Tag Archives: theriac

Theriac: an Imperial Recipe

By Barbara Di Gennaro Splendore

Over two millennia, the theriac recipe was the most debated in Galenic pharmacy throughout Europe and the Middle East. From the seventeenth century onward, missionaries, soldiers, and merchants carried it around the world. New versions of theriac were created in China, and across the Russian, Portuguese and Dutch empires, often incorporating local ingredients. The two excerpts below, from Barbara Di Gennaro Splendore’s  The State Drug: Theriac, Pharmacy, And Politics in Early Modern Italy (Harvard University Press, 2025), detail how theriac was made and argue that it was an imperial recipe from the very beginning.

Repeated by hundreds of authors over the centuries, the origin story of theriac and mithridate told by De theriaca ad Pisonem explicitly outlined the relationship between the state and the two remedies. The state was both the creator and the recipient of such outstanding drugs: a king (Mithradates) created the antidote; a general (Pompey) secured powerful medicines; and an imperial physician (Andromachus) modified the king’s antidote for his emperor (Nero). Furthermore, De theriaca ad Pisonem associated the remedy with other emperors, not just Nero: “We know that the divine Marcus Aurelius . . . used the drug greedily and as if it were a food.”[1] Emperors used, commissioned, and cherished theriac.

Theriac’s imperial birth derived from its very materiality. Rare ingredients from across the known world entered its composition. Only a colossal empire at the peak of its power could plausibly expect to produce such a compound. A proper theriac demanded Cyperus longus from Africa, Costus odoratusfrom India, and licorice juice from Cappadocia, Turkey, to name just three ingredients. Such an antidote was the outcome of a productive, highly organized society with a vast and well-developed commercial network, the ability to set up complex supply chains, and wealthy patients willing to pay for expensive medicines.

Colloquially, preparing theriac was the epitome of complex tasks. In a letter to his dear friend Farinelli (Carlo Broschi, 1705–1782), the famous castrato singer, the poet Pietro Metastasio (1698–1782) ironically lamented how in Vienna it was easier to have the best cooks make a pot of theriac than a homey dish of macaroni with zucchini.[2] In the early modern period, making theriac was a significant undertaking, not limited to apothecaries. In 1687 the Bolognese Collegio Medico informed the Senate that “this year, since making theriac and other noble compositions requires it, the College will be occupied with great diligence throughout spring and summer.”[3]

Ceramic pharmacy jars. Wellcome Collection.  (CC BY 4.0)

Making theriac demanded time and refined artisanal skills. Recent scholars have described the making of theriac as nothing less than “an artistic endeavor,” recognizing the skills it demanded.[4] Early modern apothecaries approached production with reverence: it represented both the pinnacle of their various preparations and the culmination of their careers. As the editor of the Roman Antidotario declared, “After having discussed it, I was able to observe the composition of this antidote [theriac] many times. Yet, I only dared to attempt such composition at the age of forty-five, and not before.”[5]Making theriac was a challenging process for many reasons: the sheer number of ingredients and their cost; the difficulties in sourcing several components; the uncertainty of identifying which plants to use; the uncommon skills and knowledge required to carry out the long and intricate compounding procedure; and the need for money, preparation, and a wide network of social connections.

As we have seen, the successful production of “true theriac” was an apothecary’s key to becoming regarded as a “learned apothecary.” Recipes such as that of theriac needed interpretation by skilled artisans. Learned apothecaries became aware of and vocal about their artisanal competence, stressing the “universal rules of the apothecary art” over Galen’s instructions, as Georg Melich described: “Practice [l’esperimento] has found a better way . . . than what the Ancients wrote, and good apothecaries rely more on the general rules of the art and on experience than on the authority of Galen, although he is a great authority.”[6]Melich’s sense of pride and  independence in his work, knowledge, and experience was shared by many learned apothecaries.[7] Most Theriaca magna recipes used in Italy in the early modern period listed sixty-three ingredients, not sixty-four as is often stated.[8] More precisely, the recipe comprised sixty-one ingredients plus wine and honey, which served as the medium for blending. The ingredients were divided into six classes, and each had a usually fixed number of components: one, four, eight, seventeen, twenty-four, and seven. […] 

Three components of theriac—trocisci hedicroi, scyllitici, and viperini—were preparations that themselves involved several ingredients, so the actual number of ingredients totaled seventy-one (not counting repeats). However, the number of substances needed for the entire theriac manufacture was higher, because single components required other ingredients for production. For example, to make chalcitidis, apothecaries needed vitriol; to cook squill for trocisci scyllitici, they needed wheat flour; yet vitriol and wheat flour were not listed as ingredients of theriac.[9]

The ingredients of each class were added to the compound in fixed proportions: 48, 24, 12, 6, 4, and 2 drachms. Pharmacopoeias used the same scale for weights, but systems of weight differed greatly. Aldrovandi acknowledged the difficulties imposed by this variation: “As for the measures, we grope around and go blind in our understanding of Ancients’ medicinal doses.”[10] Apothecaries often compounded more than one batch at a time, multiplying each quantity to maintain the right pro-portions. Some pharmacopoeias, such as De Sgobbis’s Universale theatro farmaceutico, provided specific instructions for producing theriac in bulk.[11]

The ingredients were as diverse as they were numerous. […]

This enormous variety required apothecaries to have good planning, timing, and organization—indeed, it sometimes took over a year to assemble the ingredients in their entirety. Because theriac had to ferment, it was good practice to make it early, before the summer, in May or June, so the fermentation could benefit from the season’s natural heat.[12] This meant many herbs and roots had to be harvested a year before, during the previous summer, and then stored.[13] But then there was the risk of supplies becoming rotten, dusty, or moldy—especially trocisci viperini, which was notoriously susceptible to mold. For this reason, many apothecaries preferred to make theriac at a later date, in August. In 1577 the Collegio Medico in Florence decreed theriac-making season to run from June 1 and August 31.[14] Apothecaries wishing to make theriac had to navigate recipes rife with contradictions, follow steps that were often ambiguous or down-right obscure, then justify their decisions.

Excerpted from THE STATE DRUG: THERIAC, PHARMACY, AND POLITICS IN EARLY MODERN ITALY by Barbara Di Gennaro Splendore, published by Harvard University Press.  Copyright © 2025 by the President and Fellows of Harvard College. Used by permission. All rights reserved.


[1] Robert Leigh, On Theriac to Piso, Attributed to Galen: A Critical Edition with Translation and Commentary (Leiden: Brill, 2015), 89.

[2] Pietro Metastasio, Lettere (Nice: Soc. Tipografica, 1787), vol. 5, 203.

[3] Archivio di Stato di Bologna (ASB), Assunteria di Studio 87, March 17, 1687.

[4] Nils-Otto Ahnfelt, Hjalmar Fors, and Karin Wendin, “Making and Taking Theriac: An Experimental and Sensory Approach to the History of Medicine,” British Journal for the History of Science Themes 7 (2022): 39–62, 43; Martin Kluge, “Das Theriak-Experiment,” in Materialwissen: Experimentelle Geschichte im Pharmaziemuseum, edited by Barbara Orland and Byron Cole Dowse (Zurich: Intercom, 2022).

[5] Collegio dei medici di Roma, Antidotario romano latino e volgare (Rome: Ruffinelli, 1624), 37.

[6] Georg Melich, Auertimenti nelle compositioni de’ medicamenti per vso della spetiaria (Venice: Giovanni e Andrea Zenaro, 1575), 42–43.

[7] On artisanal awareness, see Pamela H. Smith, The Body of the Artisan: Art and Experience in the Scientific Revolution (Chicago: University of Chicago Press, 2004).

[8] See also Edoardo Rosa, “La panacea dell’antichità approda all’Archiginnasio,” in L’Archiginnasio: Il Palazzo, l’Università, la BibliotecaGiovanni Roversi ed. (Bologna: Credito Romagnolo, 1987), vol. 1, 334.

[9] Archivio di Stato di Napoli, Badia di Mileto 268, 33r; vitriol was part of an apothecary’s list of missing ingredients for making theriac.

[10] Biblioteca Universitaria di Bologna, Ald. Ms. 21, IV, 127v.

[11] Antonio De Sgobbis, Nuovo et universale theatro farmaceutico (Venice: Stamperia Iuliana, 1667), folding sheet at 424–425.

[12] Bartolomeo Maranta, Della theriaca et del mithridato libri due (Venice: Marcantonio Olmo, 1572), 50–52.

[13] Adriano Riccardi, Istruttione intorno al comporre la Theriaca d’Andromaco (Bologna: Vittorio Benacci, 1606), 4.

[14] Sharon T. Strocchia, Forgotten Healers: Women and the Pursuit of Health in Late Renaissance Italy (Cambridge, MA: Harvard University Press, 2019), 260 n62.

 

Ambire: An Amerindian Antidote Against All Types of Poison. New Kingdom of Granada (today Colombia) ca. 1628.

Pablo F. Gómez

Ambire, an Amerindian remedy for bites and poisons

During the last decades of the sixteenth and the first ones of the seventeenth century, the Spanish surgeon Pedro López de León worked at the San Sebastian hospital in the city of Cartagena de Indias in the New Kingdom of Granada.  At the time, Cartagena was the most important port of the Spanish empire in the Caribbean and the official entry of all the slave trade coming into South America. Not surprisingly,  San Sebastian was the busiest hospital in the region. Drawing from his work at the hospital and around the region surrounding Cartagena and the wider Caribbean, López de León wrote a medical/surgical treatise called Practica y teorica de las apostemas en general y particular that detailed his experiences treating patients from all over the Atlantic while using state of the art surgical and medical techniques, and incorporating treatments he first saw in the New World.

The portada of the first edition of Pedro López de León’s Practica y teorica de las apostemas published in Sevilla in 1628. Credit: Google Books.

Salient among the treatments López de León details in his work was his use of an antidote he learned from Amerindian practitioners in the Caribbean coast of the New Kingdom of Granada. This treatment was, in his words, the only effective remedy against the bites of native snakes that, López de León thought, “were worst than the vipers of Spain.” The famous theriac from Toledo, a variation of the common medieval European panacea for poison, was completely ineffective against New-World snakes’ poison. When one of these snakes bit a person, López de León, said, health practitioners should instead use ambire—a remedy he had learned from Amerindian health specialists. Ambire was “a mix of many counter-herbs, tobacco juice and honey.” Amerindians cooked these ingredients until the resulting liquid was “as thick as the egypciaco ointment, and with the same color and consistency.” Ambire was “so strong and with such virtue,” López de León maintained, that if a person who had been bitten by a snake “drinks the weight of a real [3.5 gm.]” of ambire “dissolved in wine or water” within fifteen minutes of the snake’s bite, or that of any other poisonous animal, the remedy would stop “and kill” the poison and “repair the heart.” López de León recommended that—besides administering ambire orally to patients bitten by poisonous animals—health practitioners should “cut and suck the bite wound” and put “ambire macerated with four garlic cloves in a mortar” on the wound which should be then covered. This procedure, including the drinking of the ambire potion, should be repeated after three, seven, and thirteen hours. If the recipe was prepared correctly and the procedure followed strictly, “most patients would be cured,” López de León maintained.

Remedies for “Fresh Wounds” in Pedro López de León’s Practica y teorica de las apostemas general y particular (1628), 160.

 

More impressively, ambire served as a prophylactic against any “poison” that “one will be given” during a day. Death, one should remember, lurked around every corner in the early modern world, and poisons of all sorts (and not only of animal origin) were a particularly common menace. In order to be protected López de León said, a person should “put three drops of ambire” in her palm and “lick them every morning.” According to the Spanish surgeon, this was a remedy that was highly esteemed by both Amerindians and Spaniards. Everybody in the region thought that ambire was far better than theriac. After all, ambire protected not only against physical but also spiritual poisons. Ambire made people expel the “spells through the mouth or anus” in the form of vomit or diarrhea. López de León himself had seen people that, after having been treated for spells with ambire, “had expelled bones of little toads,” a common description in the New Kingdom of Granada of the widespread bundles of evil associated with witchcraft, “in the quantity of an escudilla [a small bowl].”

López de León’s account of the uses of ambire is an illuminating example of the vibrant, multi-originated, and epistemologically diverse world of early modern Caribbean medicine. It showcases an era of pharmacological exchange, and of challenges to old Western medical traditions (including that of the quintessential Galenic remedy, theriac) on the basis of experiences gained from exchanges with native populations around the globe. It also reminds us of the fluid avenues linking the human body with the physical and spiritual realms in the ideation about nature of early modern people

Reference:

León, Pedro López de. Pratica y teorica de las apostemas en general y particular: questiones y praticas de cirugia de heridas, llagas y otras cosas nuevas y particulares. Sevilla: Luys Estupiñan, 1628. 198.