Category Archives: Series: Ancient Greek Studies

Harnessing Heat in Greco-Roman and Islamicate Medicine

By Aileen R Das

Associated and sometimes identified with the life-giving (or vital) principle, heat occupied a central place in ancient Greek, and subsequently Roman and medieval Islamicate, theories about the human body and its care. The medical literature surviving from classical Greece shows that early doctors’ understanding of human physiology was greatly informed by philosophical speculations about the basic constituents of the world. Heraclitus of Ephesus (fl. 500 BCE) appears to be the first natural philosopher to give fire a primary role in the cosmos; according to him, everything originates from fire, which undergoes various changes to become the materials that we see around us. His now fragmentary writings do not discuss medical or biological themes, but later ‘Pre-Socratics’ – a modern term that describes Heraclitus and other thinkers before or roughly contemporary with Socrates – such as Empedocles (495–435 BCE) did explain how this element affected the body. Both a physician and a philosopher, Empedocles of Akragas is the progenitor of the four element theory, according to which earth, water, fire, and air are the building blocks of the universe, and he asserted that heat was responsible for sexual differentiation. In his philosophical poem On Nature, Empedocles remarks, ‘For in its warmer part the womb brings forth males, and that is why men are dark, more manly, and shaggy’ (fr. 67).

The authors of the Hippocratic corpus developed several of their therapies in light of the notion that an innate heat sustains essential processes in the body such as growth and digestion. The intensity of this heat supposedly varied not only according to sex – with men being warmer than women – but also from person to person. Thus, when deciding on a course of treatment, the doctor had to make sure that they did not excessively increase or reduce the natural heat of their patients. Dietary regimens were the mainstay of Hippocratic therapeutics, for doctors working in this tradition assigned to food a range of properties (cooling, warming, drying, and moistening, to name just a few) that could influence the condition of the body. For example, the Hippocratic treatise Regimen II recommends that the herb coriander, which is described as being ‘hot and astringent’, be eaten to combat heartburn and to induce sleep.

None of the Hippocratic writers offer an overarching theory of the powers of nutriment and other natural substances. Rather, centuries later the physician Galen (d. c. 217 CE) of Pergamum, who drew on the Hippocratics, their philosophical precursors, and earlier pharmacological writers, formulated a system that ranked the properties of plants, minerals, and animal products. The dividing line between what counted as a drug as opposed to a food was blurry in the ancient (as well as medieval) world, so Galen elaborates his theory in both his dietetic and pharmacological works. On the Powers and Mixtures of Simple Drugs, which lists several hundred one-ingredient drugs, offers the most comprehensive account; it relates that all substances possess a mixture of active (hot or cold) or passive qualities (wet or dry) in four varying degrees of intensity, with the first degree being weak and the fourth strongest. For example, in the entry on the chaste-tree (vitex agnus-castus), Galen reports that the leaves and seeds of this Mediterranean plant is warm and dry to the third degree. By learning the properties and strengths of a range of materia medica, the doctor can select the appropriate remedy that will match their patient’s imbalance. Regarding the power of the chaste-tree, Galen recommends that the seeds be used to dissolve wind in the stomach and to relieve uterine pain, but he cautions that they are so warming that they can cause a headache. Thus, to avoid this affect, he advises that they be ingested with sweetmeats or other dessert items.

While Galen’s theory of the potency of natural substances was extremely influential throughout antiquity and the middle ages, later medical thinkers looked to redress his failure to explain how a doctor (or pharmacist) calculates the right proportion of ingredients in a multi-ingredient (that is ‘compound’) drug to achieve the desired potency. The Muslim philosopher Abū Yaʿqūb ibn Ishāq al-Kindī (c. 801–66), who was not a doctor himself but had sponsored the Arabic translations of Greek medical works, developed a complex arithmetical theory to quantify the strength of a drug that contained varying degrees of warmth, for instance. According to it, a substance’s intensity increases with an increase in degree according to the double ratio. Thus, if one takes a ‘temperate’ drug that has equal parts of warmth and coldness and doubles the parts of warmth, the drug will be hot in the first degree; if the parts of warmth are quadrupled, then the drug is hot in the second degree and so on. With these proportions in mind, the practitioner can weigh out the simple ingredients of the compound drug to obtain the intended strength. Al-Kindī’s solution to the gap in Galen’s pharmacology was popular not only among medieval Islamicate but also European doctors, who read it through a 12th-century Latin translation.

From the dry sands of Egypt… Greek medicine labels on papyrus

By Isabella Bonati

Amongst the many objects depicted in the “unswept floor” mosaic by Heraclitus (II cent. CE) there is a drug container (unguentarium) with a narrow, probably folded, papyrus tag suspended from its neck. This tag likely offered the identification of the content, possibly an ointment or some aromata, stored into the unguentarium. This striking mosaic provides archeological evidence of the common use of medicine labels across the ancient world. [1]

imm1-unswept-floor-mosaic
Drug container with papyrus label. Detail of the asàrotos òikos mosaic (“unswept floor”) by Heraclitus, Gregorian Profane Museum (Vatican Museums), cat. 10132.

Like the modern patient information leaflets, the practice of labeling containers was particularly useful in medical contexts. In spite of the perishability of their support, some of these labels on papyrus have been preserved by the dry sands of Egypt. One example is a strip of papyrus cut on all sides (8,5 cm x 22 cm), dating back to the first half of the III century BCE on paleographical ground (SB XIX 12074).[2]

imm2-papyrus-with-a-list-of-spices
Ptolemaic list of aromata and honey on papyrus (SB XIX 12074), Ann Arbor, Michigan University, Library P. 3243

The papyrus contains a list of five spices – cassia, cinnamon, nard, myrrh and saffron – and two specific kinds of honey – the Cretan and the Theangelic – commonly used in medical recipes. The strip was folded vertically down the center in order to obtain five panels of equal size. Then a notch was cut along the right-hand fold producing two holes. It is likely that a string was passed through the holes to suspend the folded sheet from or attach it to some other object, such the container storing the remedy obtained by the ingredients mentioned in the list, like in the mosaic image above. Thus, this papyrus seems to represent a concrete specimen of the practice illustrated in the “unswept floor” mosaic.

This particular medical label belongs to a broader context. Greek medical papyri coming from Egypt, dating from the III century BCE to the VII century CE, represent a body of evidence offering a rich and veritable picture of medical tradition over this thousand-year period.[3] Indeed, aside from literary fragments and adespota handbooks copied by professional scribes, practical medical texts constitute the largest group of surviving papyri. Thus, collections of drug recipes used by physicians and medical prescriptions written on single papyrus sheets attest to the wide variety of remedies circulating in Egypt at the time.

Among the medical papyri discovered and published so far, just a few of them – about 10 items – may be interpreted as medicine labels. These share formal and material features. Often the writing is concise and the small papyrus is expressly cut from a larger sheet of a particular thickness. According to the kind of information they contain, these labels on papyrus, parchment or ostraca may be divided in three categories: some of them carry only the name of a drug or medicine, others only the therapeutic indication introduced by pros (“against”) plus the name(s) of the disease(s) in accusative, reproducing the typical formula of the epangelia of the medical prescriptions. A third category displays both the therapeutic indication and the name of the medicinal substance, occasionally followed by the quantity. So, these last specimina have features more similar to actual recipes. A papyrus strip measuring 10,6 x 4 cm, P.Prag. III 249 (VII CE),[4] may serve as an exemplar of this category:

‘Against spreading ulcers. Of incense ounce(s)…’

imm3-p-prag-iii-249
Medicine label on papyrus (P.Prag. III 249), Prague, National Library P. Wessely, Prag. Gr. III 1204 v

In conclusion, in the everyday practice, these tags were attached to – or stored with – small containers or boxes for aromata and medicaments by the pharmacopolai, the apothecaries who were used to sell drugs and pharmaceutical products to the doctors. These inscribed labels likely identified the content of small jars or vases circulating on the trade-market: they are a surprising witness of both the medical practices and the commerce in the ancient world, as is concretely revealed by the dialogue between the archaeological and papyrological evidence survived from the telling silence of the past.

[1] The “unswept floor” mosaic asàrotos òikos is in the Gregorian Profane Museum (Vatican Museums). This detail is taken from L. Taborelli, Sulle ampullae vitreae. Spunti per l’approfondimento della loro problematica nell’ottica del rapporto tra contenitore e contenuto, ArchCl 44 (1992) 311, cf. pp. 326-7 for description and bibliography. For the entire mosaic see http://mv.vatican.va/3_EN/pages/x-Schede/MGPs/MGPs_Sala01_03.html#top.

[2] Editio princeps by A.E. Hanson, A Ptolemaic List of Aromata and Honey, TAPA 103 (1972) 161-6. For the image reproduced below see http://quod.lib.umich.edu/a/apis/x-1906.

[3] On medical papyri see, e.g., I. Andorlini, Prescription and Practice in Greek Medical Papyri from Egypt, in H. Froschauer-C.E. Römer (Hrsg.), Zwischen Magie und Wissenschaft, Ärzte und Heilkunst in den Papyri aus Ägypten. Katalog der Asstellung, Österreichische Nationalbibliothek, Wien 2007, 23-33.

[4] Editio princeps by R. Luiselli, Etichetta di sostanza medicinale (Gr. III 1204 verso), in R. Pintaudi-D. Rathbone (eds.), Papyri Graecae Wessely Pragenses (P.Prag. III), Firenze 2011, 157-8, from which the image is taken (Pl. XLVI).

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Isabella Bonati is currently completing a Post-Doctoral Fellowship in Papyrology at the Department of Letters, Arts, History and Society (L.A.S.S.) of the University of Parma, Italy, where she is involved in research activities in the ERC project DIGMEDTEXT (Online Humanities Scholarship: A Digital Medical Library based on Ancient Texts). She holds a PhD in Papyrology from the University of Parma and she received an Yggdrasil grant 2012-2013 at the University of Oslo. Her main research interests are concerned with papyrology, especially lexical studies. Other research interests include classical philology, linguistics, archaeology, history of medicine. For list of her publications go here.

Lizards and lettuces: Greek and Roman recipes for Valentine’s Day

As you prepare to tuck into your oysters, followed by a garlicky main course, and a chocolaty desert on Valentine’s night, spare a thought for the Greeks and Romans, whose aphrodisiacs I now present to you. Ancient medical treatises contain numerous recipes for aphrodisiacs. This abundance may give the impression that the Greeks and Romans were a liberated bunch, with a healthy interest in a fulfilled sexual life.

Sexual scene on one of the walls of the lupanar at Pompeii. Photo: Laurence Totelin, October 2014
Sexual scene on one of the walls of the lupanar at Pompeii. Photo: Laurence Totelin, October 2014

Certainly, archaeologists have discovered a wealth of sexually-themed Greek and Roman objects over the years. Many, like those found at Herculaneum and Pompeii, were hidden away for decades in ‘Secret Rooms’ in museums, only to come to full light quite recently. One has to be careful, however, not to look at such objects with too modern a gaze. Many had ritual purposes: they were meant to ward off various dangers. And among the perils the ancient feared most was infertility, human, animal, and vegetal. Barrenness of the earth would bring hunger; human barrenness would mean the end of the family line. I believe it is in this context that ancient aphrodisiac recipes are best read.

One of the most impressive collection of aphrodisiacs is to be found in the pseudo-Galenic Euporista. Euporista’ is the title of several ancient medical recipe collections. It simply means ‘Remedies easily procured’, that is, remedies whose ingredients are relatively easy to find, and whose preparation is relatively simple. This particular collection of Euporista is attributed to Galen in the manuscripts, although it is quite clear that Galen himself did not write it. The chapter on aphrodisiacs starts as follows:

Aphrodisiacs for the penis: these stretch the penis and lead to sexual union: pine-cones, pepper, parsley, fillings deer’s penis, turpentine, of each the same amount; mix with honey, and give to drink in wine. [Pseudo-Galen, Euporista 2.2]

This recipe is quite clearly meant to be used by men! It explicitly states that it will stretch out the penis. It features one of the most common ancient aphrodisiac ingredients – deer’s penis – with herbal ingredients. The deer’s penis is very large and was therefore considered useful as a sexual stimulant. Two of the herbal ingredients (pine-cones and pepper) present themselves as seeds, which again had links with fertility. Pseudo-Galen then gives several other similar recipes, most of which seem passably palatable, with the exception of the following:

Another [aphrodisiac]: when the bull defecates after sexual intercourse, mix clay with the pat from the bull, and coat the penis with this poultice. [Pseudo-Galen, Euporista 2.2]

Perhaps one had to have reached a certain level of desperation to make use of that particular remedy. A man under less pressure might have prefered to consume cow’s milk, which features quite often in ancient aphrodisiacs.

Aphrodisiacs could be more complex than those preserved in the pseudo-Galenic Euporista. For instance, the seventh-century author Paul of Aegina transmits the following recipe:

Man orchis (saturion), the penis of deer, of each 2 drams, seed of rocket, pellitory, barley (?), wax, of each 2 drams, turpentine, 1 dr., 3 eggs of sparrows, 3 geckos, pine or iris oil, a sufficient amount. Steep the live geckos in vinegar until 40 days have passed, smearing the vessel [containing the gecko] with dung. [Paul, Medical Collection 7.17.84]

Satyr on a red-figure cup, sixth-century BCE. Source: Wikipedia
Satyr on a red-figure cup, sixth-century BCE. Source: Wikipedia

The Greek name of the man orchis, saturion, does more than hint at its alleged aphrodisiac properties: this is the plant of the Satyrs, the companions of the god Dionysus, usually represented with huge erections. This plant, like other orchids, has a bulb that can be perceived as resembling a testicle (the Greek word for testicle is – you may have guessed – orchis). Beside this most powerful plant, the recipe also boasts herbal ingredients, deer’s penis, gecko, sparrow’s eggs, and dung.  The gecko deserves special attention. It is a type of lizard whose kidneys in particular were reputed for their aphrodisiac powers. This is what the pharmacologist Dioscorides (first century CE) had to say on the topic:

They say that the part around the kidneys of the gecko, in the amount of one dram drunk with wine, has such a sexually-stimulating power, that the intensity of desire must be checked by drinking a broth of lentil with honey, or the seed of lettuce with water. [Dioscorides, Materia Medica 2.66]

Now the lettuce has always been reputed for its soporific properties – recall Beatrix Potters’ story of the Flopsy Bunnies. Of course, sleep is the worst enemy of sexual intercourse, and if you fall prey to sleepiness, pseudo-Galen gives us a recipe to prevent sleep immediately after his chapter on aphrodisiacs:

Against sleep: Write upon the surface of a bay leaf and secretly place it on the head [of the patient], uttering ‘konkofon brachereon’. [Pseudo-Galen, Euporista 2.3].

Happy Valentine’s Day!

 

 

The Recipes of Cleopatra

By Jennifer Park

In Robert Allott’s edited prose commonplace book, Wits Theater of the Little World (1599), he introduces a section on beauty with this line: “Cleopatra writ a booke of the preseruation of womens beauty.”[1]

Cléopâtre (étude) by Alexandre Cabanel, at the Musée des Beaux-Arts - Béziers. Image available on Wikimedia Commons.
Cléopâtre (étude) by Alexandre Cabanel, at the Musée des Beaux-Arts – Béziers. Image available on Wikimedia Commons.

Today’s post is an introductory foray into the figure of Cleopatra as an apparent source of medical knowledge in early modern England, with recipes that apparently come from the “Book of Cleopatra.” During the time when Shakespeare was believed to have been writing Antony and Cleopatra, Cleopatra’s book was mentioned in a range of early modern works. What’s fascinating about the recipes attributed to Cleopatra is that they appear in a wide range of works, from secrets to cosmetics to surgery and medicine to natural history and the natural sciences.

To provide a brief example, I’ll begin with a few recipes that dealt with the problem of hair loss, found in a work on surgery, as well as in a work on, surprisingly, insects. The first is physician Thomas Bonham’s The Chyrurgian’s Closet (1630), a posthumously published compilation of his medical work.[2] Cleopatra is listed as one of the “Authors of this Worke,” and is referenced in two brief unguent recipes to restore hair growth, a concern explored for the early modern period by Jennifer Evans and for Graeco-Roman antiquity by Laurence Totelin. The first recipe is for greater ease of hair renewal and growth:

Rx. Cort: arundinis, & Spuma nitri, ana {ounce} ss. picis liquida, q. s. f. vng. *. To restore hayre in an inueterate Alopecia [or baldness]. It will be [ B] very profitable daily to shaue the place, and to rub it with a lin|nen cloath, and then to anoint it, by which meanes the hayre will grow with more speed. Cleopatra. [3]

The other is to preserve hair from falling:

Rx. Brassicae aridae, q.s. stampe it cum aq: q.s. vnto the forme of an vng: *. To preserue haire from falling. Cleopatra. [4]

Cleopatra’s expertise in this domain also appears in Thomas Moffet’s work on insects, which was completed in manuscript form in the 1590s and posthumously published. In his section “On the use of Flies”, Moffet mentions a recipe purportedly contained in Cleopatra’s book in which flies are used to treat baldness.

Title page of Thomas Moffett's work on insects, posthumously published. Image available on Wikimedia Commons.
Title page of Thomas Moffett’s work on insects, posthumously published. Image available on Wikimedia Commons.

For Galen out of Saranus, Ascle|piades, Cleopatra, and others, hath taken many Medicines against the disease called Alopecia or the Foxes evill; and he useth them either by themselves or mingled with other things. For so it is written in Cleopatra’s Book de Ornatu. Take five grains of the heads of Flies, beat and rub them on the head affected with this disease, and it will certainly cure it. [5] 

[Nam Galenus é Sarano, Asclepiade, Cleopatra, & aliis, medicamenta contra alopeciam exscripsit: iisdénique nunc solis nunc mixtis usus est. Sic enim in libro Cleopatrae de ornatu scribitur: R. muscarum capita.g.v. contere et affrica capiti alopeciâ laboranti, & certò sanabitur.] [6]

That Thomas Bonham and Thomas Moffet, who practiced medicine around the turn of the seventeenth century, both reference Cleopatra for these hair-related remedies establishes that they took for granted Cleopatra’s perceived expertise in this area.

Cleopatra’s medical knowledge primarily passed into early modern use through the work of Galen, the Greek physician whose work on the four humors would form the foundation of early modern medical beliefs about the body. Laurence Totelin, for example, provides an example of a recipe in Galen’s work, excerpted from “Cleopatra’s Cosmetics”. The figure of Cleopatra closer to her time was, it turns out, a figure closely associated with cosmetics, gynaecology, and alchemy. That Shakespeare’s Cleopatra—Cleopatra VII, former Queen of Egypt—was probably not the actual author of these receipts seems not to have mattered much for their transmission. Totelin documents a few such Greek cosmetic recipes that used her name and convincingly reads Cleopatra in early Greek medical writings as an example of medical authors claiming famous women as an authority for gynaecological and cosmetic remedies. The attribution of Cleopatra as the author or source of recipes in the early modern period is, I suspect, the inheritance of this practice put into use in posterity. Since the beginning, then, it seems that Cleopatra’s reputation has exceeded her.

What we get is a female figure whose relationship to medicine and to recipe-culture throughout the centuries was quite different from that of the early modern woman. Rather than having to develop and prove expertise in culinary, medical, and pharmacological knowledge by experimenting with receipts, as early modern women did, Cleopatra in the early modern period was already held to be a figure of medical authority. During a time when women were carving a place for themselves in the domain of household physic, Cleopatra may have been a shining example of a woman memorialized through her recipes as evidence of her medical expertise.

[1] Robert Allott, Wits Theater of the Little World (1599),75v.

[2] Thomas Bonham, The Chyrurgians Closet, or, An Antidotarie Chyrurgicall (1630).

[3] Bonham, 283.

[4] Bonham, 283.

[5] Translation quoted in John Uri Lloyd, “Ancient Therapeutics,” The Eclectic Medical Journal 76.4 (1916), 177.

[6] Thomas Moffet, Insectorum, sive, Minimorum animalium theatrum (1634), 71.