The pharmacy of the Benedictine monks: The use of medicinal plants in Northeast Brazil during the nineteenth century (1823–1829)
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The health of nineteenth century Brazilians is only alluded to in historical documents, and researchers still have much to discover.
Aim of the study
This study aims to show the medicinal plants used in the 19th century in Brazil.
Materials and methods
To this end, information was obtained from the prescription book deposited in the archive of the Monastery of Saint Benedict in Olinda, Pernambuco, northeastern Brazil, about the daily use of medicinal plants.
By analyzing the prescriptions, we ascertained the terms and/or species and diseases and/or symptoms that existed among the people who were treated at the Benedictine hospital between 1823 and 1829.
The data presented here are relevant to other subject areas, especially modern pharmaceutical research. This study seeks to demonstrate the importance of plant resources in the nineteenth century and aims, through the detailed study of documentary sources, to provide a wealth of new information to modern science. Understanding the practices of the past provides insight into and may lead to improvements in modern pharmaceutical practice.
- Historical sources;
- Historical ethnobotany;
Ethnobotanical research on medicinal plants has been developing for over a century. The therapeutic use of plant resources within distinct human populations has long been understood to be part of a system of knowledge subject to historical, geographical, cultural, economic and social influences (Vandebroek et al., 2004, Lozada et al., 2006, Reyes-García et al., 2006, Jaríc et al., 2007, Eyssartier et al., 2008, Lira et al., 2009, Liu et al., 2009, Molares and Ladio, 2009 and Thomas et al., 2009).
In Brazil, the ethnobotanical literature on medicinal plants has typically focused on the traditional use of these plants within a specific present-day cultural context (e.g., Medeiros et al., 2002, Medeiros et al., 2004, Albuquerque et al., 2007, Albuquerque et al., 2008, Albuquerque et al., 2011 and Almeida et al., 2011). In the development of scientific ethnobotanical discourse, few studies have been conducted from a historical perspective, and fewer still have used both data obtained from historical documents and more modern information derived from secondary literature (Medeiros et al., 2007, Medeiros et al., 2010, Rodrigues et al., 2007, Almeida et al., 2008, Brandão et al., 2008a, Brandão et al., 2008b, Alencar et al., 2010 and Scalco et al., 2010).
Other countries have also produced studies on medicinal plants within the context of historical ethnobotany. These have focused primarily on identifying the plants mentioned in ancient literature according to Linnaeus’ binomial nomenclature. The focus of such studies has been either on the pharmacopeia/traditional materia medica or on the history of the use of certain plant species (e.g., Moisan, 1990, Touwaide, 1997, Touwaide, 1998, Lev, 2002, Moussaieff et al., 2005, Lardos, 2006, Lev and Amar, 2008 and Pollio et al., 2008).
During the nineteenth century, Brazilian materia medica included products of both animal and mineral origin, but a much greater contribution was made to medicine by plant products ( Medeiros et al., 2010). Although there is written evidence showing that plants were widely used in Brazilian medical practice, few studies have been conducted to identify which plant species were used in nineteenth-century medical practice ( Medeiros et al., 2007, Medeiros et al., 2010, Almeida et al., 2008 and Alencar et al., 2010).
Because their medical practices were primarily derived from the Portuguese and French schools, the monks of the Order of Saint Benedict in Brazil provided medical care that was strongly influenced by Hippocratic and Galenic medicine. The buildings of this religious order always contained hospitals, clinics and pharmacies. Their laboratories played an extremely important social role in providing therapeutic aid to the communities adjacent to the monasteries.
A nineteenth-century prescription book from the archives of a Benedictine monastery in Olinda provided the source documentation for this study. The Monastery of Saint Benedict in Olinda, located in the historical city of Olinda, Pernambuco State, northeastern Brazil, was established in the year 1599. In its 412 years of existence, this monastery has played an important role in the culture, education, agriculture and health of the region.
The preservation of the prescription book of the Monastery of Saint Benedict in Olinda is probably due to the influence of the monastic tradition and of the Benedictine tradition in particular, which has, for centuries, maintained collections that serve today as important sources of information to many fields of humanities research. Regarding this preservation of documents, Silva (2003) has stated that various manuscripts have been maintained in Benedictine monasteries throughout the ages. The monasteries have therefore been able to preserve rare texts, key political documents chronicling the development of various regions and documents related to medicine, botany and horticulture, among other subjects (Ker, 1942, Carley, 2002, Carley, 2006, Ramsay, 2004, Watson, 2004 and Cohen, 1997).
A prescription book is a rich source of information, seldom preserved, about how people of a particular era dealt with issues of health and disease. As has been stated by Lev and Amar (2008), prescription books are rarely found among historical documents because doctors usually prepared formulas themselves, eliminating the need for a prescription record. Moreover, the same authors have suggested that these documents were usually discarded because there appeared to be no justification for their preservation. It is also plausible that the preservation of these documents would have been undesirable because of their ability to reveal the identity of individuals or villages that had been devastated by epidemics. This could create a negative association of individuals, civilizations or cities/regions with a particular ailment, which is not the way in which people wish to be remembered.
With this in mind, this study presents information about the use of plant ingredients in nineteenth century (1823–1829) therapeutic practice by analyzing Benedictine prescription books.
2. Material and methods
2.1. Description of the study
The documentary research for this study was conducted in the archives of the Monastery of Saint Benedict in Olinda, located in the historical city of Olinda, State of Pernambuco, Northeast Brazil. The primary sources used in this study were the prescriptions that were documented in the historical document entitled “Prescription Book of Dr. Serpa” (or “Codex number 91” according to the number of the codexes from the Benedictine archives), which contains informations since the year of 1823–1829. It is a technically skilled manuscript characterized by leaves of paper inscribed with iron gall ink on both sides. The authorship of this Codex is attributed to Joaquim Jerome Serpa, a surgeon and naturalist born in the State of Pernambuco (northeastern Brazil) who lived from 1773 to 1842. In 1835, Serpa became Professor of Botany and Agriculture and went onto become the penultimate director of Olinda's Botanical Garden. He served as a surgeon at the Monastery of Saint Benedict, eventually becoming the head of the hospital, during which time he wrote his prescription book (Schmalz, 1966). The subject of this prescription book is simply the daily practice of medicine as it was carried out in the Hospital of the Monastery of Saint Benedict in Olinda. Information within the manuscript indicates that the prescription book contains descriptions of the medical prescriptions released daily to each patient who entered the hospital. It is, therefore, an unpublished document that describes Brazilian medical practice and lists the preparations of the formulas dispensed to each patient.
In the first phase of the research, the prescription book was pre-read to identify the elements that would compose the fields of the data collection worksheet (Medeiros, 2010). In the next stage, the codex was read carefully and thoroughly, with data being continuously transcribed while maintaining the original paleography of the text. From this collection worksheet, a database was created of the terms (popular names) that appeared in the prescription book and made reference to the plant materials used at the time. Although Dr. Serpa was an academic professional and probably knew the scientific names of the plants, in each formulation, he cited only the popular names of the plants. This could be a form to adequate the comprehension of the formulations to the practice knowledge of the apothecary. This reason is reinforced by the observations in a similar document by Medeiros et al. (2010), where the scientific names of the plants were not included in the formulations by the physicians and surgeons from Rio de Janeiro (Brazil), during the nineteenth century.
The second step, therefore, was to identify the plants indicated by these popular terms by cross-referencing them with information from the medical literature of the era (Gomes, 1876 and Chernoviz, 1908). To establish taxonomic groups, scientific names were obtained by consulting botanical specialists, the Missouri Botanical Garden's VAST (Vascular Tropicos) nomenclatural database (W3 Tropicos; 2010) and The International Plant Names Index (IPNI, 2010). The classification system adopted for Angiospermae and Pinophyta was the Angiosperm Phylogeny Group (APG III, 2009) and the Ascomycota of Kirk et al. (2001). The information obtained from the manuscript was also cross-referenced for therapeutic indication and part of the plant employed with indications of medicinal use presented in Schmalz's (1966) work on the same prescription book and information collected by Chernoviz (1908) and Gomes (1876).
The species were classified according to their origin as native of the Americas or exotic as a way to indicate the presence of American plants in the academic medical practice during the considered period. To observe the most common medicinal use of the species, the medicinal uses’ frequency of occurrence was calculated.
Information from the prescriptions was collected and analyzed to obtain the following data: (1) total number of prescriptions; (2) total number of terms related to medicinal plants mentioned in the document; (3) total number of terms identified at species, genus and family levels; (4) number of citations per term/species and the terms/species most often cited/used; (5) the biogeographical origin of these plants to assess the contribution of species from the Americas in the prescriptions; (6) number of different uses, highlighting the most common; (7) plant parts most used.
3. Results and discussion
3.1. Prescription, therapeutic indications and parts of plant used
Of the 621 prescriptions found in the prescription book, 23% (145) called for materials of plant origin in their composition. The remaining 77% (476 prescriptions) were composed of parts and/or products of animal origin (e.g., bee honey) or mineral origin (e.g., antimony), were compound formulas indicating a mixture of elements (e.g., deocodio syrup) or made reference to a product derived from plants (e.g., vinegar) (Fig. 1).
By analyzing the prescriptions using the methodology described above and information extracted from relevant secondary medical sources, a considerable number of therapeutic indications were found that related to the botanical terms mentioned in the prescriptions. Seventy-two different medicinal uses for plants were identified in the manuscript. These therapeutic indications covered a wide range of ailments and symptoms affecting virtually every part of the human body. The properties that were most commonly used during the period under review were as follows: tonic (present in 18.1% of the medicinal citations for the species), stimulant or excitant (15.7%), febrifuge, diaphoretic or sudorific (15.7%), laxative (14.5%), emollient (10.8%) and antispasmodic (9.6%). Plants with these properties were used to treat cases of rheumatism, syphilis, inflammatory diseases, bronchitis and diarrhea (Table 1). Note that the use of tonics and stimulants was supposed to strengthen and activate the patient's general health. The febrifuge and diaphoretic properties of certain plants mentioned in the prescription book were meant to treat diseases such as syphilis, influenza, and inflammatory diseases. Plants were also commonly used to heal cuts and wounds and to treat cases of injury and bodily pain (local and muscle pain), which could have occurred as a result of workplace accidents. Lev and Amar (2008), who reviewed prescriptions from medieval Cairo, have pointed out the prevalence of ophthalmia there. They also noted that fever and intestinal problems were among the most common diseases. The data from this study can also be compared to the results found by Medeiros et al. (2010) at the Monastery of Saint Benedict of Rio de Janeiro, which confirmed the predominance of purging, sudorific and expectorant medicines in the medical practice and health care provided by Benedictine monasteries. These patterns reveal the marked influence of Hippocratic medicine and Galenic therapy on the Benedictine orders. At the time the prescription book was kept, disease was thought to be contracted by contagion through contact and sense (tactile and olfactory). That is, it was believed that diseases were acquired through the senses rather than through injury to an organ of the body (Varela, 2006). According to Jesus (2005), infirmities were thought to develop either from pathological disposition or from external factors, such as air, food and water, or both. It was believed that a patient's health would be restored through the expulsion of blood, urine, stools or vomit. The belief led to the practices of bleeding, purging and enemas.