Tag Archives: honey

Sugar versus honey in Byzantine recipes

By Petros Bouras-Vallianatos

The Byzantine Empire, with its capital in Constantinople (now Istanbul), then a mainly Greek-speaking region, constituted a natural crossroads between East and West for more than a millennium (AD 324–1453). Its history is an indispensable part of the medieval period in both Europe and the Middle East. In the field of medicine, for example, we can attest to widespread interactions with the Islamic tradition.

The most dynamic part of Byzantine therapeutics was pharmacology. We are privileged to have several surviving pharmacological manuals, especially dating from the later period, i.e. from the twelfth to the fifteenth centuries, which provide us with a unique testimony to Byzantine composite drugs. Here I have selected the example of sugar-based potions, as it offers an excellent case-study that helps us to better understand the way Byzantine recipes were developed through a process of both practical experimentation and influence from outside.

Before the introduction of sugar, people relied on honey to make medical potions sweet. Greek and early Byzantine medical authors referred to honey-based drugs such as oinomeli (a mixture of honey with wine), hydromeli (a mixture of honey with water) or oxymeli (a mixture of honey with vinegar). For example, Paul of Aegina (fl. first half of the seventh century) recommends the following recipe for those suffering from calculi:

One ounce[1] each of saxifrage, betony, dog’s-tooth grass, maidenhair fern, spikenard, carpesium, hazelwort, and eryngo; one half ounce each of Macedonian parsley and seed of rue; two ounces each of green fennel, iris, baked squill, and periwinkle; three ounces of bark of the root of capper; two ounces of water-parsnip; and two sextarii[2] each of water, vinegar, and honey.[3]

Meanwhile, the cultivation of sugarcane gradually spread throughout the Islamic East from the seventh/eighth century onwards. Sugar was used as a simple drug, for stomach ailments and the relief of pain in, for example, the chest and kidneys. However, it also became popular as an excipient in liquid pharmaceutical dosage forms, used as a sweetener and preservative, initially supplementing and gradually replacing the use of honey for pharmacological purposes in the Islamic world. Sugar is of higher purity than honey, thus a smaller quantity has a stronger preservative action; it is also less susceptible to changes of temperature and ensures greater homogeneity into the final product. Among the most commonly used potions in Islamic medicine are the so-called julep (julāb) and syrup (sharāb), both of which consisted of sugar and one or more kinds of fruit juices or extracts of flowers.

Figure 1. Medieval, cone-shaped earthenware devices for the refining of sugar from Cyprus. Courtesy of Bank of Cyprus Cultural Foundation.
Figure 1. Medieval, cone-shaped earthenware devices for the refining of sugar from Cyprus. Courtesy of Bank of Cyprus Cultural Foundation.

By the eleventh century sugarcane cultivation was thriving in Syria and Palestine, eventually reaching the large Mediterranean islands of Cyprus and Sicily. Western merchants, such as the Genoese and the Venetians, played an important role in the distribution of this commodity throughout the Mediterranean, including Byzantium. For example, sugar is mentioned among the main supplies for the newly established Byzantine hospital (xenon) of the Pantokrator Monastery in Constantinople in the early twelfth century, but it was not until the late thirteenth century that sugar became widely available in the Byzantine world.

At the same time, we can observe the transfer of medical knowledge to Byzantium through translations of Arabic and Persian works into Greek. The earliest text of this kind, which preserves a large number of references relating to the various kinds of sugar-based potions, is the Greek translation of Ibn-Jazzār’s (fl. tenth century) Ephodia tou Apodēmountos (Zād al-musāfir wa qūṭ al-ḥāḍir/Provisions for the Traveller and Nourishment for the Sedentary), which must have been translated in the late eleventh/early twelfth century by scholars working in Southern Italy. By the early fourteenth century recipes for sugar-based potions had become very common in Byzantine manuals. The Constantinopolitan medical author and practising physician John Zacharias Aktouarios (ca. 1275–ca. 1330) provides an extensive list consisting of about thirty recipes, and he often explicitly acknowledges that he was introducing a new recipe. For example, he gives the following recipe for a julep for heart palpitations:

One hexagion[4] of the three sandalwoods; three hexagia of violet; two hexagia of basil seed; two hexagia of rose; five hexagia each of bugloss and ox-eye flowers; two hexagia of aloeswood; one hexagion of ambergris; two hexagia of saffron; three hexagia each of dried flower-buds from the clove-tree and nutmeg; one hexagion each of cinnamon, anise, caraway, and fennel seed; five grains of musk; one hexagion of poppy seed; three ounces of the juice of sweet apples; one ounce of rosewater; five ounces of distilled endive water; one ounce each of the roots of fennel, wild celery, and chicory; three hexagia each of marjoram, chamomile, and wormwood; and three ounces of sugar.[5]

Figure 2. A julep recipe added in the lower margin of a fifteenth-century medical manuscript, MS.MSL.52, f. 143v. Courtesy of the Wellcome Library, London.
Figure 2. A julep recipe added in the lower margin of a fifteenth-century medical manuscript, MS.MSL.52, f. 143v. Courtesy of the Wellcome Library, London.

In this recipe, in addition to sugar, we can also see ingredients from Asia and the Far East, such as musk, amber, and sandalwood, which became common in European pharmacology, especially during the thirteenth and fourteenth centuries after the Mongols’ conquests in Eurasia that led to the Pax Mongolica and the resulting improvements in trading conditions. To sum up, the fact that Byzantine physicians were aware of the usefulness and effectiveness of these sugar-based potions and made extensive use of them is at odds with the established view that Byzantine society was not very open to outside influence. Nowadays sugar is omnipresent and often replaced by sugar substitutes for the sake of diabetics and the diet-conscious; but once it was a novelty and highly desirable!

[1] One ounce is equal to 27.288 g.

[2] One sextarius is equal to 54.58 g.

[3] Ed. J. L. Heiberg. Paulus Aegineta, vol. 2 (Leipzig-Berlin: Teubner, 1924), 309, 1-6.

[4] One hexagion is equal to 5.166 g.

[5] Vindobonensis med. gr. 17 (first half 15th c.), f. 118r, lines 4-11.


Petros Bouras-Vallianatos studied pharmacy, ancient and Byzantine history, before completing his PhD on the late Byzantine medical author John Zacharias Aktouarios; a revised version of his doctoral thesis is to be published soon. He is Wellcome Trust Research Fellow in Medical Humanities in the Department of History at King’s College London, where he is working on a three-year project entitled ‘Experiment and Exchange: Byzantine Pharmacology between East and West (ca. 1150-ca.1450)’. He has published several articles on Byzantine and early Renaissance medicine and pharmacology, the reception of the classical medical tradition in the Middle Ages, and palaeography, including the first descriptive catalogue of the Greek manuscripts at the Wellcome Library in London. He is also co-editing the Brill’s Companion to the Reception of Galen.

Sweet as Honey

By Laurence Totelin

Yesterday I read some press releases about a fascinating Welsh research project (based at my University: Cardiff University) that will screen Welsh honey for antibiotic properties.  The aim is to find the Welsh answer to Manuka honey, by driving bees to flowers with the highest antibiotic properties. This project, if successful, will no doubt have significant positive medical, ecological, and economic implications. The press release mentions the use of medicinal honey since the Middle Ages. One should never take press releases too literally, but the history of employing honey medicinally goes much further than the Middle Ages. I will focus here on the Greek and Roman periods of antiquity, but honey was used in many cultures well before the Greeks started using writing.

A coin from ancient Ephesus, representing a bee. Source: wildwinds.com
A coin from ancient Ephesus, representing a bee. Source: wildwinds.com

Honey is one of the most common ingredients in Greek and Roman pharmacopoieias. It was taken orally as well as applied to the body.  What interests me here is the great care the ancients took to differentiate between types of honey. In particular, ancient recipes frequently and consistently ask for Attic honey. For instance, the Hippocratic text Internal Affections (end of the fifth, beginning of the fourth century BCE) has the following recipe for a ‘hip-disease’:

If this [previous treatment] does not help, purge with the following remedy: crush half a kotyle of cumin; chop into pieces an entire gourd, of the small and round variety, in a mortar; sprinkle with the finest red Egyptian natron, in the amount of a quarter of a mina; roast; pound finely; put these ingredients in a pot; pour in a kotyle of oil, half a kotule of honey; a kotyle of sweet white wine, and two kotylai of juice of beet. Boil these [ingredients] until they have the right consistency; pass them through a cloth; add to them a kotyle of Attic honey, if you do not want to boil they honey together with the other ingredients. If you do not have Attic honey, use some of the best honey and heat up in the mortar. If this clyster preparation is too thick, add the same wine to the recommended thickness. Use this as a clyster. [Hippocratic Corpus, Internal Affections 51]

Several interesting things here: first, the Attic honey is not the only ‘ethnic’ ingredient in this recipe: it also contains Egyptian natron. This use of geographically-qualified ingredients is a characteristic of ancient recipes. Second, the author understands that not everyone will have access to Attic honey and suggests using the best possible honey available if that is the case. Third, the recipe recommends not to boil the honey together with the other ingredients, possibly indicating an awareness that heat destroys some of the qualities of honey.

The Hippocratic authors do not tell us what made Attic honey special, but other medical authors tell us that Attic honey (and in particular the honey of Mount Hymettus) was special because the bees fed on thyme, which was itself an important medicinal herb. Some writers produced lists of plants that produced the sweetest honey (thyme, violets, asphodel, iris), and those that should be avoided (spurge, thapsia, wormwood, wild cucumber). According to Palladius, a fifth-century CE agronomist, these plants had to be avoided because their bitter taste would prevent the creation of sweetness (1.37).

The Greeks and Romans also mention poisonous honeys. The historian Xenophon (fourth century BCE) describes the effect of a poisonous honey to be found in the land of the Colchians (East Coast of the Black Sea, modern Georgia).

And swarms of bees were numerous there, and the soldiers who ate the honeycombs all went out of their mind, vomited and suffered from diarrhoea, and none of them was able to stand up; but those who had consumed only a little appeared like those who are extremely drunk; while those who had taken a lot seemed like mad or even dying men. Thus many lied there as if there had been a defeat, and there was much despondency. But the next day nobody had died, and around the same hour as they [had taken the honey], they came back to their senses. And on the third or fourth day they got up, as if after a poisoning (pharmakoposia). [Xenophon, Anabasis 4.8.20-21].

Unfortunately, Xenophon does not tell enough about the flora of the region to make a hypothesis about the nature of the plants upon which these bees fed. Pliny the Elder also describes a poisonous honey from Heracleia Pontica (on the Black Sea, modern Turkey), this time produced from a plant called ‘the goat killer’ (Natural History 21.74). I wonder whether modern apiculturists are aware of such poisonous honeys, and whether these dangerous honeys, taken in small doses, could be used medicinally? In any case, there is much scope for honey bioprospecting, and I wish my Cardiff colleague the best of luck!