Christopher Duffin
London, England

Antimony (Sb) occurs most commonly in the form of the antimony trisulfide mineral stibnite and has enjoyed a long history of medical use.¹ In the fourth century BCE, Hippocrates used it as a sudorific (sweat inducer) and cordial (strengthener) in cases of fever and syphilis. The first-century Greek physician Pedanius Dioscorides recommended powdered preparations of the ore be applied topically for skin ailments, sores, and ocular disorders. During the sixteenth century, however, there was a resurgence of interest in antimony as a therapeutic material. This was due largely to the influence of the itinerant Swiss physician and alchemist Paracelsus (1493–1541) who wrote:

Of all minerals, antimony contains the highest and strongest Arcanum [remedy]. It purifies itself and at the same time everything else that is impure. Furthermore, if there is nothing healthy at all inside the body, it transforms the impure body into a pure one, which was proved in cases of leprosy.²

Experience showed that antimony was a highly toxic metal. Upon ingestion, symptoms commonly include headaches, dizziness, nausea, and abdominal pain, usually accompanied by violent vomiting and diarrhoea as the body tried to rid itself of the poisons. The latter two effects appeared to support both Galenic and Paracelsian philosophies. According to Galenism, strong emetics and laxatives, or purges, were useful in evacuating excess (and hence disease-causing) humors from the body, and the sudorific qualities of the material was useful in breaking fevers. Paracelsus famously indicated that all materials could act either beneficially as a medicine or, in excess, be considered toxic.

In 1566, noting the toxic properties of antimony, the Faculty of Medicine of Paris declared it to be a poison and restricted its distribution, a practice adopted in several other European cities. This was rescinded in 1657 when, in desperation, Louis XIV (1638–1715) was treated with antimony as a last resort for his otherwise seemingly mortal fever by the royal physicians led by Cardinal Mazarin (1602–1661); the outcome was successful.

Perhaps in response to the limited availability of antimonial medicines, cups began to be cast from the material. Normal practice was to fill the cup with wine, which was allowed to stand overnight. The acidity of the wine encouraged dissolution of the antimony so that by the morning, a draught of wine now infused with strongly emetic qualities was ready to drink. The antimony apparently did not affect the taste of the wine; it was suggested that a clove and some mace be added to the liquid before going to bed. Further details are given in a letter by Richard Brocklesby (1722–1797), a well-known London physician, to Ann Shaw of Goodwood, Sussex, in response to her request for instructions:

Fill the cup with Lisbon Wine, or Moselle Wine, set it by to stand 24 hours, and then pour it into a Wine Glass, Two Table Spoonfuls are to be taken at first, & after waiting from 10 to 15 Minutes, Give a 3rd Spoonful, unless the first has begun to operate, but if 3 fail & 15 Minutes, then give a fourth or a fifth if requisite at due intervals, & most commonly the 3rd produces Nausea, Sickness & Vomiting. It is to be wrought off like another Vomit by taking at proper intervals (a pint at a time) from 2 to 3 quarts of bitter strong chamomile Tea. London 13th May 1775.³

Credit for inventing the antimonial cup was claimed by Welsh astrologer and minister John Evans (c. 1594 – c. 1659) who sold the items for one shilling each from his shop in Gunpowder Alley, near Fetter Lane in London.⁴ In his promotional volume, Evans builds on quotations concerning antimony from Paracelsus, ascribing the cups’ nineteen “admirable vertues.” These included efficacy against humoral excess as well as curing a wide range of conditions ranging from malaria, fevers, madness, green sickness (chlorosis), renal stones, sciatica, “Morbus Gallious” (syphilis), epilepsy, worms, hemorrhaging, wens, sores, fistulas, ocular conditions, and gout.

Many in the medical establishment were violently opposed to the use of antimonial cups because the extreme toxicity of the metal potentially could lead to the death of the patient. Sir Nathanael Kitch and Lady Amye Blunt (dates unknown) both died from drinking from antimonial cups.⁵ James Primerose (died 1659) was a particularly vocal opponent who dedicated an entire section of his Popular Errours, or the errors of the people in Physick (1651) to the topic.⁶ The frontispiece to this volume (Fig. 1) shows a bedridden patient being attended by a physician, accompanied by a female assistant bearing an antimonial cup; an angel has interposed himself between the physician and the woman, blocking her administration of the emetic. An explanatory poem emphasizes the sense of this holy intervention.

Evans claimed that Sir Theodore Turquet de Mayerne (1573–1655) approved using the cups. Misrepresented, de Mayerne wrote a letter of complaint to the Royal College of Physicians who raised the matter with the Archbishop of Canterbury. The ensuing High Commission summoned Evans to provide answers to his accusers. Dissatisfied with Evans’ responses, the archbishop decreed that all copies of the book should be destroyed; it is now a very rare volume.⁶

Surviving examples of antimonial cups are likewise very rare. Part of the reason for this is that the crystalline structure of the cast metal is very prone to cleavage and fracturing. Furthermore, antimony is quite flaky, hard, and brittle, rather than malleable as in many other metals. A rather plain English specimen in the Victoria and Albert Museum (Fig. 2), made around 1680–1720, comes with a red tooled and gilt leather case and a woven straw box. A late seventeenth-century specimen in the Boerhaave Museum, Leiden (Fig. 3) is a little more ornate, with some circumferential decoration and a series of applied seal-like saintly portraits.

References

1. Ian McCallum. Antimony in Medical History. Bishop Auckland: Pentland Press, 1999.
2. Paracelsus. Sämtliche Werke. Nach der 10 Bändigen huserschen Gesamtausgabe (1589-1591) zum erstenmal in neuzeitlliches deutsch übersetz. Trans. Bernhard Aschner, 14 volumes. Jena: Fischer, 1922-1933, vol. 3: 151.
3. Antimonial cup with case and box. c. 1680–1720. Cast antimony, red tooled and gilt leather case, woven straw box. Victoria & Albert Museum South Kensington. https://collections.vam.ac.uk/item/O10985/antimonial-cup-with-unknown/
4. John Evans. The vniversall medicine. London: John Haviland, 1634.
5. StClair Thomson. “Antymoniall Cupps: Pocula Emetica or Calices Vomitorii.” Proceedings of the Royal Society of Medicine, 1926; 19: 122-128.
6. James Primerose. Popular Errours. London: W. Willson, 1651.
7. Ian McCallum. “Antimony in Medicine.” The Scottish Society for the History of Medicine. Report of Proceedings, 1992-1993: 1-16 (at page 8).