Today's Reading

Among its boosters was one of the strangest and most fascinating figures in medical history, a Swiss alchemist and revolutionary healer with the impressive name of Philippus Aureolus Theophrastus Bombastus von Hohenheim. Today he is better known as Paracelsus. He was a one-of-a-kind medical genius, part rebel, part con man, a bit mystical, a bit mad, a larger-than-life figure who trekked from town to town across Europe with his bags of remedies and instruments, carrying a huge sword with a pommel said to hold the Elixir of life. He would come to a town, talk to the locals, hawk his skills, heal the sick, argue heretical new theories, pick up tips from local healers, and rail against the entrenched medicine of the day. "In my time there were no doctors who could cure a toothache, never mind severe diseases," he wrote. "I sought widely the certain and experienced knowledge of the art [of medicine]. I did not seek it from only learned doctors: I also enquired of shearers, barbers, wise men and women, exorcisers, alchemists, monks, the noblemen and the humble people." He listened, he argued, he learned, and he applied the best ideas to his patients.

Along the way he penned several books, most of which were not published until after his death. These were written in a style that one historian called "very difficult to read and more difficult to understand," a mishmash of fantastic alchemical symbols and magical allusions, astrological references and Christian mysticism, medical recipes, divine inspirations, and philosophical ruminations. But underneath much of it lay a core of breakthrough ideas in medicine.

Paracelsus thought that most physicians were "vainglorious chatterers" who grew rich by simply parroting the mossy old ideas of the ancients, regurgitating the received wisdom of Roman and Greek and Arab authorities, repeating old mistakes. To this Paracelsus offered a simple alternative: True seekers of knowledge should read the book of nature. Instead of blindly following old texts from ancient authorities, physicians, he believed, should rely on what they see working in the real world, open themselves to all the wonders that nature offers, find new approaches, use new medicines in new ways, see what happens, and then use that knowledge to improve the art of healing.

Paracelsus experimented with his medicines, trying new mixtures and seeing what worked. (It's important to note that this was not experimentation in the modern scientific sense. It was more along the lines of "Here's something that looks interesting. I'll try it and see what happens.")

Chief among his successes was a mysterious and miraculous little black pill that seemed to ease almost any ill. "I possess a secret remedy I call laudanum and which is superior to all other heroic remedies," he wrote around 1530. One of his contemporaries remembered it this way: "He had pills which he called laudanum, which looked like pieces of mouse shit, but used them only in cases of extreme illness. He boasted he could, with these pills, wake up the dead, and certainly he proved this to be true, for patients who appeared dead suddenly arose."

Paracelsus's laudanum became the stuff of legend. We now know his secret recipe: About a quarter of each pill was raw opium; the rest was a fanciful (and mostly inactive) mix of henbane, bezoar stone (a solid mass gathered from the intestines of cows), amber, musk, crushed pearls and coral, various oils, bone from the heart of a stag, and, to top it off, a dash of unicorn horn (a much touted and certainly imaginary ingredient in many medieval medicines; what passed for "unicorn horn" in the day was most often the tusks of narwhals). Most of laudanum's effects came from opium.

Paracelsus was so sure of his views, so certain when he stated things like "The ignorant physicians are the servants of hell sent to torment the sick," or when he ostentatiously burned one of Avicenna's books in a public bonfire, that many considered him an arrogant braggart. But he was no charlatan. He was, instead, one of the fathers of pharmacology, a man who single-handedly helped wrestle drug studies away from the stranglehold of ancient theory and stand them on a more modern footing. He is said, for instance, to have studied opium by using it on himself and his followers, then tracking the effects—a practice of self-experimentation that would become common among physicians in coming centuries.

By the time Paracelsus died in 1541, the European appetite for opium was growing. Columbus had been briefed to look for and bring back opium from his voyages of discovery, as did explorers like John Cabot, Ferdinand Magellan, and Vasco da Gama. The reason was that opium, as opposed to many other Renaissance pills and potions, worked. As its popularity grew, so did the ways physicians found to use it. Some bright physician dissolved opium into a solution with mulberry and hemlock, then cooked the brew into a sea sponge. When this drug-infused "Sleepy Sponge" was dampened and heated, it released fumes that could both ease pain and put patients to sleep, making opium one of the first anesthetics. Venetian treacle, a mixture of opium with up to sixty-two other ingredients ranging from honey and saffron to viper's flesh, was used to treat everything from a snakebite to the plague. The popularity of treacle was so great that it helped spur the first drug regulations in London. In 1540, Henry VIII empowered physicians with the right to search apothecaries' shops and report any medicines found to be dangerous or defective, including treacle. By Shakespeare's day, only one man in London was allowed to make it, and even he had to show it to the College of Physicians before selling it.

One problem for early physicians using opium was that they never knew how strong the drug would be. Because opium came from different countries with different processing methods, there was no way to tell exactly what you were getting in a given ball. One pill maker's medicine might contain two or three or fifty times the dose of another's. Physicians had to try each new batch on their patients and hope for the best. Patients paid their money and took their chances.
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