Introduction and Acknowledgments

Eighteenth-Century Colonial Formularies:
The Manuscripts of George de Benneville and Abraham Wagner

Exploring therapeutic resources in colonial North America: Two medical manuscripts made accessible on line

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This website provides direct access to two rare dispensatories and receptures that illuminate the therapeutic practices and medical orientation of two dispensing physicians in the multilingual colonial medical market of rural Pennsylvania. The project was supported by grants from the National Library of Medicine and the German Alexander von Humboldt Foundation. Both digital images of the original manuscripts and searchable text have been incorporated into the Historical Medical Digital Library at the College of Physicians of Philadelphia. The overall objective is to preserve in their entirety and to make accessible to scholarly and lay audiences a body of writings that offer insight into some of the medical resources available to the North American colonial population:

Our transcription and translation of prescriptions and therapeutic recommendations in both manuscripts must be viewed as work in progress. Time and resource constraints have made it difficult to check all possible interpretations against the European sources of information evident throughout the manuscripts. The decision to concentrate on English language renditions, while rational in view of the resources at our disposal, is nonetheless regrettable and acknowledged in a crosscultural project.

On the other hand, and relying on the dynamic and interactive nature of on-line text, we hope to have provided a useful research tool for access to a period of North American medicine that remains relatively poorly documented despite the important work of John Worth Estes, David L. Cowen, Norman Gevitz, and J.W. Bell. We welcome critique and emendations in our rendering of these complex manuscripts and look forward to incorporating them, resources permitting.

The manuscripts

Different in many respects, most importantly their structure and stage of completion, the manuscripts can be dated roughly to the period 1740 to 1780. Both drew on numerous 18th century continental European and English sources, explicitly in the case of the Wagner manuscript and unacknowledged but obvious in the Medicina Pensylvania. Both offer copious and often highly technical receptures from the armamentarium of chemiatric and botanical substances that were in general use at the end of the early modern period. Similar to other physician manuals of the period, they lay out medicinals and related procedures for treatment of major diseases and conditions, including female complaints and pre- and perinatal advice. A strong but eclectic orientation to chemiatric preparations is evident, matched by reliance on the traditional botanical and animal reservoir.

The eventual plans for these manuscripts remain unknown. The Wagner book is clearly not even close to being a clean copy, in striking contrast to the extant de Benneville, which is transmitted as a meticulously prepared and scripted compendium of 17th and 18th century pharmacy for a bilingual English and German physician audience, with some interesting Paracelsian inclusions, possibly for a wider public.

The abundant recipes in these formularies for botanical and chemical compositae suggest unexplored sources of supply to rural practitioners outside the major chain of imports from England, although neither specifically addresses the need for laboratory equipment and raw materials. Both presuppose considerable technical, chemical and botanical knowledge and neither can be regarded a domestic self-help manual of the type then beginning to emerge on both sides of the Atlantic, as in the works of John Buchan and Samuel Auguste Tissot.[1] On the other hand, some of the material, in particular the fully collated de Benneville work, indeed calls to mind this transition to an emerging genre. A short excerpt of the material on women and children in the Medicina Pensylvania is part of the papers of the Sauer family, famous German printers of the colonial period, and may well have been intended for separate publication.

But the bulk of the instructions in both manuscripts clearly address knowledgeable medical providers, presume some knowledge of Latin despite their use of English and German, and require understanding of questions of safety, adverse effects, and dosage characteristics. Wagner's explicit use of a large number of the proprietary medicines from the Halle Orphanage and his specific mention of medical Pietists like Georg Ernst Stahl, Samuel Carl, and Johann Juncker on the one hand, and the military surgeon Laurence Heister on the other hand, is of considerable interest in terms of the wider network of colonial medical practice. On the other hand, there is in these North American collections of recipes a full awarneness of current British pharmaceutical practice, in particular the formularies and dispensatories based on the Edinburgh and London pharmacopoias. Both manuscripts thus strengthen the assumption of a distinct and sophisticated medical market and print culture oriented to Central European medical traditions and patients but reflecting as well the practices and concerns of the prescribing physicians and apothecaries of the North American colonial area.

In personal terms, both George de Benneville and Abraham Wagner were the product of and fed into an intense transatlantic religious network which sponsored their passage to America and in which they remained active throughout their lives. They came from medical cultures that flourished in the radical religious communities in Protestant Europe in the 17th and 18th century, often protected by tolerant princely patronage (Moran,1991, Habrich, 1982, Shackelford, 1996). While the medical orientation in this network remained much indebted to the chemiatric traditions of the 17th century, its members promoted reform of the medical profession and religious reconciliation. They were thus quite distinct from the contentious and competitive culture of earlier practitioners of alchemy and chemiatric medicine (Young, 1998, Shackelford, 2004). They rejected academic and social vanities, combined with the strong obligation to charity practice observed for the Hartlib circle (Webster, 1975; Young, 1998; Debus and Walton, 1998; also Wilson 2000, ch. 1 and 2). In this country, they served mainly as practitioners within rural communities and seem to have had no academic aspirations, unlike a younger, native born cohort that included the descendants of Pietist German immigrants like Caspar Wistar and Adam Kuhn.

A few notes on the medical context

Before directing the user of this website to specific information on the respective manuscripts and to the technical instructions for access and use, a summary of some general characteristics, tendencies and changes in the eighteenth century with respect to therapy might be in order.[2] It is well known that the century was a time of "reform" in terms of both the simplification of complex polypharmaceutical preparations, and the discarding of many specific plant and, more conspicuously, animal drugs from pharmacopoeias -- the so-called cleansing of the materia medica.

Paralleling changes in their armamentarium, physicians needed to respond to contending theories of disease and, hence, theories of the action of medications or their effectiveness. The broad sweep of current or evolving theories embraced actions of medicaments linked to iatrochemical explanations such as effects due to acid or alkaline properties of the medicines and effects on the blood and other fluids. Iatromechanical concepts, on the other hand, embraced concepts of particles (sometimes viewed as corpuscles) of medicines affecting the body (perhaps fibres, perhaps nerves) through their physical structure or Newtonian forces. Such notions contrasted with animist or vitalist notions that were promoted by, for instance, the teaching of Georg Ernst Stahl and his concept of the healing power of the anima or soul. There were, too, notions of the need to stimulate or depress bodily functions, which became the essence of the Brunonian theory at the end of the century. Given multiple theories amidst remnants of galenic humoral doctrine, it is not surprising that theoretical positions could also straddle various concepts.[3]

One question of interest is how did theories of drug action translate into actual practice? Physicians generally chose medicaments out of a fairly basic armamentarium irrespective of their theoretical persuasion. What could be significantly different, however, was the regimens in which the medicaments were used; for instance, the frequency of use, especially of "favorite" medicines, the dosages, and the formula in which the principal medicine was compounded. The adherents of Stahl's teaching viewed opium as a remedy oflast resort, because it was thought to suppress the healing power of the soul (anima). Stahlians had similar objections against the treatment of fevers with Peruvian bark. Their negative attitude was here shared by Galenists who were worried about the lack of evacuant power in the bark, while iatrochemists and iatromechanists appeared as supporters of the new drug. And Christa Habrich, a noted expert on Pietist medicine, has observed that sal nitrum or saltpeter (potassium nitrate) was popular with Stahl and his whole school as a cooling salt (Habrich, 1991), a comment we also find in a 1768-1770 German translation of William Lewis' Edinburgh Dispensatory.

Such interpretation is derived largely from the writings of ?academic? medicine, which included not only teachers, but also those interested in researching why or how a drug influenced a disease process. Yet in trying to feel the pulse (or pulses) of eighteenth-century therapeutics, we have also to consider what we would now call the primary care physician practicing away from academic centers.[4] After all, there is every reason to believe that variations in the therapeutic practices of individual physicians resulted from many factors, aside from their diagnostic abilities; for instance, their theoretical leanings, the extent to which they relied on textbook knowledge, on their own teachers, and on their own experiences, as well as taking into account the class and social circumstances of patients. This has always been part of therapeutics.

The strengths and weakness of practicing on the basis of clinical experience -- commonly viewed as the empirical approach -- have aroused much debate over time. In modern parlance, it is a question whether to practice by the patient or the book. It is noteworthy that the eighteenth century commonly extolled the importance of empiricism in practice. At the beginning, Friedrich Hoffman, for example, the influential colleague of Stahl (albeit favoring iatromechanical rather than Stahlian animist concepts), stated: "The safest way to choose effective drugs is a posteriori, from experience and observation."[5] Physician attitudes to popular or lay medicine, which was generally permeable to ideas from conventional practice, also had a bearing on variations in practice. Physicians commonly denigrated popular medicine, but there were those who placed some confidence on the supposition that popular medicine rested on generations of experience, at least if the magical/astrological aspects are left aside. They also may have recognized folkways as a prudent and economical alternative to expensive treatments, as can be seen in the many medicinae pauperi or recipes for the common folk that persisted until well into the 18th century, when they slowly morphed into self-help texts. The Advice to the People... by Tissot is a good example of this transition.

Noteworthy are comments in the Wagner manuscript, for instance, with respect to vomiting: "The common people use only tea of Alexander which has helped many." For convulsions or spasms of the bowel, the author stated: "Thanks be to God, I have found the following method to have served me well and often in many cases. First two or three doses of my Anti-Emetic powder every hour in a Tea of Alexander". And, for tenesmus (a strong tendency to want to pass faeces): "The common people drink tree oil [olive oil] and consider this good." (see folios 19 verso-21 recto of the Wagner manuscript on this website for these quotes and the context).

Such comments suggest that experience was at least a significant factor behind what Wagner felt worthy of passing on. And this leads us to the larger question of audience or intended audience in the medical market place. In the following, therefore, we offer a few comments on the market for medical and pharmaceutical literature in the decades before the American Revolution.

The audience

Before the 1760s, American print culture was in its early stages and divided by language and region. It lacked suitable printing presses and the complex fonts needed for pharmaceutical texts. The market for learned works was small and oriented to European centers of learning and authority. As a result, the corpus of original American medical imprints, in particular dispensatories, is small until the late 1760s.[6] Among those of interest in our context is Nicholas Culpeper, published in Boston in a bastardized pirate edition, John Tennent's and the herbal almanac series by the radical Pietist printer C. Sauer. Cotton Mather's Angel of Bethesda remained in manuscript until this century.[7] The absence of a coherent and structured medical culture and patient population forced educated medical providers in the colonies to rely on European imprints and imported texts and journals to keep their practice up to date. Until the end of the 18th century, both physicians and the educated lay public had to turn to publications from their countries of origin, whether England or the German presses.

De Benneville may therefore well have intended to close a gap and compete with European imports or even the new English language manuals coming off the Pennylvania presses in the early 1770s, when the American market began producing local imprints of self-help manuals and dispensatories of various provenance. Buchan's Domestic Medicine or the Family Physician (Philadelphia, 1774) and S. A. Tissot's English version of his famous self-help book published in 1771, again in Philadelphia, as Advice to the People... were only the most prominent and successful on this list.[8] Local German publishers began to put out domestic and veterinary medicine imprints.[9]

These new manuals threatened the main American printer of German almanacs, Christopher Sauer, son of the famous radical printer, who had published his serial edition of mainly botanical remedies beginning in 1762 and ending in 1778. Here, he drew on a wide range of early modern sources, in particular Zwinger's Vollkommenes Kräuterbuch.[10] It is not unreasonable to assume that de Benneville, a close associate of the Sauer family, had been asked -- or offered -- to provide a larger and more sophisticated dispensatory joining spiritualist concepts and a more learned and inclusive level of practice. His manuscript shows every sign of having been intended for a bilingual audience of dispensing practioners; subsequently, a lay audience at the upper end of the market may have been included, as indicated by the fanciful double and bilingual title page. De Benneville was known both as a universalist minister and a physician, and he may also have hoped to address those who were joined by their profound religious beliefs and a rejection of purely secular and rationalist principles in medicine, from Quakers to Universalists.

However, the Medicina Pensylvania remained unpublished. The Sauer press was dismantled during the Revolutionary War because of the loyalist sympathies of the family,[11] and one successor, Michael Billmeyer, reprinted parts of the Sauer herbal but apparently no longer saw the need for the more costly de Benneville dispensatory. By the 1780s, the new medicine of North America was looking elsewhere for its theories of disease causation, although its urban and rural practitioners still used, often to excess, many of the remedies developed over centuries of mixed chemiatric and Galenical practice. As noted, we find many of these medications, minus the more complex products, and courses of therapy embedded in the voluminous self-help or domestic manuals that became of mainstay of American publishing by the end of the 18th century.[12] But these new manuals were clearly structured to address a domestic audience, particularly of women, and eschewed learned discourse in favor of a didactic and homiletic approach.

The purpose of dragging the Medicina Pensylvania and the Remediorum specimina from their repositories for examination and wider dissemination lies in the conviction of the makers of this website that whatever barriers of politics, language and understanding prevented their publication or further elaboration as a medical vademecum, we can still gain insight into the practices introduced to a sparsely settled continent with few generally accessible and widely approved medical resources. The Medicina Pensylvania and its companion volume, the Remediorum Specimina ex Praxi A. W., are examples from a closely knit network of Central European dispensing physicians and pharmacists who practiced and served the medical market in colonial North America and continued their medical traditions into the New Republic.

Website Objectives

Presenting these two previously unpublished manuscripts in the Historical Medical Digital Library of the College of Physicians is intended to fulfill a number of specific objectives:

In the following, we have provided explanatory and supporting material about the background, structure and content of the two manuscripts. Editing and search conventions are summarized in Technical Notes. For full bibliographic references cited in the text, the user should consult the Selected Readings provided as part of this supporting material. The readings are a brief selection culled from the 17th and 18th century printed primary sources relevant to the manuscripts, and selections from the rich secondary literature in the field. We have presented this secondary literature by topic to permit easier access to this material.

Acknowledgements. The construction of this website was made possible by the cooperation and support of numerous individuals and organizations. Funding was provided by the National Library of Medicine under a publications grant (1 G13 LM 007664-01; Renate Wilson, Johns Hopkins University Bloomberg School of Public Health, Principal Investigator) and by a matching collaborative grant of the Alexander von Humboldt Foundation in Germany (III-TCFO-DEU/1113677; Renate Wilson and Jürgen Helm, Martin Luther University, Halle, coinvestigators). The College of Physicians in Philadelphia, at the initiative of their former archivist, Charles Greifenstein, and Edward Morman, College Librarian and Director, Francis C. Wood Institute for the History of Medicine, graciously offered both the Medical Historical Digital Library as a site and the Medicina Pensylvania of George de Benneville for imaging and transcription. David W. Luz, Executive Director, Schwenkfelder Library & Heritage Center, generously afforded access to and imaging rights for the Remediorum specimina aliquot ex praxi A. W., the second manuscript from the rich heritage of colonial medicine which this project hopes to uncover more fully.

The transcriptions were done by two researchers of considerable experience with 18th century German manuscripts, Axel Utz, Penn State University, and Elisabeth Quast, Göttingen, who also prepared the final bibliography. Responsibility for criteria of usage and rendition, consolidation and standardizing of the English transciption of the Medicina Pensylvania, and the translation into English of the Remediorum specimina into searchable text was shared between Jole Shackelford, University of Minnesota, John K. Crellin, Memorial University of Newfoundland, and Renate Wilson, Johns Hopkins University.

Imaging, software selection, and the intricate and demanding task of website design and construction were carried out with admirable skill and patience by Charles Greifenstein, now at the American Philosophical Society, and Laura Blanchard, Philadelphia Area Consortium of Special Collections Libraries. We are indebted to the librarians at both sites, in particular Hunt Schenkel, archivist of the Schwenkfelder Library and Richard Fraser at the College of Physicians, and to Christine Ruggere and the late Linda Bright at the Library of the Institute for the History of Medicine at Johns Hopkins. Jennifer Dyer was responsible for formatting the text, PDF tables and final proofs. Especial thanks to Hal Cook, Director, Wellcome Institute for the History of Medicine, University College, London, for sharing the Hayne manuscript with us. We are deeply indebted for expert advice and suggestions to Gregory Higby, Director, American Institute for the History of Pharmacy, James Green, Librarian at the Library Company of Philadelphia, Joel Fry, Curator, Bartram Gardens, Richard Kahn, University of Vermont College of Medicine, Wolf Dieter Müller-Jahnke, Heidelberg University, and Mary Fissell, Johns Hopkins University. Allen Viehmeyer, a consultant to the Schwenkfelder Library, introduced the project team to the rich history of the Schwenkfelder community.

Above all, however, the principal investigator fully and gratefully acknowledges the indispensable support and advice of David L. Cowen, Emeritus, Rutgers University, and of Jacob Woodrow Savacool, Jefferson University Medical School, who did not live to see this project to completion. Both were her mentors on the road to Pennsylvania medicine before the War of Independence. Without their generosity and deep knowledge, both manuscripts would still slumber in their repositories, their history unattributed and unattributable.

Endnotes

  1. For full references to their works and other primary and secondary literature cited in the text in an abbreviated format, see the Selected Readings.
  2. For a more extensive and annotated version of the following, see J. Crellin, "It is a proven remedy: 18th century perceptions of clinical effectiveness," paper delivered at the International Congress for the History of Pharmacy, Edinburgh, 2005.
  3. For a recent overview in English of theoretical positions, see A.-H. Maehle, Drugs on Trial: Experimental Pharmacology and Therapeutic Innovation in the Eighteenth Century, Rodopi, Amsterdam, 1999.
  4. In colonial North America, most medical providers were of this kind and we still know little of their therapeutic background and persuasions. See, for example, Estes, 1980, 1987. However, there were apparently quite a number of practitioners influenced by Stahl's teachings, among them C. E. Thilo, a colonial practitioner in Georgia and student of Juncker, whose opposition to Peruvian bark in particular aroused the ire of Savannah physicians (Wilson, 1991, 2000).
  5. Friedrich Hoffman, Fundamenta Medicinae; translated and introduced by L. S. King, London: Macdonald, 1971, p. 119. See also Lanz, 1995.
  6. David L. Cowen, America's Pre-Pharmacopoeial Literature. Reprinted in Pharmacopoeias and Related Literature in Britain and America, 1618-1847, Variorum Collected Studies Series, Aldershort, 2001, pp. 185-221.
  7. For Culpeper, see the Boston edition of his Pharmacopoiea Londinensis (D. L. Cowen, 1956, "The Boston Editions of Nicholas Culpeper," Journal of the History of Medicine and the Allied Sciences,11: 156-165); Tennent, John, 1734. Every Man His Own Doctor: or, The Poor Planter's Physicia (Williamsburg, Parks. A German translation was published by B. Franklin in 1736). Jones, Gordon W., ed., 1972. Cotton Mather: The Angel of Bethesda (Barre, Mass.: American Antiquarian Society and Barre Publishers).
  8. Buchan, William, 1774. Domestic Medicine; or, The Family Physician,(Philadelphia: Crukshank); Tissot, Samuel Auguste, 1771. Advice to the People in General, with Regard to Their Health..., (Philadelphia: Sparhawk).
  9. Ein wohl-eingerichtes Arzney-Büchlein...zum Dienst des gemeinen Mannes, insonderheit die Landleute heraus gegeben (Philadelphia: Miller, 1771). These texts are discussed by David L. Cowen "'Zum Dienst des Gemeinen Mannes insonderheit für die Landleute': The Domestic and Veterinary Medical Books Printed in Colonial North America and the United States in the German Language,"Orbis Pictus: Kultur- und pharmaziehistorische Studien: Festschrift für Wolfgang-Hagen Hain zum 65. Geburtstag, ed. Werner Dressendörfer, and Wolf-Dieter Müller-Jahncke (Frankfurt am Main: Govi-Verlag, 1985): 60-66.
  10. William Woys Weaver, in Sauer's Herbal Cures (2001, Routledge) has collated these publications from "Agaric to Zedoary," tracing much of the contents to Theatrum Botanicum, das ist, Vollkommenes Kräuter-Buch, by Theodor Zwinger (sr), Basel, 1696.
  11. That de Benneville himself, born and reared under the patronage of Queen Anne, would have remained loyal to the Crown is hardly surprising.
  12. Among the rich secondary literature on English-language manuals, see Murphy, Lamar Riley, Enter the Physician. The Transformation of Domestic Medicine, 1760-1860 (Tuscaloosa: University of Alabama Press, 1991). For German imprints see Cowen, David L., "Zum Dienst des Gemeinen Mannes insonderheit für die Landleute."


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