Anglo-Saxon Medicine: Not ALL Leeches and Cow Dung

Over the past few years there have been more and more articles and social media posts about the Anglo-Saxons, the denizens of the ‘dark’ ages. People know more about the rulers, battles, and beliefs of these people but what about their medicine? Their healing potions and practices?

In Northern Queen, my main character Aelfgifu has to treat a man injured by a sword and who has a head wound. While researching the scene I was astonished to find how sophisticated Anglo-Saxon medicine actually is.

England is unique amongst European countries in that there survives an extensive medical literature from the Anglo-Saxon period in a vernacular language. Other surviving texts from Western Europe are all written in Greek or Latin. The sheer number of surviving manuscripts illustrates the importance of medicine to the Anglo-Saxons. There are more than a thousand pages of medical notes written in Old English still in existence. The works contain translations of Greek and Latin medical treatises but also have original local cures unknown on the continent.

The oldest known English medical work was written by Aldhelm of Malmesbury in the late seventh or early eighth century. The work, called Enigmata, is a series of writing on illnesses and their treatments. The author includes a number of cures for eye and skin ailments and mentions plants still in use today (ie wallwort).

For this article I’m going to focus mainly on a single manuscript (Bald), although there are three ‘main’ early manuscripts. The first two are contained in a collection unromantically titled “London, BL, Royal 12.D xvii”. The manuscript was written in Winchester around 950 and is comprised of three parts. The first two are known collectively as Bald’s Leechbook. (‘Leech’ in this case does not refer to the animal but is an archaic word for a doctor: læce).

BaldLeechbook
Bald’s Leechbook (Photo: British Library)

The third part of London, BL, Royal 12.D xvii is referred to as Leechbook III. Leechbook III is less contaminated by classical medical ideas from the continent and it follows a traditional schema, ordering the symptoms and treatments in order from head to foot.

This third manuscript is, again unimaginatively, titled “BL, Harley 585”. Thankfully it’s also known as Lacnunga, which means ‘Remedies’. It was written later than Bald’s Leechbook and Leechbook III and contains less medical advice and more charms.

There are a surprising number of illnesses addressed in these books. Bald, in his section on eyes, lists the following different types of recognised conditions: mistiness of the eyes, inflammation, scarring of the cornea, pain in the eye, cataracts, and styes, among others. Treatment of eyes takes a large amount of space in the books; in a world without corrective lenses or safety goggles, and where sitting in your dark home with the fire burning for hours must certainly have affected your vision, it’s little wonder the Anglo-Saxons put a premium on eye care.

Bald structured his work by starting with a list of symptoms and their appropriate diagnosis, then treatment, and finally a prognosis. Other medical texts from the time do not include a prognosis; Bald is unusual in this respect. He even tried to distinguish between different types of pain that could appear in the body’s side, recognising those that were treatable and those that weren’t.

But did any of the treatments work? In a word, yes. While charms and prayers were still being said over a patient (“Eorþe þe onbere eallum hire mihtum ⁊ mægenum – Earth bear on thee with all her might and main”), there are a large number of cures in the books that are very effective.

One of Bald’s cures for an eye infection is to create a salve:

“Take onion and garlic equal amount of both, pound well together, take wine and bull’s gall equal amounts of both, mix with the leeks, then put in a brass vessel, let stand for nine nights in the brass vessel, strain through with a cloth and clear well, put in a horn and about night time put on the eye with a feather, the best remedy.”

Without knowing anything about bacteria, the author of this treatment has created a treatment for staphylococci. Onion and garlic have antibiotic properties and bull’s gall, with its detergent properties, is still in use today (now called oxgall). And by boiling the ingredients with the wine in a brass container, the mixture collects copper salts, an antibacterial ingredient. (Many of the cures in all sources include boiling specific ingredients in copper or brass pots). It is this cure that was recently discovered to be an effective treatment for superbugs or MRSA.

pots

Pots similar to these were used to prepare medical remedies

Bald must have devised his cures through careful observation and record-keeping. Another example of a particularly effective ‘dark’ age treatment was the inclusion of plantain in numerous medicines. The plant, now known to have antibiotic qualities, was crushed and used to treat skin infections. According to biologist M.L. Cameron “Against a culture of staphylococcus aureu, 1 ml of 2% aqueous solution of aucubin (the antibiotic ingredient in plantain) had … the same effect as 600 I.U. of penicillin.”

drawing - plantain
Plantaine

There are many examples of Bald’s expertise with medicine. His treatment for a harelip included a plant with antiseptic qualities as well as a binding agent to aid in healing. The section on amputation includes an antiseptic plant as well as leek leaves, which help with scabbing and prevent scarring. And there is evidence to suggest that these early physicians were familiar with the pain relieving effects of mandrake, poppy, and henbane.

220px-Poppies-seeds-dry
Dried poppy pods and seeds

A myth perhaps many people share is the use of leeches (the creatures this time, not the doctors) for bloodletting. There is actually no record in any of the Old English medical texts suggesting the use of leeches. Bloodletting was performed, but under the guidance of very specific rules concerning the time of the year and month when it would be effective. Bald even cautions about the consequences of such a treatment.

leech
Hirudo medicinalis – The European Medicinal Leech (Photo: Wikipedia)

Not so ignorant after all, the Anglo-Saxons. They used early scientific practices such as observation and documentation, calculated exact dosages of potentially dangerous ingredients (poppy or mandrake) and cured diseases and conditions still in existence today, using some of the same ingredients we use. And they were realistic. Bald’s advice for dysentery: “If the pottage and the drink remain inside, then you may cure the man; if they flow out, it is better for him that you do not deal with him, his fatal illness is upon him.”

And not so unlike us today either. Many cultures still believe in the power of prayer as an aid to healing. Charms and tokens are still worn, for good luck . But we do it, one thousand years later. Because, like the Anglo-Saxons, we have the same fear of illness and the same trust that our physician will help us. And judging by the margin notes on leechbooks, the same healthy scepticism about certain cures. Not much has changed.

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