Devon colic and lead in cider

Physicians in Devon had described a distinctive endemic colic since at least the seventeenth century, and by the early eighteenth it had a Latin name of its own, colica damnoniorum, the colic of the men of Devon. William Musgrave and later John Huxham, both practising in the county, wrote accounts of it, and it was understood as something particular to that part of England.

The clinical picture is that of chronic lead poisoning as it is now recognised. Severe griping abdominal pain came in bouts, with stubborn constipation, loss of appetite and progressive weakness. In advanced cases the extensor muscles of the forearm failed, producing the dropped wrist characteristic of plumbism, and some patients suffered fits, blindness or death.

It was not a rare complaint. Contemporary descriptions treat it as a familiar seasonal presence, arriving with the new cider and falling most heavily on those who drank the most of it.

Cider is acidic, and acid liquid standing in contact with lead dissolves it. The equipment of an eighteenth-century cider house offered many opportunities for that contact. Press beds and the stone or wooden troughs called pounds were sometimes sheeted or lined with lead to make them watertight. Lead was used for the linings of cisterns and collecting vessels, for pipes and spouts, and to repair cracks in stone and timber.

Beyond the fixed equipment there were further routes. Lead-glazed earthenware was in common use for storing and serving. Lead shot was used to scour the insides of vessels. And lead acetate, known as sugar of lead for its sweet taste, was a known adulterant used to sweeten sour drink and to check fermentation — a practice attacked in the period and impossible to quantify now.

The geography followed the equipment rather than the drink. Herefordshire, where lead was little used in presses, did not show the same endemic colic despite making and consuming cider on a comparable scale. That contrast was the hinge of the eighteenth-century argument.

George Baker, a physician from a Devon family, published his Essay concerning the Cause of the Endemial Colic of Devonshire in 1767. He did three things that made the argument stick. He tested cider chemically and demonstrated lead in samples. He examined the equipment and identified where the metal was in contact with the juice. And he compared the incidence of the disease between cider districts that used lead and cider districts that did not.

The comparative step is what makes the work notable in the history of medicine. Baker was reasoning from the distribution of a disease across populations to an exposure they did not share, at a period when that method was uncommon. He also drew on the established European literature on lead colic, including the colic of Poitou and continental prohibitions on lead in wine, to argue that Devon was a local instance of a known phenomenon.

Baker did not discover that lead is poisonous, and he was not working alone or without predecessors. What he did was to connect an established toxicology to a specific regional practice and to press the case in public. Accounts that present him as the sole discoverer of lead poisoning overstate the claim.

The finding was not welcomed. Devon physicians published rebuttals, disputing Baker’s chemistry and his inferences, and the cider interest had obvious reasons to resist a conclusion that identified their product as poisonous. The controversy ran for years before the argument was generally conceded and lead was progressively removed from cider-making equipment through the later eighteenth and nineteenth centuries.

The distribution of harm followed the distribution of drinking. Farm labourers receiving a daily cider allowance were exposed most heavily and had least recourse; their illness appears in the record largely as a general observation about the labouring poor rather than as individual cases. Landowners and clergy who drank their own cider were also affected, and their illnesses were attended, described and published. The disease became visible partly because it crossed into the class that had physicians.

The episode belongs to the history of occupational and environmental medicine rather than to the history of drink. It is an early instance of a hazard being identified through a comparison of exposed and unexposed populations, of the resistance such findings meet from the interests they implicate, and of the long interval between demonstration and remedy.