Category Archives: Series: Galen

You’ll thank me later

In my previous post, I presented a comic parody of an ancient eye-remedy. That recipe, created by the comedian Aristophanes, was too horrid to be true. Yet eye-remedies were far from pleasant in the ancient world. Witness the achariston, the ‘thankless’. There are various recipes for acharista (that’s the plural of achariston) preserved in ancient medical writings. The following one, transmitted by Galen, is representative of this lovely (not) type of medicament:

Oculist stamp Roman Britain, 1-4 century CE, Kenchester Herefordshire This stamps bears the inscription: 'Titus Vindacius Ariovistus', Source: British Museum
Oculist stamp
Roman Britain, 1-4 century CE, Kenchester
This stamps bears the inscription: ‘Titus Vindacius Ariovistus’,
Source: British Museum

The so-called ‘thankless’ against persistent flows of tears. Physicians who used it, in Egypt only, were succefsul, especially when using it on rustics: cadmia, 16 drams; acacia, 8 drams; burnt, washed copper, 8 drams; opium, 4 drams; seed of tree heath, 4 drams; myrrh 4 drams; gum, 16 drams. Take up with water. Use with woman’s milk.  (Galen, Remedies according to Places 4, 12.749 Kühn).

It is fair to say that this remedy, before curing any flow of tears, would have made the eye cry some more. Each of the ingredients, taken separately, might have had a beneficial effect on the eye, but this remedy just goes for the rather brutal approach of accumulating as many unpleasant ingredients as possible. Thankfully, perhaps, the remedy had to be applied with woman’s milk,a very mild product, which midwives still recommend today for a baby’s sticky eyes.

These ingredients were crushed in a mortar, mixed with a small amount of water, then moulded into ‘lozenges’ and dried. These lozenges were light and easy to carry around. When a physician needed to apply the medicament, he (or the patient) crushed one of the lozenges and mixed it with a liquid – here woman’s milk. The remedy was then applied to the eyelids. Not that this particular recipe specifies any of this… One needs to have read quite a few ancient eye recipes to fill in the gaps left by Galen.

This recipe, on the other hand, gives some interesting and unusual details. The remedy was used ‘in Egypt only’. Eye-ailments seem to have been common in the land of the Nile, and eye-remedies are recorded in hieroglyphs on papyri from the Pharaonic period, going as far back as the second millennium BCE. By the time of Galen (second century CE), Egypt was a Roman province, whose elite spoke Greek (yes it’s all rather confusing). The ‘physicians’ mentioned in the recipe above were probably Greek-speaking, although it is not possible to exclude the possibility of Egyptian-speaking physicians.

Eye-shaped votive. Roman period. Source: Wellcome images
Eye-shaped votive. Roman period.
Source: Wellcome images

The recipe also specifies that the remedy was particularly successful when used on ‘rustics’. The ancients believed that ‘rustics’ and members of the elite required different types of medicaments. Where peasants could cope with harsh, but very effective remedies, rich people, softened by their luxurious ways of life, needed milder concoctions.

Thankless eye-remedies did not just exist as texts in recipe books; they are also attested archaeologically. Ancient oculists used stamps to mark their medicines (the ‘lozenges’ I described above). Numerous stamps have been preserved. Some of these carry the inscription ‘acharistum’ (the Latin form of the Greek word achariston). One can just imagine a mother telling her reluctant child suffering from an eye disease: ‘You will thank me later’… or perhaps not!

Cold, dry and bald

By Laurence Totelin

A few months ago, I read with fascination – and surprise – a post by Jennifer Evans on the treatment of baldness in the early modern period. According to one of her sources (William Drage, a physician and apothecary from Hitchin) anything drying, and in particular sexual intercourse, would be detrimental to he who is thinning on top; women and eunuchs, for their part, rarely went bald because of their moist nature.

I was fascinated to find that the early-modern recipes and remedies listed by Jennifer were very similar to those preserved in texts from Graeco-Roman antiquity. Thus recommendations to cut the hair short; to use a laudanum unguent; to anoint the head with juice of onions/leeks, or with radish oil are all to be found in one of the earliest medical treatises preserved in Greek: the Hippocratic Diseases of Women 2 (chapter 189, 8.370 Littré). Some early modern treatments of baldness that presented, such as Mary Glover’s recipe involving cow’s piss and stinking old shoes, were rather unsavoury, but they pale in comparison with pigeon dung (also listed in Diseases of Women 2.189) or the following recipe, excerpted from Cleopatra’s Cosmetics by Galen:

Deer hunt on a fourth-century BCE mosaic from Pella. Source: Wikipedia
Deer hunt on a fourth-century BCE mosaic from Pella. Source: Wikipedia

Another [remedy against alopecia]. The power of this [remedy] is better than that of all the others, as it works also against falling hair and, mixed with oil or perfume, against incipient baldness and baldness of the crown; and it works wonders. One part of burnt domestic mice, one part of burnt remnants of vine, one part of burnt horse teeth, one part of bear fat, one part of deer marrow, one part of reed bark. Pound them dry, then add a sufficient amount of honey until the thickness of the honey is convenient, and then dissolve the fat and the marrow, knead and mix them. Place the remedy in a copper box. Rub the alopecia until new hair grows back. Similarly, falling hair should be anointed everyday. [Galen, Composition of Medicines according to Places 1.2, 12.404 Kühn]

So how is this supposed to work? Ancient recipes do not come with explanation as to their functioning. One must turn to more theoretical texts to find out more. The philosopher Aristotle devoted a long passage of his treatise Generation of Animals to baldness, stating that this affliction is linked to sexual intercourse:

The reason is that the effect of sexual intercourse is to cool, as it is the excretion of some of the pure, natural heat, and the brain is by its nature the coldest part of the body; thus, as we should expect, it is the first part to feel the effect. [Aristotle, Generation of Animals 5.3, 734b. Translation: A.L. Peck]

He went on to explain that children and women do not go bold because they are incapable of producing seminal secretion. Thus, for Aristotle, the cause of baldness is a loss of vital heat through sexual intercourse. Galen, for his part, sees dryness as the cause of the affliction, explaining that women and eunuchs have moist heads, while bald people have dry ones [Galen, Commentary on Hippocrates’ Sixth Book of Epidemies, 17b.5  Kühn]. The physician’s explanation is closer to that found in early-modern treatises: it is through loss of moisture that the hair thins on top.

Wounded bear. Mosaic from Pompeii. Source: Wikipedia
Wounded bear. Mosaic from Pompeii. Source: Wikipedia

Where do remedies fit within shifting systems of explanation? The burnt ingredients in the Cleopatra remedy could be interpreted as both warming and drying, while deer marrow and bear fat would have been emollient (moistening). But I would argue that these explanations are too simplistic. One needs to go further and look at what brings cold, dry and baldness together.

In ancient humoural theory, cold and dry were associated with the Autumn season. (Clearly the theory was not devised in the UK!) It is in the Autumn of life that man loses his hair. There is no real solution to the problem, but ‘fertilising’ ingredients such as ashes could perhaps help. Fats from animals born in the spring and hunted in the autumn might also add to the efficacy of the remedy.

Sounds too far-fetched and less ‘rational’ than humoural explanations? Consider the following: Aristotle himself compared hair loss to shedding of leaves, and poets sometimes drew an analogy between lush greenery and animal hair (see for instance Columella, On Agriculture 10.71).  Ancient recipes can always be read in many different ways!

A recipe fit for a king

Attalus II or III. Altes Museum, Berlin. Credit: Marcus Cyron, licensed under Creative Commons.
Attalus II or III. Altes Museum, Berlin. Credit: Marcus Cyron, licensed under Creative Commons.

By Laurence Totelin

One of my favourite characters in the history of ancient pharmacology is Attalus III, king of Pergamum (ruled from 138 to 133 BCE). As a king, he is remembered for bequeathing his small kingdom to Rome at his death. Apart from that, we know very little about his rule. Instead of focusing on his political achievements, ancient historical sources dwell on his strange hobbies. According to the historians Plutarch (first-second century CE, wrote in Greek) Justin (second century CE, wrote in Latin), after having his mother and wife killed, the king lost all interest in his physical appearance and developed a passion for gardening.  He planted highly poisonous herbs such as henbane, hemlock and hellebore in his gardens. He then sent to his friends samples of these plants, mixing their sap to that of non-poisonous plants. Tired of this, he then moved on to wax-modeling and pouring and forging bronze.

Plutarch and Justin are very negative in their presentation of these silly pastimes. For a more positive view of Attalus, one has to turn to medical and agronomic texts. The Latin agronomical writers Varro (116–27 BCE), Columella (first century CE), and the encyclopaedist Pliny the Elder (23-79 CE) list the king as a source on animals, fruit trees, crops, drugs from animals, metals and gems. Celsus (first century CE), in his work on medicine, gives a recipe for an Attalic plaster (5.19.11), which contains relatively large amounts of copper.  He does not, however, say whether that plaster had been created by the king Attalus or by a namesake:

There is the Attalic plaster for wounds. It contains: copper scales, 16 sextulae; frankincense soot, 15 sextulae; ammoniac salt, same amount; liquid turpentine resin, 25 sextulae; bull suet, same amount; vinegar, three heminae; oil, 1 sextarius.[1]

Although interesting, these Latin sources do not add more to our knowledge of Attalus. For more information, one needs to turn to Galen. The famous physician too came from Pergamum and on several occasions refers to Attalus as ‘Attalus who was king among us’, that is, king among the people of Pergamum. Galen was active several centuries after the death of the king, but he may have had access to some lost Pergamene sources. He may also have consulted the king’s lost medical works. He casts a very different light on Attalus’ experiments with dangerous plants. In a passage on another king, Mithridates VI of Pontus, he writes that:

Mithridates himself, like Attalus among us, desired to have experience of almost all simple drugs that are given against deadly substances, testing their powers on evil men who were condemned to death.[2]

Galen presents the two kings as methodic researchers in the field of pharmacology. While their method of experimentation seems abhorrent to us, Galen approves of it, as it greatly advanced knowledge of poisons and their antidotes. Galen also devotes a great part of his treatise On the Composition of Medicines according to Types I to various Attalic plasters. There is no doubt in Galen’s mind that these were created by the last king of Pergamum:

White plaster made with pepper, according to Attalus… This remedy has already been prepared many years ago by Attalus, ruling over us people of Pergamum, a man who was most studious about all sorts of remedies.[3]

Again Galen presents his fellow countryman as a serious scholar, not as a mad hatter. Who is right? Galen or the historians Plutarch and Justin? Nobody will ever know, but Attalus’ story is an excellent exercise in source criticism!


[1] Celsus, De Medicina 5.19.11. A sextula is a sixth of an ounce. An hemina is a half of a sextarius. A sextarius is roughly the equivalent of a British pint.

[2] Galen, On Antidotes 1.1 (14.2 Kühn).

[3] Galen, On the Composition of Medicines according to Types 1.13 (13.414 Kühn).

Sticky eyes or weeping wounds: trying to interpret the Pozzino tablets

Thousands of pharmacological and cosmetic recipes have come down to us from the Greek and Roman world. On the other hand, archaeological discoveries of ancient remedies are few and far between, and findings that can be analysed chemically and botanically are even rarer. Recently, ancient medicine made the news with the publication by a team of Italian scientists of the chemical analysis of remedies found aboard a Roman shipwreck – the Pozzino shipwreck, second century BCE [1]. The ship carried numerous pharmacological preparations, some of which are still in the process of being analysed (see here for more detail), and the publication focused on six roundish tablets preserved in a tin box. The scientific analysis revealed that the tablets contained 80% of inorganic materials, mainly zinc oxide and hematite, as well as starch, beeswax, animal and plant fats, pine resin, and other plant remains.

The tin box (pyxis) in which the tablets were found
The tin box (pyxis) in which the tablets were found

The authors of the article, referring themselves to ancient treatises on simple medicines (that is, treatises dealing with one pharmacological ingredient at a time), suggested that these tablets are eye remedies. A search (with the help of the electronic database of ancient Greek texts – the Thesaurus Linguae Graecae) through ancient collections of pharmacological recipes also shows that zinc oxide and hematatite were used together in the treatment of eye diseases, as in the following example, which is extracted form Galen’s collection of Medicines according to Places :(second century CE)

Sweet-smelling remedy of Syneros against long-lasting ailments [of the eyes]: it works against eye-discharge and lachrymal fistula: cleaned Cadmia [zinc oxide], 28 drams; hematite stone, burnt and washed, 25 drams; Cyprian ash [i.e. copper], 24 drams; myrrh, 48 drams; saffron, 4 drams; Spanish opium-poppy, 8 drams; white pepper, 30 grains; gum, 6 drams; dilute with Italian wine. Use with an egg. (Galen, Compositions of Medicines according to Places 4.8, 12. 774 Kühn)

This recipe, like many others, gives very little indication as to how the remedy should be prepared. I would suggest that all dry products should be crushed together in a mortar; diluted in wine and moulded into tablets. These should then be dried and dissolved in a liquid (here an egg) when needed. The modern reader will wince at the use of pepper in eye remedies, but making the eyes cry appears to have been one of the aims of ancient ophtalmological preparations, one of which was so unpleasant it was called ‘the thankless’.

Powdered zinc oxide

While zinc oxide and hematite stone would confirm an interpretation of the tablets as eye remedies, fats, resins and waxes are rarely listed in ancient ophtalmological recipes. To find an ancient recipe combining mineral ingredients, wax, fat and resin, one must look at formulae for cicatrization. The following example is attributed to Asclepiades (first century BCE) and preserved by Galen:

Asclepiades wrote the following concerning cicatrizing poultices…: burnt zinc oxide prepared with wine; roasted copper; of each 16 drams; wax, 80 drams; Colophonian resin, 8 ounces; sufficient amount of Italian wine. Crush the copper and zinc oxide with the wine, until the preparation has the consistency of wet cerate. Break the wax and resin into pieces, place in a ceramic vessel and add to these 1 litra of myrtle oil. Place on coals and stir continuously. When the ingredients have dissolved, remove from the fire and let the preparation cool down. Add the crushed ingredients, mix together, and use diluted with myrtle oil. (Galen, Compositions of Medicines according to Types 2.14, 13.524 Kühn)

Experimentation would be required to determine the exact consistency of this remedy, but it is clear that it would have been much waxier than the Pozzino tablets. And here is the crux of the problem: it is impossible to find a recipe that lists all the ingredients entering the composition of these pills. And the same issue occurs every time scholars try to bring together written and archaeological sources in the field of ancient medicine. Some scholars will argue that many written recipes have been lost; others that every physician and pharmacologist in the ancient world had his own ‘secret’ recipes that were never written down. Whatever the case, the fascinating discoveries relating to the Pozzino tablets offer much opportunity for archaeologists, chemists, ethnopharmacologists and medical historians to collaborate and establish sound methodologies to bridge the gap between material and written pharmacological evidence.

[1] Gianna Giachi, Pasquino Pallecchi, Antonella Romualdi, Erika Ribechini, Jeannette Jacqueline Lucejko, Maria Perla Colombini, and Marta Mariotti Lippi, ‘Ingredients of a 2,000-y-old medicine revealed by chemical, mineralogical, and botanical investigations’, PNAS 2013 110 (4), 1193-1196