Snake oil charms of popular medical history

The mention of ‘snake oil charms’ in the King’s speech at the opening of Parliament in July reminded me of one of the most unusual cases I encountered in my final years as a consultant surgeon, writes Bryan Rhodes.

European adder in dried grass next to a log.

Adder photo by Illuvis, Pixabay

A middle-aged man had gone for a stroll close to Fell Foot Park in the Lake District and sat down on a flattened patch of long grass. Suddenly, an adder appeared between his legs, and as he lifted his arm in self-defence, it bit him on the right hand. Despite the administration of two different types of anti-venom in A&E, by the following day swelling and discolouration was spreading up his arm, and I was beginning to consider whether an amputation could become necessary.

The adder is Britain’s only venomous snake, so mortality from snake bites is quite rare in the UK, roughly one a decade. Worldwide however, snakebite envenoming kills about 100,000 people a year, so it is perhaps surprising that the snake has become such a widespread symbol of health and healing. Certainly, our patient survived, and fortunately, no surgical intervention was required.

Indeed, the coat of arms of the British Orthopaedic Association features the Greek demi-god of healing Asclepius, pictured as usual with a large snake winding its way up his staff, the snake’s head perilously close to the demi-god’s abdomen. There are many theories about the ‘Rod of Asclepius’ and associated snake including one that the snake’s ability to shed its old skin and generate a new healthy skin explains its presence. Another theory links it to the Old Testament story in which God tells Moses to ‘make a bronze snake, put it on a pole, and place it where people can see it; anyone who is bitten by a snake can look at it and live’.

White marble statue of Asclepius, Greek demi-god of healing, with his staff and serpent.

Greek demi-god of healing Asclepius Photo by Michael F. Mehnert, Museum of Epidaurus Theatre, via Wikimedia Commons

 

Folklore

In English folklore, adders were thought to be deaf, and oil derived from adders was considered a valuable treatment for deafness and earache. To obtain the oil an adder was caught and killed, its skin was lacerated multiple times, and it was hung in a warm location with a container placed below it to catch the viscous liquid dripping from its carcass. The Oxford Dictionary of English Folklore indicates that provincial chemists would purchase this snake oil from snake-catchers, presumably for onward sale to their customers.

The adder’s shed skin was also thought to have healing power: able to help extract thorns and splinters from a person’s hand. Traditional cures for an adder bite included oil from the offending snake, wrapping the victim in a fresh sheepskin, or applying a flat ‘snakestone’ to the site. Of all the strange historical treatments provided for adder bites in the centuries before anti-venoms, perhaps the most bizarre was that discovered in Wiltshire by the notable antiquary and natural historian, John Aubrey FRS (1626 – 1697) which involved fastening a succession of live pigeons to the site of the snake bite.

Norman Morrison, a retired Scottish police officer who developed a fascination for adders and published ‘The Life Cycle of the Adder’ in 1924 was himself bitten on the right hand by an adder and wrote about the experience and some of the traditional Hebridean ‘cures’ in his later publication ‘My Story’.

Snake oil salesman

The term ‘snake oil salesman’ now means the archetypal charlatan: the fast-talking seller of quack or fake cure-all remedies. The term has also spread more widely such that it is often applied to politicians, businessmen and anyone offering false hope or dubious treatments. The poor reputation of snake oil salesmen appears to be largely attributable to a Texan called Clark Stanley (b. 1854). In the late 1880s, Chinese itinerant railway workers commonly used a Chinese liniment derived from water snake oil.

Stanley produced an American alternative which he claimed to contain rattlesnake oil, which was sold widely across the US. The Pure Food and Drug Act of 1906 brought in a new era of scrutiny for all American products claiming medicinal properties, and Stanley’s Snake oil liniment was analysed in 1916. The product was found to be almost entirely mineral oil and didn’t contain any snake oil at all. Stanley was found guilty of ‘misbranding’ his product and fined $20.

Since the release of Captopril in 1980, an ACE inhibitor and anti-hypertensive drug developed following research by John Vane and Sergio Ferreira on a component of Brazilian pit viper venom, there has been increasing interest in the therapeutic possibilities of snake venom. There seems to be much less enthusiasm for the charms of snake oil!

Bryan Rhodes is a retired consultant orthopaedic surgeon. He is the book review editor of BSHM and the chair of the Lancaster Health and Medical Museum Collection.

References and further reading:

  1. A Dictionary of English Folklore, Editors: Jaqueline Simpson and Steve Roud, 2003, OUP
  2. Oliveira, A.L. al.  The chemistry of snake venom and its medicinal potential, Nature Reviews Chemistry, 6, 2022, pp451-469
  3. Morrison, N., My Story, 1937 Published in Inverness

 

 

 

 

“The forgotten man of Africa”

Standing on the deck of the exploring vessel Pleiad in July 1854, Edinburgh trained doctor William Balfour Baikie was about to lead an expedition into the interior of Africa to test the validity of a cure for malaria, writes Wendell McConnaha.

B&W photo of bearded man, formally dress, 19th century

William Faulkner Baikie at the time of his first voyage, Orkney Library

Baikie had been seconded to the mission sponsored by the merchant Macgregor Laird and the Royal Geographical Society, which would leave from Fernando Po, an island in Equatorial Guinea, now called Bioko. Baikie was initially to serve as naturalist and assistant surgeon, but a series of events had elevated him to the expedition’s leader.

For years, men had attempted to explore the path of this great river and, although they encountered natural barriers and local hostility, it was malaria that threatened to cut short the life of any European who ventured inland, and the Bight of Benin was referred to as the Whiteman’s Grave. As the anonymous rhyme said: “Beware and take care of the Bight of Benin. There’s one comes out for forty goes in.”

Although the death rate among Europeans traveling into the interior in this part of Africa often exceeded 70 percent, the focus up to the time of Baikie’s voyage was curing the disease rather than looking for a prevention, and even the preferred method for treating those contracting the disease remained in doubt.

Sailed 19th century exploring vessel
The exploring vessel Pleaid, Frank Cass & Co.

As early as 1630, Jesuit Brothers working in Peru had observed the Quechua Indians using bark from the cinchona tree in treating malaria. The bark was collected, dried, ground into a fine powder and mixed with water to form a strong tea. The treatment had quickly been adopted by the crews of slave ships traveling between Europe, Africa and South America. Royal Naval surgeons soon began utilizing the treatment for sailors who had contracted malarial fever. In 1817, two French chemists isolated the crystals within the bark naming their extract quinine. However, bloodletting and purgatives remained the standard methods of treating malaria within the general medical establishment.

Not just treating

In 1847 Dr Alexander Bryson, an Assistant Surgeon in the West Africa Squadron, presented the Admiralty with a report in which he announced the use of quinine had cut the mortality rate in half, and proposed quinine might also be used as a prophylactic. Baikie was convinced that Bryson was correct in his assumption.  Although the purpose of his mission was to explore the Niger and Benue rivers and establish trading sites, Baikie would also use his command position to conduct the first clinical trial testing Bryson’s theory.

Each crew member would be given two-thirds of a glass of wine containing five grains of quinine each morning and a second glass before retiring in the evening. Baikie was staking his reputation and the lives of those under his command on this untested theory. If he were correct, the centre of Africa would be opened to outside exploration.  If wrong, he could lose his life and the lives of all those entrusted to him.

On 7 November the Pleiad returned to Fernando Po. They had been on the river for 118 days, explored and charted over 600 miles, and established a series of trading sites. Most importantly, for the first time in the history of African exploration, they had completed the mission without the loss of a single life.

Baikie travelled to England, published the journal of his exploring voyage and then returned to the Niger, where he spent his last five years living alone among the Igbo. His enlightened approach in working with the indigenous people earned him such respect that to this day the Igbo word for “white man” is “Beke.” Baikie died at age 39 of tropical fever. Revered in Africa, his role in establishing a prevention for malaria is largely forgotten by the rest of the world.

Memorial to William Balfour Baikie
Memorial tomb to William Balfour Baikie (1825-1864),
St Magnus Cathedral, Kirkwall, Orkney Library and Archives

Professor Wendell McConnaha is a retired university professor in education who has worked around the world. When in Nigeria, he first learned of William Baikie and resolved to write his story, which he has now done in The King of Lokoja: William Balfour Baikie the Forgotten Man of Africa

References and further reading

Christopher Lloyd, The Search for the Niger, (London, Collins, 1973), pp. 21-22

C. M. Posser and G. W. Bruyn, An illustrated history of malaria, (New York, NY:

Alexander Bryson, Report on the Climate and Principal Diseases of the African Station, Printed by order of the Lords Commissioners of the Admiralty, (London, W. Clowes and Sons, 1847)

Recycling Penicillin from Urine in Post-War Germany

Limited supplies of penicillin and Allied restrictions on German access to the drug in the immediate aftermath of World War II led to its recovery from the urine of treated patients. Susanne Krejsa MacManus explains.

German research on penicillin started only in 1942 and then on a very small scale.[1]  Gerhard Domagk (1895-1964), the German scientist who in 1935 had developed sulfonamides, had advised the Nazi government to concentrate on improving of “his” type of antibiotics instead of trying to get its own penicillin production going.

It took Germany till the end of 1943 to really understand the importance of penicillin, but because of the efforts of the Allies to restrict information and materials,[2] German scientists were not able to learn about the right mould, nor could they develop the process to get a good supply.

From autumn 1945, British and American forces increased the amount of penicillin flown into hospitals in Berlin – mostly for their own soldiers as a treatment for sexually transmitted diseases. But the occupying forces faced a dilemma: on one hand, they had to look after the health of the population of the occupied areas; on the other hand, there was a hostile atmosphere against the German population – at least in the first months after the end of the war. Germany was categorised as a “defeated enemy” – in contrast to Austria which was categorised as a “victim”.

There was even a third aspect. The German pharmaceutical industry was known as being innovative and effective. The occupying forces hoped for “penicillin made in Germany” and encouraged companies like I.G. Farben, Hoechst and Chemie-Grünenthal to start such an undertaking.

The USSR did not have penicillin production of its own, although they claimed two of their scientists had invented the antibiotic long before Alexander Fleming. As early as early May 1945, Soviet forces who were eager to get penicillin as part of German reparations were pushing the German company Schering .[3]

Since one of Schering’s production sites lay in British territory, the company got support from the British element of the occupation forces for building laboratories and getting raw material (as this ad shows.).[4] 

Salzburger Nachrichten, 9/1/1946  Schering AG produces penicillin Berlin,  As the British broadcast has reported, the Germany pharmaceutical company Schering AG in Berlin will manufacture penicillin for Germany. The British military government has promised its support to the company in procuring the laboratory and the necessary material, so far as it is available in Germany.

But sufficient output was not available before the end of 1946/the beginning of 1947.

Two-thirds excreted

During their struggle to set up a production site, scientists at Schering recalled that two- thirds of penicillin given by injection left the body very quickly, so quickly that injections had to be repeated every few hours.[5] “If we could get the urine of patients treated with penicillin”, the scientists speculated, “we might be able to reclaim and concentrate this substance.”

The British and American forces permitted them to collect the urine from their hospitals on the condition that they got their share of the recycled substance. From March 1946, Schering’s scientists organised milk-churns and bicycles and went from hospital to hospital to collect patients’ urine. The recycling process was successful, and in spring 1947 it was extended into American and British areas of West Germany. In April 1949, nearly 5000 liters of urine from 3153 patients were collected from hospitals. This activity lasted till 1950, when the manufacturers’ penicillin production was sufficient to meet demand.

Recycling penicillin from urine was not a new idea, but its use on this scale was was exceptional. It showed that the German researchers had clearly understood the character of penicillin being excreted from the organism so quickly. Secondly, the process of recycling penicillin purified the substance, which at the initial injection had produced sharp and unpleasant feelings for the patient. And third, it shows how Schering’s researchers could act on their own initiative, without having to ask boards and committees for permission as they would have to do today.

Susanne Krejsa MacManus PhD is an independent journalist, author and archivist in Vienna. She is a member of the History of Medicine/Medical Humanities working group of the Commission for History and Philosophy of the Sciences at the Austrian Academy of Sciences (ÖAW).

References

[1] I. Pieroth: Penicillinherstellung – Von den Anfängen bis zur Großproduktion, Heidelberger Schriften, 1992, p. 103.

[2] P. Rostock: Die Wunde, Berlin: De Gruyter, 1950, p. 290.

[3] J.-P. Gaudillière, B. Gausemeier: Molding National Research Systems, OSIRIS 2005, 20:180-202.

[4] Schering A.G. Berlin produziert Penizillin, Salzburger Nachrichten, 9. 1. 1946, p. 2.

[5] J.H. Humphrey: Excretion of Penicillin in Man, Nature 3920, 1944, 765.