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  • Fig. 90. Cripps Colotomy Dilator
  • Lithotomy dilator with fenestrated blades, 16th century type.
  • Effacement and dilatation of the cervix before birth
  • Dilation of the right ventricle of the heart
  • Plate 77, Dilation of cervix and preforation of membrane.
  • Tortuous and dilated subcutaneous veins on the trunk of a man
  • Dilatation of a bronchial tube in the lower lobe of a lung
  • Two specula for dilating the womb and administering treatments for ulcers. Woodcut, 1560/1600.
  • Respiration d'un air suroxygene, dilate par la diminution de pression (Breathing air suroxygen)
  • Face of a girl with a marked blush in the cheeks due to dilated capillaries
  • A diagram showing the dilation and changes in a pregnant uterus from the first to ninth month. Etching.
  • A woman lying on her back with her legs raised during labour while a midwife checks her cervix for dilation.
  • Surgery: an assortment of surgical instruments, including an instrument for the dilation of the foreskin, a cannula and a syringe for the bladder. Engraving with etching by B.L. Prevost after L.-J. Goussier.
  • Scutellaria baicalensis Georgi Lamiaceae. Baikal skullcap. Distribution: China. There are several hundred species of Scutellaria, also known as skull caps, so correct identification is important - in particular from Scutellaria lateriflora an American species known as Blue skullcap. The latter is used as an abortifacient and to expel placenta by the Cherokee and for cleaning the throat by the Iroquois (Austin, 2004). Much vaunted as a treatment for rabies with unlikely statistics (1,400 cases cured by one doctor alone). Also as ‘antispasmodic, nervine, [for] chorea, convulsions, tetanus, tremors, delirium tremens, [and as a] diaphoretic and diuretic'. Toxicity symptoms include mental confusion, stupor, headache, vertigo, photophobia, dilated pupils, difficulty in micturition, bradycardia, tremulousness and languor, followed by wakefulness and restlessness (Milspaugh, 1974). Hutchens (1991) reported that it reduces sexual desire and was used for almost every nervous illness. Scutellaria baicalensis contains baicalin, baicalein and wogonin (European Medicines Agency, September 2010). It is used in Traditional Chinese Medicine for treating inflammation, cancer, bacterial and viral infections of the lungs and gut and is one of the '50 Chinese herbs' in the lists of some authors. Scutellaria lateriflora (combined with Verbena officinalis, Passiflora incarnata and the seed of Avena sativa (oats) is licensed for use in Britain as a herbal medicine for temporary relief of mild symptoms of stress such as mild anxiety and to aid sleep, based upon traditional use only. Scutellaria baicalensis is not licensed for use in the UK (UK Medicines and Healthcare Products Regulatory Agency (MHRA)). Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Senna corymbosa (Lam.)H.S.Irwin&Barneby Caesalpinaceae. Argentine Senna. Distribution: Argentine (other species from Europe). This beautiful shrub that flowers from midsummer until the frosts of winter, is the source of one of the best known of all herbal medicines – Senokot (and senna pods and senna tea), introduced to European medicine (as Senna alexandrina from Egypt) by the Arabians. Every part of the plant contains anthraquinones which, if taken internally, act as a powerful laxative to treat constipation by stimulating the nerve cells of the large bowel. Gerard (1633) notes ‘it is a singular purging medicine’ with over a page on its uses. When used regularly the nerves to the large bowel may be destroyed, leaving a permanently dilated large bowel that never functions properly again. This is a plant which causes the condition it treats to become permanent. Additionally, with prolonged use, the lining of the bowel turns black, serum potassium levels may fall, resulting in cardiac irregularities and sometimes death. Coma, neuropathy and hepatitis have also been reported. It is advertised on television (the actor involved is seen to be depressed and bloated until she takes Senokot, after which she is happy - Hippocrates would have attributed this antidepressant effect to the plant's ability to purge her of the black melancholic humour present in her bowel motions). It is available without prescription or health warning against long-term use. What do you think? Lyte (1578) recommends it strongly for depression, but one might claim to be cured rather than take it again. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Senna corymbosa (Lam.)H.S.Irwin&Barneby Caesalpinaceae. Argentine Senna. Distribution: Argentine (other species from Europe). This beautiful shrub that flowers from midsummer until the frosts of winter, is the source of one of the best known of all herbal medicines – Senokot (and senna pods and senna tea), introduced to European medicine (as Senna alexandrina from Egypt) by the Arabians. Every part of the plant contains anthraquinones which, if taken internally, act as a powerful laxative to treat constipation by stimulating the nerve cells of the large bowel. Gerard (1633) notes ‘it is a singular purging medicine’ with over a page on its uses. When used regularly the nerves to the large bowel may be destroyed, leaving a permanently dilated large bowel that never functions properly again. This is a plant which causes the condition it treats to become permanent. Additionally, with prolonged use, the lining of the bowel turns black, serum potassium levels may fall, resulting in cardiac irregularities and sometimes death. Coma, neuropathy and hepatitis have also been reported. It is advertised on television (the actor involved is seen to be depressed and bloated until she takes Senokot, after which she is happy - Hippocrates would have attributed this antidepressant effect to the plant's ability to purge her of the black melancholic humour present in her bowel motions). It is available without prescription or health warning against long-term use. What do you think? Lyte (1578) recommends it strongly for depression, but one might claim to be cured rather than take it again. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Veratrum nigrum L. Melanthiaceae Distribution: Europe. Cows do not eat Veratrum species in the meadows, and human poisoning with it caused vomiting and fainting. In the 1850s it was found to reduce the heart's action and slow the pulse (Bentley, 1861, called it an 'arterial sedative'), and in 1859 it was used orally in a woman who was having convulsions due to eclampsia. Dr Paul DeLacy Baker in Alabama treated her with drops of a tincture of V. viride. She recovered. It was used thereafter, as the first choice of treatment, and, when blood pressure monitoring became possible, it was discovered that it worked by reducing the high blood pressure that occurs in eclampsia. By 1947 death rates were reduced from 30% to 5% by its use at the Boston Lying-in Hospital. It works by dilating the arteries in muscles and in the gastrointestinal circulation. A further use of Veratrum species came to light when it was noted that V. californicum - and other species - if eaten by sheep resulted in foetal malformations, in particular only having one eye. The chemical in the plant that was responsible, cyclopamine, was found to act on certain genetic pathways responsible for stem cell division in the regulation of the development of bilateral symmetry in the embryo/foetus. Synthetic analogues have been developed which act on what have come to be called the 'hedgehog signalling pathways' in stem cell division, and these 'Hedgehog inhibitors' are being introduced into medicine for the treatment of various cancers like chondrosarcoma, myelofibrosis, and advanced basal cell carcinoma. The drugs are saridegib, erismodegib and vismodegib. All the early herbals report on its ability to cause vomiting. As a herbal medicine it is Prescription Only, via a registered dentist or physician (UK Medicines and Healthcare Products Regulatory Agency (MHRA)). Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Veratrum album L. Melanthiaceae Distribution: Europe. Cows do not eat Veratrum species in the meadows, and human poisoning with it caused vomiting and fainting. In the 1850s it was found to reduce the heart's action and slow the pulse (Bentley, 1861, called it an 'arterial sedative'), and in 1859 it was used orally in a woman who was having convulsions due to eclampsia. Dr Paul DeLacy Baker in Alabama treated her with drops of a tincture of V. viride. She recovered. It was used thereafter, as the first choice of treatment, and when blood pressure monitoring became possible, it was discovered that it worked by reducing the high blood pressure that occurs in eclampsia. By 1947 death rates were reduced from 30% to 5% by its use at the Boston Lying in Hospital. It works by dilating the arteries in muscles and in the gastrointestinal circulation. A further use of Veratrum species came to light when it was noted that V. californicum -and other species - if eaten by sheep resulted in foetal malformations, in particular only having one eye. The chemical in the plant that was responsible, cyclopamine, was found to act on certain genetic pathways responsible for stem cell division in the regulation of the development of bilateral symmetry in the embryo/foetus. Synthetic analogues have been developed which act on what have come to be called the 'hedgehog signalling pathways' in stem cell division, and these 'Hedgehog inhibitors' are being introduced into medicine for the treatment of various cancers like chondrosarcoma, myelofibrosis, and advanced basal cell carcinoma. The drugs are saridegib, erismodegib and vismodegib. All the early herbals report on its ability to cause vomiting. As a herbal medicine it is Prescription Only, via a registered dentist or physician (UK Medicines and Healthcare Products Regulatory Agency (MHRA)). Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Atropa belladonna L. Solanaceae. Deadly nightshade. Dwale. Morella, Solatrum, Hound's berries, Uva lupina, Cucubalus, Solanum lethale. Atropa derives from Atropos the oldest of the three Fates of Greek mythology who cut the thread of Life (her sisters Clotho and Lachesis spun and measured the thread, respectively). belladonna, literally, means 'beautiful lady' and was the Italian name for it. Folklore has it that Italian ladies put drops from the plant or the fruits in their eyes to make themselves doe-eyed, myopic and beautiful. However, this is not supported by the 16th and 17th century literature, where no mention is ever made of dilated pupils (or any of the effects of parasympathetic blockade). Tournefort (1719) says 'The Italians named this plant Belladonna, which in their language signifies a beautiful woman, because the ladies use it much in the composition of their Fucus [rouge or deceit or cosmetic] or face paint.' Parkinson says that the Italian ladies use the distilled juice as a fucus '... peradventure [perhaps] to take away their high colour and make them looke paler.' I think it more likely that they absorbed atropine through their skin and were slightly 'stoned' and disinhibited, which made them beautiful ladies in the eyes of Italian males. Distribution: Europe, North Africa, western Asia. Culpeper (1650) writes: 'Solanum. Nightshade: very cold and dry, binding … dangerous given inwardly … outwardly it helps the shingles, St Antonie's Fire [erysipelas] and other hot inflammation.' Most of the 16th, 17th and 18th century herbals recommend it topically for breast cancers. Poisonous plants were regarded as 'cold' plants as an excess of them caused death and the body became cold. They were regarded as opposing the hot humour which kept us warm and alive. Poultices of Belladonna leaves are still recommended for muscle strain in cyclists, by herbalists. Gerard (1633) writes that it: 'causeth sleep, troubleth the mind, bringeth madnesse if a few of the berries be inwardly taken, but if more be taken they also kill...'. He was also aware that the alkaloids could be absorbed through the skin for he notes that a poultice of the leaves applied to the forehead, induces sleep, and relieves headache. The whole plant contains the anticholinergic alkaloid atropine, which blocks the peripheral actions of acetylcholine in the parasympathetic nervous system. Atropine is a racemic mixture of d- and l- hyoscyamine. Atropine, dropped into the eyes, blocks the acetylcholine receptors of the pupil so it no longer constricts on exposure to bright light - so enabling an ophthalmologist to examine the retina with an ophthalmoscope. Atropine speeds up the heart rate, reduces salivation and sweating, reduces gut motility, inhibits the vertigo of sea sickness, and is used to block the acetylcholine receptors to prevent the effects of organophosphorous and other nerve gas poisons. It is still has important uses in medicine. Atropine poisoning takes three or for days to wear off, and the hallucinations experienced by its use are described as unpleasant. We have to be content with 'madness', 'frenzie' and 'idle and vain imaginations' in the early herbals to describe the hallucinations of atropine and related alkaloids as the word 'hallucination' in the sense of a perception for which there is no external stimulus, was not used in English until 1646 (Sir T. Browne, 1646). It is a restricted herbal medicine which can only be sold in premises which are registered pharmacies and by or under the supervision of a pharmacist (UK Medicines and Healthcare Products Regulatory Agency (MHRA)). Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Surgical instruments, 15th, 16th, 18th century.
  • Graeco-Roman surgical instruments.
  • Surgical instruments of the 16th and 17th centuries.
  • Dental instuments.
  • Surgical apparatus: includes demonstrations of an ophthalmoscope and a laryngoscope. Wood engraving, 1850/1880?.
  • A lateral incision into the hypogastrium for removal of bladder stone. Engraving by B. Prevost after L.J. Goussier.
  • Canine retina: increased tapetal reflectivity
  • Liver with an increase of the connective tissue along a portal canal
  • Varicose veins along the right side of the trunk of a man
  • Man with orbital aneurysm
  • Brain: bacterial meningitis