Tag Archives: drugs

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).

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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.

Situating Drug Knowledge in China: A Digital Humanities Solution

By Michael Stanley-Baker

Mandala of Medicine Buddha surrounded by medicinal plants, animals and minerals
Mandala of Medicine Buddha surrounded by medicinal plants, animals and minerals – Blue Beryl Thangka reproduction, author’s collection

Drugs, be they plant, animal or mineral, were important objects for trade, cure and even spiritual salvation throughout Chinese history even until today.  They appear in all sorts of diverse sources, from poems and diaries to scriptures, pharmacopoeias and recipe books. The historical record for the early imperial period (221 BCE – 589 CE) indicates that the majority of health care was provided by religious specialists– Daoists, Buddhists and mediums–and that doctors were in a very small minority.

Knowledge of a particular signature drug could mark a certain group’s identity, forming a means through which they showed their own therapeutic knowledge, while also distinguishing them from other players in the medico-religious marketplace. Knowledge of what drugs did, and access to them, either through physical access in the regions from which came, or through knowledge of how to identify them, could play an important part in religious identity.

Thus, simply having a drug “name” leaves a lot untold.  Unifying projects, like state-sponsored pharmacopoeias, as well as modern botanical dictionaries that make equations between traditional Chinese names and modern botanical identities, do a lot to conceal the diverse processes by which drugs circulated in pre-modern China.  Substitution, modification and the use of alternate names were common practices in this period (and still are today). The geographic origins of a plant or animal product also had an impact on its efficacy, and also on the fact that it could under different names in different regions.

However, the history of Chinese pharmacology has largely been devoted to tracking changes in different pharmacopoeic editions over time–the editorial staff on each project, increases in quantities of drugs, and development of plant knowledge, such as the identification of new species or sub-species of plants.  This approach works within the normative limits of the state-recognized and medically authorised knowledge, but studies outside of this domain are largely limited to anecdotal stories of Daoists revealing isolated recipes, or Buddhists providing healing to the laity. There have been few overall, systematic studies of drug lore in other domains – like the Buddhist or Daoist canons, for example. To what extent does the data in the Daoist canon back up the anecdotal claim that Daoists were the major stake-holders in early drug lore?  Which sects, in which periods and times, were most active in drug lore, and were they actively competing with other sects from the same time and places?

This image plots out the locations described for 36 drugs in the Daoist text, the Zhen'gao 真誥 DZ 1016.
This image plots out the locations described for 36 drugs in the Daoist text, the Zhen’gao 真誥 DZ 1016.

At the Max Planck Institute for the History of Science, Shi-Pei Chen and I are developing a digital solution to help answer such questions. This will better situate early Chinese drug knowledge within the multiple contexts, times and places in which drugs took on new meanings and interpretations. We will expand the study of Chinese drug lore into what has normally been considered “religious” literature, and perform a variety of analyses on digital transcriptions of early materia medica. A detailed description of this project can be found here.

We are considering the following open access repositories for transcribed, digital editions of the Buddhist  (see the repository here) and Daoist canons. We will do statistical analysis of the texts in the Daoist and Buddhist canons to establish the frequency of drug terms in the texts, to see how much of the pharmacopoeia figured for these actors. Based on general metadata about those texts (as available/reliable), such as date (or date range) and place of composition, author or sectarian affiliation, we can better analyse the circulation of drug lore across time, space and community.  Using GIS place name authority databases (CHGIS, CCTS and DDBC) we will associate historical place names with GIS points.  This will enable us to use time-space displays to show the distribution of drug knowledge across time and space (we are considering PLATIN, see sample applications here).

This image plots out the locations for the same 36 drugs, as they appear in the Bencao jing jizhu 本草經集注. Both texts were edited by the same person, Tao Hongjing 陶弘景, between 492 and 500.
This image plots out the locations for the same 36 drugs, as they appear in the Bencao jing jizhu 本草經集注. Both texts were edited by the same person, Tao Hongjing 陶弘景, between 492 and 500. – Both maps were made with QGIS, and appear in Stanley-Baker, 2013, p. 172.

We will then select interesting or important texts for closer study, and use an automated text-marking system, MARKUS, to markup individual texts in detail. We will focus initially on DRUG NAMES, DRUG FUNCTIONS, LOCATION NAMES, and PEOPLE. This will enable us to compare regional associations about drugs in Daoist and Buddhist texts against those in the pharmacopoeic tradition. For example, whether and how recipes vary across texts, whether the same places are identified as centres for drug supply or transcendent use, which drugs or sets of drugs circulated through which communities.

The pilot study is limited to the Six Dynasties period (220-589), a time which had the most formative influence on religious institutions, and the conclusion of which saw the establishment of the first imperial medical academy.  In later stages of the project, we hope to invite scholars working in other periods, regions, and languages to collaborate with us.  If there is enough interest from the medical history community, perhaps together we could create a research infrastructure to study drugs across the pre-modern world.  If you would like to join this venture in its future stages, please contact us!

References Cited:
Stanley-Baker, Michael. 2013, Daoists and Doctors: The Role of Medicine in Six Dynasties Shangqing Daoism PhD Thesis, London: University College London.

 

Testing Drugs and Trying Cures Workshop Summary

By Ashley Buchanan and Tillman Taape

What did it mean to test a drug or try a cure in the early modern world? This was the central question for a group of scholars who gathered for a workshop at Max Planck Institute for the History of Science in Berlin, Germany.  Since recipes emerged as one of the key themes throughout the workshop, and because the conference’s location in Berlin made it difficult for scholars outside of Europe to attend, we thought we might share a brief summary of the “Testing Drugs and Trying Cures” papers, in the hopes that we could bring the workshop’s key ideas and discussions to a larger audience.  What emerged from an exhilarating two days of discussion and debate was the conclusion that historians of science and medicine should not privilege experiment and experimentation as fixed categories, but should understand the multiple ways in which physicians, apothecaries, artisans, institutions, and individuals in the early modern world tested, tried, investigated, experienced, modified, observed, and measured medicinal remedies and materiae medicae.

As written forms of medical and pharmaceutical knowledge and practice, recipes played an important part in the testing of drugs and cures, and our discussion raised larger questions surrounding the nature and purpose of an early modern recipe.

705px-ScuolaMedicaMiniatura
A miniature depicting the Schola Medica Salernitana from a copy of Avicenna’s Canons.  From Wikimedia Commons.

Michael McVaugh’s paper opened the discussion by exploring how medieval physicians went about testing drugs. Learned doctors in the Middle Ages might appear helplessly hidebound, and inclined to follow ancient authorities over experimentation. In contrast, McVaugh showed how a group of Montpellier physicians in the fourteenth century established something of an experimental program. Medieval physicians, however, were not testing to find a cure, but to determine the quality, strength, and effectiveness of a drug as it pertained to a particular person’s complexion. McVaugh underscored an important difference in the purpose of medieval drug testing. Physicians tested not for universal effectiveness, but to determine the quality of a drug – was it hot, cold, moist, or dry.

Duclos-title-page
Title page of the Academy’s Observations sur les eaux minérales (1675). From http://cures.hypotheses.org/the-workshop/programme-2/bycroft-michael

Although it became clear in our roundtable discussion that we should be wary of labeling such practices as obvious precursors to the experimental philosophies of the Scientific Revolution, many of the papers showed that the importance of specific tests resonated throughout the early modern period. Evan Ragland’s paper, for example, traced the use of the phrase periculum facere (‘to make a trial’) in physicians’ writings on medicine, anatomy and chemistry. Similarly, Michael Bycroft showed that French physicians and chemical experts of the Académie des Sciences became increasingly interested in the exact composition of mineral waters. Contrived tests such as color indicators or the analysis of residues after evaporation increasingly became the touchstone of proper inquiry.

McVaugh, Ragland, and Bycroft’s papers all underscored the need to understand the specific nature and purpose of testing in each historical context. Continuing to emphasize the importance of historical context, Francesco Paulo de Ceglia’s paper showed just how different the purpose of testing could be in the context of seventeenth century blood miracles in the Kingdom of Naples. Catholics tested the liquefaction of the blood of their patron saint to explore the limits of nature. By discovering nature’s limits, you could then determine what was truly miraculous. Protestants, on the other hand, tested various materials and recipes to recreate the liquefaction of blood to cast doubt on the alleged miracle.

san-gennaro
Reliquary containing a glass ampoule of San Gennaro’s blood. From La Repubblica.

In the context of testing, drugs and cures are often under scrutiny in the form of recipes detailing their production and administration. While recipes emerged from many of the papers as very important forms of knowledge, it proved virtually impossible to define exactly what a recipe was. Recipes can be very short or very detailed, ranging from a mere list of ingredients to careful step-by-step instructions. If there is one thing recipes have in common, it is the need for testing, trying, modifying and adapting to different conditions. While constructing an all-encompassing definition of a recipe proved futile, all agreed that it was fruitful to understand recipes as an important genre in early modern science and medicine.

apotheke_enhausen_l
From http://www.gn.geschichte.uni-muenchen.de/aktuelles/archiv_2011/archiv_2013/science_and_medicine/index.html

For her investigation on the testing practices of Venetian apothecaries, Valentina Pugliano emphasized the difference between experiment and experience. Venetian apothecaries were less concerned with testing drugs (in a traditional sense) than they were with the experience or truthfulness of their ingredients. Testing by inspection, smell and taste was also important in this pharmaceutical context, to ensure that the ingredients were what the merchant had promised them to be, and not a cheap substitute with inferior properties. For Pugliano’s apothecaries, the important issue that required testing was the authenticity of the ingredients rather than the efficacy of the finished product; after all, most preparations had proved their worth since antiquity. Like McVaugh, Pugliano questioned traditional “Baconian” understandings of what it meant to experiment and test and argued for more nuanced notions of testing and trying, which included observing, measuring, evaluating, and experiencing.

Image_Samir
Title page of Johannes Christophorus Homann’s Dissertatio inauguralis medica de medicinae cum geosophia nexu quam auspice deo prpitio (Hala Madgeburica, Hendelius, 1725). From http://cures.hypotheses.org/the-workshop/programme-2/boumediene-samir

With early modern Europeans’ increasing forays into the New World, however, more and more materiae medicae were found which were absent from ancient medical writings. Pliny and Dioscorides were silent on such substances as guaiacum wood, Peruvian bark or New World balsam, so their medicinal properties had to be newly investigated. Antonio Barrera-Osorio and Samir Boumediene’s papers added America, or the New World, into the discussion. Both emphasized the role of new drugs and materia medica in the rise of European experimental practices. New drugs and new medicinal recipes required new ways of testing.

Antonio Barrera-Osorio’s paper argued for an empirical culture in the Spanish empire, which was well suited to respond to these challenges. He showed how his protagonists gathered information about New World remedies from natives or travellers and experimented with ways of preparing them. Some of these drugs and recipes were deemed so important for the economy and health of the empire that the Spanish crown ordered tests in hospitals all over Castile. Samir Boumediene’s paper elaborated on the issue of making workable recipes for newly discovered drugs. Once more, taste and smell were important assays, but drugs such as guaiacum and Peruvian bark were also tested on a larger scale. Dispensing them to the poor inmates of charitable hospitals (as happened in France and Germany) helped to determine their effect, and to establish recipes, which indicated how to adjust the treatment in individual cases.

books
Andreas Cleyer, Specimen Medicinae Sinicae (Frankfurt, 1682). From http://cures.hypotheses.org/the-workshop/programme-2/hanson-marta-and-pomata-gianna

Gianna Pomata and Marta Hanson’s paper showed how recipes also functioned as vehicles of knowledge between different cultures. Recipes, as either formula or prescription, were both found in European and Chinese medical cultures. According to Pomata and Hanson, it was the familiar genre of the recipe that facilitated the transmission of Chinese pharmacology to Europe in the second half of the seventeenth century. Similarly, Carla Nappi argued that the Manchu medicinal recipes of the Qing court were spaces of encounter and medical translation in the early modern world. Pomata, Hanson, and Nappi demonstrated how the recipe served as the common ground between European and Chinese medicine and made the translation of Chinese pulse medicine and the transmission of Chinese materia medica possible in the seventeenth and eighteenth centuries.

Although recipes are difficult to characterize as a genre, it is clear that they are fascinating objects of historical study. More often than not, they are fluid rather than fixed forms of knowledge, requiring adaptation at every turn. They bring together ingredients, practices and often practitioners from all over the world, and themselves have a tendency to aggregate into larger collections. As written manifestations of gestures and processes, they play an important part in testing, assessing and modifying drugs and cures.