Island, Yemen

Rx. Bol Arm. [Armenian earth] sang. Dracon. [dragon's blood resin] Terr. Sigillat. [sealed earth] Pul Rhubarb. tort. [powdered rhubarb] an. p. æ. [equal amounts of each]  Tereb. Venet. [Venetian turpentine] q. s. f. Pil. [enough to make a pill] mediocres sumat qunque bis in die. [take a moderate amount twice a day for five days]

Rx. Pil. Creteceæ [chalk pills - made from chalk, white sandalwood, nutmegs and turpentine] B. eodem modo sumend. [to be taken the same way as the previous prescription]

Rx. Decoct. Guiaiac. [guaiac decoction] Sæpe sumat Haust [frequently take this bolus]. In qua instillat. [in which infuse] {10 grains} Tinct. Guiac. [guaiac tincture] Vel [or] Tinct. Ex Bals. Peruv. [tincture of Peruvian balsam] Gilead [tincture of Gilead], & c.

Rx. Sacch. Saturn. [sugar of lead or lead acetate] Vitriol. R. [probably Roman vitriol - copper sulfate] an. {of each, ½ dram} dissolute. In [dissolved in] Aq. Ferraria [steel or iron water] {1.5 pounds} & filtretur pro injectione. [filtered for injection]

Rx. Aq. Plantag. [plantane water] {6 ounces} Tinct. Myrrh. [tincture of myrrh] {1 dram} vel [or] Tinct. Veneris [tincture of copper] {1/2 dram} tepide injicitur. [inject warm]⁵

Atkins elsewhere lists a variety of medicines which he calls 'Apozems or Emulsions' which are to be administered in between bouts of mercury & purges during treatment for gonorrhea. While he doesn't cite them as being astringent, they include many of the same ingredients as the medicines prescribed by Cockburn.

Photo: Wiki User SPOTzillah - Sal Tartar (Sodium Tartrate Dihydrate)

Rx. Sem quatuor frig. [the four (major) cold seeds – citrullus, gourd (cucubita), cucumber and muskmelon] {1 ounce} Aq. Menth. [mint water] s. {2 gallons} Sal Tartar [sodium tartrate] {1 dram} fiat Emulsio [make into an emulsion] Sacchar. candid. Ad gratiam edulcorand. [add white sugar to produce an agreeable sweetness]

Rx. Amygdal. dul. [sweet almonds] {12 each} Sem. Papav. [poppy seeds] {1.5 drams} contundantur & sensim affunde [bruise and gently pour in] Aq. Plantag. [plantane water] vel [or] decoct. Hord. [barley water] {2 gallons} Syr. Althæ [syrup of marshmallows] {1 ounce} F. Emulsiv. [make into an emulsion]

Rx. Decoct. Pectoral. [Decoction Pectoral, containing barley, raisins, figs, liquorice roots and water] {2 gallons} Spir. Nitri dulc. [sweet spirit of nitre] {30 grains} F. Apozema. [make into an apozem]

Rx. Sal Prunel. [crystal mineral] Sacchar. candid. [white sugar] p. æ {equal parts, half a handful} Pulvis [powder] sumat ad Quantitatem Scrupuli in Cerevisia tepid. ter in die. [take a scruple in warm beer, three times a day]⁶

Sea surgeon John Moyle suggests in a case study that during his treatment, the following medicine
Artist: Jacob Strum
Plantane (Plantago major) (1795) should be injected into the urethra: "Rx. Aq. Plantag. [Plantane water] {4 ounces} Troch. Alb. Rass. [white lozenge of Rhasis] {2 drams} misce. [mix] it was injected by Syringe, warm"⁷. Plantane (plantago) water is an acknowledged astringent, so it has been placed in this section.

Another of Moyle's books lists a second plantane water-based medicine along with an unusual medicine, either of which can be administered after the primary treatment has been administered and 'some small gleeting' is still occurring.

Rx. Tereb Cypr. [Cypress turpentine] {1 ounce} open it with the Vitel. ovorum [egg yolk], mix it with aqua plantag. Strain it, and let him drink it every night for three or four times. Or,

Rx. Icthyolcolla [fish glue - Ammonium sulphoichthyolate] decocted, either in water if you are on board, or in Milk if a shoar, an Ounce at a time, and drink whilst it is warm.⁸

In his next book, Moyle refers to the first medicine in the previous quote as 'Potio alba' or the white drink.⁹ There, he recommends that if a purging medicine followed by the white potion fails to stop the pus from running at the penis, the procedure should be repeated. Whether the Icthyolcolla in the second medicine is astringent or not isn't clear from the period pharmacopoeias. It is possible that Moyle got this idea from a folk remedy since it is not found in the other medical books from the period. However, since he offers it as an alternative to a plantane water-based remedy, it would appear to fit in this category.

¹ See William Cockburn, The Symptoms, Nature, Cause and Cure of a Gonorrhoea, 1713, p.110-2; ² Cockburn, pp. 113-6; ² John Atkins, Lues Venerea, p. 30; ^4,5 John Atkins, The Navy Surgeon, 1742, p. 235; ⁶ Atkins, Navy Surgeon, p. 234; ⁷ John Moyle, Memoirs: Of many Extraordinary Cures, 1708, p. 85; ⁸ Moyle, Abstractum Chirurgæ Marinæ, 1686, p. 91; ⁹ Moyle, Chirugius Marinus: Or, The Sea Chirurgeon, 1693, p. 139

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