Are researchers really mining medieval texts for ideas they can apply to modern medicine? Yes they are! Listen to Anne Renwick speak about the current efforts that inspired Evie’s character and work in A SNOWFLAKE AT MIDNIGHT.
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The Nobel Prize in Physiology or Medicine 2015
Take a look at the illustrated Old English Herbal
“Many of these recipes are complex, which makes them perfect for investigation. Take this eye salve, for example.” Bracken read aloud from the notebook. “Onion or leek. Garlic. Wine. Ox gall. A brass vessel. Mix and let sit for nine days.” He smiled, smug. “A laboratory project easily conducted. We test the antimicrobial activity of all combinations in order to tease out any and all active ingredients. Brilliant.”
PODCAST TRANSCRIPT: Getting Medieval
Hello. I’m Anne Renwick, steampunk romance author. Welcome into the laboratory. This is Episode Six: Getting Medieval. It’s part two, really, about where the ideas for A SNOWFLAKE AT MIDNIGHT originated.
After hunting down mistletoe properties, I needed to find a way to introduce the cure. I spoke about that in my last podcast, Episode Five: Medical Mistletoe. So if you missed that episode, you might want to go back and listen to that, if you’re wondering what I’m talking about. I wanted to have my character discover this formula, this cure for her father. So where was she going to find it? So I’m rabbit holing through the internet looking for things, and then I find “ancient medical texts”
As the theme of my plotting was already leaning toward sort of druidic cures using mistletoe, I ended up focusing my research on the texts that would have been available in England – and found myself all the way back in medieval times.
Now, when we think about medieval medicine, all sorts of horrible thoughts come to mind, but… did you know that there’s a 1000-year-old Anglo-Saxon antibacterial remedy that can still cure your eye infection today? In fact, it might just work better than any of our so-called modern treatments. This cure comes from a text known as Bald’s Leechbook, and it’s one of the earliest known medical textbooks.
Now, if you’re like me, you heard that word “leech”. Leechbook. What? Are they using leeches where they stick leaches onto your skin to suck blood from you? If you’ve read enough historicals, you’ve certainly run into that. So yeah, that’s the first thing that sprang to my mind as well. Leeches. But you’d be wrong in this case, the word leech and leechbook is coming from “leech”, the old Anglo-Saxon, which means “to heal”. So “leechbook” is a “healing book”. Now, that’s not to say that leeches can’t, the animal leaches, the annelid worm, can’t be useful in modern medicine. In fact, they’ve brought it back and in recent times they’ll bring out the jar of leaches and attach them to, say, a bruise or to a hematoma, a large collection of blood.
Because what our leech is good at, they’re good at drawing out the blood. Are we still bleeding people to remove the bad “humors” that are flowing through their body, making them sick? No. We’ve got very targeted purposes for leeches.
Let’s jump right in. So I find this interesting reference about a cure from the medieval textbook, and I start to dig deeper. And I find that one doctor, Christina Lee, an Anglo-Saxon expert at the University of Nottingham, has worked with microbiologisst to test this ancient cure that she has pulled out of a manuscript, out of Bald’s Leechbook.
Now, we’re going to pause right there for a minute before I start getting into the specifics of what experiments they did. And I want to remind you that you’re often going to hear the terms in vitro and in vivo when I’m talking about testing something in a biological system.
So “vivo” contains the root word for life. And so in vivo means “tested in life”. Like in a living human or perhaps a lab rat or some other sort of research animal.
In vitro, on the other hand, means tested outside the living body. So if you hear in vitro, we’re talking about test tubes or Petri dishes or some other kind of vessel that can incubate cells.
Okay. So back to Dr. Christina Lee, our Anglo-Saxon expert. She ended up working with these microbiologists at the University of Nottingham to test this cure. And I’m linking in the show notes to a fascinating video of her speaking about her role and some of the microbiologists who are involved also speaking about their role.
I would definitely recommend watching that when you have a chance. If you watch the video, you’ll also have the opportunity to hear the ingredients, the names of the ingredients pronounced out loud by an expert.
Okay. So this remedy is being tested in vitro and Nottingham. And then later on when they had success, they had it tested in vivo in the United States. And those researchers here in the United States used mice. And both of them found that this 1000-year-old cure works against MRSA, which is methicillin resistant staphylococcus aureus, a particularly worrisome antibiotic resistant bug.
And another clarification here. When I say bug, I’m not talking about an insect with legs. Microbiologists will often call a bacterium, singular form, of bacteria, or a strain of bacteria, a bug. As in, I’ve caught a bug. I’ve caught a germ, which now that I think about it, we’re probably also using in everyday life to describe viruses, which is a whole different thing.
MRSA and certain other bacteria cause a lot of trouble by forming something known as a biofilm. It’s a kind of slimy extracellular matrix that they exude and then sort of tuck themselves into this bacterial slime layer. They hide in it and this makes them anti-bacterial resistant because the drugs that might kill them or other substances that might harm them, can’t get to them. And, as biofilm is actually a very complicated sort of environmental thing, they forme colonies, they form threads. You can read up on that if you’d like to.
These microbiologists grew MRSA in a Petri dish, and then they added very carefully prepared Bald’s Eyesalve to the culture for 24 hours and were absolutely stunned when they saw how much bacteria were killed off. So this was so wonderful that they said, “we need to test this in vivo“. And they sent the recipe to someone in the United States who did wound treatments, and they applied this Bald’s Eyesalve to a wound – and the United States researchers found that this treatment actually worked better than the conventional treatment. So how does this Bald’s Eyesalve work? They’re not exactly sure, other than it appears to attack the bacteria in several different manners at once.
And it’s also possible that when they mixed up these ingredients to create Bald’s Eyesalve that there was some sort of unique chemical reaction that occurred as the ingredients were left to stand. It’s currently under investigation.
But Anne, you may be asking, what are these components involved? Bald’s Eyesalve. Here’s the list. There’s wine – and these researchers went to a lot of trouble to get the right kind of wine, going to a vineyard that had been present in England for a very long time. So we have wine, they also have garlic, and some of you may be going, garlic’s got antibacterial properties. I know about that. The ingredient also listed leeks, which is an allium species, and ox gall. Secretions of a gallbladder, I assume, which originated from a cow’s stomach. Now the directions for making Bald’s Eyesalve: mix all these ingredients together and let them stand in a brass vessel for nine nights before use brass.
Okay. Now does this formula sound a little bit familiar to those of you who have read A SNOWFLAKE AT MIDNIGHT? It should. I couldn’t resist writing this cure into the story. And here’s the passage from the book as spoken by our villain.
“Many of these recipes are complex, which makes them perfect for investigation. Take this eye salve, for example,” Bracken read aloud from the notebook. “Onion or leek. Garlic. Wine. Ox gall. A brass vessel. Mix and let sit for nine days.” He smiled, smug. “A laboratory project easily conducted. We test the antimicrobial activity of all combinations in order to tease out any and all active ingredients. Brilliant.”
Now I want to address the brass component of this recipe for a minute. Brass is an alloy of copper and zinc. And copper is known for possessing antimicrobial properties. In fact, there’s been studies done that show that surfaces that are frequently touched in medical environments, yet covered in a copper alloy.
Brass or bronze will actually kill a wide range of microbes. Which is why Evie and Dr. Wilson in A SNOWFLAKE AT MIDNIGHT were writing the – emphasis on fictional paper – titled “A survey of metals and medieval remedies, magic or medicine – a reexamination of an 1865 translation of medieval medical texts”.
Which text? Why none other than Leechdoms, Wortcunning and Starcraft of Eearly England, a translation of 11th century Anglo-Saxon medical texts by one Oswald Cockayne in a three volume set. Bald’s Leechbook is found in volume two.
So if you caught that date, translated in 1865, and you may recall that A SNOWFLAKE AT MIDNIGHT was set in 1884, there would have been every chance that our character, Evie, could’ve put her hands on this particular book. And given the plot events, it’s very possible that our character, Evie, would have been aware of this particular treatment for eye infection, Bald’s Eyesalve.
Now, who is this man, Cockayne?
He was a teacher for his day job and, on the side, he was busy translating all kinds of texts. Cockayne, when he wrote this translation, was pretty dismissive of certain parts of these ancient texts, labeling them as “magic” and not worthy of medical consideration.
To be fair, there’s often a lot of strange-sounding instructions when one is mixing up the ingredients in these ancient medical texts. So oftentimes in his books there’s a metal that is used in the cure, like we just heard: let the ingredients sit for nine days in a brass vessel. And Cockayne is often dismissive of the metal used in this cure as well.
But today, we now know that copper, silver, cobalt, nickel, zinc, zirconium, modibium, I think I said that right. These metals are also antimicrobial in that they can cause a disruption of the bacteria cell wall and can also disrupt other cellular components within the organism itself.
So do we use these metals in modern medicine today? Why, I can give you one example. I’ve got it in my own house. You can buy silver gel and use it sort of like the standard triple antibiotic ointment that you might be familiar with. You can apply it to small cuts to infected areas. It works great. It’s especially wonderful for a paper cut that’s getting a little inflamed or perhaps a slightly infected hangnail. You just put a little silver gel on, wrap it with a band aid, wait 24 hours, and it really works well.
Okay, so back to A SNOWFLAKE AT MIDNIGHT and our story. Evie and Ash decided to compile a kind of database to mine the data of these ancient texts, and they’re looking over a wide range of time periods from medieval to what would be fairly modern time for them.
Now, this idea didn’t just jump right into my head. It’s based on a current reality. There is a group called Ancient Biotics, and I’ve linked to them in the show notes that has formed. This is a group of medievalists who are working with scientists throughout multiple universities and countries to compile a database of recipes from these ancient texts.
Before I talk more about their particular group, I want to pause for a minute and point out that not just European medieval medicine is being reexamined in such ways. Ancient Chinese literature on herbal medicine has also been reexamined. In fact, in 2015 chemist Youyou Tu won a Nobel prize in physiology or medicine.
She’d reexamined an ancient manuscript. And found a “new therapy for malaria”. Where did she find it? In a 1,600-year-old text in a recipe titled “emergency prescriptions kept up one’s sleeve”. Not only did she find this old recipe, she recreated it and even volunteered as the very first test subject. Now I’ll link in the show notes if you’re interested in reading more about what she was up to.
Okay, so back to my ancient medieval texts, back to the Ancient Biotics group. So what I found while I was diving down my rabbit hole chasing all this fascinating, interesting information about how ancient texts were being reexamined using modern scientific principles, and I found an article written by Erin Connelly at the University of Pennsylvania who was working on this database. She has a doctorate in Medieval English, this after completing an undergraduate degree in biology, and she is currently putting herself in the position to study a book known as, I hope I’m saying this right, as the Lyle of medicines. This is a book in Oxford’s Bodleian Library known as Ashmole 1505
I’d like to pause here a moment to note that the word “ashmole” might be ringing bells for those of you who have read the book A DISCOVERY OF WITCHES. Yes. That Ashmole and that library, which really is why I dragged our family on the tour of the Bodleian Library when we last visited London a few years ago. If you ever get the chance to tour this library, it’s very much worth it. They even still have a few books on chains to illustrate how they used to ensure that their books stayed in the library. And by the way, the Bodleian Library was the inspiration for the library set at the Hogwarts School.
So back to Dr. Connelly. She’s the first person to translate into modern English. This 15th century, middle English translation of an even older Latin text. This book, the Lyle of medicines, contains 6,000 ingredients in a total of 360 recipes that are used to treat over 110 disease states.
What do I mean by that? Well, there’s a lot of things they treat. Here’s a list of a few of them. They treat broken skin, redness, foul smell, black crust. I’m not sure what that is, but it sounds bad. Pustules, boils and cancer. If you’ll recall from my last podcast, I did point out that in such times in the medieval era that cancers would have been limited to those they could see on the skin. There wasn’t any kind of internal abdominal surgery going on to remove tumors.
So these people who are database mining and then intend to study these various ingredients are facing a number of challenges in compiling this database. They have spelling issues. Perhaps you’ve looked at some of these older books and you notice that the spelling is just sort of phonetic and it changes from text to text, person to person, document to document.
Not only do they have spelling challenges, but sometimes the term used for an ingredient doesn’t necessarily have a modern word equivalent, or perhaps it has two. Or three and they have to decide what that person writing the text actually meant. There’s no one to ask on top of that, the details are not always there.
Sometimes when a plant is harvested will really matter, what components are in it at the time. Also, it matters which part of the plant are you using to create the secure, the leaves, the stem, the roots, the flowers. It’s not always noted and well, sometimes it is, and sometimes it’s not. Moreover, they’re finding multiple plants are recommended to treat one particular disease, and there’s no notes on how to choose between these various options.
Why is the textbook lacking in these particular details? Well, that’s probably because your medical practitioner trained under someone and it was assumed that they already had this information in their knowledge bank.
Another problem with studying plants and their bioactive components is standardizing those bioactive components, measuring the exact concentration that that plant has produced. That’s a concern. And that’s assuming that that active component can be separated from what might be other active components in the same plant. So this is always a risk factor when you’re dealing with an herbal medicine. Standardization of components. That’s why it’s so, so important to consult an expert and to do all your research before you decide to use an herbal remedy.
So I really, really, really wanted to use an ancient textbook in my story, but how was I going to do that? So I had to do more research. I dove into a book called MEDIEVAL HERBAL REMEDIES, link in the notes, that studies a book known as the OLD ENGLISH HERBARIUM. Yes. It’s also one of those books that was translated by Cockayne. Back to him again.
So there are four existing copies of the OLD ENGLISH HERBARIUM. Only one has illustrations. The one with illustrations is located in the British Library. Good news. You don’t actually need to travel to London to look at it. You can look at the OLD ENGLISH HERBARIUM and its illustrations from the comfort of your own desk, from your laptop, from your desktop. And I have linked to this in the show notes. If you’re curious. So these illustrations and the OLD ENGLISH HERBARIUM are not actually really helpful to our modern eyes to even help identify the plant they’re speaking about. Again, it was assumed you had been trained and that these illustrations were more just to sort of jog the memory.
As I read through medieval herbal remedies, learning all about these ancient cures, and the translations, and Cockayne himself, and what was being studied at the time, it started to plant seeds of ideas for what would adventure become the fictional work: Hardwicke’s Leechbook doesn’t really exist. Made this one up. This is the fictional medieval text that is discovered in the course of the plot by Evie and Ash, and as written by the fictional character, Brea. So I took us all the way back into Old English which, despite its name, is another language altogether from English.
You’ll sort of look at the words and think, yeah, I should be able to read that. You can’t, it’s a whole different language. Unless of course you’re studying Old English. So this book is fictional, as is the recipe they find to cure Evie’s father, which I discussed again in last
In fact, I used an old English translator I found online. Again, there’s a link to it in the notes if you want to take a look, but how do you pronounce them aloud? this is something my audio book narrator and I had to run around and try and figure out. And kudos to her for finding someone who actually knew how to pronounce Old English words.
So that’s the story of A SNOWFLAKE AT MIDNIGHT. It started with me hunting down the medical properties of mistletoe and wanting to play around with a little bit of the druidic traditions that have made it into Christmas. And then that landed us all the way back in a medieval manuscript, which even today, researchers are starting to look through because, with the rise of resistant strains of bacteria, we’re looking for new ways to cure infections.
All I had to do was take mistletoe, place it in an ancient fictional text, and use those Old English words and bring in some of the plants, the Druids considered sacred. And we had a
Thank you so much for listening. I hope you enjoyed hearing me talk about ancient medieval textbooks and the role they play in modern medicine.
Next time on podcast number seven, I’m going to go back to THE SILVER SKULL and talk about some of the science that we find in there. In particular, addressing bone physiology.