The medical and surgical treatment of the pilgrims of the Jacobean Roads in medieval times: Part 1. The caminos and the role of St. Anthony's order in curing ergotism

Abstract

The pilgrims of the Jacobean Roads to Santiago very often became extremely sick and died of ergotism (ignis sacer). A non-contagious epidemic had been emerging since 1090 throughout Europe, due to the consumption of rye bread contaminated by the fungus spore of ergot and causing great devastations like pestilence. In order to provide support and treatment, the order of St. Anthony founded about 200 monastic hospitals on the four roads to Santiago. In these hagiotherapeutic centres representing the first huge, highly specialized European medical welfare system, the friars separated the ill pilgrims after a careful diagnosis of “St. Anthony's fire”, gave them ergot-free nourishment, herbal wines (with vasodilating and analgesic herbals) and applied Antonites-balsam, the first transdermal therapeutic system (TTS) in the history of medicine. In a very practical manner of charity they were taking care for the mental and somatic restitution of the victims of ergotism. Unfortunately, their secret recipes were lost at the end of medieval times. Because the monks were not allowed to perform operations after 1130, barber surgeons were engaged in many cloisters for treating open sores, inflamed limbs and for amputation gangrenous legs. Due to the lack of references in medical history, it is unknown whether other complications such as septic deliriums, tetanus and toxic hallucinations causing by ergotismus convulsivus were also treated. With this study we wanted to fulfil two purposes: to study how the epidemic of ergotism was managed by medical and surgical therapy in medieval times, by the use of medical herbs and with the amputation of necrotic limbs by wandering surgeons under contract to the hospitals of the caminos ( part 1) as well as to trace the effects of historical events in the fine arts, in the paintings as a testimony of medical history ( part 2). Our further aim was also to study what types of analgesic and anaesthetic methods have been applied in every-day practice in the hospitals [M.J. Imbault-Huart, La médecine au Moyen Age à travers les manuscits de la Bibliothèque Nationale, Editions de la Porte Verte, Paris, 1983, p. 77; P.M. Jones, Heilkunst des Mittelalters in illustrierten Handschriften, Belser Verlag, Stuttgart, 1999, pp. 45–57; J. Jörimann, Frühmittelalterliche Rezeptarien, Orell Füssli, Zürich–Leipzig, 1925; Frankf. Allg. Zeitung Nr. 44 (21.2.2001) 2; CIBA Symp., Sondernummer 6 (1942) 36; H.E. Sigerist, Studien und Texte zur frühmittelalterlichen Receptliteratur, Verlag von Johann Ambrosius Barth, Leipzig (1923); Sudhoffs Arch. 67 (1923) 39].