Monday, May 16, 2016


                                   THE GUAIAC TREE:
 From syphilis to blood detection

     In 1496 a new disease broke out in Italy, producing large, disfiguring, sores over the body. It emerged after an invasion by Charles VIII of France followed by a severe winter of heavy snowstorms and floods, destroyed crops, and a malnourished population. But the French troops got the blame, hence the name “the French disease”, though some called it the Spanish or the Neapolitan disease. It surged through Europe when the troops went home.
     Treatments varied, but were oriented toward removing morbific material by means of bleeding, purging and, quite prevalent, “sweating” in enclosed hot fixtures. Soon mercury, both topical and ingested, came into practice, with its attendant symptoms of mercury poisoning.
Eventually the idea surfaced that the disease originated in America and reports came of a concoction used by the natives of Hispaniola – an extract of the guaiacum tree – that produced miraculous cures.
guaiac tree 
News of the remarkable remedy soon reached the emperor Maximilian I who ordered his chancellor, Cardinal Matthew Lang, to send a commission to Spain to investigate. The members of this commission are not known for certain, but almost certainly one was Dr. Nicolaus Pol. Pol was court physician to the emperor, a theologian, and a bibliophile.
     Nicolaus Pol published a tract on the use of the guaiac wood that appeared between 1517 and 1519. In it he clearly stipulates, bowing to Galenic theory, that before taking the guaiac potion the body must be “purged of offending humors”, the exact methods left up to the physician. This to be followed by 3 days of reduced dietary intake. Then comes a 30-day course of twice daily ingestions of a liquid made from the wood. After the morning dose the patient should be in bed, covered with blankets, to sweat. Dietary intake is gradually increased and sexual intercourse forbidden. The wood went under many names, common ones being lignum vitae or lignum sanctum.
Patient with syphilis on left drinking extract of guaiacum. On right, chopping, weighing, and boiling of wood.
Line engraving by P Galle after J van der Straet, about 1600. (Courtesy Wellcome Library, Creative Commons license:

http://creativecommons.org/licenses/by/4.0/)
     To make the concoction a pound of guaiac wood was cut into small pieces and boiled in 12 pounds of water until half was boiled off. A dose of ½ pound of the liquid was administered twice daily, altogether requiring 5 pounds of the wood for a 30-day course. The foam accumulating on the top was skimmed off, dried, and used as a powder on the sores.
     Another, and more well-known treatise on the treatment was published by the German poet-laureate and humanist Ulrich von Hutten, appearing in 1519. (David Starr Jordan, first president of Stanford, was so 
Ulrich von Hütten (Wikipedia)
impressed by von Hutten that he wrote a short book about him – see below. A phrase of Hutten's, "Der luft der Freiheit weht" - the wind of freedom blows - is on the Stanford emblem.) Von Hutten had the French disease himself and describes the treatment in this widely read book, De guaiaci medicina et morbo gallico (English translation made in 1730). His recipe is basically the same except a little stronger - one pound of wood only lasts 4 days - and the diet stricter. Von Hutten’s book sold widely and boosted the use of guaiacum immensely. He intimates that doctors and vendors of the wood were in cahoots financially, and that could be so. Jacob Fugger, the richest man in Europe and
Jacob Fugger by Albrecht Dürer
(Wikipedia)
Maximilian’s chief banker, was a major trader in the wood. He erected 3 houses for the treatment of syphilis as part of a larger “Fuggerei” – colony of houses for poor people (which still exists in Augsburg). He promoted guaiacum treatment and no doubt profited well from it.
     Finally, Fracastorio, in his treatise on syphilis, also praised the benefits of the wood. The treatment was expensive, though, and over time fell out of favor, yielding once again to Mercury.
     There are 3 varieties of guaiacum tree, 2 of which were probably used. The wood is hard and heavy, sinking in water, and has been used for mallets, bowling balls, ball bearings, and for propeller shaft bearings in steamships (they outlast steel). It grows in the Caribbean and adjacent shores and is a good shade tree. An extract of the resin of the tree is the basis of the “Guaiac Test” for occult blood, something else that is fading into medical history.

Sources:
    Muinger, R S. Guaiacum: The holy wood from the New World. J   
        Hist Med All Sci 1949, 4: 196-249.
    von Hutten, U. De Morbo Gallico (English Translation), 1730.
    Fisch, M H. 1946. Nicolaus Pol Doctor 1494. 
    Arrizabalaga, J, et al. The Great Pox: The French Disease in 
         Renaissance Europe.1997.
    Record, S J. Lignum-Vitae: A study of the woods…., 1921.
    Jordan, D S. 1910. Ulrich von Hutten: "Knight of the order of 
         poets"


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