Category Archives: Series: Galen

Conference Report: Traditions of Materia Medica: 300BCE–1300CE

By Sean Coughlin

On 16–18 June 2021, members of the research group A03 at the DFG-funded SFB 980 ‘Episteme in Motion’ and the Institute of Classical Philology, Humboldt-Universität in Berlin (Sean Coughlin, Christine Salazar, Lisa Sherbakova, Kristiane Hasselmann, Philip van der Eijk) held a conference called Traditions of Materia Medica: 300 BCE–1300CE. Over the three days, 25 speakers and over 50 guests from around the world met remotely to share research on the history of theoretical pharmacology in the immediate vicinity of Galen of Pergamum.

One goal for the conference was practical: to bring each other up to speed on what we’ve been doing since the start of the pandemic. Another was programmatic: to test the hypothesis that Galen’s writings on pharmacology constitute a key moment in the history of theoretical pharmacology, one that brought about an acceleration of pharmacological research and reflection. Speakers explored the hypothesis from the perspective of history of medicine, philosophy and science, Egyptology, philology, botany, chemistry and lexicography, focusing on Galen’s sources, his own work, and the work of those who followed him.

Image courtesy of Sean Coughlin

Galen’s Immediate Predecessors (3rd c. BCE – 2nd c. CE)

Among studies of Galen’s immediate predecessors, we heard from edition and translation projects that are bringing Galen’s pharmacological antecedents more clearly into view. David Leith (Exeter), working on the fragments of Asclepiades of Bithynia, presented part of his work into the pharmacology of Asclepiades and his school, many of whom, like Julius Bassus and Niger, were authorities for Dioscorides and Galen. Irene Calà (LMU Munich), critically editing books 10 and 14 of Aetius of Amida’s Medical Books, presented recently identified fragments of recipes from the Herophileans, Andreas of Carystus and Apollonius Mys. Costanza de Martino (Humboldt) discussed the structure and sources of Philumenus’ On Poisonous Animals and Their Remedies, part of her project producing a new edition, translation and study of this work. And Amber Jacob (NYU) presented her project editing 1st–2nd c. CE demotic medical papyri from the Tebtunis temple library, which represent some of the few surviving sources for Egyptian medicine of the period and the intercultural exchange of Greek and Egyptian pharmacology.

Galen of Pergamum (mid-2nd – early 3rd c. CE)

We also had presentations from edition and translation projects of Galen’s pharmacological works. Caroline Petit (Warwick) introduced methodological questions raised by her work on “Rethinking Ancient Pharmacology” and her edition of Galen’s treatise On Simple Drugs (Simples), which draws on Greek, Syriac, Arabic and Latin traditions. Caterina Manco (Paul Valéry – Montpellier) presented a study of Galen as reader of Dioscorides based on her forthcoming edition, translation and study of the botanical books of Galen’s Simples, books 6–8. And John Wilkins (Exeter) presented a comparative study of the ‘theoretical books’ (books 1–5) of Galen’s Simples, which he is translating for the Cambridge Galen Series, and their implementation in the ‘catalogue books’ (books 6–11).

Work on the history and philosophy of pharmacology was presented by P. N. Singer (Einstein Centre Chronoi), who discussed his work on epistemological and metaphysical issues raised by Galen’s notions of ‘changes through the whole substance’ and ‘tests’ of drugs. Simone Mucci (Warwick) presented on the relationship between imperial head-physicians (ἀρχιατροί) and antidotes in the Hellenistic and Imperial periods via Galen’s On Antidotes. And Krzysztof Jagusiak and Konrad Tadajczyk (Łódź) compared sitz-baths (ἐγκάθισμα) remedies in Galen’s work on Compound Drugs According to Kinds and in the pseudo-Galenica.

There were also two fascinating diachronic studies. Laurence Totelin (Cardiff) explored the nature, subject and variety of works called Euporista (“easily procured substances”) from their origins in Apollonius Mys via Galen to Theodorus Priscianus (4th c. CE). And Alessia Guardasole (CNRS – Sorbonne Université), who is working on an edition of Galen’s Compound Drugs According to Places, demonstrated how recipes change over time using the example of the diacodyon (διὰ κωδυῶν, “prepared with poppies”), from Galen to Theophanes Chrysobalantes (10th c. CE)

Galen’s Descendants (3rd – 13th c. CE)

Among scholars working on pharmacology after Galen, Petros Bouras-Vallianatos (Edinburgh) presented his work contextualizing ingredients from Asia in Galen, Late Antique and Byzantine medical works, exploring the reception of Arabic pharmacological lore into Greek and Latin sources. Anne Grons (Philipps-Universität Marburg) presented work on the systematization of ingredients in medical recipes preserved in Coptic pharmacological texts from the 4th–11th c. CE.

Matteo Martelli (Bologna) explored dry medicines, dyes, and alchemical xeria via the etymology of the term elixir, beginning with Arabic and Latin traditions and taking us back to their antecedents in Greco-Egyptian alchemy. Maciej Kokoszko (Łódź) looked at recipes for sweet sauces from Anthimus’ On the Observance of Foods and their pharmacological roots. Zofia Rzeźnicka(Łódź) proposed a theoretical basis for the ingredients of several recipes for peelings and scrubs in Aetius of Amida. And Lucia Raggetti (Bologna) discussed the creative weaving of ancient pharmacological, medical, and philosophical works (Hermes, Galen, Dioscorides, Aristotle) with technical and artisanal knowledge in Malmuk, Cairo of the 7th H/13th CE in the work of Kaylak Qabǧāqī.

Experimental, Lexicographical and Botanical Approaches

We also heard from several groups taking broadly empirical approaches to the history of pharmacology. On the chemical and biochemical side, Manuela Marai (Warwick) presented her work comparing the activity of drug combinations found in Galenic recipes to that of the individual components. Effie Photos-Jones (Glasgow) presented surprising results from the experimental work of her Wellcome Trust-funded group, “Greco-Roman Antimicrobial Minerals,” on the chemical and biological activity of Greco-Roman mineral preparations (lithargyros, psimythion, molybdos). Members of the ERC-project Alchemeast at Bologna, Matteo Martelli and Lucia Raggetti, included their work on replications of ancient alchemical recipes. And Sean Coughlin(Humboldt, Czech Academy of Sciences) introduced a new interdisciplinary research group funded by the Czech Science Foundation, “Alchemies of Scent,” that will replicate the methods of Greco-Egyptian perfumery using analytical chemistry and Greco-Egyptian literary and archaeological sources.

On the botanical and lexicographical side, Maximilian Haars (Philipps-Universität Marburg) gave an overview of his new DFG-funded project producing an encyclopedia of all medicinal plants and herbal drugs in the Galenic corpus—approximately 1,500 entries. And Barbara Zipser (Royal Holloway University London) and Andreas Lardos (Zurich) presented a new interdisciplinary methodology from their project “Plants and minerals in Byzantine popular pharmacy: a new multidisciplinary approach” for the identification of medicinal plants that can provide a more solid and replicable starting point for pharmacological screening.

Hopefully, this brief overview conveys some sense of the variety of research projects exploring Galenic pharmacology and its immediate predecessors and descendants. For those interested, abstracts for the talks are available here.

Thanksgiving with Galen and Apicius

By Sean Coughlin

For Thanksgiving, I thought I’d come up with a new English translation of a seasonal recipe from the Roman cook-book of Apicius. It comes from the third book of De re coquinaria. The Latin is cucurbitas cum gallina. In Joseph Vehling’s English translation: “Pumpkin and Chicken”.

If only the Romans had turkeys. And pumpkins.

I first learned that the Greeks and Romans were pumpkinless from Laurence Totelin earlier this year and it left me utterly confounded.

I had been revising a translation and commentary of the first book of the sixth-century CE physician Aetius of Amida’s Medical Collections, and a question came up about how to identify different kinds of cucurbits, that immense botanical family of vines which produce comically-large-berries, like cucumbers, melons, watermelons, pumpkins, squashes, gourds, and luffa sponges.

Naively, I thought it would help to look at how authors like Aetius or Galen say cucurbits are prepared. And, since Galen (On the Properties of Foodstuffs, 2.3) tells us that people always ate their cucurbits cooked, I figured that Greco-Roman cucurbits must be something like zucchini.  After all, who on earth would cook a melon?

“But,” Laurence told me, “zucchinis are new world.”

Now, before going into why I found this so shocking, I want to bring everyone up to speed.

“Old world” cucurbits include a lot of different genera: Cucumis, the cucumbers and melons; Citrullus, the watermelons and colocynths; Lageneria, the bottle gourd or calabash; and a few others like Luffa and Bryonia. No one is quite sure where in the old world they first evolved, but the recent consensus is somewhere in Africa. In other words, they could have existed in the Greco-Roman world.

Various old world cucurbits: cucumbers and melons. Photo from the author.

“New world” cucurbits, however, are the vines descended from plants native to the Americas. They almost certainly could not have been known in antiquity, and the group includes all species of the genus Cucurbita. This includes zucchini, courgettes, pumpkins, squashes, decorative gourds, and even those 1000 kg monsters at fall fairs. None of them were known in Europe before Columbus.

I would like to imagine that there is at least one other kindred reader of classics in English who feels a bit anxious at this news. It’s not just a problem for Apicius’ Thanksgiving casserole or my rehearsal of Epicrates’ lampoon of Plato’s Academy.

What about the “Pumpkin Pirates” of Lucian’s True History (2.37)? Or Psyche’s sister’s husband who Apuleius says is “bald as a pumpkin” (Apuleius, Metamorphoses 5.9)? And what will become of Seneca’s Apocolocyntosis divi Claudii – the Pumpkinification of the Divine Claudius?

English translations are unusually problematic in the case of cucurbits. Pumpkins show up all over the place. And this isn’t merely because of translators’ license, or a confusion of names.

As far as I’ve been able to sort out, it’s mainly the result of an unfortunate coincidence between the rise of an influential but erroneous botanical hypothesis, and the publication of two influential Greek and Latin English dictionaries.

Here is the story:

Before the mid-19th century, the evidence about the origins of Cucurbita was mixed. The names of the plants suggested they came from the “old world”, but depictions of Cucurbita species don’t show up before the mid-1500s.

For instance, in Leonhart Fuchs’ 1542 herbal, De Historia Stirpium, we get one of the first European depictions of the pumpkin plant, the species Cucurbita pepo L. Fuchs, however, calls it cucumis turcicus, the Turkish cucumber, a name which might lead one to think the plant was native to the “old world”.

Not long after Fuchs, in an herbal of Matthiolus from 1586, the same plant appears again, but with a different name: cucurbita indica – the Indian gourd. And “Indian,” Matthiolus tells us, means American: “they say these [new gourds] came into Italy from the West Indies, whence they are called by many ‘Indian’” (Matthiolus of Padua, Commentary on Dioscorides 1559, p. 292, my emphasis).

“He has a pumpkin” (ipse cucurbita habet). Using pumpkins as camouflage. Woodcut, late 16th century, Netherlands. CCBY

Both Fuchs and Matthiolus agree that these cucurbits are foreign (and probably even recent) imports to European markets. They disagree about where they came from: were they indigenous to the old or the new world?

This continued until the 1850s, when the hypothesis that Cucurbita species were indigenous to the old world reached its most articulated form. It happened as part of a public debate between two great 19th century botanists: Alphonse de Candolle and Asa Gray.

De Candolle argued that because people had used the same names for cucurbits since ancient times, the plants with those names must have come from the old world.

In response, Gray argued that new and ‘foreign’ cucurbits only start showing up in 16th century herbals like those of Fuchs and Matthiolus. That, along with documentary evidence from the first European explorers, suggests a new world origin.

The debate continued for over thirty years, only coming to an end in 1883 after a devastating two-part review of De Candolle’s last book, The Origin of Cultivated Plants. In this review, Gray, along his colleague J. Hammond Turnball, presented almost documentary evidence from European explorers that cucurbits were cultivated in the Americas before European explorers ever reached it in 1492.

These explorers recorded indigenous names for the plants they encountered, but they also used European ones, and these are the names that stuck: in Latin, cucurbitae and cucumeres; in Spanish, calabaças, melones, pepinos and cogombros; in French, melons, concombres, citrouilles, and courges; in Italian, zucca; and in English, musk-melons, cowcumbers, and, — most importantly — the pompion, the source of our word, ‘pumpkin’. Only the name “squash” from the Algonquin vernacular made its way into English.

Gray and Turnball’s review, however, appeared only after the work on the great Greek and Latin lexica had finished up – A Greek-English Lexicon by Liddel and Scott, and A Latin Dictionary by Lewis and Short. Both dictionaries identify some Greco-Roman cucurbits with American pumpkins (Cucurbita pepo L. or Cucurbita maxima L.), and pumpkins have shown up in English translations ever since.

So for this recipe, I figure, why fight it?

Tune in tomorrow for Apicius’ recipe!

The author with pumpkins, sometime in the late 2000s. Photo from the author.

Sean Coughlin is Research Fellow in the history of philosophy, science and medicine at Excellence Cluster Topoi and the Institute for Classical Philology, Humboldt-Universität zu Berlin. He is completing a revised translation and commentary on Aetius of Amida, Medical Collections, Book I, an edition and translation fragments of the 1st century Pneumatist physician, Athenaeus of Attalia, and co-editing a volume on the concept of pneuma after Aristotle.

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.

The Live Chicken Treatment for Buboes: Trying a Plague Cure in Medieval and Early Modern Europe

By Erik Heinrichs 

Titlepage of Philippus Culmacher’s plague treatise, Leipzig: circa 1495
Credit: Wellcome Library, London.

While researching German plague treatises I became fascinated by one odd treatment for buboes that appeared again and again, despite sounding so far-fetched. One sixteenth-century version calls for plucking the feathers from around the single hole in a chicken’s backside, then placing it on a person’s bubo. The instructions say to hold the chicken on the bubo until it dies, when it must be replaced with a new chicken, similarly plucked. I soon dubbed this the “live chicken treatment for buboes” and after years of casual encounters I began to track the recipe more systematically. As strange as it sounds, versions of this “live chicken treatment” were fairly common in plague writing, beginning with the Black Death and lasting, amazingly, into the eighteenth century. Tracing the long history of this recipe led me to explore questions such as: Where might this come from? Why chickens? Why might healers think that this was a good idea? Did anyone actually try this or is this all theoretical? As a historian, I was also interested in change over time within the recipe. Here I found much to explore, as I followed the recipe’s twists and turns over a seven-hundred year period, roughly 1000 to 1700.

The “live chicken treatment” turns out to have a long history, indeed. Its origins seem to lie in Avicenna’s Canon of Medicine, although it may be older than that. Chickens and chicken broth were a common source of medicine in early times, probably because chickens were such ubiquitous and useful animals since antiquity. Not only did Avicenna praise chicken broth for its general benefits for the body, but he also recommended placing a cut chicken on a poisonous bite or sting in order to fight poisons. In later centuries European physicians turned to Avicenna’s advice when they faced the mysterious and devastating epidemics of the fourteenth century. As Europeans emphasized the poisonous nature of the plagues around them, older treatments for poisons drew new attention. The first mention of using a chicken rump to draw poisons out of a bubo appeared in the very first plague treatise of 1348, coming in response to the so-called Black Death. Here the Catalan author Jacme d’Agramont seems to have introduced a novel and lasting adaptation of Avicenna’s recipe, although the “cut chicken” version persisted in plague treatises for centuries to come.

Most interesting for the history of trying and testing cures are the many variations of the “cut chicken” and “chicken rump” versions of the treatment, as well as physicians’ comments about how effective they are. Especially after 1400, physicians seem to be thinking about this recipe quite often as they seek practical treatments for the plagues of the time. Physicians were preoccupied with altering the recipe in order to reason out the nature of the mysterious poisons underlying the plague. Some add substances to the process, such as salt placed on top of the chicken as it is placed on the bubo. During the fifteenth century, a number of German physicians began to explain the treatment’s workings in a strikingly physical way—that the chicken breathes through its backside and thus pulls the bubo’s poisons into itself. This change led to the suggestion to hold the chicken’s beak shut during the treatment in order to force the chicken to breathe from below. My article (accessible here) show how all aspects of the treatment changed over time as physicians engaged with the recipe, including the quantity of chickens used, the amount of time required, and even the type of animal in question. This work demonstrates the importance of the recipe itself as a platform for thought, experimentation, and communication among physicians.

Perhaps a surprise to modern readers, many physicians praised their version of the “live chicken treatment,” describing it as effective and desirable. Such comments multiply after the introduction of print, which encouraged the production of plague treatises, some fitted with fetching cover illustrations for the marketplace (see image below of Philippus Culmacher’s treatise of circa 1495). In German-speaking lands especially, sixteenth-century physicians used their printed plague treatises to promote their own services and expertise at a local level.[1] This brought about a change in the genre whereby physicians seem more eager to discuss their own experiences with effective recipes in order to appeal to the practical interests of a broad audience. Amidst this change comes evidence that some German physicians witnessed first-hand the successful use of the “live chicken treatment.” Another interesting change during the sixteenth century is the increased attention to the bodily warmth of the chicken as the treatment’s active healing force. These emergent views provide a tantalizing link to modern medicine, since moist heat remains one of the treatments for buboes today. For more information, please read my article.

Erik Heinrichs is an associate professor of history at Winona State University (Minnesota). His interests are the history of medicine and religion in the late medieval and early modern periods. His book Plague, Print, and the Reformation: The German Reform of Healing, 1473-1573 will be published by Routledge this November.

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[1] For a survey of German plague treatises from the first century of print, see: Erik A. Heinrichs, Plague, Print, and the Reformation: The German Reform of Healing, 1473-1573 (London: Routledge, 2017).