Předmět měsíce: září 2019

The larger half of a bezoar (tricholith), probably from the rumen of an adult bovine (external view). NML Medical Museum Pharmacy Collection, PH 500.

Object of the Month: September 2019

Bezoar Stone: Tricholith

The bezoar ibex, the main source of bezoar in the Mediaeval times, came to be named after the substance. https://en.wikipedia.org/wiki/Bezoar_ibex#/media/File:Bezoarziege.jpg

Bezoar forms in the hollow organs of the gastrointestinal system – mostly in the stomach, but also in the intestine, the rectum or the oesophagus – of ruminants and exceptionally of humans. Bezoars were extracted from the bowels for pharmaceutical use. The term can be traced to the Persian expression pad zahr, meaning antidote.

Objects from the size of a quail egg to 2,5 kilograms are formed by gradual accumulation and compression of undigested remains of food or materials consumed with food, which later mineralize and harden. Bezoars are, in essence, perfect concrements. Stomach wall movements give them their round, more or less smooth shape. Their colour varies from lemon yellow, yellowish green and light brown to dark brown (such as the specimen in the Medical Museum collections) and coal grey.

Bezoar with a golden ring and Spanish inscription „PEDRA . BESOHAR . FINISSIMA . PESA . OCHO . ONCAS“ (The finest bezoar stone weighing 8 ounces). Kunsthistorisches Museum Wien, Kunstkammer, Inv. Nr. 958, www.khm.at/de/object/1aef8e81f5/

Contemporary medical science divides bezoars into several types according to their composition:
Phytobezoars composed of insoluble plant fibres (from coconuts, figs, oranges, apples, pulses, cabbage, potatoes, dried plums, leeks or even broccoli)
Diospyrobezoars, which form due to excessive consumption of incompletely ripened fruit, such as persimmons. Inthe acid stomach environment, tannins contained in the fruit coagulate into a sticky mass and form a concrement.
Trichobezoars formed from hair matted with cellulose, such as cotton fragments, threads and strings, animal hairs and pieces of plastic. Their occurrence in humans is most often linked to mental disorder.
Pharmacobezoars, formed in the stomach due to certain medications, such as long-term aspirin use. Other bezoars can be traced to swallowed resins (shellac), stones, pebbles, sand or other objects.

Generally, magical or mythical powers were ascribed to bezoar. Crushed into powder or submerged in liquids, bezoar was believed to cure all forms of poisoning, to alleviate insomnia, nausea, aches, digestive problems or epilepsy and to protect against evil spirits.

Pliny the Elder (23- 79 C.E.), the author of encyclopaedic Natural History (Naturalis historia) that summarized various data of ancient mineralogical literature, believed that certain minerals

A physician approaches a poisoned person and administers bezoar. Illustration from Hortus sanitatis [Strassburg: Johann Prüss, not after 21 Oct. 1497], Universitäts- und Landesbibliothek Darmstadt, http://tudigit.ulb.tu-darmstadt.de/show/inc-iv-201/0608

(precious stones) have curative powers: diamonds in particular were to be effective against poisons, function as antidote. The belief in protective function of stones was, through Arabic intermediation, extended to mediaeval bezoars as well. Portuguese physicians Garcia de Orta, Amatus Lusitanus, Cristobal Acosta and others introduced bezoar into mediaeval medical literature.

The popularity of bezoar, not exclusively as medicine, peaked during the Renaissance. Bezoar stones or their parts were literally worth their weight in gold. The wealthiest had them mounted in gold or had various objects of daily use made of them. The Emperor Rudolf II, noted for his fear of being poisoned, had a whole goblet made of bezoar, according to the court physician Anselmus Boëtius de Boodt (1550-1632) from Bruges.

Bezoar from the Wittelsbach family treasury, 16 century, Wien. Source: Wikimedia Commons https://commons.wikimedia.org/wiki/Category:Bezoar#/media/File:Bezoar.jpg
Bezoáry z klenotnice rodu Wittelsbachů, Schatzkammer der Münchner Residenz, München. Zdroj Wikimedia Commons https://commons.wikimedia.org/wiki/Category:Bezoar#/media/File:M%C3%BCnchner_Residenz,_Schatzkammer,_Bezoarsteine_02.jpg

Bezoar appears frequently in 17 century pharmaceutic handbooks, pharmacy inventories and geological and mineralogical treatises, which attests to its continuing popularity in the Baroque era. Until the end of the 18 century, bezoar was considered a respectable medical preparation: in the London Pharmacopoeia it was listed continuously from 1618 to the V Edition published in 1746.

If one considers the biological process through which bezoar originates, slow accumulation of indigestible food remains to form a single mass, one may grant a degree of truth and logic to the claim of absorbing poisonous and harmful substances in the body. Traditional Chinese, Indian and Nepal medicine continues to use bezoar from the stomach of the macaque monkey; in African medicine bezoar still serves to cure a variety of ailments.

The perception of bezoar as a therapeutic and apotropaic (protective) agent, widespread from the ancient Orient to the High Baroque, and thus its important place in the history of medicine, is beyond doubt. The spread of this perception made bezoar an important notion in the history of toxicology as well.

Mgr. Michaela Lindová

NML Medical Museum Pharmacy Collection, PH 500: internal view