A Few Medical Firsts

Gentile da Foligno was a physician who learned his art at Padua and Bologna and then became a teacher—quite a wealthy one, as it happens. At the University of Perugia in Siena he made 60 gold florins per year (1322 - 1324). He then went back to his origin at the request of the Lord of Padua, Ubertino I da Carrara.

Besides teaching, he produced several medical treatises. One was a massive and widely copied commentary covering the Canon of Medicine by Avicenna. The Nuremberg Chronicle of 1493 referred to him as Subtilissimus rimator verborum Avicenne, "that most subtle investigator of Avicenna's teachings"; the illustration above shows Gentile learning "at the feet of Avicenna."

He is said to have performed the first medical dissection in centuries. Even the Romans, for all their search for knowledge, did not approve of cutting open the deceased. Examining the insides of the human body was necessary for starting to learn how organs work; for example, how liquids flow through the body.

Foligno wrote a commentary on urine and suggested that the blood passes through "porous tubules" (per poros euritides) in the kidneys, which strain it and pass the urine to the bladder. He was also the first to suggest that a fast pulse rate led to higher urine output (as a faster metabolism would). He also believed there was a correlation between the heart and the color of urine. A Journal of Nephrology article says he may have been the first cardionephrologist in history.

He also wrote a popular treatise on the Black Death, and recommended theriac for its treatment. Unfortunately, theriac preparation was complex and time-consuming, so there may not have been enough of it to go around. Not that it would have helped: presumably Foligno would have had access to some; however, he died of the plague at its start, on 18 June 1348.

To cure the plague, you would probably want to know what caused it, and that was a puzzle. Tomorrow I'll tell you of the Paris Consilium, who believed they had the answer.

The Poison that Cures

It started with King Mithridates IV of Pontus (132 - 63 BCE), who was afraid of being poisoned. He wanted to know all about poisons, so he not only tested them on criminals so he would understand their symptoms (and antidotes), but also he ingested the poisons himself in order to build tolerance. His personal physician developed for him a universal antidote which he named mithridatum, composed of 40 ingredients, including opium, myrrh, saffron, ginger, and cinnamon.

Mithridates' method of self-inoculation worked so well that, when he was captured by Pompey, he tried to poison himself, but the poison had no effect. His writings about developing the cure-all was found by Pompey's people and translated into Latin. Nero's physician added more ingredients, most notably mashed and roasted viper's flesh.

The search for a panacea, a universal cure, has a long history. Mithridatum is one example. The Greek physician Galen (mentioned many times in this blog) wrote an entire book on the making of his cure-all; he called it Galene after himself, but it also became known as theriac (from the Greek word for a wild beast); it contained viper's flesh, opium, honey, wine, cinnamon, and more than 70 other ingredients. It needed to ferment for six years and then be applied orally or topically; it kept its potency for 40 years.

In the 7th century a theriac made by the inhabitants of Anatolia was given to the emperor of the Tang Dynasty. The Tang apothecary declared its usefulness against a hundred illnesses. The Middle East called it Tiryaq. Medieval English apothecaries called it "Venice Treacle" because it came from the Mediterranean, and was distributed by the Worshipful Company of Grocers. "Treacle"? Yes. Produced from cane sugar, the thick and sweet syrup was considered "good for what ails you"; the word is actually linked to theriac. In modern medicine, the word "treacle" is defined as

A medicinal compound once in wide use as an antidote to poisons. Treacle was a kind of salve. It was reputed to be a remedy against venomous bites in particular and against poisons in general. It also came to be considered a "cure" for cancer. [source]

In Henry Grosmont's 1354 treatise,  Le Livre de Seyntz Medicines or "The Book of Holy Medicines," he mentions theriac: "the treacle is made of poison so that it can destroy other poisons."

You may ask: if they believed it was so effective, wouldn't they try to make vast amounts to keep on hand? Would they try it as a cure for the Bubonic Plague? Well, one man thought that was a good idea, but ... well, we can talk about him next time.