The Drug Trade in Antiquity


An apothecary publicly preparing the drug theriac. / Image via Wellcome Collection, Wikimedia Commons

Exploring the wandering life of the marsus and druggist and their ambiguous position within society.


By Dr. Vivian Nutton
Emeritus Professor of the History of Medicine
University College London

The Passion of St Eugenius and St Macarius is a work as obscure and at times implausible as the very existence of the saints themselves. Written in the eighth or ninth century, this epic of Christian fortitude relates a long list of dreadful tortures applied to the saints, or merely attempted by their accuser and judge, the ferocious emperor Julian the Apostate. As the ultimate in exquisite punishments, Julian ordered poisonous snakes to be brought before him and to be made so angry that they would bite the first persons they encountered. The first snake was stimulated by having its tail showered with boiling water, but in vain, for on meeting the saints it was lulled to sleep by their obvious gentleness. The second snake, even more dangerous, was urged into action by boiling pitch, but, thoroughly confused, it turned upon Julian, who was forced to flee for his life from his judgment seat. The point of this story for medical historians does not lie in its delineation of the possibly fatal occupational hazards of life on the bench – other Christian martyrdom stories tell of similar accidents to emperors and governors – but in the identity of the snakes’ owners. The Greek original merely terms them ‘displayers of wild animals’, theriodeiktai, but the Latin contemporary translation uses the more precise word ‘marsi‘.

As Louis Robert (1940) has shown, this identification is not fortuitous, but reflects a feature of the drug trade in antiquity that has often been neglected in an understandable concentration on a few important medical texts. This paper, which relies on a much wider range of documentation, is an attempt to broaden the traditional historical perspective and to set the drug trade of antiquity not just in Rome or Alexandria but the small towns of Asia Minor and in the haunts of the marsi and their Greek confreres.

The marsi were in origin a tribe or racial group inhabiting the central, mountainous area of Italy, the Abruzzi. They had a reputation, well deserved, for being wild and warlike, for they were only incorporated in the Roman state after a series of long and bitter campaigns in the fourth century BC. Life in the Abruzzi is hard even today among the mountains and forests, and in antiquity it must have been even harder. Its inhabitants lived in poverty, in houses that offered little shelter from the rain, consoling themselves for their indigence with strange and archaic religious practices, and with a little banditry on the side. Their image in classical literature was a bad one, and, although they made excellent soldiers for the Roman legions, of their civilian activities only one stands out – their role as snake hunters, snake charmers and druggists. They were possessed of almost legendary magical powers: they could sing a snake to sleep and extract its venom, they could allow the most poisonous of snakes to rest inside their tunics, and they alone had a store of knowledge about poisons and venoms. Their reputation was such that their tribal name of marsus became the regular Latin equivalent of ‘snake-charmer’, and even of poisoner. These were marginal men, in more than one sense, halfway between civilization and savagery, between expert and quack, between bringer of health and minister of death.

They could come down for a while to the city: Galen talks of seeking out the marsi in Rome to give him advice about poisons and on the various snakes to include in an antidote. He expects his friend Glaucon to have seen them in action there, cutting off the heads and tails of snakes, skinning and gutting them, and then washing the flesh (I.143). But they were rarely resident for long. They were to be found on the road, circulatores, the ‘travelling people’, and at the local markets, dragging in the crowds with displays of daring – hence another name for them, ‘crowd-puller’. Just as Galen, the scientist, could carry out his experiments with theriac on cocks and hens to test the value of the various antidotes, so these travelling showmen would display their wares, allow themselves to be bitten, or remove their hands unscathed
from the mouths of poisonous snakes. Not all their audience was convinced that they possessed magical powers. The medical writer Celsus correctly notes, apropos their apparent immunity, that it was the conjunction of the bite of the snake and the saliva then injected that was crucial; so a drugged snake, even though it salivated, could not cause harm because it did not bite. Even so, if the poison was immediately sucked from the wound, it was unlikely to prove fatal.

Atum and the snake Apophis. / Image via Wikimedia Commons

But accidents did happen. At Athens, a medicine-man, ‘one of those who bred snakes for display’, put on a demonstration in front of his fellow professionals. He let an asp bite his arm, then sucked out the poison: but his water jug had been overturned, he could not immediately rinse out all the poison from his mouth, suppuration and disintegration took hold, and he died peacefully two days later. Naturally treachery and professional rivalry were suspected, but, as the writer of Ecclesiasticus put it (ch. 12, v. 13), ‘Who will pity a charmer that is bitten with a serpent?’. Certainly not the lawyers, who made it perfectly clear that if these travelling showmen harmed anyone through fear – perhaps a spectator falling backwards off a bench at having a snake thrust under his nose – they were entitled to be sued for damages. And possibly not even the gods, for, in Lucian’s satirical ‘Dialogues of the Gods’, Heracles’ complaint against Asklepios is that he is a rootcutter and travelling showman, touting around a stock of dubiously useful remedies, whereas he, Heracles, has made a truly manly living out of wild beasts and serpents by killing them with his club.

One must imagine the marsus standing in the market place, brandishing his wooden box of snakes, talking twenty to the dozen, screaming out his wares at the top of his voice, displaying his ‘volubilitas orandi‘, as Quintilian put it, in a high-pitched and grating screech. He might indeed bring help and comfort to the sick: Galen reports without qualm the antidote of Simmias the ‘crowd-puller’ against the tarantula and other poisonous insects, as well as that of Chariton, another travelling salesman, who ‘used on his way round the fairs a remedy against snake bite made from the fruit of spondylium, and catmint, pounded and mixed together in wine, to be drunk several times a day’. But there might be another side to his activities, which is best exemplified in the story of Lucius Clodius of Ancona, known to us from Cicero’s speech in defence of Cluentius. He was a travelling drug-seller, always in a hurry, since he had many markets and fairs to visit, who contracted with a certain Oppianicus to murder his aunt for 2.000 sesterces (c. £5000). The bargain struck, the deed was done: Clodius came to see the lady on her sick bed, and his first dose carried her off. Naturally, he wasted not a moment in escaping from Larinum. Emboldened by this success, Oppianicus found ways of turning medical expertise to criminal advantage. He bought from an unwitting doctor, a man of great respectability, a slave skilled in making up drugs. Urged on by his new master, the slave soon learned how to turn drugs into poisons, and Oppianicus, so Cicero alleged, was able to embark on a further career in crime.

My point here is two-fold: to emphasize the wandering life of the marsus and druggist; and secondly to stress his ambiguous position within society, at least as likely to kill as to cure. His equivalents elsewhere in the Mediterranean world, the Psylli and the Nasamones, both tribes from the backwoods, inspired a similar respect for their skills with snakes and drugs as well as a certain suspicion, and guests at dinner might relate the saga of the unwary traveller who ventured into the wilds of Pontus and to the haunts of the Palaeothebans, famous as experts in poisons. A single glance from an angry Palaeotheban was said to have proved fatal by itself. Not surprisingly, these backwoodsmen, travelling salesmen, and snake charmers were included by the early church, along with prophets, astrologers, palmists and amulet makers, among those who should not be admitted into the Christian flock without the greatest of circumspection.

Their more domesticated brethren, the rootcutters and providers of herbal simples, had a slightly better press. According to the writers of ancient astrological textbooks, they shared the same birth star with others who endeavoured to know more than the substance of human nature allows; and with the doctors and those by whom the health of men is ensured. They were praised, too, for the care with which they collected their herbs and applied them to ailing beasts. They might enjoy the name and reputation of experts: ‘rootcutter’ was an epithet born by one of the most famous of pharmacologists, Crateuas, who assisted the infamous Mithridates of Pontus, and, as Geoffrey Lloyd (1983) has recently reminded us, the great botanist Theophrastus was not above asking the aid of the rootcutters in resolving particularly difficult problems of plant identification and origin. By contrast, despite all his bluster and injunction to his readers to tramp over the countryside looking for herbs instead of sitting in front of a lecturer, the elder Pliny, that great collector of multifarious information, seems to have kept his nose firmly in his book rolls. In this he was unlike his friend, the centenarian Antonius Castor, who kept a herb garden round which to potter, for pleasure and for scientific research. How many others followed his example is not known. Certainly, we hear of the occasional experimenter in plant breeding, like Galen’s father, and doctors were regularly encouraged to grow their own simples.

Most doctors resident in a small town would also have land at their disposal; they were farmers as well as healers, but whether they used their land for growing herbs or for introducing new species is impossible to tell. Like the author of the book, ‘On Theriac, to Piso’, they may also have tested their new preparations on small animals; but that writer clearly regarded this as second best, for he looked wistfully back to the days of Attalus III and Mithridates, both kings who used human beings, condemned criminals, as objects on which to try out their new drugs. All that he could offer in its place was attendance at public executions at Alexandria, where condemned criminals were killed by the bites of snakes (XIV.214,237). Rulers and public executioniers could marry science and murder, but not the local doctor.

Preparation of Theriac: Illustration from the Tacuinum sanitatis. / Image via Wikimedia Commons

In a strange and possibly invented story, Galen talks of meeting a doctor in the wilds of Bithynia, north west Turkey, who had discovered a drug that destroyed blood and then used it on various patients (XI.336). Galen sought him out and brought him to the governor(?), who determined to kill both the doctor and anyone who had either taught him this herb or learned of it from him. Under torture, he said that he had found out its deadly properties by himself, having seen its effect in liquefying a mass of congealed pig’s blood. He had then, as an experiment, tried it out on various humans. When at the end of his examination, the wretch said that the poisonous substance was a very common herb growing wild in profusion, the governor ordered him to be blinded and led off at once to execution, lest he have the opportunity to point it out to any other person and start an epidemic of murder. Galen goes on to say that some writers with a knowledge of dangerous drugs have been equally culpable, for they have been so heedless and lavish in their descriptions that their dreadful secrets are clear to all. He himself is not so rash, and will maintain a judicious silence.

This paper so far has concentrated on what might be termed the bottom end of the drug trade, the backwoods herbalist, the mountain snakeman, the mountebank at the fair, who became an object of derision when he tried to proclaim the virtues of his wonder cold cure even as his nose dripped profusely and he coughed almost non-stop. Yet this was the most common way in which drugs of whatever sort were traded around, and the druggists who lacked the
advantages of a training in Galenic demonstrative logic vastly outnumbered the paragons of the art demanded by Galen (1.61). The so-called oculists of Britain and the north west provinces travelled light, with only a few drugs and potions. As the poor doctor complained to Galen, they could not carry with them a great range of drugs on their journeys, nor bring four separate varieties of the one type; what they wanted was a single remedy which would do for the great majority of cases (XII.908). Specificity took second place to portability.

But in the larger towns, and particularly in the great cities like Alexandria and Rome, there would be a quarter devoted to the selling of drugs and the like. Galen knew where in Rome to find the marsi, the herbalists, or the sellers of special thin cord from Gaul: it was just off the Via Sacra, which led from the temple of Rome to the fora (X.942). In Capua, in southern Italy, there was an area called the Seplasia, so famous that it gave its name to the whole drug trade in Italy. But far from being the place for a decent physician to visit, it was frequented by gilded youths with dandified manners. It was their acquaintance with the Capuan Seplasia that, according to one Roman author, finally put an end to the martial fierceness of Hannibal’s Carthaginians. Fresh from their victory over the Romans at Cannae, the Carthaginian warriors eagerly descended on the Seplasia, with its array of ointments, perfumes, spices and the like. The result was a catastrophe for Carthage: never again were her armies to defeat the Romans.

This link between luxury and the drug trade has proved harmful to more than morals. It has seriously distorted our understanding of the workings of the ancient drug trade, as well as our appreciation of what drugs were readily available, and this distortion has been increased by the bias of the sources, which have for the period of the early and middle Roman empire a distinctly Alexandrian and Roman bias. In other words, our informants come precisely from the two cities that were most involved in the trade in luxuries, either as consumer or as exporter. Pliny’s view of a massive drain of money away from Rome to the East to pay for expensive luxury drugs and perfumes, a sort of financial haemorrhage that would eventually bleed the empire to death, has been resuscitated by J Innes Miller (1969), in his ‘The Spice Trade of the Roman Empire’, into an epic of Victorian imperialism. Miller sets before us the image of great trading fleets sailing from the Red Sea to India, returning laden with spices; of Malayan outriggers crossing the Indian Ocean to Madagascar freighted with cinnamon along a route deliberately kept secret to banish competition; and of dutiful civil servants carefully totting up the taxes at the various customs posts, auditing them and sending their figures back to Rome. The more recent study of Manfred Raschke (1978), an immensely long essay which is almost as difficult to read as it is to locate in a medical library, has put an end to these fantasies: the silk route from China over the Hindu Kush through Iran to India and the sea route from India across to the Red Sea still exist, but traversed by tens rather than thousands of travellers; the Malayan cinnamon route evaporates completely; and the currency drain dwindles to an unimportant trickle.

It would be foolish to deny that certain commodities could only have come from the East, bdellium and nard, for example, or that some drugs that were once exceedingly rare or expensive did not in time become cheaper and more common. Nard is a famous example; the Gospels give a price of 300 denarii a pound, Pliny a few years later only 50. Aloe, from Socotra, seems to have come into use perhaps only in the last quarter of the first century BC. Celsus, writing c. AD 40, has only a scrappy notice of it; Pliny and Dioscorides a generation later are much fuller; and it plays a staple role in the pharmacology of Antyllus, Rufus, Soranus and Galen in the next century. Many other drugs can be presumed to have been introduced into the Roman world at the same time, and the later Greek magical papyri from Egypt are full of references to exotic gums and spices from Arabia. But it was well understood that such recondite and expensive preparations – Charmis charged approximately £5000 for one cure, and we often hear of similarly priced wonder-drugs – were only available in certain places and for certain people. Galen himself has no doubt who are responsible for this, to him deplorable, state of affairs: the culprits are the pampered ladies of wealth, in Rome and outside, who cannot bear their bandages to be tied on with anything other than the finest silken thread (X.942), who have a passion for types of myrrh called foliata and spicata (VI. 440), and who swear by a face pack made out of the dung of the land lizard, crocodilus. But it was presumably not these ladies alone who ensured that the beauty manual of Cleopatra enjoyed a roaring success. It was excerpted by both Crito of Heraclea, doctor to Trajan, and by Galen, with the amusing consequence that Galen in later biographies was assumed to have been taught pharmacology by the famous queen herself. Rich husbands, too, might lead such a dissolute and reckless life that they were forced to rely on the doctor’s drugs in order to survive. Gluttony could take its toll, and also poison, for, according to Galen, there were many men of wealth who lived in constant fear of being poisoned by an opponent, an enemy, or even the emperor himself (XIV.216; CMG V.10.2.2.494). Small-town rivalry was not just a matter of words, and a promising youth was killed by his fellow physicians in Rome because he seemed to be about to surpass them.

Asclepius (center) arrives in Kos and is greeted by Hippocrates (left) and a citizen (right), mosaic from the Asclepieion of Kos, 2nd-3rd century AD. / Image via Wikimedia Commons

Various consequences flowed from this association of the upper end of the market and the drug trade. The first, and perhaps the most important, was that some of the preparations become more and more elaborate simply in order to satisfy the expectations of a wealthy clientele. A cheap concoction to them signified a bad one, and hence physicians and druggists were advised to add harmless spices, perfumes and suchlike to common, effective and inexpensive bases in order to convince their rich customers that here was something really worth having. The poor country doctor could leave out the trimmings and happily rely on his local herbs, supplemented on occasions by windfalls, literally and metaphorically (XII.918).

Secondly, this interest in antidotes by the upper classes led to the proliferation of theriacs of all kinds. No physician of note was without his own theriac, and its ingredients and its preparation took on the aura of the greatest trade secret. Even when a recipe became famous, it was often dressed up in the trappings of wondrous and recondite learning, or set into a long, complex and highly allusive poem.

Thirdly, we can see the role of fashion in determining some of the interest in drugs. A famous example is theriac. Marcus Aurelius used to take a daily dose of it, especially of the variety containing what was then called cinnamon, and Galen, in his search round the stores in the imperial palace, discovered large quantities of this cinnamon, including a large bush some seven feet long, which had been brought in by previous emperors up to fifty years before. In Marcus’ lifetime theriac was in vogue, and so many of the ingredients that were hard to obtain were just left out by the manufacturers and the theriac itself was used straight away, within two months. But after his death in AD 180, his son caring nothing for theriac or cinnamon, the drug fell out of fashion, being compounded by only a very few. The post of maker of the emperor’s theriac, which had fallen to Galen, was now little more than a sinecure. This reversal of fashion brought one, perhaps unexpected, consequence: the rarer ingredients were once again reintroduced, and Galen, with the run of the royal stores at his disposal, could select for his own use some choice cinnamon for his own patients. He kept six different types in little boxes in a store at the Forum of Peace, but all were lost in a disastrous fire there in the year 191. When from 193 or so onwards, the new emperor, Septimius Severus, asked Galen to make up the theriac for him again, he could only use some of the more modern ingredients and they were not perhaps of the same quality. But Severus or his successors did perform a service to the community: ‘by valuing the common good as their aim, they turned a secret of the cognoscenti into a remedy accessible to all’ (XIV.217).

Galen, however, was well aware of his own privileged position. To Rome flowed the ingredients for drugs from the whole world, from the East, from Arabia, from Asia Minor, and, though in much more limited quantities, from Gaul, Spain and Morocco. The northern lands contributed very little, unless it was the mysterious ‘radix Britannicus‘, mead and a type of yoghurt called ‘melka‘. The best drugs came to Rome, and the best of them were reserved for the emperor. We can trace various stages in this trade. We can read of the expert drug-sellers of Alexandria, whose knowledge of the various types of cassia had earlier impressed Dioscorides and who specialized in the drugs and spices brought from Arabia and India. We can follow some of the loads as they travel on camels either to or from Alexandria (XII.216), or by sea to Rome. And we can meet the royal rootcutters of Crete, selecting their herbs, and packing them into large wicker baskets, roots, leaves and all, before sealing them with a special seal and sending them to the royal stores in Rome, the apothekai, where the storeman, the apothecarius, would list them – and, if Galen is to be believed, leave them untouched for years.

If Alexandria was the place to go for exotica, then Crete was a Mediterranean garden of Eden. Herbs of great efficacy and quality grew there in abundance, and botany was a regional institution. Merely to have been born there gave a pharmacologist an advantage (XIV.21 1). The emperors kept their own private staff of botanists and rootcutters on the island, and the combination of relative inaccessibility and mythical tradition gave to any plants from Crete an extra cachet that doctors and pharmacists were keen to exploit.

But even in this demi-paradise all was not well. Galen hints darkly at adulteration and deception; one could not always be sure that the seals had not been tampered with, or that the bottom of the basket did not contain useless weeds, but these are regular complaints in the pharmacological literature and are uttered by doctors and patients alike. Pliny trumpets that to rely on a made-up preparation or on the word of a drug-seller alone is tantamount to suicide. Galen refuses to talk about the useful methods of making the herb lycium indicum go a long way, for this would be an open invitation to criminals. Even when a substance was as well known as Hymettian honey, substitution and adulteration might prosper. True Hymettian honey, according to Galen (XIV.26), was clear, with just a hint of sharpness to offset the
honey’s sweetness. But much of the honey sold at Athens displayed small flecks of thyme and other foreign bodies, which gradually came to the surface and which gave to the honey a stronger smell and taste of thyme. Some dealers, both in Athens and in Rome, were quite prepared to remove the flecks – a sure sign that the honey had been kept for a while stored in jars – and to pass it off as true Hymettian on the unsuspecting buyers who were persuaded to buy by its distinctive odour of mountain thyme.

Unguentari di vetro. Hellenistic glass amphoriskoi, dating from the 3rd/2nd century BC. Belonging to the collections of the Archaeological Museum in Florence. / Photo by Giovanni Dall’Orto, Wikimedia Commons

With more exotic confections, the opportunity for fraud and deceit grew even greater – although not always with the deleterious effects that one might expect, or that Galen would lead us to believe. Theriac, he says (XIV.24), is made in great quantities in Rome, not just by a few select doctors but also by the myropolai, the unguentarii, the perfume-sellers, who all in one respect or another make mistakes in its proper composition. Nonetheless, they put together a drug that is not without its uses- faint praise indeed, but remarkably loud if one considers that Galen’s rhetoric has led us to expect a condemnation of their practices.

There might, too, be attempts to compete with foreign imports by copying the most expensive drugs locally, as in the case of nard. Dioscorides’ description of it is lengthy, and not entirely clear. He begins by describing two types of nard, called the Syrian and Indian, which may be identified with members of the Valerian family. Unfortunately, he then confuses his readers almost immediately by saying that the two geographical names do not refer to the two lands where the nard grows, but to the two sides of the Hindu Kush, one looking to India and the Ganges, the other west to Syria. Dioscorides may well be drawing on an eyewitness account of plants from near Bokhara and Sikkim, but he then adds a third variety, from Safar, an area on the tip of Arabia, which may be merely another name for the Indian nard, shipped across the Indian Ocean to Safar and now called by its port rather than its home. These exotic nards are distinguished by Dioscorides from two others – the Celtic nard, from the mountains above Genoa, and the mountain nard of Syria and southern Turkey. But even if the purchaser or supplier could distinguish between these varieties, there were still other hazards before one could be sure of getting the right nard, of the right type and in the right condition. The exotic nards steadily rotted on their journey to the Roman world and they were often adulterated with other aromatic substances, both to render them more compact and harder, and, presumably, to keep a good perfume.

Getting hold of true, unadulterated nard was clearly difficult, and one may doubt whether even Dioscorides really knew what he was up to. But more often nard was sold not as a plant or neat, as an aromatic, but in the form of ‘myrrh of nard’ or ‘nard ointment’. The finest nard ointment was produced at Laodicea in Asia Minor, a town on the great trade route that ran from Persia along the old royal road down the Maeander to the Mediterranean near Ephesus. But the secret of its manufacture had long been known, and the ointment was now made in many cities, including Naples. This was clearly the main manufacturing centre for Italy, for Galen thinks it important to warn his readers expressly that what is made there resembles the true Laodicean nard ointment merely in name (X.79 1). Not everybody knew, or even believed, Galen, and for most doctors, druggists and certainly their patients, this careful differentiation of the different types of nard and nard ointment was almost pointless. They had to take what was available and do the best they could.

The situation was no better with mineral drugs, the Cimolian and Cretan earths, or the various varieties of copper oxides and cinnabar that have been recently revealed on the new fragments of Diocletian’s Price Edict. Leaving aside the question of transport and of accessibility of the source of the mineral – some areas like the Dead Sea were famous for their bituminous shales (XII.203) and could be easily visited, but many of the mines were very remotely situated – it is also doubtful just how many physicians and druggists could tell one type of copper oxide easily from another. Cadmia, ‘bronze scales’, ‘burnt copper’ and ‘reddish copper’ are descriptions as vague as nard, and equally confusing to modern interpreters. The locals might know what they meant, and the provision of synonyms in medical texts from at least the fourth century AD onwards might enable the learned to differentiate one drug from another, and to identify quickly and accurately the required ingredient; but unless one had the necessary opportunities, the interest and the ability to gain first-hand knowledge, one was at the mercy of one’s suppliers.

There exists only one certain piece of evidence for any attempt to standardize or market a particular drug with a guarantee of authenticity, and this is the famous example of the terra Lemnia, the Lemnian earth. This, we are told by Galen (XII.169), was made into a seal and stamped with the image of the goddess Diana. Lemnian earth came in three varieties- one used in washing clothes, another used by carpenters instead of ruddle, and the third, the true medicinal earth. This was prepared from one particular hill on which only a priestess was allowed to set foot: the earth was blessed, and barley and spelt were scattered over it; then she took up a quantity of earth, put it in a wagon, and brought it back to the town to be made there into the special seals. Galen, by an error of navigation (and geographical knowledge on his part), had to make two attempts to see this earth, for on his first visit he discovered that on his short trip ashore from the boat taking him from Alexandria Troas in NW Turkey to Thessalonica, he had landed at the wrong port, on the wrong side of the island, and he had to wait perhaps over twenty years before he could return. Then he was lucky, for he arrived just after the ceremony, and there was available in the right town a large number of these Lemnian seals. Never one to miss an opportunity for bulk buying, Galen took away with him to Asia some 20 000 seals, which he employed with success as agglutinants for wounds and as emetics against suspected poisoning by cantharides.

But this story of Galen’s triumph over misfortune can tell us more about the drug trade. First, if all the earth dug up filled only one wagon, then the total number of seals produced in any year was limited (assuming that this religious rite was performed only once a year, as in its later Christian transformation) and genuine seals were not always easy to find. Galen seems to imply that his use of them only dated from his visit to Lemnos and that, before then, his acquaintance with the drug was somewhat remote. Secondly, I know of no other ‘advertizing’ mark on ancient drugs, no stamp of authenticity, and the image of Diana is more likely to have had a religious rather than a commercial significance. Thirdly, the image itself was well known, at least by repute, and could equally be counterfeited. And, finally, Galen records that, although he thinks very highly of this earth, almost as good results could be obtained by peasants in Alexandria and Egypt using local mud-plasters.

Eighteenth-century portrait of Galen by Georg Paul Busch. / Image via Wikimedia Commons

This summary of the drug trade of antiquity is indeed a sad one, in which fraud, incompetence, and ignorance vie for attention with the exotics of India and Arabia. If leading modern botanists can still argue over the identifications of ancient plants, we can hardly believe that the humble physician of Roman Londinium knew his Spanish pellitory from his Dalmatian pyrethrum, let alone the genuine bdellium. We have already seen Dioscorides’ problems with nard, and another ‘new’ plant led one of his predecessors, Niger, into great confusion. He thought that aloe was actually mined, presumably because he had only seen its black, sun-dried leaves. And who, one might ask, could distinguish, in the manner prescribed by handbooks, between the dung of swallows, sparrows and doves?

Not surprisingly, all medical writers advocated that the doctor should know the ingredients of his own drugs: he should compound his drugs himself, and endeavour to get his own stocks of valuable, proven remedies. Some lay nearer to hand than might be suspected. Galen castigated the Rome drug-sellers for their failure to know the plants growing in the woods and fields outside the city gate (XIV.30), and it was a commonplace in drug books that nature often provides inexpensive substitute drugs to those who know where and what to seek. But gaining this knowledge, or adequate supplies, was by no means easy. Galen paid large sums of money to backwoods healers for information on their wonder-drugs; he travelled in Egypt, Palestine, Lycia and the Aegean in search of rare minerals; he bargained with a camel driver for his load of rare medicaments; he went down a mine in Cyprus to collect various copper-oxides. But Galen was a wealthy man – as his opponents rightly objected – with friends in the right places, from the emperor and the chief inspector of Cypriot mines downwards. The small town doctor had fewer advantages, and he and his patients had to put their trust in the skill (and morality) of whatever pigmentarius, unguentarius or pharmacopola they could find. No wonder, then, that a popular preacher could recommend dispensing with the services of even the most highly qualified doctor and trusting entirely to a reliable drug-seller, for all was in vain if the wrong medicaments were given.

The latest study of Galen’s pharmacology, by Caius Fabricius (1972), gives the impression that this prescription of the good life, by Teles the Cynic, could be very easily fulfilled, for the list of writers on pharmacology cited by Galen is high in quantity and in quality. These were learned men, distinguished in their generations. But what this paper has tried to show is that this universe of competent, qualified, moral, professional pharmacologists and druggists is, as Fridolf Kudlien (1983) puts it, a merely hypothetical possibility. Historians of medicine and pharmacy should lower their sights and consider what was the more complex, varied and sordid reality of the drug trade of antiquity. As a final illustration of this, I offer a litany of the names of some authors or providers of drugs listed by Galen, men (and a woman) of all classes and religions, who secured a sort of immortality by their invention of a healing remedy: Achillas the eye-coucher; Antonius the drugdealer; Apollonius the pharmacist; Aquillia Secundilla and her recipe against lumbago; Axius, doctor in the British fleet, with his eye ointment; Celer the centurion; Cletius Abascantus of Lyons; Diogas the trainer; Euschemus the eunuch; Flavius the boxer; Orion the groom; Pharnaces the Persian rootcutter; Philoxenus the schoolmaster; Protas of Egyptian Pelusium; Publius of Pozzuoli; and Simmias the crowd-puller.

That is the ancient drug trade in kaleidoscope.

References

  • Fabricius C (1972) Galens Exzerpte aus alteren Pharmakologen. De Gruyter, Berlin
  • Gallen. References in the text are to the ‘Opera Omnia‘ by volume and page in the edition of C G Kuhn (Leipzig, 1821-33), or to the CMG edition (Berlin 1909-
  • Kudlien F (1983) Gesnerus 40, 91-98
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Originally published by the Journal of the Royal Society of Medicine 78 (February 1985, 138-145), republished by SAGE journals under a Creative Commons license.

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