Human Milk As a Medicine Historically

Home , Wet nurse

Th ese ideas should not be discredited. Th ere are two ARTICLE situations where, instead of treating the patient directly, the physician would administer medicaments to another Human milk as a medicine historically person who is biologically conjugated with the patient: that is, the mother in the early stages of her child’s devel- Tomasz Sioda and Virginia Th orley opment when she communicates with the foetal child through her blood; and, subsequently, with the newborn Abstract: child by means of her milk. In both these situations, it From ancient times breast milk was used to combine was suggested that the child would receive a medicine good nutrition and medication in diseased infants. Var- indirectly via the mother or a wet-nurse serving as a bio- ious modifi cations to make the milk more therapeutic logical intermediary. Th e former situation has been used were practised, whether by dosing the mother or wet- with success only recently for the treatment of foetal car- nurse with medicines or by subjecting her to ancient diac arrhythmias.1 Th e latter situation has been recom- treatments such as cupping or blood-letting. Concerns mended since antiquity by scholars who most probably about toxicity from direct dosing of syphilitic infants observed the medicinal properties of human milk by it- with mercurial compounds led to administering these self and the infl uence of ‘maternal milk changed by cer- to the wet nurse as proxy, despite uncertainty about tain food, remedies, poisons and even vivid moral exci- bioavailability. Th e use of human milk therapeutically tations’.2 In the last stage of procreation – breastfeeding continues today. – mothers who were not suckling, or who delayed suckling during the colostral phase, often had a proxy at the Résumé: ready in the form of a wet-nurse. Depuis les temps les plus reculés, le lait humain est uti- In our article we will focus primarily on ‘good’ milk lisé chez les nourrissons malades en tant que combinai- and its modifi cations with the aim of treating sick in- son d’une bonne nutrition et un bon traitement. Di- fants. Th e problem of ‘bad’ milk in the etiology of dis- verses modifi cations du lait ont été introduites pour eases of breastfed infants is a separate and extensive is- obtenir plus de propriétés thérapeutiques, que ce soit en sue. Milk secretion is undoubtedly infl uenced by administrant des médicaments à la mère ou à la various pathological factors active in maternal diseases, nourrice, ou en soumettant la nourrice à un traitement especially in mammary gland diseases, or by environ- de l’époque tel que l’application de ventouses ou les sai- mental toxins. In the historiography of breastfeeding, gnées. Les préoccupations concernant la toxicité des these problems occupied a prominent place at least un- composés du mercure lorsqu’ils sont administrés direct- til the mid-twentieth century, and have lived on in pa- ement aux enfant atteints de la syphilis ont conduit à rental assessment of the causes of various disorders in leur administration indirecte par la mère nourricière ou infants to this day. Th e mother’s frequent reaction to a la nourrice d’un enfant malade, malgré l’incertitude health problem in the nursing baby is to blame her concernant la biodisponibilité. L’usage thérapeutique milk, recent food intake or specifi c behaviour. In the du lait humain se poursuit aujourd’hui. historical perspective, corrective actions in such situations, if required in the interests of the infant, were di- Introduction: Modifi cation of breast milk for the ex- rected towards the mother or wet-nurse, and also in- pected benefi t of diseased sucklings cluded, in addition to changes in her diet and Th e signifi cance of good food and nourishment for pharmacological measures, the surveillance of her life- healthy sustenance or restoring lost health was always style in order to advise changes in her behaviour. common knowledge. Th e joint action of special food and medicines, supposed to be eff ective in achieving Human milk as a basic medicine the cure, was the basis of any treatment since ancient Th erapy with the milk of domesticated animals was times, so it was natural that it would also be applied for recommended by scholarly authors for a variety of de- the benefi t of diseased infants at the breast. Th e idea of bilitating diseases, especially tuberculosis, in infancy modifi cation of human milk in vivo by changing the and adulthood. When used in therapy, milk was not mother or wet-nurse’s diet, or by giving her medicines only ‘an indispensable nutriment for children’ but also to treat the child at breast through her milk, probably an eff ective medicine.3 Human milk – lac mulieris – was arose from medical observations; fi rst, that infants at always considered superior for these purposes as the the breast fared much better in disease than weaned in- best medicine and energizer by itself,4, 5 “one of the fants, and second, the generally poor tolerance of avail- greatest restoratives for enfeebled and debilitated pa- able medicines in paediatric patients. tients”.6 Heinrich Agrippa (1486-1535) wrote after

16 PHARMACEUTICAL HISTORIAN · 2019 · Volume 49/1 Pliny the Elder7 that “...nature has given to women milk volved adding medicines in vitro to the expressed human of such power, that it not only brings up little children, milk or its whey.38 Human whey therapy was recom- but also heals the sick, and helps every adult to achieve mended in ‘every destructive body impotence’, especial- a healthy life”.8 Th e use of human milk as a medicine ly for patients with general weakness, gout, tuberculosis, was convincing not only by its observed eff ectiveness scurvy and hypochondria.39 Butter made of human milk but because the milk was regarded as (in today’s word- was once a secret medicine of a certain apothecary for ing) species-specifi c, easy to metabolize, and of high phthisis.40 Lacto-engineering today is a direct develop- caloric value.9, 10, 11 ment of these methods. Although probably not inspired Th e most frequently used route of administration by them, the foundational idea is the same. of human milk was naturally the oral route. Patients Other attempts at modifi cation were indirect by received it orally as the last resort treatment in very se- acting in vivo on the nurse’s lactation in three diff erent vere unspecifi c diseases,12, 13 ‘hectic fever’,14 syphilis,15 ways with the aim of therapeutic infl uence on the dis- dysentery and intestinal gangrene.16 Taken orally, it was eased suckling. Th e fi rst measure relied on deliberate considered the best kind of milk in milk therapy for changes in the nurse’s diet. Th e second measure in- tuberculosis,17 and recommended for senile weakness18 volved administering specifi c medicines to the nurse. and stimulation of labour.19 Other historical methods Th e third group of indirect treatments included four of human milk application included injections into the basic treatments of the times – blood-letting, cupping urethra in gonorrhea,20 vaginal pessaries,21 collyrium with possible scarifi cation, purgation and inducing and cataplasms (compresses) in neonatal conjunctivitis, vomiting, and with exclusion of the fi fth treatment – eye trauma and other ophthalmic diseases,22, 23, 24, 25, cauterization. Th ese three groups of treatments were 26 topical application in teething problems,27 cataplasms usually employed simultaneously as a standard way of with poppy seeds for ‘watchings’ (sleep problems) in treating diseased sucklings until the mid-nineteenth children,28 and cutaneous application for specifi c “pos- century. Th eir joint action was supposed to restore the tural diseases” in folk medicine. Th e last mentioned balance of body humours when disturbed by the dis- were assumed to be caused by improper handling of the ease, according to the theory of four humours and their small infant by a nurse.29 Generally, it can be summa- four pairs of specifi c qualities. We shall describe the us- rized that the milk was considered a good remedy for age of these treatments below. any ailment where its ‘cooling’ eff ect was desired. In the twenty-fi rst century, expressed human milk from donors has been used to relieve the side eff ects of chemotherapy and to improve the quality of life of on- cologic patients.30 Stem cells derived from human milk have been postulated as a treatment for central nervous system damage.31 Not surprisingly, some of these indications received scientifi c confi rmation in recent research on the immunological and anti-infective properties of human milk, and only its bactericidal properties against Neisseria gonorrheae are mentioned here.32 While fortifying expressed human milk (EBM) with bovine-based additives has been a common practice in many Neonatal Intensive Care Units for some years, the new century has seen the introduction of fortifi ers Figure 1. “Die Mütter” [Mothers] by J. Weber, after made from human milk to modify EBM for the growth Juan José Zapater Rodríguez (1866-1922). Wood engrav- needs of individual premature infants (‘lacto-engineering published in “Illustrirte Zeitung” No. 3092, Leipzig, ing’) in some units.33 2 October 1902. (Source: private collection, open access)

Medicinalisation of human milk – making human milk medicinal Dietary injunctions for nurses Human milk was also considered the best of all available Since ancient times, every major text on nursing usu- milk as a simple vehiculum for medicines34, 35, 36 or the ally provided more or less specifi c recommendation for basis of making the wet-nurse’s milk ‘medicinal’37 by spe- the mothers’ and wet-nurses’ diet. Generally, this diet cial processing and adding specifi c medicines. Attempts was to be prescribed depending upon the qualities of to modify human milk for direct therapeutic use in- milk after it was tested, and specifi c circumstances re-

PHARMACEUTICAL HISTORIAN · 2019 · Volume 49/1 17 garding the suckling child, on the ground that the same tus habeat proprium [In all infants’ diseases, the nurse milk might have a benefi cial or detrimental eff ect in should have a proper diet regime] formulated by Paolo diff erent infants.41 Th e common knowledge regarding Bagellardo (fi fteenth century) or his editor Pierre Tolet the dependence of domesticated animals on the fodder (1502-1586).51 Th is explicit theorem shows that for a received for high milk yield of good quality was the ba- particular treatment of diseased breastfed infants, the sis of these recommendations to benefi t a suckled in- appropriate food for mothers and wet-nurses was con- fant. As ‘a good milk’ was essential for the suckling, sidered equally important as medicines administered every vague symptom regarding the child’s well-being directly to the child. It was emphasized most positively directed the attention of caretakers towards the nurse by certain prominent early paediatricians like George and her supposedly ‘corrupt milk’. Armstrong (c.1720-1789) from London or professor Jo- Two main reasons deserve mentioning here: fi rst, hann Wendt (1777-1845) from Breslau [Wrocław].52, 53 the observations that health and many diseases depend While specifi c food recommendations may not have on the food ingested, and the second, the poor under- been uniform, the concept remained relatively constant standing of the etiology and pathogenesis of diseases in across time. Certain authors formulated holistic recom- children throughout the whole period when wet-nurs- mendations for the breastfeeding mother or wet-nurse ing was common. Th ese reasons led to diagnostic eff orts regarding lifestyle, diet and medicines to be taken by toward questioning, fi rst of all, the quantity and qual- them for prevention and treatment of other diseases in ity of the nurse’s milk, which meant inspection of her the sucklings.54, 55 Th e search for appropriate food in lifestyle, including any changes in the diet which might disease, especially when given to wet-nurses of sick chil- have aff ected the milk.42, 43 In cases of any infant dis- dren, was intense but arbitrary until the advent of food turbance, many authors and practitioners in the past science. Th at search had a lot in common with unfo- recommended alteration of the nurse’s diet or, if need cused quests for new medicines, which until the second be, replacing the nurse. Th is served also as a diagnostic half of the nineteenth century concentrated on fi nding tool and possible remedy. them in natural sources, most of which were useless or Naturally, attention to the nurse’s diet followed the of low value for human nutrition. main bowel problems in nurslings, like loose stools, It must also be remembered that only affl uent fam- constipation and the gripes. In such situations the cure ilies – a small minority of the population – were in a was directed to the nurse who was obliged to amend position to follow advice to the letter. Yet these were her ‘bad milk’ and change her diet accordingly. For in- also the families which most frequently relied on wet- stance, if the child had diarrhoea the nurse had to ab- nurses. Th e surveillance of the wet-nurse’s diet and be- stain from fruit and raw meat, while in the case of con- haviour was possible only when she was staying in the stipation she was obliged to drink more, abstain from house of the employing family. Th e general recommen- food ‘binding the belly’, eat raisins and prunes, and the dation was to nourish the wet-nurse with the food to like.44 In case of the child’s aphthae, the nurse “should which she had been accustomed at her home. make use of sweeteners and purifi ers of the blood, as Yet the reality was frequently diff erent in affl uent temperate decoctions of herbs and roots, diaphoretics, families who over-indulged the wet-nurse for the pre- absorbents and gentle laxatives”.45 sumed benefi t of the nursling. Th is meant fulfi llment For nurses breastfeeding syphilitic infants acidic of all her whims and exceeding her real dietary needs. food was not recommended during the treatment,46 and Any judicious management of possible problems was drinks such as rice water or thin barley water were usu- blocked by the generally accepted opinion that making ally administered.47 Th is latter drink was also recom- the nurse distressed or furious could cause serious det- mended, besides water with a little wine, as a part of rimental consequences for the nursling, including con- good diet for a nurse breastfeeding an infant with mea- vulsions and death.56 Th ese beliefs persisted among la- sles or chickenpox,48 but no wine should be taken by a ity and medical professionals until the nineteenth wet-nurse feeding an infant ill with plague.49 Th e rec- century. An undesired side eff ect of receiving an im- ommendations usually complied with the theory of proved diet could have been the increased sexual needs four humours, which meant prescribing for the nurse in women separated from their husbands that might ‘a hot, drying diet’ in the case of nocturnal enuresis, or lead to morbus hystericus.57 ‘a cooling diet’ in the case of meningitis.50 Th e above examples of detailed dietary recommen- Treatment of infants by administering medicines to dations to nurses breastfeeding sick infants confi rm their nurses that the medical authorities quoted here stuck to the Dosing the nurse to treat the nursling through her milk aphorism In omni infantium morbo, nutrix regimen vic- had already been practised in the ancient world.58 Ex-

18 PHARMACEUTICAL HISTORIAN · 2019 · Volume 49/1 medicines should suit the age and constitution of the treated child.63 Recommendations sometimes included prescribing an adequate, larger dose of the medicine for the wet-nurse than for the infant, or timing the dose in relation to the time of breastfeeding.64, 65 Specifi c tar- geted recommendations presented by established authorities, for instance Rosén’s indirect treatment of sca- bies with Sulphur,66 could have an apparent impact at least for a while until proven futile.

Laxatives and botanicals to reduce fever Th e signifi cance placed on having ‘clean bowels’ and frequently prescribed purgation until the nineteenth century, were examples of the most frequent indication for indirect treatment in suspected ‘constipation’ in infants. In such cases their nurses were ordered laxatives.67, 68, 69 Regarding breastfed infants, this term usually meant, until present times, longer than accepted delays in defecation rather than problems arising from a hard consistency of stools. Th erefore, the sense of that particular indication can be rightly questioned. Anoth- er example of an indication was fever in children, for Figure 2. “L’Enfant Malade” by an unknown artist the treatment of which Robert Pemell (d.1653) pre- after a painting by Eugène Carrière (1849-1906) at the scribed for the nurse a complex recipe with lettuce, en- Musée d’Orsay, Paris. Th e picture shows Madame Eugène dive, sorrel, violet and strawberry leaves, etc., in addi- Carrière and their son Léon. Th e image of a breastfed in- tion to a special ‘cooling’ diet.70 fant during illness was rarely taken up by artists because of diffi culties in its presentation. Even in expert hands it Indirect treatment of syphilitic infants by dosing the was challenging to accurately portray the act of breastfeed- nurse ing and the child’s body position so that the fact of his ill- For scholarly physicians, the most serious indication ness was visible to the viewer. (Source: private collection, was congenital syphilis. Until the mid-twentieth cen- open access) tury, the basic condition for the eff ective treatment of congenital syphilis and syphilis acquired in infancy de- amples of such recommendations by ancient and early manded that the child was breastfed or – not generally modern authors were compiled by Estelle Brodman.59 recommended – fed expressed human milk. In fact, it Th e reasoning for this form of indirect treatment of was observed that the treatment of syphilitic infants at sucklings was generally the same as for specifi c dietary breast was easier and more eff ective than the treatment restrictions and recommendations for breastfeeding of weaned ones, as mentioned elsewhere.71 Widespread mothers and wet-nurses, described in the preceding awareness among physicians of the risk of infecting a sub-section. Th is was refl ected in an authoritative pre- healthy wet-nurse by a child with congenital or ac- cept by Girolamo Mercuriale (1530-1603): Lactantium quired syphilis led to an essential therapeutic dilemma: cura posita est tota in medicatione nutricum [Th e success- whether to insist on breastfeeding by a wet-nurse in- ful treatment of sucklings relies completely on giving formed about the risk of infection with syphilis or to medicines to their nurses].60, 61 recommend artifi cial feeding with animal milk, with a very high risk for the sick infant. Dosing via human milk Th e acceptance of the direct treatment of syphilitic By being subject to intentional changes, both medica- children with mercury – considered “the true Antidote ments – human milk and medicines – were purpose- against [syphilis]”72 – had proceeded slowly, because of fully and inherently integrated into the course of treat- mercury toxicity, since the sixteenth century.73 Jacques ment. Th e main principle of that therapy was for the Guillemeau (1550-1613) accepted only a direct external nurse to take medicines and observe a special diet as she mercury ointment applied carefully in order to avoid would be ill with the disease and “yield milk which may salivation. His prescriptions for a healthy wet-nurse have the facultie both of meat and medicine”.62 Th ese consisted of three recipes without mercury – a compos-

PHARMACEUTICAL HISTORIAN · 2019 · Volume 49/1 19 ite decoction, an opiate medicine, and a treacle water milk of the nurse.88 Th e idea of indirect mercurial treat- – which had to be ingested in order to “make her milk ment of congenital syphilis was continued in France in medicinal” and to protect her against contagion from the fi rst half of the nineteenth century, with sometimes her charge.74 dire consequences to affl icted infants.89

Beginnings of direct dosing of syphilitic infants Ongoing doubts about dosages When from the eighteenth century the direct internal Th e transfer of mercury into breast milk, however, was treatment with mercury for infants gradually became a controversial problem for chemists.90, 91, 92, 93 Th e more commonly accepted, this innovation reduced to opinions and up-to-date investigations on the passage some extent the moral weight of the dilemma about of mercury into human milk from French, German and how to feed the syphilitic infant. Waiving the prohibi- English literature were described comprehensively by tion of direct use of mercury in infants conversely led Edward Klink in 1874.94 Th at author’s own investiga- to reports by some authors that a diseased infant could tions (which were realized correctly according to the be cured if fed by a healthy nurse who is “under saliva- then current state of knowledge95) at the Imperial Uni- tion” during dosing with mercury. Th e side eff ect of versity at Warsaw confi rmed the presence of mercury salivation was considered an indication the infant in breast milk of syphilitic mothers on treatment. How- would receive an adequate amount of a mercurial prep- ever, it was never certain to what extent mercury was aration via her milk.75, 76, 77, 78 absorbed by the child (bioavailability) and whether the Th is revived specifi c method of medicating syphi- dose received was suffi cient to prevent recurrence of the litic children was intended to spare them the toxic ef- disease. fects of mercury. It had the advantage of simultaneous- From the 1830s a new treatment of infantile syphi- ly treating a syphilitic mother or wet-nurse, or lis involved the administration of potassium iodide di- preventing syphilis transmission to a healthy wet-nurse. rectly or through the medium of wet-nurses.96 One of Th e treatment, however, should have proceeded cau- the modes of administration of salvarsan was also via tiously as the maintenance of adequate lactation was human milk, although this route was considered less essential.79 Dosing via breast milk was considered most eff ective than giving it directly to the child97 or not ef- appropriate for infants “young, weak, and incapable of fective at all.98 Although there have been many physi- bearing [mercurial] frictions in venereal cases”80 (which cians who have tried to treat syphilitic children through was the opinion ex professo of the unknown English the medium of their breastfeeding mothers or wet-nurs- translator of the Astruc manuscript81). es, the opinion prevailed in the beginning of the twentieth century that the results had not been as good as Th e failed Vaugirard experiment those authors believed.99 A meaningful illustration of therapeutic dilemmas and Th at particular failure possibly dispelled any re- consequences is the indirect treatment of syphilitic in- maining therapeutic hopes attached to the indirect fants at the Vaugirard hospital in Paris from 1780. treatment of infants at the breast. Yet, in the authors’ Th ese infants received preparations of mercury through opinion, this very specifi c fi eld of pharmacotherapy their mother’s or wet-nurse’s milk, as was described in cannot be considered as a blind alley forever. One can detail by Joan Sherwood.82 With so many therapeutic imagine that with the continuously increasing knowl- limitations due to mercury toxicity, it was soon noted edge of processes governing human milk secretion new that often this treatment with mercurialized breast applications will be found for indirect therapeutics or milk was not suffi cient to cure the child. Th e supposed prevention, be it only for developing specifi c adaptive ‘cure’ was merely a dormant or latent state, as the dis- immunity in infants. ease soon broke out in a new form,83 and precious time to try direct treatment was lost.84 Four standard treatments of the times Th e Vaugirard experiment was assessed negatively As briefl y mentioned already, blood-letting – once a in 1790 and the hospital was closed. In the ten-year pe- popular method of treatment for many diseases – was riod only 15 per cent of infants were discharged alive.85 recommended also for wet-nurses with sick charges, per More advantageous eff ects were observed when indirect analogiam, along with indirect pharmacological treat- treatment through the medium of the nurse was com- ment, by the medical authorities Avicenna (c.980- bined with direct administration of mercury prepara- 1037),100 Bartholomäus Metlinger (d.1491)101 and Cor- tions to the sick child (traitement mixte).86, 87 Th e oral nelis Roelants (1450-1525).102 Such a recommendation medicine, mostly calomel, when given cautiously, was could not be found in later works. Slightly less demand- usually administered diluted in the expressed breast ing for wet-nurses was the requirement, by some au-

20 PHARMACEUTICAL HISTORIAN · 2019 · Volume 49/1 thoritative doctors, for them to undergo cupping in pressed human milk has been applied topically for a proxy for the child,103 usually combined with scarifi ca- range of ailments, up until today. It has been used to tion, or the ritual of purgation of the bowels with a mild improve the well-being of adults with a variety of ill- laxative – honey and olive oil – before taking up a new nesses, whilst in some instances ailing adults were di- charge104, 105 and on specifi c indications.106, 107, 108 rected to be suckled by hired wet-nurses.

Authors’ addresses: Tomasz Sioda, emeritus paedia- trician and neonatologist (corresponding author) Poznań, Poland. Email: [email protected]. Virginia Th orley, School of Historical and Philo- sophical Inquiry, University of Queensland, QLD, Aus- tralia. Email: [email protected]. Th is research was not supported by external grants.

Endnotes and References 1. Wacker-Gussmann, A., Strasburger, JF., Cuneo, BF., et al. Diagnosis and treatment of fetal arrhythmia. American Jour- nal of Perinatology. 2014; 31(7): 617-28. 2. Czekierski, J. Chirugia [Surgery]. Vol. 4. Warszawa: 1818: 302-7. 3. Nothnagel, H. and Rossbach, MJ. Handbuch der Arz- neimittellehre [Handbook of Pharmaceutical Teaching]. Fourth Edition. Berlin: 1880: 781-2. Figure 3. “La Maladie de Las Casas” by Pierre Mi- 4. Zerbi, G. Gerontocomia: On the Care of the Aged. [Roma, chel Adam (1799-?) after Louis Hersent (1777-1860), 1489]. Transl. Lind LR. Philadelphia: 1988: 179-81. 1823. Th is illustrates direct breastfeeding of an ailing, 5. Perzyna, L. and Tissot, SA. Porządek życia w czerstwości aged adult, in this case Bartolomé de las Casas (c. 1484- zdrowia w długie prowadzący lata : ze wszystkich dzieł p. Tyssota 1566), Bishop of Chiapas in Mexico (Source: Bibliothèque w iedno zebrany [Order of life resulting in the robust health for long years: collected into one from all works by Mr Tissot]. Nationale de France, with permission) Supraśl: 1789: 17-25. 6. Turnbull, W. An inquiry into the origin and antiquity of the lues venerea; with observations on its introduction and progress Conclusion in the islands of the South Seas. London: 1786: 90. Human milk, preferably directly from the breast, was 7. Pliny the Elder. Th e Natural History. Transl. Bostock J, for centuries considered an important part of the treat- Riley HT. London: 1855: 28.21. Cit. URI: http://data.perseus. ment of sick infants. During certain times and in par- org/citations/urn:cts:latinLit:phi0978.phi001.perseus- eng1:28.21. Accessed 2 September 2018. ticular situations, it was also recommended for the 8. Agrippa von Nettesheim HC. O ślachetności a zacności treatment of ailing adults with a variety of illness, either płci niewieściej [Declamatio de nobilitate et praecellentia foemi- as expressed breast milk or via direct suckling by hired nei sexus eiusdemque supra virilem eminentia libellus (Antwerp: wet-nurses. Among its uses was to promote health and 1529)]. Transl. Wirzbięta M. Kraków: (1535) 1891: 25-6. recovery through its own intrinsic properties, and to be 9. Zerbi, G. (Note 4) 1988: 179-81. 10. Pallierio, PF. De vera lactis genesi, & usu, disquisitio me- a vehicle for the passage of medicine or other treatment dico anatomica multa nova ad Hippocratis mentem complectens. to a sick child. Dosing with medications via the milk Genua: 1663: 34-9, 80-4. was particularly recommended in cases of congenital 11. Perzyna, L. and Tissot, SA. (Note 5). syphilis or early acquired syphilis, when the treating 12. Anon. Gazette de France. No. 85 d. 21.07.1663, 675; No. physician was reluctant to treat the child directly with 88 d. 28.07.1663, 700. the toxic substances used, principally mercurial com- 13. Patin, G. and Reveillé-Parise, JH. Lettres de Gui Patin. Vol. 1. Paris: 1846: 521. pounds. 14. Palliero, PF. (Note 10) 1663: 58-63. Th e intention was to treat the child, while avoiding 15. Turnbull, W. (Note 6) 1786: 90. unpleasant side eff ects, but little consideration was giv- 16. Fabricius von Hilden, W. Opera quae extant omnia. en to the welfare of the mother or wet-nurse obliged to Frankfurt-am-Main: 1646: 676, 879. ingest these compounds. Th e wet-nurse could also be 17. Sioda, T. and Th orley V. Unfortunate creatures: Th e haz- subjected to non-pharmacological treatments that were ards of infection in wet-nursing. Unpublished manuscript. 2018. 18. Zerbi, G. (Note 4) 1988: 179-81. in vogue in the past, such as blood-letting and cupping, 19. Siennik, M. Herbarz, to jest Zioł tutecznych, postronnych in the belief that this would improve the quality of her y Zamorskich opisanie [Herbarium, it is the description of indig- milk and the well-being of the child. Across time, ex- enous, foreign and overseas herbs]. Kraków: 1568: f. 461r.

PHARMACEUTICAL HISTORIAN · 2019 · Volume 49/1 21 20. Proksch, JK. Die Geschichte der venerischen Krankheiten: 45. Hoff mann, F. A system of the practice of medicine. Vol. 2. Eine Studie. Vol. 1. Alterthum und Mittelalter [Th e History of London: 1783: 500. Venereal Diseases: A Study. Vol. 1. Antiquity and the Middle 46. Szymkiewicz, J. (Note 36) 1810: 167. Ages]. Bonn: 1895: 349. 47. Swediaur, FX. A Complete Treatise on the Symptoms, Ef- 21. Laskaris, J. Nursing mothers in Greek and Roman med- fects, Nature and Treatment of Syphilis. Transl. fourth Edition, icine. American Journal of Archaeology. 2008; 112(3): 459-64. 1799. Philadelphia: 1815: 330. 22. Guillemeau, J. Th e nursing of children, with Child-birth; 48. Guillemeau, J. (Note 22) 1635: 104, 112. or, Th e happy delivery of women. London: 1635: 6, 12. 49. Paré, A. Th e workes of that famous chirurgion Ambrose 23. Gorter, J. de. Formulae medicinales: cum indice virium Parey. Transl. Johnson T. 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22 PHARMACEUTICAL HISTORIAN · 2019 · Volume 49/1 74. Guillemeau, J. (Note 22) 1635: 114-5. 94. Klink, E. Badania nad przechodzeniem rtęci, przy wcie- 75. Garnier, P. Traité practique de la Verole. Lyon: 1696: 65. raniach szaruchy, do mleka karmiącej [Research on mercury 76. Astruc, J. De morbis venereis libri sex. Paris: 1736: 345-6. passage, during frictions of grey ointment, to human milk]. Me- 77. Duncan, A. Observations on the operation and use of mer- dycyna. 1874; 2(45): 725-9. cury in the venereal disease. Edinburgh: 1772: 157. 95. Sioda, R. Personal information. 2013. 78. Lancereaux, E. (Note 73) 1869: 326. 96. Lydston, GF. Lectures on syphilis. Chicago: 1885: 165. 79. Fabre, P. Traité des maladies vé né riennes. Paris: 1782: 97. Findlay, L. Syphilis in Childhood. London: 1919: 133. 362-3. 98. Aschheim, S. Zur Behandlung des hereditär syphiliti- 80. Astruc, J. A general and compleat treatise on all the dis- schen Säuglings durch Behandlung seiner stillenden Mutter mit eases incident to children, from their birth to the age of fi fteen. Lon- Salvarsan [On treatment with salvarsan of infants with heredi- don: 1746: 229. tary syphilis through medication of their breastfeeding mothers]. 81. Astruc, J. Traité des maladies des enfans. Paris: 1744. Zentralbl Gynakol. 1911; 35(31): 1117-8. Manuscript in Bibliothèque Universitaire Lille, 229. 99. Hazen, HH. Syphilis: a treatise on etiology, pathology, di- 82. Sherwood, J. Infection of the Innocents. Wet Nurses, In- agnosis, prognosis, prophylaxis, and treatment. St. Louis: 1919: fants, and Syphilis in France, 1708-1900. Montreal: 2010. 458. 83. Bell, B. A treatise on gonorrhea virulenta, and lues ve- 100. Still, GF. Th e History of Paediatrics (1931). London: nerea. Philadelphia: 1800: 196. 1965: 50. 84. Cullerier, AFA. Précis iconographique des maladies véné- 101. Ruhräh, J. Pediatrics of the Past. An Anthology (1925). riennes. Paris: 1861: 414-27. New York: 1995: 93. 85. Sherwood, J. (Note 82) 2010: 56-58, 66. 102. Roelans von Mecheln, C. Libellus egritudinum infan- 86. Lagneau, LV. Traité Pratique des Maladies Syphilitiques. tium. Leuven: 1483/1484: f. 119r. Sixth Edition. Vol. 2. Paris: 1828: 260-1. 103. Still, GF. (Note 100) 1965: 50. 87. Colles, A. Practical observations on the venereal diseases 104. Rosén von Rosenstein, N. (Note 66) 1776: 5. (London: 1837). In McDonnell R. (ed.). Th e works of Abraham 105. Struve, CA. A familiar view of the domestic education Colles. London: 1881: 273. of children during the early period of their lives: being a compen- 88. Szymkiewicz, J. (Note 36) 1810: 169. dium addressed to all mothers, who are seriously concerned for the 89. Diday, P. A treatise on syphilis in new-born children and welfare of their off spring [...]. Transl. Willich AFM. London: infants at the breast. London: 1859: 238-45. 1802: 240. 90. Cullerier, AFA. (Note 84) 1861: 314-27. 106. Brodman, E. (Note 59) 1978: 36-46 [in Appendix 1, 91. Bouchut, E. Practical treatise on the diseases of children 44-46]. and infants at the breast. London: 1855: 66, 72. 107. Rösslin, E. and Th omas, R. (Note 67) 1994: f. 133r/v. 92. Lancereaux, E. (Note 73) 1869: 326. 108. Culpeper, N. A Directory for Midwives: Or, A Guide 93. Jacobi, A. Infant Hygiene. In Robinson WJ (ed.) Contri- for Women, In their Conception, Bearing, and Suckling their Chil- butions to Pediatrics by A. Jacobi, M.D. Vol. III. New York: 1909: dren. London: 1693: 389. 76.

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