Cider and eighteenth century evidence based healthcare
a Devon pamphlet war
Note. This is based on a paper originally given at the Health Libraries Group conference in Exeter in September 1996.
Cider, the traditional drink of Devon, has been made since at least the thirteenth century. In the year 1285-6 the bailiff's account for the Exminster manor of the Earl of Devon indicates cider-making on a scale sufficient to generate a regular source of revenue and at Plympton in that year a small quantity of cider is recorded as remaining from the previous season. There may have been some neglect of orchards in the later Middle Ages but apple growing was revived in the period of the later Tudors, according to Harrison in the description of England prefixed to the version of Holinshed's Chronicle which was edited by John Hooker, the Exeter historian, and published in 1585. Harrison mentions the cider made in parts of England where apples were plentiful but makes no specific mention of that of Devon. In fact he mentions that cider was not a common drink in most parts of England at that time and was looked on as a "delicate sort of drinke". Hooker himself in his "Synopsis chorographical", a description of Devon written in about 1600 but never printed, refers to the abundance of fruit in Devon and the careful management of orchards and apple gardens. One reason for this increase may have been that cider, especially that produced in coastal areas such as the South Hams of Devon, was in great demand for supplying ships, perhaps because of the large number of Devonians in many of the naval expeditions which were undertaken during this period. The production of cider seems to have increased further during the early part of the following century if the statement of Westcote in his View of Devonshire, written in 1630, can be relied on. He relates (p.56) that "of late years there had been an enlargement of Devon orchards", particularly for the making of cider which he describes as "a drink both pleasant and healthy, much desired of seamen for long southern voyages as more fit to make beverage than beer, and much cheaper and easier to be had than wine." Various authorities, including John Huxham in 1738 explain the high regard in which cider was held, by reference to its antiscorbutic properties. It helped to prevent scury on board ship long before the introduction of lemon and lime juice in the eighteenth century. Indeed Huxham attributed the general improvement in the health of many parts of Devon largely to the more extensive use of cider.
But there was one malady which by the early 18th century did not give Devonians a reputation of being a healthy people: the Devonshire colic. It is first described by Dr William Musgrave of Exeter. Musgrave was born in Nettlecombe, Somerset in 1655, was educated at Winchester and New College Oxford and subsequently studied medicine at Leyden. He beacame a fellow of the Royal Society and its Secretary in 1684. He graduated as a M.D. of Oxford in 1689 and became a Fellow of the College of Physicians in 1692. He had settled in Exeter in 1691 where he practised for more than thirty years in an alley off the north side of the High Street which was later named after him. Since World War Two Musgrave Row, where the Central Library is located, continues to honour him. Musgrave was a learned man and was at least as highly regarded for his antiquarian researches into the early past of the South West as for his medical work. He wrote a number of works on both subjects, mainly in Latin and died in 1721. Among medical treatises was one published in Exeter entitled Dissertatio de arthritide symtomatica. In this he referred in passing to a colic peculiar to Devon which prevailed in certain seasons, although he did not describe the symptoms in any detail.
This was done in 1738 by John Huxham (1692-1768) who had been born and educated at Totnes and, like Musgrave, went to Leyden to study medicine, where his tutor was Boerhaave. He graduated as a Doctor of Medicine in 1715 and settled in Plymouth where he practised until his death. He wrote many medical treatises, mostly in Latin, was a Fellow of the Royal Society and contributed frequently to their Philosophical Transactions between 1723 and 1762. From 1728 to 1748 he kept a continuous record of the weather and health of Plymouth, which was first published in Latin in 1752. It came out in two volumes, the first covering the period from 1728 to 1737 and the second from 1738 to 1748. Both were jointly published by the London bookseller John Hinton and the Plymouth bookseller Henry Whitfield. The first volume was published in translation in 1759 as Observations on the air and epidemic diseases from the year MDCCXXVIII to MDCCXXXVII; made by Doctor Huxham, at Plymouth: together with a short dissertation on the Devonshire colic. Translated from the Latin original, and now published with the Doctor's approbation. The second part was not published until 1767 when it was stated to have been translated by his son John Corham Huxham.
The tract on Devonshire colic was originally published in London in 1738 with the title Opusculum de morbo colico Damnoniorum. Huxham vividly describes the symptoms as manifested in the epidemic of 1724:
This disease began its attack by an excessively tormenting pain in the stomach, and epigastric region, with an unequal weak pulse, and coldish sweats; the tongue in the meantime was coated with a greenish, or brown, mucus, and the breath was most offensive. An enormous vomiting soon followed, for the most part of exceeding green bile, sometimes black, with a great quantity of phlegm excessively acid and very tough; nay the foul matter brought up was oftentimes so very acrid, that, by excoriating the throat and oesophagus, it was tinged with blood, and created a difficulty and pain in swallowing. ... Things continuing in this state for a day or two, the belly became extremely bound, neither answering to the most drastic purges, or sharpest clysters, the latter coming off without wind or stool, the former being soon vomited. The vomiting abating somewhat, the pain descended, and most grievously tormented the umbilical region, and small of the back, so that you would have thought the patient actually laboured under a nephritic paroxysm and that rather as a suppression of the urine now comes on, and yet a perpetual desire of that discharge is urgent; nay very frequently there is a most troublesome sense of weight in the perineo, as if from an incumbent stone.Huxham then describes the muscular aches, terrible pains in the bones and the subsequent paralysis which, in the most severe cases (fortunately rare) ultimately lead to death.
Before Huxham the cause of this distressing sickness had been laid at the door of cider. One of the first to do so was John Philips in his work Cyder: a poem in two books. This appeared in 1708 and contains the following lines:
The Must, of palid Hue, declares the SoilThe year before this poem was published William Musgrave had indicated the immoderate consumption of rough and acid cider as the cause of colic in more prosaic terms: "It only infests those that make use of that liquor, and in the same proportion as they make use of it; so that in those times when cider abounds it increases and becomes very common on the other hand when Pomona witholds her bounty it is observed more rarely."
Devoid of Spirit; wretched He, that quaffs
Such wheyish Liquors; Oft with Colic Pangs,
With pungent Colic Pangs distressed he'll roar,
And toss, and turn, and curse th'unwholesome Draught.
In 1738 Huxham noted that Devonshire colic made its appearance during the autumn when new cider began to be consumed and, like Musgrave, he put its cause down to the consumption of too much fresh rough cider. He noted that in the autumn of 1724, when there was a particularly bad epidemic the apple crop was greater than at any time within living memory. Sackfuls of apples were to be had for the mere labour of gathering them, and apples during that year formed almost the entire diet of many Devonians. He also pointed out the colic of Poitou which had been known since the early seventeenth century, was the same malady as the Devonshire colic. Again he thought that the excessive acidity of the unfermented grape juices was the cause, as indeed it was in other wine-growing areas where there were similar cases of sickness.
It was George Baker who took the investigations a stage further and at the same time gave rise to a heated controversy. Baker was born in Devonshire in 1722, the son of the Vicar of Modbury. He was educated at Eton and King's College, Cambridge and later became a Fellow of his College. He graduated as a B.A. in 1745, became a M.A. in 1749 and M.D. in 1756. He was elected a Fellow of the College of Physicians in 1757 and was also a Fellow of the Royal Society. He had started his career in Stamford in Lincolnshire but settled in London in 1761 where he was appointed physician to the Queen's household. On 29 June 1767 he read a paper on the cause of the endemial colic of Devonshire in the theatre of the College of Physicians.
After quoting from Musgrave and Huxham he went on to point out the similarity of Devonshire colic to lead poisoning. He agreed that there was no obvious link between the "juice of apples and the poison of lead" and proceeded to dismiss Huxham's theory that the colic was caused by acidity. The Turks, whose religion obliges them to abstain from wine, drink every day large quantities of an acid sherbert" yet the colic of Poitou was little known among them. Jockeys drank vinegar to encourage sweating when they had to lose weight and did not suffer from colic. The effect of eating unripe fruit was diarrhoea rather than colic.
Baker next investigated the epidemiology of the disease "I find that this disease is common all over the county of Devon; but that it particularly infests those parts of the county, where the greatest quantities of Cyder are made. I likewise find that it is not only common among the lower class of inhabitants; but that it is much more frequent among people of all ranks, than in other parts of England; and that it is not entirely confined to the autumnal season." Baker had the benefit of a source of statistical data. In 1741 the Royal Devon and Exeter Hospital had been opened and Dr John Andrew, one of the physicians appointed when it opened, supplied statistics of admissions of sufferers from colic from September 1762 to July 1767. The patients had come from all parts of the county but chiefly from areas where cider was made. By the time the patient was admitted the most violent symptoms had generally abated, leaving normally a "paralytic weakness in the limbs". Of 285 cases admitted 209 were cured. He also compared statistics from the Bath Hospital for 1766. Of 80 patients admitted 40 were cured and 36 were sent away greatly relieved. The proportion of such patients from Devonshire to that of the counties of Hereford, Gloucester and Worcester was generally eight to one. Dr Wall of Worcester supplied additional information, confirming that the inhabitants of those counties were not subject to the colic of Poitou. "There is no lead, which can give occasion to that colic, used in any part of the Apparatus for grinding or fermenting the apples, or fermenting the liquor." One significant exception was a farmer who ran out of casks and filled a lead cistern with new cider "[...] all who drank of it were affected by it as the lead workers usually are. We had eleven of them at one time in our Infirmary."
Baker then considered the manufacturing processes of cider in Devon. "The large circular trough, in which the apples are ground, is generally composed of several pieces of moor-stones, cramped together with iron, some melted lead being poured into the interstices." Indeed in several parts of the county it was common to line the cider presses entirely with lead to prevent their leaking. In other places it was the practice to nail sheet-lead over any cracks or joints in the presses. The apple juice might be conveyed from the presses in leaden pipes, or lead weights might be placed in the casks to prevent the cider from becoming sour. Baker obtained some apple juice produced in a press lined with lead in the parish of Alphington just outside Exeter. He made several experiments locally using "liquor vini probatorius and the volatile tincture of sulphur" and took samples of the juice and of cider to London to undertake further experiments with the assistance of Dr William Saunders who was familiar with the practice of chemistry. Among the experiments the cider was soaked onto clean paper and exposed to the fumes of volatile tincture of sulphur. The resulting dark colour could not be produced by any other substance than lead. This colour was not produced in the case of Hereford cider. In all five different experiments were conducted which convinced Baker that the cause of colic was not acidity of the fruit but lead in the apparatus.
Saunders who had assisted Baker in his experiments was born in Banff in 1743 and graduated From Edinburgh. After receiving his doctorate in 1765 he settled in London. After his experiments with Baker he had a distinguished career, becoming physician to Guy's Hospital and in 1807 physician extraordinary to the Prince Regent.
Baker concluded his paper:
The subject therefore having appeared to me important, I have spared no pains in this investigation; and I am insured of my reward in the consciousness of having endeavoured to perserve my countrymen and fellow-creatures from one of the most dreadful diseases, incident to the human body.This advance publication was printed by J.Hughs, near Lincoln's Inn Fields with the title An essay concerning the endemial colic of Devonshire, but in the version which appeared in the first volume of Medical transactions, published by the College of Physicians, Baker made some amendments which are more outspoken than in the version intended for the Devon audience and suggested that there were other more deliberate ways in which lead may have been introduced into cider: "It is very certain that, in various parts of the county of Devon, there are those, who possess certain secrets for the management of cyder; the general object of which secret is, to correct the sourness and austerity of that liquor ... I have several times discovered marks of a solution of lead in the English-made wines."
This essay will probably be hereafter published in a medicinal collection. Some copies of it are now printed, with a particular view to giving the inhabitants of the county of Devon the earliest intimation of their danger; in order that they take the proper steps to preserve their health, and to secure the value of their property.
The reception to Baker's paper in Devon was sympathetic in many quarters. There were two letters to the Exeter Flying Post in August 1767. On 21 August Dr E.Spry of Totnes wrote "I ... take this early opportunity, as it's nearly about the Cyder-making season (tho' I fear there will be but little made, in this quarter, this year) of acquainting you thereof; at the same time advising you cautiously to avoid the least utensil of lead, tin, or copper; ..." His own investigations over the past days had satisfied him that the cyder-engines used to cut apples contained no lead but "the breaking or stone troughs ... held together by means of iron cramps with lead cast at their ends are , with ther rollers, certainly with some people about us still in use; the lead in their construction might be altogether omitted, or buried with the iron so deep in the stone as (to prevent its being in contact with the apples) to admit a thick cover of plaister of Paris, or the like."
The following week a letter signed Medicus also supported Baker, adding "I wish that these experiments were more generally known: the circulation of his treatise on that subject being as yet confined to Devonshire. It is unnecessary here to comment on the utility of a discovery so beneficial to mankind; and for the future it is to be hoped, that the manufacturers of cyder will avoid the use of every utensil in which there is the smallest proportion of lead.
But there was also opposition from Devon. In 1767 an anonymous pamphlet signed Danmoniensis was printed by R.Trewman of Exeter with the title An answer to Dr. Baker's essay concerning the cause of the endemial colic of Devonshire. The writer claimed that in his visits to cider pounds in Devon he had found only one which contained any lead, although he concedes that in some "common troughs" there may be some lead. He had also conducted an experiment by putting a quantity of lead in some cider for four weeks and weighing it before and after. He had noted no difference in the weight. He surmised that lead shot may have entered the apples as a result of farmers shooting birds who were feeding on the heaps of fruit.
A more serious attack on Baker's findings came from the Plymouth surgeon Francis Geach who worked at the Royal Hospital in Plymouth. In his pamphlet Some observations on Dr Baker's essay on the endemial colic of Devonshire, published in London by R.Baldwin, Geach supported Huxham's theory that colic was due to acidity "owing, partly to the use of crude fruit and its juice not well fermented, and partly also to some peculiar disposition of the atmosphere ..." He attributed the prevalence of rheumatism in Devon to the excessive use of cider, scarcely a good tribute to the beverage he was seeking to defend, and noted that among the poorer inhabitants of Gloucester and Hereford, who drank weak cider and were not subject to colic "it was not uncommon ... to meet deplorable objects , with their hands dangling, and, who by such imbecility, are distinguished by the appellation of the danglers".
Geach also produced two letters from Samuel More "an eminent chemist in Jermyn Street" and later Secretary to the Society of Arts, who claimed that Saunders had described his experiments to him. More apparently maintained that the lead came not from the cider but from lead shot which was used to cloean the retorts.
Appended to Geach's pamphlet was an essay by the Rev Thomas Alcock of Plymouth (1709-98). He stated that the use of lead in lining troughs was unusual and indeed had never heard of this until Baker had informed him of the one in Aplphington. He "wished that the essayist had made his trials from other and fairer specimens". He suggested that the dark colour produced may have derived from the greater acidity of Devon apples. The trees in Devon were planted more closely than in the northern counties. "Much of the fruit, must in consequence, not having equal advantage of the sun and wind, be green and crude, and the juice austere and sharp; the Hereford people are also more careful in collecting their apples; do not pound them until they are thoroughly mellowed and sweetened ..."
It is worth examining the background of Alcock, the author of the essay. He was born in Ruccorn, Cheshire and was educated at Brasenose College, Oxford, where he gained his M.A. in 1741. He was vicar of Runcorn but in his later years lived mainly in St Budeaux, near Plymouth. His brother Nathan studied medicine in Leyden, Edinburgh and Oxford and practised in Oxford where he gained a high reputation as a physician. In 1763 Thomas Alcock published a pamphlet Observations on that part of a late Act of Parliament which lays an additional duty on the cyder and perry, which was printed for him in Plymouth by Orion Adams and was also distributed in Exeter and London. It formed part of a vigorous campaign against the cider tax imposed by Bute in 1763. Benjamin Heath, Town Clerk of Exeter with the support of the Corporation of Exeter, organised a national campaign of petitioning Parliament coordinated by county committees. The Corporation of Exeter had in May 1763 agreed to defray Heath's expenses in getting published in London a pamphlet entitled The case of the County of Devon with respect to the consequences of the new excise duty on cyder and perry. There was also a host of unofficial satirical broadsheets, for example Britain excis'd, or a copy of verses on the duty on cyder. There were demonstrations and meetings across the county and reports of excisemen being obstructed in their attempts to collect the tax. The hated Bute was burned in effigy and solemn processions through the streets bore apple trees and empty cider hogsheads hung with black streamers. Significantly Alcock's 1763 contribution to the debate had been signed Thomas Alcock, A.M. and a cydermaker in Devonshire". When the tax was repealed in July 1766 there were celebrations with bellringing, public illuminations, dances and dinners. Clearly less than a year later, in June 1767, the last thing that the cidermakers of Devon wanted was a second blow to the industry.
William Saunders reentered the lists in 1767 with a pamphlet entitled An answer to the observations of Mr Geach and to the cursory remarks of Mr. Alcock on Dr. Baker's essay on the endemial colic of Devonshire, couched in the form of a letter to Baker, in which he drew attention to the fact that Alcock was a cider dealer and so had a vested interest. He also demolished Geach's contribution "a dull, uninstructive repetition of a vain unsubstantial theory". He mocks Geach's reference to "sulphur of fruits, quite a new principle and not to be understood by anyone, not even by himself". He claimed that it was common in Dorset for the farmers to purchase sugar of lead from the apothecaries to sweeten their cider and contradicted Geach's statement that the use of lead in cider presses was rare: "It can be proved by certificate ... that in three parishes only, there were at least thirty presses lined with lead. This is no hearsay or random assertion." He also replied to Samuel More's assertion that the lead in his experiments came from shot stored in the retorts by saying that he had indeed found a small amount of malleable lead in some of the cider. He immediately set about making a further experiment without the impurities. Saunders added: "It may be perhaps of some service to Mr. More if I publicly acknowledge that he used many arguments, to dissuade me from pursuing such an enquiry; or even be witness to any experiments, which might end in discoveries in any way disagreeable to his very good friends of the county of Devon."
Geach enlisted no less a person than the chemist William Cookworthy in A reply to Dr. Saunders's pamphlet relative to the dispute concerning the Devonshire cyder, which was printed in London for Richard Baldwin in 1768. Cookworthy, who was born in Kingsbridge in south Devon in 1705 had been apprenticed to a firm of London druggists. In 1768 he had applied for a patent for the manufacture of hard paste porcelain which lead to the opening of a factory in Plymouth. This soon after moved to Bristol and Cookworthy's discovery paved the way to the development of the pottery industry in the Midlands. Cookworthy, who contributed 32 of the 52 pages in the pamphlet, had repeated Saunders's experiments on cider taken from the pound in Alphington, and from another from Sharpham which was lead lined, and claimed to have found no lead in the cider.
Finally Alcock returned to the fray, probably late in 1769, with an amended version of the essay he had appended to Geach's first pamphlet. The title reflects the cut and thrust of this extended debate: The endemial colic of Devon, not caused by a solution of lead in the cyder. A particular reply is here given to Dr. Saunders' answer to cursory remarks; with some further remarks on Dr. Baker's essay on that subject. He answered Saunders' doubts as to Alcock's qualifications to write on the subject: "My name was entered on the Physical line in Oxford, and ... I had opportunities, if I had but made proper use of them, of learning something both of Physic and Chemistry from a professor in those sciences, perhaps not inferior to this great doctor Saunders" He claimed that to censure the clergy "for meddling with other subjects, and confine them merely to theology, would be stopping up some of the principle sources of literature, and doing great injury to the public." He also answered Saunders' claim that he had a vested interest as a cider maker, replying that he would only sell a hogshead of cider when they happened to make more than was needed for consumption within the family. He also produced further evidence that there were a large number of pounds in Devon which contained no lead and that, on the contrary, there were many pounds in Herefordshire and Worcestershire which had either been lead lined or had lead poured around the cramps between the stones.
But Baker's thesis soon became generally accepted. He took no direct part in the exchange of pamphlets, although he appears to have advised Saunders. He continued to present a number of further papers to the College of Physicians on various aspects of lead poisoning, the next as early as 13 July 1767 where he commented on the effects of drinking wine impregnated with litharge, or lead monoxide. He went on to become physician-in-ordinary to the Queen and then physician-in-ordinary to King George III. He was the only doctor in attendance when George III showed the first signs of madness in 1788 and attended him regularly, receiving thirty guineas for each visit. In 1776 he was created a baronet. He was a fellow of the Royal Society and of the Society of Antiquaries. In London he was highly regarded for his taste and accomplishments. In his circle of friends he could include people like Sir Joshua Reynolds, Oliver Goldsmith and the poet Thomas Gray who, according to one authority, dedicated to him the "Elegy written in a country churchyard".
Baker was apparently a great believer in spa treatment and many patients with Devonshire colic were admitted to the hospital at Bath. In 1770 Rice Charlton published An inquiry into the efficacy of warm bathing in palsies. Among the 1053 cases he analysed over the fifteen years from 1751 to 1764, there were 237 suffering from cider and bilious colics. Of these, 218 were cured, only five were not improved and nine died. Today warm fomentations are a recognised treatment of lead poisoning.
Devonshire colic became rare as the nineteenth century progressed. When Baker's son edited his father's collected papers in 1818 he stated "It is a fact, well ascertained, that a malady, which from its former prevalence in that county had acquired the name of the Devonshire colic, is at this time hardly known to exist there." Addressing the Devonshire Association on the subject in 1885 Frederick Willcocks stated that the North Tawton physician Dr Christian Budd (1815-91) "in the early part of his career some forty years ago ... occasionally saw cases of lead colic produced by drinking cider made in a lead press." Such presses had since entirely disappeared and Dr Budd had "not for many years seen any case of lead poisoning produced by cider. He further adds that he believes that there is no more wholesome drink than pure cider ..."
All that is added to the vat of cider now, according to some, is a dead rat, to give body to the fermenting liquid. If any in the audience are worried about at having consumed the local drink, I would suggest that the next conference of the Group be held in Bath in the elegant surroundings of the Assembly Room, with a therapeutic plunge in the King's Bath as part of the programme.
Page last updated 1 Feb 2007
© Ian Maxted, 1996