# What conditions would a pre-modern doctor be able to treat effectively? **URL:** \ **Category:** Factual Questions\ **Created:** [June 24, 2017, 6:39pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774 "2017-06-24T18:39:31Z")\ **Posts on this page:** 14\ **Page:** 3
**Author:** ![Quartz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quartz/32/267_2.png) [@Quartz](https://boards.straightdope.com/u/Quartz)\ **Post date:** [June 26, 2017, 10:32pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/41 "2017-06-26T22:32:02Z")
> [@Chronos](#): > > And it’s not easy to process salicylic acid into acetylsalicylic acid. [Here’s](https://www.youtube.com/watch?v=amTAuK25P6c) how to do it. ---
**Author:** ![bob\_2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bob_2/32/3341_2.png) [@bob\_2](https://boards.straightdope.com/u/bob_2)\ **Post date:** [June 26, 2017, 10:37pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/42 "2017-06-26T22:37:15Z")
Sam Pepys had a stone he size of a tennis ball removed from his bladder by Thomas Hollier of St. Thomas’s and Bart’s on March 26, 1658. > [@](#): > > Claire Tomalin’s biography, ‘Samuel Pepys: The Unequalled Self,’ gives a well-researched description of this surgery, its risks, the preparations, the surgery itself, and the follow-up care. Here is the gory heart of her account, but read her book for the all the preparations–the foods and herb, the fast-binding done in place of an anesthetic–and the follow-up care–a really amazing passage in the book: > > “The surgeon got to work. First he inserted a thin silver instrument, the itinerarium, through the penis into the bladder to help position the stone. Then he made the incision, about three inches long and a finger’s breadth from the line running between scrotum and anus, and into the neck of the bladder, or just below it. The patient’s face was sponged as the incision was made. The stone was sought, found and grasped with pincers; the more speedily it could be got out the better. Once out, the wound was not stitched–it was thought best to let it drain and cicatrize itself–but simply washed and covered with a dressing, or even kept open at first with a small roll of soft cloth known as a tent, dipped in egg white. A plaster of egg yolk, rose vinegar and anointing oils was then applied.” ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [June 26, 2017, 10:40pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/43 "2017-06-26T22:40:30Z")
> [@Quartz](#): > > [Here’s](https://www.youtube.com/watch?v=amTAuK25P6c) how to do it. Acetylizing is not always easy, and it can go awry. Could end up with cholesterol instead. Hence the rhymes, sung to the tune of “Jingle Bells”. We used to sing this in organic chemistry lab in the mid 70’s, when the mood was Christmassy. 😉 Take an acetate, Condense it with a mate Pretty soon you have Acetoacetate. Let 'em have a ball You get geraniol, Add another isoprene And you’ve got farnesol. Farnesol, farnesol, good old farnesol, First it goes to squalene, then you get cholesterol. Farnesol, farnesol, good old farnesol, First it goes to squalene, then you get cholesterol. Now squalene makes a roll, Becomes lanosterol The extra methyls do Come off as CO2; Then comes zymosterol, And then desmosterol If you don’t take Triparanol You get cholesterol. Repeat chorus ---
**Author:** ![clairobscur](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@clairobscur](https://boards.straightdope.com/u/clairobscur)\ **Post date:** [June 26, 2017, 11:00pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/44 "2017-06-26T23:00:34Z")
> [@Chronos](#): > > Likewise, it’s easy to get bread mold, but that does you very little good. One particular strain of one particular species of bread mold produces a very safe and effective antibiotic. Not just that. The bacteria that naturally produced antibiotics produced very little of it. They had to take years to select a strain that would produce absurdly high quantity of it for it to be of any use. It was a massive endeavor. So your bread mold would be ineffective, even if you chanced on the right strain. I remember an example showing that pre-modern doctors in fact knew something. It’s related to the autopsy of the remains of a 15th century famous person body to determine the causes of death. IIRC (not sure I’ll remember everything right), they found evidences of a massive intestine worms infestation (so bad that worms were probably getting out of her mouth too), of consumption of a fern, and of the presence of a toxic compound. It is apparently known that this particular fern was used effectively in conjunction with the compound to treat intestinal worms (some alcaloïde in the fern would paralyze the worms, and the compound was used to then “flush” them out). The toxic compound was however apparently used in this case in doses massively higher than was the norm, hence the death was ruled as being probably a poisoning by her own physician. Which means that said physician : -knew an effective treatment for this ailment -knew that one of the elements of this treatment was toxic and at what dose (of course, I guess it’s possible he was in fact clueless and thought : “well, it works with X ounces of it, probably will be even better if I try with twenty times more of it”). ---
**Author:** ![clairobscur](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@clairobscur](https://boards.straightdope.com/u/clairobscur)\ **Post date:** [June 26, 2017, 11:13pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/45 "2017-06-26T23:13:05Z")
Personally, if I was somehow sent back to an earlier era and seen by a physician (or a traditional healer) for some disease, I would probably pay attention to his advice, after asking him what exactly he was prescribing me, why and what it was supposed to do. If it wasn’t something that is known bullshit (bleeding me, giving me mummy powder, regulating my humors) but rather something along the lines of a plant potion intended to, say, reduce an inflammation, I would give it a try, since I believe that they knew at least _some_ things that could be _sometimes_ useful. ---
**Author:** ![clairobscur](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@clairobscur](https://boards.straightdope.com/u/clairobscur)\ **Post date:** [June 26, 2017, 11:28pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/46 "2017-06-26T23:28:42Z")
When I think of it, Ambroise Pare, a 16th century surgeon who came up with several significant improvements in his field, and is particularly well known wrt the treatment of battle wounds (sewing up blood vessels, discarding cauterization) used turpentine on said wounds. Which means again that its antiseptic properties were known at the time (even if they obviously didn’t know that it was an antiseptic). I suspect that physicians and doctors of past ages knew more than they’re generally credited for. ---
**Author:** ![griffin1977](https://avatars.discourse-cdn.com/v4/letter/g/977dab/32.png) [@griffin1977](https://boards.straightdope.com/u/griffin1977)\ **Post date:** [June 26, 2017, 11:30pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/47 "2017-06-26T23:30:17Z")
> [@bob\_2](#): > > Sam Pepys had a stone he size of a tennis ball removed from his bladder by Thomas Hollier of St. Thomas’s and Bart’s on March 26, 1658. Wow! I wonder what the survival rate on that surgery was? I’m not a doctor (and never had a bladder stone) but I guess while having a bladder stone like that is very unpleastant and painful, it wouldn’t be lethal. I am guessing there is a lot of survivor bias in these descriptions, in the many cases where the patient died during the surgery or afterward from infection, it was simply blamed on fate. Where as if they survived and got better, the doctor would claim success even if their intervention had nothing to do with it. ---
**Author:** ![Weisshund](https://avatars.discourse-cdn.com/v4/letter/w/ba8739/32.png) [@Weisshund](https://boards.straightdope.com/u/Weisshund)\ **Post date:** [June 27, 2017, 12:58am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/48 "2017-06-27T00:58:41Z")
> [@Chronos](#): > > The compound in willow bark is salicylic acid. Aspirin is acetylsalicylic acid, a closely-related compound derived from it. Both have similar benefits, but the side effects from salicylic acid are much worse, especially on the digestive system. And it’s not easy to process salicylic acid into acetylsalicylic acid. > > Likewise, it’s easy to get bread mold, but that does you very little good. One particular strain of one particular species of bread mold produces a very safe and effective antibiotic. Other strains or species of mold produce other substances, some of them more or less similar to that antibiotic. Some of those substances aren’t safe to humans, some aren’t very effective versus bacteria, and some are neither. And I don’t think it’s even known how common the “good” strain is in the wild: It’s very common now due to us going to great lengths to cultivate it, because it’s so useful to us, but we don’t know exactly how lucky Fleming was to have that particular strain growing in his petri dish. > > Don’t read too much into the fact that premodern doctors used moldy bread in poultices, by the way. They did, but then, they used just about everything imaginable in poultices, including various sorts of dung. It’s conceivable that some few patients in history might have gotten lucky and ended up with the good strain of penicillium in their moldy-bread poultice, but overall, people would have been much better off with poultices of just boiled cotton cloth with no mold (or honey or dung or whatever) at all. When i wrote that, i was envisioning our Doctor member going back in time. I figured he would not have too much of a terrible time isolating the things he needed. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [June 27, 2017, 3:35am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/49 "2017-06-27T03:35:53Z")
> [@griffin1977](#): > > Wow! I wonder what the survival rate on that surgery was? I’m not a doctor (and never had a bladder stone) but I guess while having a bladder stone like that is very unpleastant and painful, it wouldn’t be lethal. If the stone completely blocks the flow of urine yes, it could potentially be lethal. ---
**Author:** ![AK84](https://avatars.discourse-cdn.com/v4/letter/a/85e7bf/32.png) [@AK84](https://boards.straightdope.com/u/AK84)\ **Post date:** [June 27, 2017, 11:39am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/50 "2017-06-27T11:39:27Z")
> [@Qadgop\_the\_Mercotan](#): > > Basically the biggest benefits I’d bring to bear would involve better hygiene and water and sewer arrangements, No running water. No functional sewage system. Takes an effort to boil water. Good luck with that. [QUOTE=Broomstick] Folks, you certainly CAN do surgery without anesthesia. I don’t know where you get this notion that no one removed anything from a human body before anesthesia. Lots of surgeons did lots of surgery before anesthesia. It sucked if you were the patient, of course, and there would be several people holding you down so you did thrash too much, and surgeons got used to ignoring the screaming and got the job done as quickly as possible. But surgery did occur back in the old days. It helped often enough that desperate people continued to undergo it when necessary. [/QUOTE] Opium and cannabis have been used as painkillers for centuries. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [June 27, 2017, 7:05pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/51 "2017-06-27T19:05:27Z")
From **bob++** ‘s quote about Pepys’ bladder surgery: > [@](#): > > Once out, the wound was not stitched–it was thought best to let it drain and cicatrize itself–but simply washed and covered with a dressing, or even kept open at first with a small roll of soft cloth known as a tent, dipped in egg white. I can understand not stitching the outer incision, but what about the bladder itself? It seems to me that, if you don’t close that up somehow (how? I dunno) then any further urine accumulation would just leak out into the abdominal cavity, which seems like it’d have to have bad effects. And I don’t think there’s any way to stop the kidneys from producing urine for long enough to let a three-inch incision heal. Incidentally, the original version of the Hippocratic Oath specifically prohibited “cutting for stone”. Such surgeries were known, but they were so risky that it was considered impossible for it to be an ethical option. At the same time, though, stones could cause so much pain that a patient might be willing to brave the risks, hence the need for the injunction in the first place. ---
**Author:** ![Quartz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quartz/32/267_2.png) [@Quartz](https://boards.straightdope.com/u/Quartz)\ **Post date:** [June 27, 2017, 8:58pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/52 "2017-06-27T20:58:03Z")
> [@AK84](#): > > Opium and cannabis have been used as painkillers for centuries. As was alcohol. Alcohol also sterilises. ---
**Author:** ![MacLir](https://avatars.discourse-cdn.com/v4/letter/m/9e8a1a/32.png) [@MacLir](https://boards.straightdope.com/u/MacLir)\ **Post date:** [July 13, 2017, 4:53pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/53 "2017-07-13T16:53:01Z")
> [@AK84](#): > > Presumably either the Doc was from 1900BC or your memory really has faded. A Doctor in 1900AD had quite a lot of effective medication and diagnostic techniques. Quinine for pain. Carbolic acids for infection. Aspirin. Radiation therepy for cancer. Plus X Rays When I was in college, and living with relatives who kept small livestock, I owned a 19th Century _Materia Medica_. It was quite useful, as it predated (prescription) antibiotics. I use some of the techniques from time to time to this day ---
**Author:** ![MacLir](https://avatars.discourse-cdn.com/v4/letter/m/9e8a1a/32.png) [@MacLir](https://boards.straightdope.com/u/MacLir)\ **Post date:** [July 13, 2017, 4:58pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/54 "2017-07-13T16:58:27Z")
> [@sirwired](#): > > Carbolic acid is a disinfectant, like for cleaning surgical instruments, it’s not something you take as a drug to treat infections. (It does have some use as a drug; it’s the active ingredient (in small, dilute, doses) in throat spray.) It was used as a topical medication to treat or prevent infections. You used to be able to buy carbolated Vaseline and similar preparations for application to wounds and abrasions. Phenol was also used similarly. [Previous page](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774.md?page=2)