Medieval Blood Sugar...

[Phyrebrat]

I was determined not to ask this, but I am now getting stupid answers online under my own research so I thought I'd ask your opinions.

One of my MCs has hypoglycaemia. She does not have it as a complication of diabetes. I'm also hypoglycaemic and have to eat regularly (and as my friends will tell you if I get to the moderate stage before I pass out, I get rage and emotional and dizzy). I manage it but there are times when it creeps up and I have to act very quickly (usually a spoonful of sugar at that point as carbs would be too slow to have any effect).

Alaina is unable to get back to her hovel in time and passes out. I've been writing the short passage for an hour but am starting to find it difficult to define her relationship with this condition. At the moment she refers to it as her 'choler' which is the nearest I can come up with, but it is a rather standout word which I don't want to use repeatedly, and there are no terms online other than ones directly related to diabetes (some of which are quite funny; honey-piss anyone?) on medieval-theme websites.

What can I use? Fever doesn't work and I used apoplexy (as an analogue for a stroke) in the previous POV when Gilbert knocks himself unconscious.

Thanks

pH

The context is:

If that stupid man had not woken, Alaina would have attended him, concerned that he needed aid. The thick-headed dullard had shown her no gratitude; she could have robbed him. She could have murdered him right where he lay.
‘But you didn’t,’ she murmured and carried on through the forest. Her fingers were raw with the excavations and the cold, yet they burned as her blood coursed with an uncommon rage. She had not eaten since rising, had been acting in great haste, and spirit since then, so that the anger coursing through her tired rather than invigorated her. She recognised the onset of the choler that made her sleep and her anger turned into panic.

Must get back, must get back…must…

She saw the spread of bedimmed yews swing away to be replaced by a sickle-moon twilight sky as she swooned and fell.

Moments later she woke, her mood now placid, her body weak, her racing heart now calm. The

 

[Dave]

I was determined not to ask this, but I am now getting stupid answers online under my own research so I thought I'd ask your opinions.

Really, why are you engaging other people?

"Choler" works for me. I not clear what your problem with it is? It does fit the symptoms and is consistent with the cause. I've looked in some medical dictionaries and can't find an alternative for you that would be better.

What about her referring to it as her "fasting sickness?"

I get rage and emotional and dizzy.

On First Aid Courses they tell you to recognise it this way, and that the person may get violent and appear to be drunk. However, I have seen it before in a child. The restaurant was taking too long to serve the meals. He wasn't violent or dizzy or raging at all, but he was almost climbing up the wall. (He was a kid with a learning disability so had difficulty expressing his emotions even under normal circumstances.)

 

[Phyrebrat]

I really like the term fasting sickness a lot, but I'm wondering if they would have known in 1178 what the root cause was, bearing in mind the complexities of BSL. So you think choler is okay? I just thought it seemed a bit - I don't know - I just don't want to sound pretentious, and was concerned it may sound so.

Personally: I damaged my kidneys, liver and pancreas when I was a late teen and have been managing it since then. It goes from light, to moderate, to passing out and when I'm in the lightly affected stage, I get peckish and feel a little anxious. That's when I'll make sure I eat something. If I don't I get to moderate stage - this is the only way to describe this - where I feel like I'm made of water. Then I shake, and panic and rage, get very dizzy etc. I mentioned my long-suffering friends - one of the most common things I hear them say is 'when did you last eat?' If I still don't get sugar I pass out. TBH that is preferable to getting the sugar. Passing out seems to just 'reset' everything for me and I come round within seconds feeling totally normal. If I get sugar though, I'll get back to normal but feel like crying for about 2 hours.

To each, their cross, though

pH

 

[Dave]

The following is not from any medical background, just the university of life. She would know her own body, like you do, so she would read the symptoms. She would know that when she didn't eat, that is what happened, just like you. I think that is more likely than her having learnt about the four bodily humours, which would require a medical training. Choler is a word associated with one of the humours, the bile, so in that respect it is unlikely she would use it.

I had another thought, but I'll message you with it.

 

[goldhawk]

I don't know much about medieval word usage but I think the word fit (as in "having a fit") seems more appropriate.

 

[Ragandar]

I agree with Dave. I like choler as a word, and I like it in this context.

With regards to the fasting sickness, would it not be possible for them to correlate the condition with their eating habits? Like, 'Oh hey, if I don't eat, I die,' but then, 'Oh hey, if I don't eat in time, I suffer from these other symptoms.' If they could do that, then it would be a perfectly fine term to use, right?

-EDIT- Seems like Dave beat me to the punch, eh.

 

[ErikB]

I was determined not to ask this, but I am now getting stupid answers online under my own research so I thought I'd ask your opinions.

One of my MCs has hypoglycaemia. She does not have it as a complication of diabetes. I'm also hypoglycaemic and have to eat regularly (and as my friends will tell you if I get to the moderate stage before I pass out, I get rage and emotional and dizzy). I manage it but there are times when it creeps up and I have to act very quickly (usually a spoonful of sugar at that point as carbs would be too slow to have any effect).

Alaina is unable to get back to her hovel in time and passes out. I've been writing the short passage for an hour but am starting to find it difficult to define her relationship with this condition. At the moment she refers to it as her 'choler' which is the nearest I can come up with, but it is a rather standout word which I don't want to use repeatedly, and there are no terms online other than ones directly related to diabetes (some of which are quite funny; honey-piss anyone?) on medieval-theme websites.

What can I use? Fever doesn't work and I used apoplexy (as an analogue for a stroke) in the previous POV when Gilbert knocks himself unconscious.

Thanks

pH

The context is:

If that stupid man had not woken, Alaina would have attended him, concerned that he needed aid. The thick-headed dullard had shown her no gratitude; she could have robbed him. She could have murdered him right where he lay.
‘But you didn’t,’ she murmured and carried on through the forest. Her fingers were raw with the excavations and the cold, yet they burned as her blood coursed with an uncommon rage. She had not eaten since rising, had been acting in great haste, and spirit since then, so that the anger coursing through her tired rather than invigorated her. She recognised the onset of the choler that made her sleep and her anger turned into panic.

Must get back, must get back…must…

She saw the spread of bedimmed yews swing away to be replaced by a sickle-moon twilight sky as she swooned and fell.

Moments later she woke, her mood now placid, her body weak, her racing heart now calm. The

I agree that your solution seems viable. But if you need a more mundane and descriptive term that a character might use she might reference it as her "hungry blood." Since the condition forces the body to eat or tire/weaken.

I would assume that calling it hungry blood ailment would be safe. I would not reverse the words because it would be construed as vampirism or lycanthropy at work making her appear evil to a superstitious group.

You could also call it something more simple. "The hunger" or "the need" etc.

Perhaps "famine's ghost."

Hope this helps. Cheers!

 

[Alex The G and T]

I like "The Vapors." But I guess that's a more 19th century thing; with women constantly "swooning with 'the Vapors.'"
Probably associated with shortness of breath, caused by an overly tight corset.

 

[Brian G Turner]

My first thought is to call it a "fainting sickness", probably caused by an imbalance of the humours. In the mediaeval period, I think it's already considered a "fact" that women's humours are more prone to be unbalanced and make women more volatile and hysterical.

but am starting to find it difficult to define her relationship with this condition.

This may be your problem - illness remains a mystery in this period. Her condition could be regarded as a punishment for sins, or even a sign of Divine influence. Either way, if you try and relate any of this a modern understanding of biology and medicine, things are likely to not simply become over-complicated, but appear forced.

IMO this is one of those details you put in your notes and leave it at that. By all means, show the character being grumpy and having mood swings when not having eaten for some time - those with hypoglycaemia will likely recognise what's going on. But I think you will struggle to explain it to those readers who don't. Especially as neither food security nor basic food hygiene are going to be common in this period - so a lot of people may be hungry and grumpy because of it, and those who eat well may become easily sick anyway.

2c.

 

[The Judge]

I think Brian is right that you have to remember this is a time of little medical knowledge outside the Moslem world, and a great deal of superstition. There would be folk remedies handed down -- eg cobwebs for healing wounds -- and a knowledge of herbs (hence such names as knitbone and allheal), but they existed alongside things like amulets and tokens and particularly prayers to ward off illness/evil. There was little or no understanding of the body's processes. Having said that, people were no more stupid than we are, and could understand cause and effect. So if by chance she had learned that eating** something during the onset of the symptoms prevented them worsening, then she would be able to grasp food had something to do with it.

** or drinking? Does that help sufferers? Drink might be more plausible as a remedy when she felt unwell the first time, leading her to experiment later on. When did the condition first affect her though? If it came on when she was a child, would she have survived? (I ask in all seriousness, having next to no understanding of the condition.) And at a time when sugar is incredibly expensive, and honey a treat, how is it treated? (By the way, how does she know she woke only moments later and not eg half an hour?)

Choler doesn't work so well for me, because of its more recent meaning of anger and ill-humour which affects how I read it, even if this is one of the side-effects of her attacks. If she did collapse, I'm sure "fits" would come into it somewhere. Is there any shivering involved in the symptoms? "Ague" was used for malaria-type fevers from 1300, but might perhaps be co-opted for shivering, in which case you could coin an expression like shiver-ague.

I've got a Culpeper -- which was written long after this, of course, but might still be useful -- so I'll have a poke around in it to see if I can come up with other commonly used illness words. (I was hopeful for quinsy, but I'm disappointed to see it's just tonsillitis!)

NB Poking around, I see hypoglycaemia can cause ketosis. Do you know if this means the sufferer's breath takes on that acetone smell? If so, that was known in the middle ages, since women fasting for religious reasons experienced it, when it was known as the odour of sanctity. (That's one theory for the use of the phrase, anyway.) If others had smelled that on her after an episode, then she might have given it a name connection with smell.


PS Sorry to hear you're afflicted. No wonder the bounty bars are in constant demand!

 

[Ursa major]

Although it has, obviously, all sorts of unpleasant connotations and isn't descriptive of the physical symptoms, wouldn't the word, curse, fit the bill?

 

[Dan Jones]

Having not read the other replies, apologies if I'm going over old ground. Would not some mention of sweet things as her remedy provide the necessary implication that she's diabetic? ie honey as medicine, or something along those lines? This doesn't necessarily reveal that she understands how or why the sickness works the way it does, but does show some understanding of cause and effect - I eat honey, I feel better, the sickness subsides. A modern reader can put 2 + 2 together.

 

[Mirannan]

I think Brian is right that you have to remember this is a time of little medical knowledge outside the Moslem world, and a great deal of superstition. There would be folk remedies handed down -- eg cobwebs for healing wounds -- and a knowledge of herbs (hence such names as knitbone and allheal), but they existed alongside things like amulets and tokens and particularly prayers to ward off illness/evil. There was little or no understanding of the body's processes. Having said that, people were no more stupid than we are, and could understand cause and effect. So if by chance she had learned that eating** something during the onset of the symptoms prevented them worsening, then she would be able to grasp food had something to do with it.

** or drinking? Does that help sufferers? Drink might be more plausible as a remedy when she felt unwell the first time, leading her to experiment later on. When did the condition first affect her though? If it came on when she was a child, would she have survived? (I ask in all seriousness, having next to no understanding of the condition.) And at a time when sugar is incredibly expensive, and honey a treat, how is it treated? (By the way, how does she know she woke only moments later and not eg half an hour?)

Choler doesn't work so well for me, because of its more recent meaning of anger and ill-humour which affects how I read it, even if this is one of the side-effects of her attacks. If she did collapse, I'm sure "fits" would come into it somewhere. Is there any shivering involved in the symptoms? "Ague" was used for malaria-type fevers from 1300, but might perhaps be co-opted for shivering, in which case you could coin an expression like shiver-ague.

I've got a Culpeper -- which was written long after this, of course, but might still be useful -- so I'll have a poke around in it to see if I can come up with other commonly used illness words. (I was hopeful for quinsy, but I'm disappointed to see it's just tonsillitis!)

NB Poking around, I see hypoglycaemia can cause ketosis. Do you know if this means the sufferer's breath takes on that acetone smell? If so, that was known in the middle ages, since women fasting for religious reasons experienced it, when it was known as the odour of sanctity. (That's one theory for the use of the phrase, anyway.) If others had smelled that on her after an episode, then she might have given it a name connection with smell.


PS Sorry to hear you're afflicted. No wonder the bounty bars are in constant demand!

Fruit is a very good source of sugar, particularly grapes; of course, which fruit is available depends on time of year to some extent, and also geography. (Grapes would be hard to come by in mediaeval northern England, for example.)

Failing that, bread (particularly white bread, again very expensive in mediaeval times) is quite quick to release its carbohydrate content when eaten. And drinks containing sugar, including most ales, certainly mead and probably cider, would also release sugar quickly.

Regarding time sense in this context; well, I imagine that one would feel a lot more uncomfortable after half an hour in an uncomfortable position than a couple of minutes.

 

[The Judge]

Yes, I'd wondered about mead, hence my question about drinks, but being utterly ignorant of the condition, I wasn't sure if liquid acted in the same way, nor how other foods worked -- I've only ever come across the sweet/sugar lump thing when someone was having problems, and that was donkeys years ago.

Dried fruits would presumably have a higher concentration of sugar, and they'd be available year round. Do they have the same effect? You're right about white bread being expensive, though, so it's more like to be maslin, or just rye. Would that be as effective, do you know?

Re the time, I was rather pulling pH's leg, as there are obvious ways of telling the time, but starting the sentence with "Moments later she woke" seems to me to be written from outside her experience, not within it, so I thought I'd flag it to show I was paying attention!

 

[Phyrebrat]

Thanks all! Long day for me am on the hop between Walthamstow and Hackney so Will try to answer.... But I'm on my phone so please forgive typos etc.

She's Muslim (Ethiopian descent). This early type of Islamic faith is similar to a lot of west African Christian religions today which quite happily blend shamanism - vodun - with Christianity.

African heritage people are genetically predisposed to blood sugar issues and sickle-cell anaemia. And the condition of diabetes was semi-described- if not quite understood - in very early Greece. The early Arab would be quite aware of it despite the lack of cure or medical understanding.

She's certainly aware she has a condition but I'm not concerned with the pathology of it, so that's not what I meant. I just wanted differing names so I'm not using choler all the time. She has grown up with it, her father telling her the fainting is when she's communing with Allah and the other deities.

As someone who suffers a mild form of this myself, there is no way she would not be constantly aware of it. I can't think of a time when I have not been aware of the condition in the back of my mind as I go about my day <cry me a river, okay >. The point is, it's not credible for her to have this condition and not think about it in POV anymore than a blind person would ignore their sightless-ness.

The fainting is momentary, it always is, as she knows. I doubt she would rationalise it as in 'the moon hadn't moved in the sky' because she's always used to it being momentary.

And it leads to her death. Poor lass.

I really like some of the suggestions you put forward (altho 'fit' speaks to me of seizing and spasm which is nothing like this) and would still be interested in more and TJ's 'erbal erudition.

pH

Ps. This wasn't a sly attempt at a crit request btw. I'd have posted a tidier draft

 

[Dan Jones]

How about "sweet-thirst"?

 

[anno]

Am I missing something here,diabetes is terminology from the Greeks around 250 BC, 'honey urine' was also used.

 

[The Judge]

But not used here until very much later. According to the Online Etymology Dictionary:

1560s, from medical Latin diabetes, from late Greek diabetes "excessive discharge of urine" (so named by Aretaeus the Cappadocian, physician of Alexandria, 2c.), literally "a passer-through, siphon," from diabainein "to pass through," from dia- "through" (see dia-) + bainein "to go" (see come).

An old common native name for it was pissing evil. In classical Greek, diabainein meant "to stand or walk with the legs apart," and diabetes meant "a drafting compass," from the position of the legs.

My bolding, pH!

I was going to mention earlier that something-evil might be one way out of it, along the lines of the King's-evil (scrofula -- I think because a king was supposed to be able to cure it, not because one had it!) and another one which I had a minute ago and now can't find/remember.

My Cupeper-ing hasn't thrown up anything yet, though I'm knee deep in running of the reins, stopping of the spleen and laxes at the moment

 

[Ursa major]

her father telling her the fainting is when she's communing with Allah and the other deities

So it's a Blessing, not a curse.

 

[Mirannan]

Yes, I'd wondered about mead, hence my question about drinks, but being utterly ignorant of the condition, I wasn't sure if liquid acted in the same way, nor how other foods worked -- I've only ever come across the sweet/sugar lump thing when someone was having problems, and that was donkeys years ago.

Dried fruits would presumably have a higher concentration of sugar, and they'd be available year round. Do they have the same effect? You're right about white bread being expensive, though, so it's more like to be maslin, or just rye. Would that be as effective, do you know?

Re the time, I was rather pulling pH's leg, as there are obvious ways of telling the time, but starting the sentence with "Moments later she woke" seems to me to be written from outside her experience, not within it, so I thought I'd flag it to show I was paying attention!

Wholewheat bread and rye bread would probably release sugar slower, so might not be quite as useful here. Dried fruit would probably do the job; with further info given, assuming the milieu is something like RL then the most likely common dried fruit might be dates, I suppose.