Doctor's Review: Medicine on the Move

October 25, 2021
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Rock star

Back in the day, bezoar bulbs were celebrated as a cure-all and cutting-edge medical science

Once upon a time, the most revered remedy in a physician’s arsenal of cures was the mighty and mystical bezoar stone. Though still occasionally hawked by herbalists in the Far East as a fix for virtually everything, bezoars are now largely the domain of fantasy fiction.

Few medical students today know much about them, though anyone who’s passed Potion Making 101 in Harry Potter’s world can tell you that the bezoar stone is the ultimate antidote: a cure-all rooted as much in medieval mysticism as eternal optimism. Regardless, this dubious antivenom was considered cutting-edge medical science for centuries.

Bezoar beginnings

As far as noxious nostrums were concerned, the bezoar stone was unmatched. Its unusual sources and resulting rarity are, perhaps, what led to its reputation for fantastical powers.

First, consider their repugnant origins: the result of a sort of gastrointestinal perfect storm in ruminants and cloven-hoofed creatures that tend to nibble their own hides, borne from the subsequent calcification of some nugget of fibre or food wrapped in layers of indigestible hair and fuzz. Over time, some of these masses hardened and became smooth; others remained hairy, tube-shaped blockages. Both were as precious as they were putrid.

Of course, true bezoars didn’t form overnight, but over years, and knowing that an animal was suffering from one required a keen eye and confidence in its keeper to slaughter an otherwise healthy and valuable beast for the gem contained within its entrails.

Even the awesome curative and protective properties of powdered unicorn horn could not beat these enteroliths, as they are now more commonly known. And so, these hairy pearls were purged, puked, even ripped from the guts of camels and goats in the name of medical science.

Early rock

Evidence of their use dates to the 7th century, but the first official reference to the stone in medical literature comes in the late 10th century in the Book of the Remedies by Persian physician Abu Mansur Muvaffak Harawi. In fact, the very word “bezoar” is derived from the ancient Persian term pâdzahr meaning “protection from poison.”

News of their formidable health powers trickled in from the Far East centuries before they became popular in Europe. Small stones found in the intestines of farm animals were worn as protective amulets around necks in Ancient China, following the legend of one wild goat whose diet of poisonous snakes and healing herbs led to an intestinal enterolith whose properties were revered as the ultimate antivenom.

By the 1600s, the bezoar stone had already captured the imagination of a desperate European populace, still reeling from memories of the noxious air presumed to have caused the Black Death. Plagues and poisons lurked around every corner, and everyone from serfs to kings feared being done in by either some devastating disease or jealous rival.

In England and France, kings and queens had been implanting bezoar stones in the gold used to make their drinking goblets since the 15th century: a built-in antidote to foil would-be poisoners. Indeed, it was the paranoid royals in particular who fed the people’s appetite for the stone since poison was the most popular form of regicide of the day.

King Edward IV (1442-1483) reportedly credited his recovery from an infected wound to his physician’s use of the bezoar. Less than a century later, another English monarch, Queen Elizabeth I (1533-1603), famously owned a rare and exceedingly expensive “unicorn” horn embedded with a bezoar to ward off the constant treachery she faced at the dinner table.

Of course, bezoars weren’t used just in Europe; the contaminant-fearing colonists of North America were also wise to their wonders. Records exist of their use in Massachusetts and Virginia during the 17th century.

Stones for sale

Not surprisingly, a worldwide market in bezoars sprung up to accommodate the European appetite. Stomach stones poured in from around the globe, purportedly ripped from the bellies of Chinese ruminants, scraped from the guts of Javanese porcupines and plucked from the entrails of Chilean and Peruvian mountain goats. Their price was often exorbitant. Physicians and their well-to-do patients kept their bezoars in ornate boxes and flaunted them as status symbols.

The poor, of course, were forced to pray that the pebble they’d used their life savings to purchase was not the local pebble it likely was. Even fake bezoars, though, were occasionally believed to be powerful protectors. (In fact, they’re still cultivated in yaks’ bellies in parts of China.) In the 1600s, Portuguese monks inhabiting the Indian state of Goa responded to the global bezoar shortage by creating their own stones out of a paste of precious stones, herbs and animal tusks. They did quite a brisk business well into the 18th century, though Goa Stones, as they were known, could never really match the power of a true bezoar.

Debunking the myth

It wasn’t until a critical-thinking medical mind challenged the magical enterolith that doubt arose about its mystical qualities. Ambroise Paré (1510-1590), the oft-known Father of Surgery and long-suffering physician of France’s King Charles IX, perhaps had had enough of his paranoid patient’s insistence on bezoars being embedded in his cups and dishes that he eventually proposed an experiment to test the enterolith’s efficacy.

Of course, the only way to do this was to enlist the aid of a research subject, in this case, a cook in Charles’s kitchen who’d been caught stealing silver forks. The hapless fellow was given two choices: either be summarily sent to the gallows for his crime or submit to a simple scientific study. He unwisely chose the latter. The court apothecary prepared a string concoction of mercury chloride and served it up in a chalice containing a bezoar stone. It wasn’t long before the cook was begging to be hanged. After seven hours of violent vomiting, hemorrhaging from the ears and nose, and a great deal of excruciating pain, he at last expired.

Despite Paré’s proof, the public and scientific communities were not so quick to discount the powers of the stone. Instead of seeing the light, King Charles himself decided that he and Paré had been duped by a fake stone and burned it in a great display of disgust.

Buyer beware

Word of Paré’s experiment spread, however, and those in power figured they better do something. Naturally, that meant stopping the spread of those counterfeit bezoars. In 1603, England’s King James I (1566-1625) brought the full wrath of the law down upon a goldsmith who’d been sued by a customer and convicted of creating and selling 100 pounds of fake stones. It was in the court’s decision that the concept of “caveat emptor” was first mentioned in the law: buyer beware... because if the price of a bezoar stone seems too good to be true, it probably is!

Eventually, common sense and the scientific method came together to debunk the myth of the mighty bezoar stone. The enterolith remains, however, an interesting medical phenomenon. From time to time there are reports of human bezoars in the large intestines, primarily occurring in small children who eat their own hair and those suffering from an unfortunate combination of pica and trichotillomania. The excessive ingestion of persimmons, too, is known to cause these fibrous fecaliths in humans, as is too much popcorn and chewing gum. And, although no long-term double-blind studies have yet been conducted on the efficacy against poison of these hairy wonders — either human or animal in origin — it’s safe to say that Paré probably had it right back in 1575.

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