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What treatments did they prescribe?

As well as providing advice, Forman, Napier, and their associates suggested and arranged treatment for their patients. More than 51,000 of the cases include notes about treatment; 476 include recipes. Treatments in entries range in complexity from the simplest notes, indicating in a word or two that pills are to be taken or a quantity of blood let, up to lengthy and detailed courses with numbered steps, incorporating many elements and full recipes. A small minority (such as CASE14895) explicitly record that nothing was prescribed. Some treatments were written as recipes, some in imperative form (‘give her ...’) as instructions or memoranda; some were written in the past tense, after the treatment had been applied and sometimes after its immediate effects. Forman’s treatments tend towards the formulaic: ‘prepar 3 days and purg 2’ is typical, indicating the processes and their durations, but not giving details of the substances involved. Napier’s treatments are typically more varied and recorded in more detail. This page gives an overview of the sorts of treatments employed. Note that if a case does not record a treatment, it is still possible that the astrologer recommended one. Forman seems to have kept a separate notebook, now lost, of treatments and payments, and Napier and his associates may have done the same.

Purging | Herbal remedies | Animal remedies | Human ingredients | Mineral remedies | Compound medicines | Bloodletting | Sigils | Rings | Blessings

Purging: The majority of treatments recorded in the casebooks incorporate the consumption or application of medicinal substances of one sort or another. The rationale behind the choice of these substances varied: some of the treatments were purgative, in the tradition of Galenic medicine that sought to achieve balance in the humours by expelling those that were in excess or corrupted. Forman’s treatments typically centred on purgation, the most familiar being the ‘prepare X days and purge Y’ instruction. Napier used purgatives too, but his treatment notes record far more specific details about what precisely was to be given to his patients, and here we see a variety of other long-standing Galenic medicines: lenitives, for instances, softened humours in the body to soothing effect; repercussives drove humours away from a particular part. In Napier’s detailed notes it is also possible to see a range of non-purgative medicines in use. These often tied a medicament to a particular problem — as in the case of eyebright, used for eye complaints (see for instance CASE13711), or scurvygrass to cure scurvy (for example CASE76874). Or a medicine might be used for a range of ailments, but operate in a mysterious (non-humoral) fashion, as in the case of some of the compound medicines (see below).

Herbal remedies: Many of the substances prescribed were herbal, running from aloe to lily root, periwinkle to wormwood; some of the plant-derived substances are recognisable today as foods: ginger, endive, and figs, for instance. Others, such as nightshade, are definitely not. Among the medicines prescribed are some that were also consumed as drinks for entirely non-medical reasons: beer, claret wine and Rhenish wine. Tobacco was prescribed in a number of cases.

Animal remedies: Alongside these are animals and substances derived from animals: one entry advises using ‘bees burnt’ (CASE47017), while someone who had been bitten by a mad dog was told to ‘eate the liver of the dog killd’ (CASE66825). Sheep’s bladders were used in several cases for people unable to ‘hold their water’ (CASE22997 and CASE27088, for instance; CASE38901 specifies that they should be ‘made in pouder’). Oil of swallows, an unguent made from the bodies of the birds ground up, is another example (e.g. CASE36013). Perhaps most striking among the treatments involving animals are those that consist of applying the bodies of pigeons, slit, to a part of the body: ‘a pigon slitt & applyed to the sole of each foote’ (CASE51060; ‘a pigeon slit to the neck. app. & to the soule of the feete’ (CASE30882). Confusingly, Napier often abbreviated pigeon to ‘pig’: ‘pig for neck & feete 3 nights’ (for a nine-week-old child in CASE51965; ‘pig to each soale of the foote’ (CASE58436). The employment of another piece of meat in one case indicates that pigeons may have been the most common animal used in this sort of treatment, but they were not the only one: ‘a pig to each foot & beefe strayned in Aq to her neck’ (CASE50148).

Human ingredients: A special type of animal derivative employed in medicines in the casebooks involved the supposed healing power of the parts of dead human bodies. Several cases of falling sickness include prescriptions for the skull of a man powdered: two drachms in CASE59696, a spoonful of it a drink in CASE64664, some mixed with powdered horse‘s hoof in CASE71683. A few patients suffering from swellings were told that the solution was the touch of ‘a dead mans hand’ (CASE68295), sometimes accompanied by a plate or plaster of lead with which the afflicted part was also to be rubbed (CASE71209 and CASE45669). In CASE68294 Napier records that the patient ‘hath bene touched with the hands of a dead man & woman’ without success. In addition to all these, a note among Napier’s papers (NOTE776) explains the means of preparing the substance ‘Mumia’, an imported medicine derived, or thought to be derived, from mummified bodies.

Mineral remedies: Alongside the medicinal substances derived from plants and animals were some that derived from stones: mineral and metallic medicines, some the products of alchemical procedures. The purgative antimony appears numerous times, whether prescribed as tablets (‘tab stib.’ or ‘tab ’; e.g. CASE19431 and CASE43969) or taken in quantities of a few grains (CASE39864), used to prepare antimony wine (CASE43093 records Robert Wallis’s consumption of antimony wine in broth) or a water with which patients could wash (CASE74029). Alchemical preparation of antimony from its ore, stibnite, could be carried out in a number of ways, a key example being the production of ‘regulus of iron’, metallic antimony produced using iron. The treatment in CASE74414 includes five grains of it, as do the treatments in CASE74779 and CASE74848. Some patients were prescribed crocus metallorum, a yellow powder derived from some metal (see for instance CASE49271 and CASE52294); in CASE35313 the substance is specified as ‘crocus ’, the iron compound crocus of Mars. Another purgative, ‘mercury vitæ’ (or ‘ vitæ’, mercury of life), appears in a scattering of entries: CASE40483 and CASE72252, for instance, and in one consultation the Countess of Buckingham requested that Napier give her son Lord Purbeck a vomit and two doses of mercury vitæ, each dose consisting of four and a half grains of powder (CASE73858)

Compound medicines: While the treatment notes typically include lists of simples, some of the medicines prescribed were compound medicines concocted elsewhere and bought in by Napier. Most pre-eminent of these was theriac, an ancient antidote to poisons also referred to as ‘treacle’: CASE32226 records a consultation in which Mably of North Crawley asked ‘for london triacle’ (the place is presumably specified to distinguish it from the famed Venice treacle), and Napier prescribed it in several other entries (such as CASE14846, CASE21274, and CASE49923). Elsewhere in the casebooks instances can be found of the employment of medicines such as ‘confectio alchermes’ (CASE35244) and ‘flos unguentorum’ (CASE24843); and it seems reasonable to suppose that the mysterious ‘luton salve’, mentioned in CASE38300 and CASE38660, was something similar.

Bloodletting: One of the commonest treatments to appear in Napier’s casebooks is bloodletting. Sometimes this is explicit and clear, as in CASE34857, where Gerence James has advised ‘min: sang: in Iecor: dext:’ (let blood in the right hepatic vein), but more often treatment notes specify only the name of the vein and a quantity of blood (‘ceph. viij’, eight ounces from the cephalic vein, CASE43855), or even just the name of the vein itself in abbreviated form (‘Iecor’, CASE36541). In a few entries Napier advocated the use of leeches, specifically horse leeches: CASE20601, for instance, recommends dealing with haemorrhoids by ‘fasten[ing] horse leaches to the emrod vaines’. At one point (CASE73638) Napier remarks on the best leeches to use: ‘Dorcester leaches. but beakinsfild better. for leaches’. Another process occasionally recommended by Napier was an issue, the surgical draining of fluid, which he described at length in CASE30459. Lastly cupping, a form of bloodletting that involved applying a heated cupping-glass to skin to draw humours to the area, sometimes scarifying the skin to remove those humours. We have few references in the casebooks to cupping being carried out on behalf of the practitioners (CASE51075 CASE64346 are exceptions), but there are entries in which people ask about it (such as CASE19343), and some that mention past, typically unsuccessful, experiences of it (such as CASE11100 and CASE41692).

Sigils: From 1611 on, Napier begins recording prescriptions of sigils for some of his patients. He occasionally spells the word ‘sigill’ out in full, but more often abbreviates it as a capital S, typically followed by a planetary symbol standing for the material out of which the sigil was made, or the planet under whose influence it was believed to be, or both: ‘S ’, ‘S ’, ‘S ’. It might be supplied ‘w[i]th a string’, ‘w[i]th silke rib’ (ribbon), ‘in taffata’, ‘in sarcenet’, ‘in serico’ (in silk), or ‘in aq hyp’ (then a quantity), most likely indicating that the patient was to be given water of St John’s wort in which a sigil had been left for some time. The dates and times at which sigils were prepared and put on were crucial to their effectiveness, so the casebooks contain a number of elections to determine when sigils should be made, and a few interrogations in which charts were cast for the moment at which a sigil was completed or first worn, presumably to determine how successful they would be.

Rings: In a number of cases Napier supplied patients with rings that could be worn to help prevent the falling sickness. He referred to these variously as ‘Annulus Epilepticus’, (CASE79353), ‘Annulus pro morbo Caduco’ (CASE79706, CASE79708, and CASE79808), ‘ad morbo comitialem’ (CASE79385), or ‘pro morbo comitiali’ (CASE79455), and ‘a Ring for the falling’ (CASE74978). In an entry for Matthew Stayne, suffering from falling sickness, Napier wrote as a reminder for himself: ‘Make for this litle child a Ring of silver to preserve him a month henc’ (CASE68057); when consulted about how to stop the fits suffered by Mary Parsons, he wrote: ‘Looke out a ring to weare for that purpose’ (CASE52560). In October 1627 it was noted that Mr Anthony King had ‘found no good by his ringe’ (CASE64794, but in December 1628 his mother was sending for it again (CASE67447). Napier had more success with the young Mistress Frances Latch, who it was reported in November 1627 had had fewer bad fits since using his powders and wearing the ring (CASE64973). The rings produced and employed by Napier were presumably part of the afterlife of the so-called cramp rings of the later Middle Ages, which up to the middle of the sixteenth century had been blessed by royal touch and handed out at the Tower of London’s Chapel Royal.

Blessings: Many entries include blessings of the patients recorded by Napier; whether they were intended to have any specific effect is unclear. A small number of entries, however, include references to charms or exorcisms. CASE52627 has the rather cryptic ‘deus Elohim Iehova destinat omnem malef.’ In CASE11001, a consultation about witchcraft, Napier writes: ‘Deus sathanum sub pedibus conterat’; similar invocations appear in CASE20232 and CASE42206, the former entry including references to witchcraft, and both concerning patients with problems of the passions. More explicitly practical are the detailed instructions in CASE35312 for tying about the patient’s neck a parchment with a legend beginning ‘A.b.r.a.c.a.d.a.b.r.a. O lord god I beseach thee to take this disease from this thy servant ...’. Some of the notes in the casebooks consist of instructions for charms and exorcisms: NOTE5539, for instance, suggests an invocation to be used (along with bloodletting) for anyone mopish and distempered in brain.

For an alphabetical list of some of the tricky terms and abbreviations to be encountered when reading treatment notes and recipes in the casebooks, see our glossary of treatments. For a few examples of treatments prescribed in particular cases, or written out in the casebooks for later use, see our Selected treatments.

Cite this as: Lauren Kassell, Michael Hawkins, Robert Ralley, and John Young, ‘What treatments did they prescribe?’, A Critical Introduction to the Casebooks of Simon Forman and Richard Napier, 1596–1634,, accessed 22 February 2019.