About the Remediorum Specimina and Abraham Wagner
Eighteenth-Century Colonial Formularies:
The Manuscripts of George de Benneville and Abraham Wagner
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The Remediorum Specimina ex praxi A.W., or Examples of Remedies from the practice of Abraham Wagner, is a roughly 200-page octavo manuscript in German with clinical notes and patient observations and recipes reproduced both in Latin and in the extensive pharmaceutical notation of the period. Apparently begun in 1740, it is oriented to the practical side of medical care and the dispensing physician. The manuscript provides the large and eclectic list of recipes customary for the early modern period, and includes considerable detail on their preparation. Although its intended audience is not obvious beyond his immediate circle, it is definitely not a domestic manual.
The life of Abraham Wagner and its transatlantic context
Abraham Wagner (1715-1763) was a Schwenkfelder physician from Silesia. In Pennsylvania he was part of the early migration of religious dissidents into North America. Here they expected to find both religious toleration and room for professional practice and Abraham Wagner seems not to have been disappointed in his expectations. The Schwenkfelders were a small, pertinaceous sect founded in the 16th century by a Silesian nobleman, Caspar Schwenckfeld von Ossig, a well known and well travelled dissident who opposed both Lutheran and Calvinist dogma. Many of his followers came from the professional and land owning classes of Silesia, and another Caspar von Schwenckfeld, a physician from Hirschberg in Silesia, in 1580 authored a famous medical thesaurus still quoted in many 17th and 18th century medical and pharmaceutical works. A prosperous and well developed area, partly reflecting Polish ascendancy and the rule of the Piast dukes during the late middle ages and the beginning of the early modern period, Silesia was the birthplace of a famous literary and humanist culture of the baroque period and well endowed with humanist schools of higher learning in its Protestant areas.
The Schwenkfelders mainly came from the territory west of the River Oder ruled by various branches of the Dukes of Liegnitz, who in turn ruled under Austrian suzerainty, Silesia being one of the hereditary territories of the Hapsburg Crown. An apparently well developed medical culture flourished since the 16th century, with the groundwork being laid at several famous humanist gymnasiums. Lacking their own university until 1702, Silesian medical and other students of all denominations attended the universities of the Empire, the Netherlands, and to universities in northern Italy, including in particular the famed medical school at Padua (Conrads, 1994); there is a report of a medical college in Liegnitz, although information is poor on this period and this locale. We note that neither Wagner nor his predecessors can be traced to a major European university but seem to have been apprenticed in an interesting line of spiritualist practitioners.
A major enemy of the Schwenkfelders and similar spiritualist sects throughout the 16th and 17th century was in fact the Lutheran establishment, although there were intermittent mandates from the Imperial and Catholic Court in Vienna for expulsion and conversion. Only during the final push of the Counter Reformation did religious persecution finally put paid to the existence of this dissident sect in a multiethnic and multiconfessional society. By the early 18th century emigration into Saxony, including the estates of the Moravian leader Count Zinzendorf, and later to North America through the Mennonite centers at Krefeld and Rotterdam was one choice for those wishing to retain their religious and civic liberties. While most of these emigrants -- male and female -- were by now artisans and of relatively modest social standing, they were usually highly literate, and the Schwenkfeld tradition of learning seems to have come over with the medical men, in particular Melchior Hübner, who arrived with an earlier group of roughly two hundred Schwenkfelders in 1734. His eventual apprentice, Abraham Wagner, came over in 1738 as a young man, having served apprenticeships in Silesia with his great grandfather and, in this country. Melchior Hübner (spelled in America as Heebner: see the Genealogical Records of the Schwenkfelder Community).
During the 17th century in particular, and despite intermittent persecution in Silesia, several Schwenkfelders had been involved in the network of dissidence, spiritualism, and Christian reform that continued to prevail in Germany, Holland and England. The linkage of many in this network to Johann Comenius and the Hartlib circle and the larger network of Quakers is well established (Webster, 1975, J.T. Young, 1998, Newman, 1994, Debus, 1965, Weigelt, 1987). Wagner's great grandfather Georg Hauptmann (or Haubtmann, 1635-1722), a well known medical pracititioner in Silesia, seems to have corresponded with the founder of German Pietism, Philipp Jacob Spener, in the 1690s. When he came to North America, therefore, Abraham Wagner neither came from nor entered an intellectural void but was able to continue both transatlantic links to fellow believers and thinkers and participate in the chymiatric tradition of the European Christian radicals on these shores. Wagner's mentor Melchior Hübner (b.1668) had also been apprenticed in Silesia in the practice of a relative, the well known and widely travelled medical practitioner and Schwenkfeld representative Martin John the Younger (1624-1707), who was in correspondence with and had met on travels as far as Amsterdam many famous spiritualists of his day, including Jane Leade, Johann Georg Gichtel, and Johann Wilhelm Petersen (Weigelt, 1987). Hübner had practiced medicine in Hockenau and subsequently in Görlitz. He was a follower of Jane Leade and disagreed with any attempt to reconcile the Schwenkfelders with Imperial authority. He practiced in Pennsylvania from 1734 until his death in 1738 in Frederick, close to Falckners Swamp, apparently leaving behind in Europe most of a religious and medical library.
That Abraham Wagner enjoyed a considerable medical and personal reputation is clear from his complex and detailed will, in which he left one third of his considerable estate (well in excess of &163;1000) to be distributed to the poor through a number of surviving associates (Berky, 1954). The bequests included a donation of &163;20 to Pennsylvania Hospital, and he forgave his impecunious patients their book debts, incoming monies to be added to the charity trust. His will does not inventory his medical library, but it must have been sufficiently substantial to allow extracts of recipes from numerous European authorities. His brother kept his books and medical and pharmaceutical apparatus at his death, but it is not clear from the records if Melchior Wagner, who died in 1789, in fact continued his brother's practice. Both held adjoining properties in Worcester township in Montgomery county and we may presume that that was the locale of the Wagner medical practice. The more extended religious and spiritualist written legacy of Abraham Wagner is also at the Schwenkfelder archives, and includes extensive religious writings, correspondence with European and American coreligionists, and some alchemical manuscripts.
The English rendition on this website of the Remediorum Specimina is a first step in tackling a complex manuscript with multiple revisions, in the author's own and different, later hands. In particular, the editorial additions and deletions point to a thoughtful and critical approach to the recording of therapeutic instructions, whether from the author's own practice or his critical selection of sources. In particular, we note qualifying adjectives (e.g., the deletion of often, very, etc., and their substitution by more moderate descriptors like some and occasionally); the addition of more specific instructions (e.g., the insertion of additional or alternative remedies) or a more specific description of symptoms and their causes. This does not necessarily mean a writer other than Wagner or his copier, unless editions or authorities cited refer to dates subsequent to his death; note that reference is made to practices later that Wagner's death in 1763 (e.g, a competing preparation at the Bartram pharmacy in Philadelphia dating to 1776 and to a panchymagogue extract by George de Benneville, possibly his son, dated 1781. While it is certainly not unreasonable to assume that later changes were made by Melchior Wagner, a younger brother born in 1725 and the patriarch of a long line of Schwenkfelders in North America, we have no direct proof of his apprenticeship with his older brother or other training. The presence of pharmaceutical equipment, including a still, in the inventory accompanying his will suggests but does not prove medical practice.
Another concern is that the margin of error caused by the use of traditional but by no means standardized pharmaceutical symbols is wide. Additionally, while certain terms (e.g., tempering, discutient) have been used throughout for consistency, they may not always capture the intended meaning. If readers find discordance between some English terms used in the translation and those found in contemporary sources, this reflects lack of concordance in the literature of the time.
Accession and material aspects
The leather-bound octavo manuscript was given to the Schwenkfelder Library in 1924 by two descendants of Abraham Wagner, George S. Sheppard from Penn Yan in New York, who is identified as the great-great-grandson of Melchior Wagner, and Mrs. Ethel Richter. They presented it to Dr. Samuel K. Brecht in 1923, as a sign of appreciation for the extensive work on the Schwenkfeld genealogical and other archives done during the early part of the century. It is not known where among the papers of the Wagner descendants the manuscript resided during the 150 years between the death of Melchior Wagner and the date of the bequest. Nor, more importantly, is there a record of its compilation: work by one of our collaborators established several different paper signatures and a good amount of cutting and pasting is visible even to the reader of the images on this site. There are some changes in handwriting, but in view of the difficulty of distinguishing these from simple differences in Latin versus German cursive script, we will leave their identification to future researchers, except in cases where even the ink was different. We note that like the Moravians, the Schwenkfelders had a distinct and longstanding tradition of script copying, probably attributable to their lack of access to printing presses and printed spiritualist and devotional literature.
In its current form, the manuscript and its recipes and observations on specific diseases and therapies appear to constitute the attempt to integrate two major schemata for setting forth the practice -- not the theory -- of medicine:
- the tradititional medical scheme classifying organs and sites of the body and its afflictions
- and the standard approach in official pharmacopoias and public and private dispensatories by type of preparation and their use for specific or general conditions. (For a selection of relevant pharmacopoias and dispensatories, formularies or other Rezeptbücher, see Section I of the Selected Readings.)
The medical scheme runs in the standard classes of medical textbooks of the period, from head to toes, with special classes for women and children and exanthemous diseases of the skin and limbs, including those due to injuries and accidents. Fevers and generalized internal conditions occupy their separate classes, but it is interesting to note that many of the subheadings under these are left without text -- possibly for lack of patients on whose condition observations could be made.
The second scheme is an equally standard but again not fully consistent attempt to integrate into the medical scheme recipes for specific conditions and instructions for manufacture and use for a full range of medications, classed by their mode of preparation, from pills and powders to potions and plasters. The medical portion in particular, but by no means exclusively, contains case stories or clinical notes with brief descriptions of individual patient complaints and general disease outbreaks, patient descriptions and treatment accounts. These include venesection and numerous non-medicinal treatments such as plasters and infusions. At several points in the writing or in revision, the author or collator decided to change tack, and moved medical portions into the pharmaceutical formularies and vice versa, occasionally omitting whole classes or reversing their order, and pasting in pages out of sequence.
In actual fact, however, the progression is more orderly within sections than this arrangement might sound on the face of it. Once past the first pages of Section I, entitled Powders, we encounter a sequence running more or less along traditional lines from complaints of the head and the emotions, through the various parts of the body, and ending with female problems of birth and the problems of children and nursing, for a total of nine classes. As we note in the translation of the manuscript, some of these classes are missing or placed in the wrong order.
The scheme reverts to pharmaceutical preparations for specific conditions at about midpoint, on folio 53 recto, entitled Pilulae or Pills. Conditions are here listed not by classes of body organs, but stress exanthema and external conditions, such as burns, frostbite, gangrene, and erysipelas and skin infections of various types.
By the final third of the Remediorum Specimina, extemporaneous recipes for potions, pessaries, ointments, plasters and waters, in standard order, are given for a range of disparate conditions. The final page, although bearing the inscription Finis, seems not in fact to have been the last page, but carries a carry-over "the" for which there is no corresponding page following but a (standard?) final prayer, in a different hand.
Throughout, the recipes are carefully attributed to numerous and generally recurring sources. According to the notes in the manuscript, the author(s) worked from several desk copies, including an unspecified Stahl, Heister's Chirurgia, Rothe's Chymie, Caspar Neumann's Chymie, and an otherwise unidentified English Dispensatory, the latter with page reference for the source. The recipes include
- a large portion of the post-medieval medical canon, beginning with Johann Agricola and proceeding over several centuries of often chymiatric authors: Robert Boyle and Johann Becher are mentioned with one recipe each, Otto Tachenius and Adrian Mynsicht for roughly 5 mentions each of their standard eponymous preparation. Georg Ernst Stahl of the Friedrich Universität in Halle is mentioned on several occasions, and even more frequently his teacher Georg Wolfgang Wedel in Jena. Stahl's students Samuel Carl and Johann Juncker appear with several preparations. Outside of this circle are Lorenz Heister, the famous 18th century military surgeon and professor at Helmstedt University, with several treatment regimens, and Caspar Neumann, whose Chymie was translated by William Lewis in 1759. Both appear above all in the latter part of the manuscript. Other references go back as far as Johann Agricola, who died in 1570, David Ludovicus, (d. 1680), a well known reformer of the materia medica, and Francois Burrhus, whose balsam is cited several times as Balsam Burrhi (Balsam of Burrhus) and Francois de la Boe (Sylvius).
- Many famous Halle Orphanage medications (Poeckern 1984, Wilson, 2000) are included, although these were supposed to be jealously guarded arcana, and Heister and Stahl are juxtaposed in a final recipe discussing the cleaning of impure teeth -- neither suggestion being accepted by Wagner, it appears. There is little explicit reference to Friedrich Hoffmann, the contemporary of Stahl and a prolific inventor of arcana (Lanz, 1995; here fol. 20r), and none to the classic authors, although the reservoir of Galenic botanical materia medica is relied upon throughout.
- A second set of sources for numerous prescriptions are the author's own preparations and those of his Silesian mentors: George Haubtman Medicus, Martin John, Melchior Hübner (Heebner).
- And finally, there is the colonial medical establishment, including a recipe from George de Benneville, one by a neighboring Moravian physician, Johann Adolph Meyer, and the brothers Isaac and Moses Bartram in Philadelphia.
Note that since these names are in the main spelled in reference to their preparations (as in Balsam Burrhi), or mentioned only by their initial letters (W., which we assume stands for Wedel based on a reading of contemporaneous sources), they are not straightforward to search for with our software. (See the section entitled Technical Notes for further information.)
The external conditions which begin to govern the presentation in part 3 follow closely the scheme adopted by Lorenz Heister, whose terminology and descriptions of diseases are often taken over verbatim, followed in each case by a trimmed down selection of recipes. Note, however, that reliance on this surgical text extends only to selected portions of Heister's Chirurgie, Part I, which is structured around conditions and their treatment. In our manuscript, close concordance with the Chirurgie is mainly limited to Books 4 and 5, Of Tumors or Growths (Von den Geschwulsten or Phlegmone) and Of Abcesses (Offene Schäden oder Ulcera), respectively. While the sequence is followed precisely, many conditions are omitted, including boils resulting from venereal diseases, and carbuncles from plague conditions. The choice among the numerous recipes is likewise selective, but where used, follows amounts and dosages carefully.
The omission of operational and other surgical procedures and instruments from Heister's Parts II and III (Bandages etc.) indicates that Wagner and his successors did not practice surgery other than the customary bloodletting and similar minor procedures (see for example, f. 57 verso for caution against bloodletting in conditions affecting the skin). Local reference to English practices, such as excessive bloodletting in an epidemic of pleurisy in 1748, and to the practice of more favored colleagues remain anonymous, in the practice of the period. In general there is little engagement with the medical controversies among the Edinburgh trained physicians in Philadelphia, most of which date to the period after Abraham Wagner's death in 1763.
Treatment regimens and patient histories
In contrast to de Benneville, Wagner offers several sets of clinical notes and observations on current epidemic outbreaks, such as a pleurisy or pleuritis with numerous fatalities in the 1740s, on throat diseases in children, and birthing and perinatal instructions to midwives and attending physicians. Some of the formula for medicines are cross referenced or given in abbreviated form in the clinical notes. Fever regimens are common, although not summarized in a specific class. Although Peruvian bark (cinchona) is occasionally recommended, as is opium, here too Wagner seems closer to Stahl and his school than de Benneville, whose treatment regimens appear to date to an earlier period. Mercury is common throughout, in particular for conditions of the skin.
It would seem that Wagner or his successor concentrated more and more on conditions frequent in a primary care rural practice, such as skin infections, frostbites and broken limbs, and the numerous infections with erysipelas at various body sites, including female breasts and male testicles, again following Heister in emphasis and identification. We even find one reference to a medicine for cattle (pecud), here an ointment for fissures of the hoof.
What remains to be integrated into the larger account of colonial German medical practice is a better understanding of what drove Wagner to collect not only his own store of recipes as they related to the chronic and acute conditions seen, but a whole welter of detailed named or proprietary recipes. Since he was not known to have run an apothecary's shop outside his own dispensary, we may well assume that he was retaining, for his own successor and for other physicians in his network, his own thesaurus of European medicine as brought over to this country. The most likely explanation for the genesis of the compilation is that it was intended to pass on Wagner's experiences and suggestions to an apprentice, or to a successor in practice, who might have been his brother, Melchior Wagner. The author or authors of the additions and emendations after Wagner's and his brother's death remain unidentified. What remains is a closely written manual of treatments for common and frequent conditions, both acute and chronic, and detailed recipes, that rely on and incorporate the canon of European medical authority, with an obvious but not exclusive reliance on the group around Wedel and Stahl and their students and followers.
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