Medicine and Herbs
by Dr. Tig Lang

When someone fell ill in fifteenth-century Britain, where did they go for treatment, and what was a practitioner likely to recommend?   The evidence we have for fifteenth-century medicine does not make these easy questions to answer.  We have no diaries for the period, and only a few collections of letters, and although medical texts both in Latin and English survive in large quantities (particularly from the later fifteenth century), there is often no way of knowing who owned them and how much they were used. 

One form of healing in common use in the Middle Ages, though hardly at all today, was pilgrimage to a healing shrine.  The records kept at shrines provide valuable evidence on many aspects of medieval illness and treatment.  Because clergy keeping the records were keen to report the success of their shrine compared with the non-success of other forms of healing previously tried by their pilgrims, their records can give an idea of the various forms of healing available at the time. Most pilgrims had consulted some form of practitioner before setting out on pilgrimage, and had used treatments including herbal remedies, charms, prayers, hot baths, and even healing waters such as those of Bath.  Some had consulted physicians, surgeons or barbers, while some had been treated by a variety of ‘unofficial’ practitioners, such as their own family or other local healers.  The miracles of Henry VI include one instance where a patient had previously consulted a local herbalist, whose official trade was that of weaver.  Who people consulted first when they fell ill might depend largely on what types of practitioner existed in their area.  For example, it has been estimated that York in 1381 had about 7,500 inhabitants, with only one physician and eight barber-surgeons, so clearly not everyone who fell ill would be able to consult the physician.  As well as physicians and surgeons, there were barber-surgeons (chiefly concerned with bloodletting, which was used as both a treatment and a prophylactic), and ‘leches’, which sometimes implies a less well-trained practitioner, but is confusingly sometimes used of quite eminent surgeons.  Cost might also be a factor in determining who the sick person turned to, even though some practitioners tailored their fees according to the patient’s ability to pay, and some medical texts offered alternative remedies for the poor. 

People might travel to seek medical help.  The Paston Letters, so often quoted by anyone working on the fifteenth century, have several references to medical matters.  In one letter, dating from 1452, Margaret Paston writes that her uncle is so ill that he will not survive without medical help, so he is to travel to Suffolk where there is a good physician.  On other occasions, however, the Paston women and their friends themselves acted as healers.  For example, in 1455 Alice Crane writes to Margaret Paston for news of her illness, and to ask whether the medicine she had recommended in her last letter had been any use.  In this letter there are no details of Margaret’s illness, nor of the contents of the medicine Alice had recommended, which is disappointing, but sometimes the letters are more specific.  In Margaret Paston’s letter of 1473 to Sir James Gloys about an illness suffered by her cousin, for example, quite a lot of information is given.  It is clear that her cousin has some sort of digestive problem.  Margaret suggests that he should use water of mint or water of yarrow (incidentally both these herbs might be prescribed by a herbalist today for digestive problems).  She tells Sir James that Dame Elesebeth Callethorppe will have either of these waters, and probably others for the same purpose.  Dame Elesebeth was obviously known to have store cupboards well stocked with remedies, and no doubt there were many people like her.  In another letter, Sir John Paston writes to Dame Margery Paston asking to have her own special medicine ‘flose ungwentum’ to put on a friend’s sore knee, and asks her to send him, along with the medicine, directions for how it should be applied, how it keeps, whether it should be kept warm, and so on.  It is interesting to see from these references the sort of medical knowledge that the woman of a household might be expected to have.  The remedies used by the Pastons and people like them do not differ greatly from many of those recommended in medical texts; for although physicians and surgeons do recommend mixtures containing gold, pearls, and exotic and expensive spices, they also frequently recommend mixtures of more homely herbs, and lard, honey, eggs, and flour.  The Paston family owned at least one medical book, which they commissioned a scribe, William Ebesham, to produce for them.  

In 1452 Margaret Paston writes to John Paston asking for a book with a recipe for Chardequince, so that she can take it in the morning as a preventive medicine ‘for the air is not wholesome in this town’.  (Chardequince was a confection of quinces, honey and sugar, sometimes with other ingredients such as pears and spices.  One recipe for it is given below.)  It is interesting that she was planning to make the medicine herself rather than buy it in the town, even though this would mean a delay while her letter was received and the book returned.  Perhaps this was not the sort of remedy that she could expect to buy from an apothecary ready made, unlike another favourite remedy in times of pestilence, Theriac (otherwise known as treacle).  This was immensely complicated to make, with many ingredients.  It was generally imported from the continent, particularly from Venice or Genoa.  It is widely recommended in medical texts, and we know that ordinary people put their faith in it too, not only because of the presence in town records of people who made their living by importing and selling it, but because the ubiquitous Pastons mention it.  In a letter of 1479, John Paston writes asking, ‘I prey yow send me by the next man that comyth fro London ij pottys of tryacle of Jenne – they shall cost xvj d. – for I have spent ought that I had with my yong wyf, and my yong folkys, and my sylff, and I schall pay hym that schall bring hem to me, and for hys caryage.  I prey you lett it be sped.  The pepyll dyeth sor in Norwyche, and specially abought my house, but my wyf and my women came not ought, and fle ferther we can not; for at Sweynsthorpe, sythe my departing thens, they haue dyed, and ben syke nye in every house of the towne’.

Medical recipes turn up in non-medical sources as well as in manuscripts that are entirely devoted to medicine or surgery.   They may be added on flyleaves or spare pages within account books, commonplace books, and notebooks of the period, jumbled together with the other information, and they seem to have been passed on in the same way that one might pass on a cookery recipe to a friend today.   In contrast to the great divide in modern times between the production of medicines in laboratories and the production of food in the home, many medieval remedies call for similar ingredients (herbs, spices, flour, honey, eggs, lard) and similar methods to ordinary cookery, so that making them up would not have presented too great a challenge.  Some establishments, such as monasteries and large houses, would have had gardens in which medicinal herbs could be grown, or else the herbs, as well as spices and more exotic ingredients, could have been bought in from a spicer or apothecary.  They could also, of course, have gathered some of the ingredients from the wild, and some medical texts give directions as to the sort of place where particular herbs might be found.  Alternative recipes, or alternative ingredients within one recipe, are often provided so that if the person wishing to make up the medicine were unable to obtain one or other of the ingredients, they would not necessarily be at a loss.  Some sample recipes, from a recipe collection which could as well have been owned by a family such as the Pastons as by an official medical practitioner, are given below. 

Various recipes exist for Chardequince, mentioned earlier.  Here is one from the fifteenth century.  ‘Chardecoynes that is gode for the stomake is thus made.  Take a quart of clarified hony and ij unces of powder of pepyr and medle hem togedre; and then take xx gwyncis (quinces) and x wardons (pears) and payr hem and take owte the kernellys with the cores, and seith hem in clene wort* till thei be tendyr; and then stamp heme in a mortar as small as thow mayst, and then streyne heme thorow a streynyor, and that that will not well thorow put in again and stamp it oft and oft dryve it thorow a cloth or streynyor and iff it be to dry putt in halue a sawser full or alyttill more for to gett oute the other the bettyr, and then put it to the hony and sett it on the fyre and make it to seth wele and stir fast with a grete staff, and iff ther be ij styrreres it is the bettyr for bot if it be strongly stired it well syet to the vessel, and then it is lost: and seith it till it sothen thik and then take it down of the fyre and when it is wele nygh cold put in a quart of an unce of ginger and as moch of galyngall and as moch of canell powdrede and medle hem wele togedre with a slyce, and then latt it kele and put it in a box.  Thys maner of makynge is good…’

*If wort (a product of brewing) was not available, other recipes say water could be used instead.

This recipe, and also those below (for what might be called ‘everyday’ illnesses), are taken from Warren R. Dawson, A Leechbook or Collection of Medical Recipes of the Fifteenth Century,  (London, 1934).  Likely identifications for the plants concerned are given in brackets after the recipes, and are based on the lists given in Tony Hunt, Plant Names of Medieval England, (Cambridge, 1989).

(Recipe no. 453) A Goode Medecyn for the hede.  Take betayn, vverveyne, wormode  and celidoyne, weybrede and ruw, walwort and sawge and v cornes of pepper and stamp heme and seth heme togedir in watir and drynke it fastynge.  (Betony, Vervain, Wormwood, Greater Celandine, Greater Plantain, Rue, Ground Elder, Sage, Peppercorns.)

(Recipe no. 190) Ffor the perilous coughe.  Take sawge rw comyn and pepir and seith hem togedir with hony and ete theroff euery day at morrow a sponefull at evyn an other.  (Sage, Rue, Cumin, Pepper.)

(Recipe no. 197, for a dry cough).  Take a garlike hede and rost it at the fire then take away the pyllynge and ete it with good purid hony. 

(Recipe 303, to draw out a splinter) Make an empleyster of southernwood and medle it with fresshe gresse and it will draw owt stubb or thorne that stykkyth in the fflesshe. (Unlikely as it may sound, this plaster of Southernwood mixed with lard was very effective when I tried it on a large splinter embedded in my finger in the summer of 2005.)

(Recipe no. 648) Oyntment for to hele woundis.  Take oyle of olyue, hony and may butture of euery ich lich moch and juyse of planteyn as moch as of all tho and seth hem all togedir till that thei be sodden to the haluendelle and then take that ointment and enoynt the wound therwith and it shall hele it faire and clere or elles take lynet and wete therein and lay it in the wound and it shall hele fayre.

(Recipe no. 133, for bites and stings).  Stamp garlike and lay upon the sore, and for houndis bitynge take hony ther with, and garlyke distroieth venym.

The relationship, as regards method of production, between such medicines and cookery, is immediately obvious.  Although the ingredients in such recipes also sound far more like cookery than medicine, it is worth noting that some medieval remedies, such as the use of honey as a wound dressing, are receiving renewed attention today, as research shows their value even exceeds that of modern conventional treatments in some cases.  A research project currently under way at Kew Gardens aims to extend knowledge of British medicinal plants, and has already confirmed the usefulness of several of them for exactly the complaints recommended in Culpeper’s seventeenth- century Herbal.   Such findings should increase our respect for our forbears, whose understanding of illness was in so many ways far behind our own, yet who sought to do their best for the sick with all the means available to them, and who had found many remedies whose usefulness is still worthy of study today.