Abstract
‘You have taken the strength from henbane, with which ungrateful love drowsed my painful virtue’.
Miguel de Cervantes
The Galatea
Introduction
Miguel de Cervantes (1547–1616) is recognized as one of the most important figures in the history of world literature. While Cervantes' literary production was not prodigious, and occurred late in his life, he has a worldwide reputation due largely to a single work, Don Quixote (El Ingenioso Hidalgo Don Quijote de La Mancha, 1605). 1 The Cervantine works, and especially Don Quixote, have been the object of all types of detailed study across all the fields of human knowledge, including sociology, medicine and therapy. 2, 3, 4, 5, 6, 7, 8, 9, 10 In this regard, we might recall the well-known anecdote attributed to Thomas Sydenham (1624–1689), the so-called ‘English Hippocrates’, who in response to the request for advice from his disciple Richard Blackmore (1654–1729), the poet and court doctor of William III, on the best scientific text for learning medicine, recommended that he read Don Quixote. 11
Cervantes lived in a period in which Spanish medicine was making great progress, most notably in the field of ‘medicine of the mind’. However, to talk of ‘psychopharmacology’ in the late Renaissance is stretching a point somewhat. During this period, the Galenism that had dominated previous eras continued to provide the frame of reference for therapeutic practice, in which, furthermore, the nature of mental illness as a disorder of the humours was often concealed by a preoccupation with exorcism, which considered the ‘madman’ as possessed. 12 Such conceptions were compounded by an alchemical view of the functioning of the human body. In the late sixteenth century, therefore, pharmacological remedies for internal diseases, be they organic or mental, were scarce, highly unspecific in nature and of vegetable origin. As an example of a hypothetical aetiological remedy we might mention hellebore, obtained from the plant Helleborus niger. The emetic properties of this substance were understood at the time as a means of bringing about catharsis, purification or purgation. Thus, vomiting would permit the recovery of ‘eukrasia’, that is, the correct combination of humours on which good health was based. 12 Other substances extracted from plants that formed part of the medicinal arsenal of the time were henbane (Hyoscyamus albus or niger), belladonna (Atropa belladona), mandrake (Mandragora officinarum), jimsonweed (Datura stramonium), and valerian (Valeriana officinalis), agents that during the middle ages had been used as poisons in witchcraft and sorcery (‘witches' ointments’). Nor should we overlook opium (Papaver somniferum), the prototype of sedative agents.
In this context, the literary works of Cervantes constitute a magnificent mirror in which to observe the therapeutic remedies available in late-Renaissance Spain. 6 , 9, 10, 11 13, 14
The pharmacotherapeutic management of madness and psychotropic drug use in Cervantes' works
The difficulty involved in assessing the extent of Cervantes' medical knowledge has been highlighted by various authors. 2 , 4 , 8 We should not forget in this regard that Cervantes, as the son of a surgeon–bloodletter (Rodrigo de Cervantes, 1509–1585), brother of a nurse (Andrea de Cervantes, 1545?–1609) and great-grandson of a Cordoban physician (Juan Díaz de Torreblanca, ?–1512), had considerable knowledge of the art of medicine, a knowledge that pervades his literary work. Moreover, and in particular relation to mental illness, Cervantes would have been able to obtain direct information, both clinical and therapeutic, through his immediate contact with patients at the Seville Mental Hospital. 15 Also, his private library clearly contained several medical texts, including a copy of the famous edition of the Dioscorides (1555) annotated by Andrés Laguna (1494–1560) in the mid-sixteenth century. 6 The following passage from Don Quixote lead us to suppose that Cervantes had read this work: ‘“For all that,” answered Don Quixote, “I would rather have just now a quarter of bread, or a loaf and a couple of pilchards' heads, than all the herbs described by Dioscorides, even with Doctor Laguna's notes”.’ 1
The literary works of Cervantes (excluding his poems) *
There are also four Interludes (Los habladores; La cárcel de Sevilla; La soberana Virgen de Guadalupe; El hospital de los podridos) and an Exemplary Novel (La tía fingida) attributed to Cervantes.
Works with references to the use of therapeutic remedies of a psychopharmacological nature or the use of ‘recreational’ psychotropic drugs.
Herbal remedies mentioned in Cervantes' works in association with their psychotropic properties
As ingredient of Balsam of Fierabras.
The Balsam of Fierabras: therapeutic panacea
In Don Quixote, the therapeutic remedies par excellence are the balms, the most notable of which, given the continual references to its successful use, is the so-called ‘Balsam of Fierabras’, a kind of panacea for the knight. The Balsam of Fierabras, which falls outside the range of conventional medical therapies of the time, belongs to set of magical remedies that crop up constantly in medieval chivalric literature. 16 It should be borne in mind here that a version of Chivalric Stories of Charlemagne acquired some popularity in Spain in the sixteenth century after the publication, in Seville, of a translation into Spanish. 17
The health-giving and extremely efficacious balm to which Don Quixote refers,
administered in this case orally and purporting to cure any type of illness, would
consist of oil, wine, salt and rosemary (Rosmarinus officinalis), in
line with a customary pharmaceutical practice at the time, namely the mixture of various
simple medicinal elements (three of vegetable and one of mineral origin) to obtain a
compound formula in the style of the famous ‘Theriaca’.
16
,
18,
19
The preparation of the balm ( Detail of a nitric acid engraving by Ricardo de los Ríos (1846–1929) on an
original drawing of Jules Worms (1832–1924), entitled Don Quixote
prepares the Balsam of Fierabras, for the French translation of
Don Quixote by Cesar Oudin and Francois de Rosset
(L'Histoire de Don Quichotte de la Mancha, Paris, Librairie
des Bibliophiles, 1884)
The effects of the Balsam of Fierabras are also described by Cervantes: intense vomiting at first, followed by profuse sweating and great fatigue, and finally a deep sleep. On waking (three hours later), the restorative effect was so marked that the nobleman believed himself to be completely cured. Quite possibly, the psychopharmacological effect of the balsam actually derived from its capacity to induce a deep sleep that led to the subsequent reparative effect. 20 Indeed, remedies involving prolonged sleep, with barbiturates and other psychopharmacological agents, have constituted a widely used practice in the history of psychiatry. 21 , 22
Among the balm's ingredients, rosemary stands out as the agent to which abundant
therapeutic properties have been attributed. A member of the Lamiaceae
family, rosemary ( Botanical laminae of different plants mentioned in Cervantes' works by their
psychotropic properties or their use in the treatment of mental diseases
Purgatives and emetics: the properties of rhubarb
Purgatives are mentioned in Don Quixote more than anything because at the time Cervantes wrote the book it was customary, within the general health framework, to prescribe them as agents capable of eliminating morbid humours, permitting spiritual purification. Thus, the priest of the village whose name Cervantes had no desire to call to mind remarks, in relation to the novel's eponymous character: ‘he stands in need of a little rhubarb to purge his excess of bile’. 1 The rhizome of monk's rhubarb (Rumex alpinus and Rumex patientia) (Figure 2b), a plant that grows in the North of Spain, rich in tannic and chrysophanic acids, possesses purgative and tonic properties, and was used for purging the choleric and phlegmatic humours. 25 The remaining types of rhubarb (Rheum species), typically Chinese rhubarb, also have laxative properties, 26 though their exotic origin and high price were practically prohibitive for the general population in sixteenth century Spain. In the Iberian Peninsula, however, sorrel (Rumex acetosa) (Figure 2c) is widely found. The rhizome of the plant Spaniards call ‘romaza’ is, like that of rhubarb, rich in chrysophanic acid. Cervantes, on referring to rhubarb, may well be talking about any of the plants belonging to the genus Rumex. Also referred to in Cervantes' novel is the consumption of the seeds of gopher spurge (Euphorbia lathyris) (Figure 2d), commonly known in Spanish as ‘ruibarbo de los labradores’ or ‘tártago’, a plant now considered as toxic, but popular in the sixteenth century in view of its dual purgative and emetic action. It was said that if one pulled the leaves off downwards, the plant worked as a purgative, whilst if one pulled them off upwards, it would induce vomiting. 24
A possible explanation of the effects of purgative agents on some psychiatric symptoms may be found in the biological therapies that prevailed in the treatment of mental illnesses in the first third of the twentieth century. From this perspective, the purgative techniques would result in a state of hypoglycaemia that could benefit the course of certain psychotic disorders. Hence, for example, the renowned Sakel cures or insulin comas with which schizophrenic patients in asylums were treated until the mid-twentieth century. 27
Hypnotic substances: chicory
Chicory water is mentioned by Cervantes in the famous passage about the adventure with the windmills in Don Quixote: ‘All that night Don Quixote lay awake thinking of his lady Dulcinea… Not so did Sancho Panza spend it, for having his stomach full of something stronger than chicory water he made but one sleep of it’. 1 This remedy was made by distilling the flowery tops of Cichorium intybus (Figure 2e) in water, and was widely employed in the treatment of insomnia, in addition to its use for soothing burning sensations in the liver and relieving opilations. 19 In general, it was a tonic and stomachic medicine. Andrés Laguna gives a detailed description of a wild variety of chicory, Cichorium hedypnois, stressing that is was a substance ‘giving rise to sweet slumbers, since it induces an oblivious sleep’. 24
The narcotic effect of henbane and opium
Narcotic and sedative remedies are scarcely mentioned in the literary works of Cervantes. The sole exception is henbane (Hyoscyamus niger and albus) (Figure 2f), whose mention in The Galatea recalls its narcotic properties: ‘You have taken the strength from henbane / with which ungrateful love / drowsed my painful virtue’. 1 In Voyage to Parnassus there is also a brief reference to the properties of this plant: ‘… whose crown was of bunches of sacredhenbane’. 1
Henbane, known popularly as ‘mad herb’ and ‘flower of death’, is, like the rest of the Solanaceae (belladonna, mandrake, jimsonweed, etc.), rich in alkaloids of sedative effect, such as hyoscyamine and scopolamine. This plant had been used since the middle ages as an ingredient of witches' and sorcerers' potions for its hallucinogenic effects, and at a medical level its narcotic properties permitted its use, from the sixteenth century onwards, as an anaesthetic in surgical interventions. 24 However, psychiatric uses of this plant flourished in the second half of the nineteenth century after the isolation of its alkaloids, especially hyoscine and scopolamine. 27
The lack of reference to such drug types in Cervantes' works, however, is quite possibly
due not to ignorance in the author – who was, as we remarked, well acquainted with
medical and therapeutic materials – but rather to a desire to avoid attracting the
attention of the Inquisition, which took a dim view of these types of medicine.
28
It was for this reason that Cervantes restricted himself to listing the
properties of the commonly used herbal preparations, without going into details about
their possible composition. Such an interesting approach, with respect to the opium, can
be seen in one of his Exemplary Novels, The Jealous Extremaduran, when
the young wife administers a narcotic preparation to her aged husband:
‘… the powders, or an ointment, of such virtue that, on applying it to his
pulses and his temples, caused a deep sleep, from which nobody could rouse him
in two days… and likewise she anointed the windows of his nose… It took little
time for the alopiado [opiate] unguent to show signs of its virtues, because
the old man soon began to snore loudly… The ointment with which her husband was
smeared had such virtues that, without actually taking his life, left a man as
though dead.’
1
In this passage, Cervantes uses an Italianism (‘alopiado’) to give account of which the ointment is elaborated with opium. According to Bucalo, 29 this meaning derives from ‘alloppiato’, term used in Italy from the fourteenth century to designate those syrups that contained opiate derivatives. Cervantes habitually used Italianisms in its works, 29 given his voyage around Italy during its youth, although in this case, it could well be a form to mask the explicit reference to the opium.
Psychostimulant agents: the tobacco plant
Curiously, in addition to his failure to mention opium, Cervantes makes no reference in his main novel to the use of tobacco (Nicotiana tabacum) (Figure 2g), a plant imported from the New World and whose use, therapeutic and recreational, was extensive in the Habsburg era in Spain, where it was known by various names (e.g. ‘devil's weed’, ‘herb of consolation’ or ‘herb of all the ills’). Nicolás Monardes (1493–1588), in his Historia medicinal de las cosas que se traen de nuestras Indias Occidentales que sirven en medicina, published in Seville in 1574, recommended tobacco for up to 36 different ailments. 30 It was also considered capable of stimulating the brain and the imagination. 24 Nevertheless, in other works of Cervantes, such as his Voyage to Parnassus, tobacco sniffing is mentioned as a strange remedy used by poets in order to avoid losing consciousness, especially in cases of intellectual fatigue: ‘That which is harvested is tobacco / which for those who are disturbed of head serves / of some feeble-brained poet’. 1
Hallucinogenic and psychodysleptic substances: witches ointments and love potions
Ointments, in the pharmaceutical context, were preparations for external application
made with fats, waxes or resins. However, their extrapharmaceutical or non-therapeutic
confection by witch doctors and sorcerers had been customary since medieval times. The
proliferation of witches throughout Europe, especially after the twelfth century,
impregnated popular culture with a whole series of legends which eventually came to
constitute a parallel ‘reality’, fiercely opposed and fought by the ecclesiastical and
civil authorities.
31
Their trials in the courts of the Inquisition confirmed the use of potions and
ointments, generally containing hallucinogenic plants such as mandrake, henbane,
belladonna (deadly nightshade) or jimsonweed, cooked in their famous cauldrons with fats
and a host of other substances ( Witches concocting an ointment to be used for flying to the coven, according
with an illustration from a work by a contemporary of Cervantes, Ein
Kurtze Treue Warning (A Short, True Warning), by
Abraham Saur (1545–1593), published in Frankfurt in 1582
‘… This unguent that we witches put on ourselves is made up of the juices
of herbs that are in all extreme cold, and is not, as the common people say,
made from the blood of the children we drown… I tell you they are so cold that
they deprive us of all senses when we spread them on ourselves, and we lie
stretched out and naked on the ground, and then they say that in fantasy
everything occurs to us that appears to happen in reality. On other occasions,
after applying the ointment, it seems to us that we change our form, becoming
roosters, owls or crows, and we go to the place where our master awaits us, and
there we take on our original form and enjoy the delights of which I have told
you… my ointments give me some good times… and the delight is much greater
imagined than actually experienced… Before finishing the application of the
ointment she said that her body may stay senseless in that room, or it may
disappear from it, and that I should not be afraid…’
1
In this passage, Cervantes gives a masterly description of the psychotropic effects of mixtures of hallucinogenic agents administered externally (out-of-body travel, visual hallucinations, pleasant sensations, etc.), and concludes with respect to the attribution by the common people of their relationship with magic practices that ‘all of these things and similar ones are deception and lies’. 1
The preparation of brews and ‘love potions’ with herbal remedies capable of changing the
feelings and desires of those who take them, in the context of popular tradition and
literature related to witchcraft (we can remember the French romance Tristan et
Iseut, or the Spanish novel La Celestina), is also referred
to in some Cervantine works, such as the novel The Licentiate of Glass:
‘And thus, on the advice of a morisca, in a Toledan quince jelly, she gave
Tomás one of those so-called spells, believing that he would be unnerved by her
forcing his will to love her: as though there were in the world herbs, spells
or words sufficient to force free will; and thus, those women who give these
love-inducing drinks or foods are called “veneficios”; for what they do is
nothing short of poisoning the one who takes them, as experience has shown on
many and varied occasions.’
1
Cervantes also describes the effects of these preparations based on herbs:
‘Such was the way in which Tomás ate the jelly that he immediately began
to suffer in hands and feet as though he had alferecía [epilepsy], and he was
many hours before recovering; and when he did come round, he was bewildered,
and said with clumsy and stammering tongue that a quince jelly he had eaten had
killed him… Six months he was in bed, Tomás… and mad with the strangest madness
of all the madnesses that up to that time had been seen. Imagine how wretched
he was all made of glass…’
1
Likewise, in the context of witchcraft and with motives related to love, Cervantes
refers to the use of poisons as such.
33
Thus, in The Spanish-English Lady, the Protestant waitress
decides to poison Isabela for having scorned the love of her son:
‘And she was determined to kill Isabela with tósigo [poison]… that same
afternoon she poisoned Isabela in a preserve that she gave her, obliging her to
take it on the grounds that it was good for the anxiety she felt in her heart…
Isabela's tongue and throat began to swell up, her lips to turn black and her
voice to go hoarse; her eyes glazed over and her chest was tight: all
well-known signs of having been poisoned.’
1
The term Cervantes uses for the poison here (tósigo) comes from the Latin ‘toxicum’, and is referred to in the Dioscorides as a poison that inflames the tongue and the lips and induces madness. 33 For his part, Laguna notes that these types of poison are associated with black hellebore or with wolfsbane (Aconitum Napellus).
In any case, at no time does Cervantes refer to the composition of any of these preparations, nor to their ingredients, despite mentioning their herbal origins, and this may well be out of precaution, to avoid any repercussions from the Inquisition. However, from the description of the symptoms experienced by his characters, it may well have been henbane in the case of The Colloquy of the Dogs, mandrake in that of The Licentiate of Glass and belladonna or black hellebore in The Spanish-English Lady. Only in his theatrical comedy Pedro de Urdemalas does he refer to vervain (Verbena officinalis) (Figure 2h), a plant to which magical properties were attributed, even during the early Baroque: ‘Here we have vervain / full of rare virtues’. 1 Vervain is a plant commonly known at the time as the ‘sacred herb’ because of its use, in the form of posies, in religious ceremonies of antiquity, or ‘herb of spells’, which highlights its magical character. 24
Conclusion
The figure of the insane and lunatic person is fairly common in the Cervantine works, but the great literary figure of the Spanish golden age does not restrict himself to describing the profile of these patients and the way they interact with the rest of the social actors; rather, he goes further, showing us many of the therapeutic remedies available at the time for the treatment of such patients, as well as other substances and preparations endowed with the virtue of modifying sense and understanding. It would seem, then, that Cervantes' knowledge of medical matters was quite extensive. By these reasons, the Cervantine texts constitute a valuable tool of study, not only from the slope of the history of the medicine, but from the perspective of medical and social anthropology.
Footnotes
DECLARATIONS
Footnotes
Acknowledgements
None