Volume 139, Issue 1, 6 January 2012, Pages 280–286
The pharmacy of the Benedictine monks: The use of medicinal plants in Northeast Brazil during the nineteenth century (1823–1829)
- Under an Elsevier user license
Open Access
Abstract
Ethnopharmacological relevance
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historical documents, and researchers still have much to discover.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.
Results
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.
Conclusions
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.
Graphical abstract
Keywords
- Historical sources;
- Historical ethnobotany;
- Ethnopharmacology
1. Introduction
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).
- Fig. 1.
Example of a recipe for a prescription, which reads as follows: “For João Antônio – Prescription. A half ounce of quinine powder, half an eighth of rhubarb; mix and divide into 24 papers” (Codex 91).
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.
