Treating the Bite of a Mad Dog

By the mid-eighteenth-century, women had already begun to experiment with treatments listed in receipt books. This can be evidenced through the introduction of efficacy statements. From the seventeenth-century onwards, they showed that treatments had been trialled and were successful. Clearly, the importance of emphasising an efficacious result is something which had been recognised as a required aspect of a receipt throughout the seventeenth and eighteenth-centuries.  One notable way which can be used as evidence of experimentation is the number of different receipts for the same illness contained within one receipt book. Historians such as Raymond Anselment have previously argued that the cure for a mad dog’s bite was ‘an expected part of any collection’ (1).  When conducting our own research, we found this to be the case with Anne Battam’s collection of receipts containing two receipts for the cure of a mad dog’s bite. Through a comparative study of experimentation, dosage, standardisation and ingredients, we will reflect on female expertise on domestic medicine in the eighteenth-century.

The 1759 edition of Battam’s compilation contains two receipts: A receipt for the bite of a mad dog and An infallible cure for the bite of a mad dog, brought from Tonquin. Battam’s decision to include two receipts for the same illness can perhaps be explained in line with Alisha Rankin’s argument. She suggests that women ‘made attempts to modify established recipes […] and frequently experimented with new medications’ (2).  In this sense, experimentation could be seen as the process of testing new treatments to determine which were the most effective in different circumstances.  In both receipts, experimentation can be seen through the N.B.’s at the end of the instructions.  In A receipt for the bite of a mad dog, the N.B. reads ‘it is good for cattle, as well as the human species’ (3). By engaging with Galen’s theory that humans and animals have similar anatomical structures, the receipt demonstrates a clear understanding of contemporary principles of medicine. Alternatively, in An infallible cure for the bite of a mad dog, brought from Tonquin the N.B. gives further information on the dosage required as well as an efficacy statement. The statement explains that ‘this medicine has been given to hundreds with success’ (4) which shows that the receipt has been tested. This acts in a similar way as annotations and cross outs (found in many early modern manuscripts); these were a recognised part of eighteenth-century receipt books. Therefore, both receipts present an awareness of the importance of experimentation. 

 

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A receipt for the bite of a mad dog – Reproduced with the permission of Special Collections, Leeds University Library (Cookery A/BAT)

An infallible cure for the bite of a mad dog, brought from Tonquin  Reproduced with the permission of Special Collections, Leeds University Library (Cookery A/ BAT)

Not only do both receipts follow the trend of experimentation, they also contain advice about how to alter dosages given.  Both receipts advise the reader to repeat the dosage after a thirty-day period. A receipt for the bite of a mad dog suggests the dose should be repeated ‘the next new or full moon after the first’ while An infallible cure for the bite of a mad dog, brought from Tonquin recommends ‘a second dose of the same must be repeated thirty days after’ (5). As discussed in a previous post, this is a common aspect of Galenic principles which were based on cycles within the body. By giving clear instructions about when to give the patient the repeat dosage, the reader could administer the treatment more confidently.

The final point of comparison between the two receipts focuses on standardisation of measurements and ingredients used. From our statistical analysis of Battam’s compilations of receipts, we found a decrease in the number of receipts containing non-standardised measurements from 32% in 1750 to 27% in 1759. This suggests a gradual transition towards more precise measurements, which could be used as evidence of attempts to make receipts more reproducible and therefore more successful. Both receipts for the mad dog’s bite in the 1759 edition of Battam’s collection follow this trend by using standardised measurements. In A receipt for the bite of a mad dog, standardisation is used in relation to pre-processed ingredients with the receipt instructing the individual to use ‘five pints of ale’ (6). This suggests that the receipt has been tested with different quantities to achieve a successful treatment. However, the receipt still uses non-standardised measurements for ‘natural’ ingredients such as the rind of an elder tree, showing a lack of consistency in terms of measurements used. Contrastingly, An infallible cure for the bite of a mad dog, brought from Tonquin uses standardised measurements for pre-processed and natural ingredients. The receipt says to take ‘twenty-four grains of native cinnabar’ and ‘twenty-four grains of factitious cinnabar’ (7).  Perhaps this receipt is more concerned with standardisation as it has been contributed to the collection from Tonquin. However, this requires further study.

A comparative study of the two receipts for a mad dog’s bite presents a number of insights into domestic medicine in the mid-eighteenth century. The N.B.’s suggest a number of revisions had been made to the receipts included in the collection and add further information connected to principles of medicine, dosage and efficacy. Equally, repeat dosages ensure that the patient is relieved of their symptoms while standardised measurements led to a reproducible receipt.

(1) Raymond Anselment, The Wantt of Health: An Early Eighteenth-Century Self-Portrait of Sickness, Literature and Medicine (1996)

(2) Alisha Rankin, Becoming an Expert Practitioner: Court Experimentalism and the Medical Skills of Anna of Saxony (1532-1585), Isis (2007)

(3) Anne Battam,The lady’s assistant in the oeconomy of the table: a collection of scarce and valuable receipts (1759)

(4) Battam (1759)

(5) Battam (1759)

(6) Battam (1759)

(7) Battam (1759)

Dosage and the Impact of Gender

 

Following on from our last post on Dosage and the Impact of Age, we have decided to focus on alterations of dosage based on gender. Historiographical debates have so far centred around dissection and the limited opportunities for formal education for women. According to N.D Jewson, dissection in the early modern period was ‘widely regarded as an insult to the body’ (1). This means that domestic medical healers, who were often women, would have had limited knowledge about the workings of the body due to a lack of dissection. Further research on women’s lack of knowledge can be found in Doreen Evenden’s work which suggests that it was ‘unthinkable’ for women to attend dissections held by the Barber-Surgeons company (2). This could be because in 1745 the Company of Surgeons became a separate organisation from the Barber-Surgeons. Making the distinction between the two companies more formal could have made it harder for women to access professional medical education due to contemporary ideals about gender roles. Both arguments make alterations of dosage based on gender, such as those found in receipt books compiled by Sarah Jackson (The director: or, Young woman’s best companion published in 1754 & 1755), surprising. These receipt books counter the arguments historians have proposed on formal medical knowledge by giving advice to readers (who were most likely women) about how to alter dosage based on gender without professional medical expertise.

Jackson’s compilation of medical and culinary receipts includes one noticeable medical receipt which mentions altering the dosage based on gender. The receipt For the Yellow-Jaundice is interesting because it recommends altering the amount of ingredients in the treatment based purely on gender. The advice of ‘eleven sows, or Wood- Lice if they be large, (if small, thirteen)’ for a man and ‘nine large Wood-Lice, or eleven small ones’ for a woman shows an understanding of the differences between male and female anatomy. This contrasts Jewson’s argument that there was a lack of understanding about the body (3). By acknowledging that the receipt may need altering for men, it assumes that the reader has basic knowledge about the human anatomy. The inclusion of this receipt could suggest that domestic healers (notably women) were, by the eighteenth-century, becoming more aware of the need to experiment with the quantities of ingredients used in treatments.

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Notably, alongside recommendations to change the quantity of ingredients based on gender, the receipt also gives instructions about the size of woodlice needed. If this alteration is read in line with Alisha Rankin’s argument that writing a receipt ‘encompassed the knowledge of all the properties of a remedy’s ingredients’, it seems the Yellow-Jaundice receipt can suggest more about knowledge of dosage and measurements than first appears (4).  We could see the inclusion of precise, standardised amounts of ingredients and dosage as evidence of attempting to create an efficacious result. After undertaking a comparative study of the 1754 and 1755 editions of Sarah Jackson’s book, we found an increase in the number of standardised receipts from 58% in 1754 to 62% in 1755. Equally, there was a decrease in the amount of non-standardised measurements used in receipts from 42% in the 1754 edition to 40% in 1755. This illustrates progression to a more standardised set of receipts with measurements such as ounces, drams, grains, pints and quarts becoming more commonly used in the 1755 edition. Despite appearing in both editions of Jackson’s compilation, the receipt doesn’t follow this trend of increasing standardisation. Perhaps this is because the receipt instead gives instructions on the size of ingredients rather than giving a standard measurement. Just like standardised measurements show concerns about the receipt being reproducible, the alteration based on size shows an understanding of the problems the receipt could cause to readers trying to follow the instructions.

The clear instructions given in terms of ingredients can also be found in advice on dosage. The receipt recommends taking the treatment for three days, ‘then forbear three mornings, and then do it for three mornings again’ (5). The cyclical nature of the dosage repetition could be linked with Galenic principles which show a connection between bodily cycles and astrology. Taking a more straightforward approach, we could simply see the cycle of dosage as a way to advise healers to alter the dosage as they see necessary. This links with ideas already covered in Dosage and the Impact of Circumstance.

By looking at alterations in ingredients and dosage based on gender, the receipt For the Yellow-Jaundice shows that formal medical education was not required to administer effective medical treatments. In the receipt books we have chosen to study, Jackson is unique in recommending different dosages based on gender. Even though, as Doreen Evenden states, ‘licensed women were expected to only practice on women’, the receipt shows a basic understanding of how to treat both sexes (6).  This could be down to an increase in female participation in medical experimentation.

(1) N. D. Jewson, Medical Knowledge and the Patronage System in 18th Century England, Sociology (1974)

(2) Doreen A Evenden, Gender Differences in the Licensing and Practice of Female and Male Surgeons in Early Modem England, Medical History (1998)

(3) Sarah Jackson, The director: or, Young woman’s best companion (1754)

(4) Alisha Rankin, Becoming an Expert Practitioner: Court Experimentalism and the Medical Skills of Anna of Saxony (1532-1585), Isis (2007)

(5) Jackson (1754)

(6) Evenden (1998)

Dosage and the Impact of Age

Increasing medical expertise during the seventeenth and eighteenth-centuries often involved the growing recognition of anatomical differences between adults and children. Despite female author Sarah Jackson’s receipts (in her book The director: or, Young woman’s best companion, 1754 & 1755) being published in a time of anti-dissection, they contain profound examples of the dosage of medication being altered to accommodate the needs of a child. Having previously witnessed the means by which ‘age’ remained an ambiguous (or missing) factor, it is interesting to acknowledge the growing importance of expertise in child-specific dosages.

Historiographical debate has focused on child-specific dosages. Historian Lisa Smith introduces the eighteenth-century concern of raising healthy children. Smith performed an analysis of medical texts in the epistolary format, finding that women were more likely than men to write to doctors concerning their child’s health (1). On the other hand, historian Jonathan Andrews explains how early modern institutions intended to discover ‘how children’s minds, bodies and constitutions were conceptualised’, and ‘why treatments were adjusted and made more specific for children’ (2). Therefore, Smith and Andrews provide contrasting views as to whether we should regard child dosages as maternal responsibilities or empirical and medical expertise.

It is important to acknowledge that we can rarely be sure of the fact that these women wrote their receipts themselves. Despite not explicitly mentioning the contributor, many receipts were copied from elsewhere. However, as ‘compilers’ (i.e. collecting receipts from other texts and compiling their own book), they made the conscious decision to include these receipts for a number of reasons. Jackson’s inclusion of the receipt for An excellent Surfeit-Water states that ‘The Dose for a Man is two Spoons full, for a Child one Spoonful’ (3). In this case, the lack of standardised measurement is immediately indicative of the absence of empiricism. Instead, it appears to be a mere recognition of the necessity to lower the dosage for a child. This could be considered to be simply part of a woman’s maternal responsibility, as supported by historian Lisa Smith. In this case, the receipt book as a whole would support a woman’s role in childcare alongside refining medical expertise. We might depict the likes of Sarah Jackson as ‘medical’ authors or compilers. However, domestic receipts ran alongside medical receipts. If we associate domesticity with the role of the female in the household, this would suggest that caring for children overlapped with both medical and domestic elements of eighteenth-century literature.

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An excellent Surfeit-Water – Reproduced with the permission of Special Collections, Leeds University Library (Cookery S/JAC)

Notably, the transmission of receipts from one owner to the next included the intermingling of receipts by both men and women. This means that we cannot know for sure whether the receipts presented in Sarah Jackson’s book were written by a man. If this is the case, the previous statement (suggesting that receipts depicted a woman’s concern for her child’s health) should be re-considered. There are more receipts in Jackson’s book which suggest elements of experimentation are related to the improvement of child dosages. Theories of female ‘concern’ for child health are gradually replaced with the desire for medical expertise in these later instances.

Sarah Jackson only published two editions of her book in 1754 and 1755. Despite only one year’s difference, we witness the disappearance of For a Cough in a Young Child, replaced with An infallible Remedy for the Hooping-Cough in Children, a Day Cold or Cough in the Adult. Notably, the entirety of the ingredients are altered, along with the purpose and versatility of the receipt. This displays the possible role of experimentation in early modern households. Experimentation might have been performed by the author or compiler in order to better understand the anatomical differences and similarities between man and child. To have trialled and modified (in this case – eradication and replacement) proves to us that early modern institutions truly did aspire to gain knowledge on childhood health.

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An infallible Remedy for the Hooping-Cough in Children – Reproduced with the permission of Special Collections, Leeds University Library (Cookery S/JAC)
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For a Cough in a young Child – Reproduced with the permission of Special Collections, Leeds University Library (Cookery S/JAC)

This refined medical expertise, proposed by historian Jonathan Andrews, is continued in the receipt for The Red Powder famous for Curing of Fevers of all Sorts, and Agues. The explanation for the administering of dosage is as follows: ‘To a Child fifteen Grains, to a Youth twenty-two Grains, to a Man or Woman thirty, or more’ (4). The introduction of standardised measurements of ‘Grains’ heightens the precision (and empiricism) of the receipt. Moreover, the categorisation of both ‘Child’ and ‘Youth’ as well as adults depicts an awareness of the gradual anatomical changes to the human body. It is therefore evident that Jackson’s choice of receipts, while depicting maternal responsibilities, strongly associate with eighteenth-century medical expertise.

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The Red Powder – Reproduced with the permission of Special Collections, Leeds University Library (Cookery S/JAC)

However, when studying these receipts, the latter sheds light on the lack of anatomical awareness of gender differences. The same dosage is to be administered to both men and women. This could be due to issues of anti-dissection. Alternatively, there are receipts in which gender dosages are more specific, however this requires further study.

(1) Lisa Smith, The Relative Duties of a Man: Domestic Medicine in England and France, 1685-1740, Journal of Family History (2006)

(2) Jonathan Andrews, History of Medicine: Health, Medicine and Disease in the Eighteenth Century, Journal for Eighteenth-Century Studies (2011)

(3) Sarah Jackson, The director: or, Young woman’s best companion (1755)

(4) Sarah Jackson, The director: or, Young woman’s best companion (1755)

Dosage and the Impact of Circumstance

We decided to start our research by concentrating on the modification of dosages in varying circumstances. This might bring forward instances of what we have labelled ‘female medical expertise’, whereby women chose to acknowledge the importance of receipts that focus on conditions affecting dosages.

Despite placing the focus of our research upon female medical expertise, the following receipts are likely to have been passed from one generation to the next by both men and women. This problem of authorship and ownership (showing the strong likelihood of overlaps between male and female involvement), means we have to decide how we wish to define female medical expertise. We have chosen to outline ‘female medical expertise’ as:

  • The way in which these women consciously decided to include particular receipts in their books.
  • The heightened likelihood of receipts being experimented on by both the female compiler and the reader.
  • The way in which alterations between two editions of the same book display the revisions made by these women to their medical literature.
  • (In relation to this post) Female compilers engaging with receipts that contain empirical and precise methods (e.g. standardised measurements).
  • Any other factors we might discover while conducting this research.

During the mid-eighteenth-century, the modification of household medicines was particularly prominent. Historian Elaine Leong proposes that household drugs were impacted upon by customisation. The variation of ‘strength according to their own requirements’ plays a central focus in the study of dosage alterations (1). Using the argument proposed by historian Leong, we might begin by suggesting that female medical expertise is, in this case, categorised as the conscious decision to include receipts that encourage customisation. Alterations of dosages relied upon three dominant factors: age, gender and circumstance. Circumstance-based dosages are associated with terminology such as ‘strength’ and ‘constitution’. Consequently, the dosage administered is impacted upon by the individual’s perception of their patient’s build, framework, and existing state of health. This is particularly prominent in Anne Battam’s 1750/1759 The lady’s assistant in the oeconomy of the table, in which there are two receipts relating to the alteration of dosage. The following examples are heavily based on inference and judgement; the reader must choose how many dimensions they wish to modify.

Battam chose to include the receipt To make the famous friar’s balsam, whereby the dosage must be altered ‘either by outward application, or taking it in drops, according to the age and constitution of the patient’ (2). Firstly, the method for administering the dosage is an added dimension – the reader is given a choice. The recommendations depict the writer’s presumption that the reader can determine the most effective way of administering the treatment as well as the dosage required. The methods are impacted directly by both ‘age’ and ‘constitution’. Despite these being vague judgements based purely on two factors, it is important to acknowledge that the receipt encourages methodological experimentation based on the perceived wellbeing of the patient.

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To make the famous friar’s balsam – Reproduced with the permission of Special Collections, Leeds University Library (Cookery A/BAT)

This is mirrored in Battam’s inclusion of Dr Willis’s Spring-ale, in which the dosage is administered ‘according to your age and strength’ (3). This receipt also adheres to the trend of relying on the reader’s perception of their patient’s health, followed by a mere estimation of the dosage that their ‘age’ requires. The lack of categorisation regarding age and different levels of ‘strength’ provides implications as to how both doctors and their followers (such as Battam) regarded dosage as important but not yet precise. Therefore, the ambiguous and unspecific instructions given by people whose advice was sought and respected suggests an incomplete understanding of the implications of altering dosage.

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Dr Willis’s Spring-Ale – Reproduced with the permission of Special Collections, Leeds University Library (Cookery A/BAT)

Notably, Sarah Jackson also conforms to this contemporary interest in the impact of circumstance on dosage in her 1754/1755 book The director: or, Young woman’s best companion. Similar to Anne Battam, Sarah Jackson’s inclusion of the receipt for Elixir Salutis, or never failing Cordial administers the dosage ‘according to the Constitution and Strength of the Patient’ (4). The use of ambiguous adjectives such as ‘constitution’ and ‘strength’ is again evident. This leads to the persistent problem of inference; the imprecise vocabulary relies on the reader’s perception of the literary meaning as well as their existing medical knowledge.

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Elixir Salutis, or never failing Cordial – Reproduced with the permission of Special Collections, Leeds University Library (Cookery S/JAC)

 

Nevertheless, Sarah Jackson includes a receipt which introduces new circumstances with the alteration of dosage, such as the likelihood of gaining successful results under varying conditions. This is prominent in To help delivery, in which the likelihood of success might be impacted by a change of circumstance, in this case a stillbirth. Whilst still relying on the midwife’s judgement, the receipt explains how ‘half a Dram’ of the ingredients must be given ‘in a little warm Ale’. However, ‘if the Child be dead give a Dram of it’ (5). This significant change in circumstance is mirrored by a change in dosage, suggesting the receipt has been tested prior to publication. Therefore, it is evident that early modern households recognised the necessity to increase the dosage to match the increased discomfort of the patient. Interestingly, this is the only given example of a circumstance-associated dosage in which a standardised measurement is provided. The ambiguity of administering medicine based on singular descriptions such as ‘strength’ and ‘age’ was no doubt a recurring issue.

From this, it would be of benefit us to study examples of receipts in which ‘age’ is more specifically addressed. This would lead to a better picture of female medical expertise in the mid-eighteenth-century.

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To help Delivery – Reproduced with the permission of Special Collections, Leeds University Library (Cookery S/JAC)

 

(1) Elaine Leong, Making Medicines in the Early Modern Household, Bulletin of the History of Medicine (2008)

(2) Anne Battam, The lady’s assistant in the oeconomy of the table: a collection of scarce and valuable receipts (1750)

(3) Anne Battam, The lady’s assistant in the oeconomy of the table: a collection of scarce and valuable receipts (1750)

(4) Sarah Jackson, The director: or, Young woman’s best companion (1755)

(5) Sarah Jackson, The director: or, Young woman’s best companion (1755)