Marshmallow and a treatment for so-called gout: experimental ancient history

Because I wanted to be an archaeologist as a child, I have a very soft spot for experimental archaeology. It gives fantastic insights into the past which help us to better understand it. Alas, I am but a humble ancient historian instead, but I still love the concepts of experimentation to better inform us of the past, and today I have worked on a little experimental ancient history in the field of ancient pharmacology. Why won't I call it experimental archaeology? Because I am using modern technology (my stove) not fire. 

I have just concluded my research on the Plinii Medicina's recommended treatment for podagra. Podagra is often translated as gout, but this isn't particularly accurate. Podagra referred to a number of different rheumatological or arthritic complaints of the feet, which could include gout.one of the treatments suggested was boiled marshmallow root applied with axle-grease as a plaster. As luck would have it, my aunt had plenty of marshmallows growing on her farm, and was coming to visit. She agreed to bring one with her. 

This is what it looked like after being transported in a bag over 600 km and kept in a bag for a five days.

I had explained that I was only needing the root, but they brought the whole plant. This was rather handy. As those people involved looking at ancient botany and pharmacology are aware, identification is a very fraught issue. While my aunt and mother identified this plant as marshmallow, it might not be the marshmallow I was looking for. Given that I am studying Roman treatments in Australia, this is even more problematic. 

With a little work on google, I identified this plant as Malva parviflora, also called cheeseweed, cheeseweed mallow, and marshmallow. According to Beck's translation of Dioscorides' De Materia Medica, I should be looking for Althaea officianalis. Both plants are members of the mallow family. 

While I was incredibly disappointed, I decided to go ahead with my intended experiment. Google did not exist in Roman times, and neither did the modern classifications of plants. In antiquity, if someone said a plant was marshamallow, or I should say ibiscum, then that was what it was. In addition to this, adulteration of materia medica was an acknowledged problem in antiquity. On that principle, I decided to go ahead with my plan. 

For such a large plant the root is rather small by comparison. 

My aunt said it was extremely difficult to pull up owing to the long tap root. I cut it off.

The root had been a little damaged and I pulled apart at the naturally formed split:

I found this very interesting as I have read about numerous medical recipes which had required the "bark of a root". This phrase has bamboozled me for years now, and this is the first moment that it has ever made sense. This outer layer of the root is what must be meant by this.

Now I know I said I cut the root off. That doesn't truly reflect what I did. I sawed through the root with a serrated edged knife from multiple sides until I got through it. This stuff is tough! Fortunately there was a very stuff strand which I could cut through which I used like the string you find on cheese portions which allowed me to open the root up fairly easily like this:

It is this inner root that I decided to use. All up I ended up with a rather small amount of inner root from the plant:

This was barely ten centimetres long. In addition to this, its damn hard. It took a considerable amount of force to snap the larger piece in two.

Now the text of the Medicina Plinii states: hibisci radices coctas cum axungia misces et cataplasma pedibus ponis. I translate this as: you mix boiled marshmallow roots with axle-grease and you apply the plaster to the feet.

So I needed to boil my root. While an earlier writer, Scribonius Largus (chapter 160), described boiling it in water and honey and Celsus (4.31.4-5) said to boil in wine, but because the writer of my text didn't specify what it was to boiled in, I boiled it in water:

After 30 minutes they were still as hard as they were when I started. 

After an hour I did manage to piece them with a tooth pick. Barely.

After two hours it looked like this:

I ended up splitting this piece up along the grain and continued boiling it for another 30 minutes. After that I just stopped. The root wasn't terribly softer than it was when I started, even those pieces I'd split, and I thought it highly improbable that a person suffering from podagra would have waited that long. I have arthritis in my feet, so I feel comfortable speaking for my imaginary ancient patient. So I drained my root and placed it in my mortar. And pounded it a bit. It looked like this first:

I pounded some more. It took a hell of a lot of effort. I also chopped up some of the softer pieces of root with a pair of scissors. After a great deal of effort and some pain, my roots looked like this:

I decided that was good enough so I needed to add some axle-grease. While we use petroleum-based axle-grease today, in antiquity they used lard or suet. No I don't know what their carts smelled like, and I don't want to think about it too much. I have always imagined that when referring to axle-grease medical writers were expecting their reader to go get some grease from a cart. I used some freshly purchased pig's lard which I'd left out of the fridge for a bit. In a nod to the idea that you don't want it to be too fresh, I let my cat lick it. 

Adding the lard little-by-little, the thing I noticed first was a change in smell. The root had a rather subtle not unpleasant scent, but adding lard to it made it smell unpleasant. I can only imagine how much worse it would have smelt with stale lard. In the end, it looked like this:

Celsus (4.31.4-5) described marshmallow applications as heating and recommended their use at night, so this treatment was more likely to have been used on the forms of podagra which weren't accompanied by a burning sensation (so it was probably not used on patients like me). I put some on my hand:

Those pieces of root which I didn't cut down with scissors didn't adhere as well, but the smaller cut pieces did so extremely well. I didn't notice any heating, but this could have been because I boiled in water instead of wine, didn't use stale grease (which wasn't mentioned by Celsus) or the fact that this wasn't the marshmallow they meant. I also didn't leave it on for terribly long because I wasn't comfortable with a strange root and pig's fat on my hand. 

As you can see from the photos, I have a fair amount of plant material on my hand, and I still had some in my mortar. The single piece of root would likely have been sufficient for a foot at the very least.

Some reflections on this experiment:

⚫️ I wonder whether it was possible to go to an ancient apothecary and buy cooked marshmallow roots? Or perhaps finely cut up marshmallow roots. All up it took me more than three hours to prepare this using a stove. If preprepared roots could be bought this would save considerable time. The pain of podagra can flare up quickly and waiting for more than three hours for relief would be horrid. Also, if this disease was also affecting the hands, it would be nigh on impossible to prepare for yourself.

⚫️ I had assumed the "root-cutters" as referred to in Sophocles' play were those who went and gathered the roots used. Given how difficult it was to cut this root, perhaps cutting roots was a specialist job when preparing medicaments.

⚫️ As stated above, I now know what is meant be "root bark".

⚫️ I followed the most basic description provided by the author and had a great deal of difficulty. It makes me wonder how much knowledge was just assumed to exist in his readers' minds. This is also relevant to the question of plant identification.

Things I would do differently:

⚫️ Aquire some Althaea officianalis and try this again. While it would be a good idea to allow the lard to go "stale", I don't know that my stomach could stand that.

⚫️ Given the difficulty I had, perhaps I should have tried to cut the roots finer before boiling them. This would have been very difficult, but perhaps it was expected.