Part 4

Take of the red and odorous hairs of the young lad whose blood is shed on the fields of Mercury (saffron), as many drachms as we have senses; of the Nauplium Euboic (pyrethrum), 1 drachm; the same quantity of the murderer of the son of Menetius, preserved in sheeps’ bellies (euphorbium); add 20 drachms of white fire (white pepper); the same quantity of the beans of the pigs of Arcadia (henbane); one drachm of the plant which is falsely called a root, and which comes from a country renowned because of Jupiter Pissean (spikenard); write pium, and place at the head of the word the masculine article of the Greeks (opium) 10 drachms; and mix the whole with the work of the daughters of the bull of Athens (Attic honey).

The words in parentheses are the explanations of this rather unwieldy joke as they are provided by Galen. It is conjectured from an obscure passage in Pliny that this antidote was prescribed against a peculiar form of colic which became epidemic at Rome about the time when Philon was practising there.

Philonium was the original of the confection of opium which remained in our pharmacopœias until 1867. In the first London Pharmacopœia the formula was more similar to that which Galen gives; later, a modification by Nicolas Myrepsus was adopted, the most important change being the omission of the euphorbium. Until 1746 it was called Philonium Romanum. In the P.L. 1746, the ingredients were white pepper, ginger, caraway seeds, strained opium, and syrup of poppies (or of meconium, as it was called). This had been substituted for honey in all the English formulas. The name was also changed in 1746 to Philonium Londinense. The proportion of opium in Philonium was 1 grain in 36 grains.

DIASCORDIUM,

the last of the four officinal capitals, was a medicinal compilation by Hieronymus Frascatorius, and is given in his book “De Contagio et Morbis Contagiosis.” It was devised as a preventive of plague, but it acquired such popularity that Dr. James in the introduction to his Dispensatory (1747) writing of the conventional esteem in which so many compounds are held, says, “Thus the Venice Treacle invented by Andromachus under the reign of Nero, and the Diascordium of Frascatorius, have been used by almost every physician who has practised since their publication.” The original formula, which was adopted in its integrity in the first P.L., was as follows:--

Cinnamon, Cassia wood, aa ½ oz.; true scordium (water germander) 1 oz.; Cretan dittany, bistort galbanum, gum Arabic, aa ½ oz.; storax, 4½ drachms; opium, seeds of sorrel, aa 1½ drachm; gentian, ½ oz.; Armenian bole, 1½ oz.; sealed earth (Lemnian), ½ oz.; long pepper, ginger, aa 2 drachms; clarified honey, 2½ lb.; generous canary, 8 oz. Make into an electuary, S.A.

In the eighteenth century this compound became a popular household opiate, and was frequently given to children for soothing purposes, especially as the Pharmacopœia had substituted syrup of meconium (poppies) for the honey. As the preparation was rather a strong astringent it was doubly harmful as a frequently taken remedy. In the P.L. 1746 two species of diascordium were prescribed, one with and one without opium; at the same time a “pulvis e bolo compositus” was introduced in which the scordium, the dittany, the sorrel seeds, the storax, the sealed earth, the bistort, and the galbanum, as well as the wine, were omitted. Edinburgh likewise omitted the scordium and other ingredients, and made the preparation still more astringent by the addition of catechu and kino. This was called Confectio Japonica. The mangled remains of the various formulas are represented in the British Pharmacopœia by Pulvis Catechu Compositus.

THERIACA.

Theriaca was invented by Nero’s physician, Andromachus, and was devised as an improvement on Mithridatium which until then was the great antidote in Roman pharmacy. The most important addition which appeared in the new formula was the introduction of vipers. Andromachus named his electuary “Galene,” which meant tranquil, probably to suggest that it was a soothing, anodyne medicine. It soon, however, acquired its permanent name, for it is referred to as Theriaca by Pliny, who would have been a contemporary with Andromachus. Pliny, it may be remarked, was rather contemptuous of the polypharmaceutic compounds which were then becoming so popular. They were devised, he says, “ad ostentationem artis;” just to “show off,” as we should say.

Andromachus (or it may have been his son, a physician of the same name) wrote his formula, and described the virtues of his compound in Greek elegiac verses which he dedicated to Nero, and which Galen has preserved. The object of giving the formula in verse was that it should be less easy to modify it. The enumeration of the medicinal properties of the antidote left very little room for any other remedy. First it would counteract all poisons and bites of venomous animals. Besides, it would relieve all pains, weaknesses of the stomach, asthma, difficulty of breathing, phthisis, colic, jaundice, dropsy, weakness of sight, inflammation of the bladder and of the kidneys, and plague.

Galen, after describing its alexipharmic properties, states that he tested it by causing a number of fowls to be dosed with it. To these he brought others to which no theriaca had been given. The poison was administered to all. The fowls to which the theriaca had been given all survived, and all the others died. Galen’s encomiums on this compound were no doubt largely responsible for the marvellous reputation it enjoyed all through the centuries in which his authority was accepted. He declares that it resists poison and venomous bites, cures inveterate headache, vertigo, deafness, epilepsy, apoplexy, dimness of sight, loss of voice, asthma, coughs of all kinds, spitting of blood, tightness of the breath, colic, the iliac passion, jaundice, hardness of the spleen, stone, urinary complaints, fevers, dropsies, leprosies, the troubles to which women are subject, melancholy, and all pestilences.

Down to the seventeenth century these virtues were almost universally accepted, and many were the learned treatises written to explain its action; how one drug toned down the effect of others, and how the whole formed a sort of harmony in medicine. At the same time most of the old masters in pharmacy fancied they could suggest some improvement, and the original formula was modified in scores of ways.

In addition there arose new electuaries, modelled more or less closely on theriaca, but perhaps devised for some special complaints, and bearing the names of their authors. Many of these also attained to considerable fame.

For some centuries the theriaca made in turn at Constantinople, Cairo, Genoa, and Venice was in such reputation that customers would have it so branded. Ultimately the last-named city secured almost the monopoly of the manufacture. A reference to its production there occurs in Evelyn’s Diary, dated March 23, 1646. Evelyn writes: “Having packed up my purchases of books, pictures, casts, treacle, &c. (the making and extraordinary ceremony whereof I had been curious to observe, for it is extremely pompous and worth seeing), I departed from Venice.”

In the reign of Queen Elizabeth English apothecaries began to claim that they could make the confection as well as their Italian contemporaries. Some curious documents illustrating their confidence were given in an interesting research by Mr. W. G. Piper, published in _The Chemist and Druggist_, March 15, 1880. He quotes from William Turner, “the learned divine, daring Protestant, and first English botanist,” the title of a work on the virtues and properties of the great Triacle (published in 1568 but not now known), and also a few paragraphs from a later volume on the same subject in which, after describing the method of making the remedy, he says: “Wherefore if there be any Apothecaries in London that dare take in hande to make these noble compositions they may know where to haue them.” It appears that Hugh Morgan, the Queen’s apothecary, accepted the challenge, for in a pamphlet by him (1585) he insists that his product has been compared with other “theriacle” brought from Constantinople and Venice, and has been better commended. “It is very lamentable to consider,” he writes, “that straungers doe dayly send into England a false and naughty kinde of Mithridatium and Threacle in great barrelles more than a thousand weight in a year, and vtter ye same at a lowe price for 3d. and 4d. a pound, to ye great hurt of Her Maiesties subjects and no small game to straungers purses.”

Mr. Piper also quoted at length from another pamphlet published in 1612 by R. Band (in a subsequent edition, R. Browne), who relates how the Master and Wardens of the Grocers’ Company, having marked that “a filthy and unwholesome baggage composition” was being brought into this Realm as Tryacle of Genoa, “made only of the rotten garble and refuse outcast of all kinds of spices and drugs, hand over head with a little filthy molasses and tarre to worke it up withal,” communicated with the College of Physicians, and induced them to prescribe the proper formula and to superintend the manufacture, which was then entrusted to Mr. William Besse, apothecary in the Poultry. Mr. Besse had to take “a corporall oath” before the Lord Mayor, and every year when he made the confection had to show the ingredients and the product to the College of Physicians. His triacle was sold at not above 2_s._ 8_d._ per lb. or 2_d._ per ounce. It appears from the same pamphlet that nothing was alleged against Venice Treacle except its “excessive dearness.”

Prosper Alpinus, a Paduan physician, wrote an account of his three years’ residence at Cairo (“De Medicina Ægyptorum”) in 1591, and has much to say of the manufacture of Theriaca in that city. It was only allowed to be made in public, and the ceremony was performed once a year in the month of May in the Mosque of Morestan by the chief pharmacist of the city in the presence of all the physicians. The operator would give no information to Albinus, a Christian, about the composition; but he got what he wanted from a famous herbalist who collected all the materials for the compound. Albinus states that at that time Italians, Germans, Poles, Flemings, Englishmen, and Frenchmen came to Cairo to purchase this true Theriaca.

Theriaca (Tyriaca, as he calls it), was among the drugs recommended to Alfred the Great by Helias, the Patriarch of Jerusalem. The manuscript is quoted in “Anglo-Saxon Leechdoms” by the Rev. Oswald Cockayne. (See Vol. I, p. 124, 131.)

Many allusions in old records show how highly the confection was esteemed by those who could afford to take it. According to Buckle (“Miscell. Works,” Vol. II, p. 303) it is first mentioned in English literature by Foucher de Chartres (1124). He had come to know of it in the first crusade. A “Pixis argenti ad Tyriacum” is named in the Close Roll of King John, 1208; in the old romance of Sir Tristrem (about 1250) a man is slain by a dragon; and “His mouth opened thai And pelt treacle in that man”; the “triacle box du pere apelle une Hakette garniz d’or” is mentioned among the precious effects of Henry V; in the Paston letters written in the reign of Edward IV we find allusions to “treacle pottes of Geane (Genoa) as my potecarie swerytht on to me, and moerovyr that they were never undoo syns that they came from Geane.”

In early English books treacle was a term used metaphorically for the divinest blessings. Nothing could better prove the high appreciation in which it was held. Piers Ploughman (about 1370) writes, “Treuthe telleth that love ys tryacle for synne”; Chaucer (1340–1400) has “Crist, which is to every harm triacle”; in Coverdale’s Bible (1535) the sentence in Jeremiah viii, 22 is rendered “Is there no triacle in Gilead?”; Sir Thomas More (1573) writes of “laying up a store of cumfort in your hart as a triacle against the poyson of desperate dread”; and later Milton speaks of “the treacle of sound doctrine”; Jeremy Taylor says, “We kill the Viper and make treacle of him; that is, we not only escape from but get advantage by temptations.”

Laurens Catelan, Master Apothecary of Montpellier, and Apothecary in Ordinary to Monseigneur the Prince de Condé, has left a full report of his discourse on the occasion of his dispensing a batch of Theriaca at Montpellier on September 23, 1628. It is a most interesting lecture, full of curious old facts chiefly about poisonings, and inspired with an unshakable faith in the importance of the operation in which he was engaged. The exordium is explanatory of the ceremony:

“The regulations and statutes under which we live in this city,” says Master Catelan, “require that whenever we prepare either Theriaca, Mithridatium, Confection of Hyacinth, or Confection Alkermes, the compounding shall be done in public, and in the presence of the very illustrious professors of this famous University of Medicine, so that they may have the opportunity of censuring or approving the ingredients, and the public may therefore be assured of the fidelity of these important medicines.

“This is why I have here spread out before you all these drugs which are used in the composition of the great and famous Theriaca.

“But as I am honoured with the attendance of such an august assembly, I ought not, I think, to omit to lay before you some of the singularities associated with the history and composition of this remedy, and I will divide what I have to say on these subjects into three sections, namely--

“(1) The discoverer of this compound; (2) the purpose of the invention; and (3) the reasons why these drugs and no others of the multitude known to us have been chosen for this purpose.”

The lecturer then entered upon a history of Mithridates and his wonderful immunity against poisons; of his defeat by Pompey, of the recovery of his formula, of the additions made to it a hundred years later by Andromachus, and of the preservation of directions for making it which Galen wrote some fifty years after Andromachus had completed his invention.

At this point the book tells us there was an interval, and some music was performed. When the lecturer resumed he proceeded to tell of the risks which princes and nobles ran of being poisoned in those old times, and of the precautions taken against such crimes. Of the rings and amulets they wore, of the tasters they employed, and of the treatment such as Mithridates went through of accustoming his system to poisons to such an extent that they took no effect on him. He quotes in support of the belief in this method of ensuring immunity against poisons two or three stories from the classics which one would have thought would have been too strong even for a professional eulogist of Theriaca.

One case was that of a girl who ate spiders from her childhood, and was so fortified against poisons as not to be afraid to take any of them. A man is alluded to by Galen who would drink a cup of wine in which a live viper had been drowned. We have also the account of a girl whose system had been so saturated with aconite that an Indian king had sent her as a present to Alexander the Great in the hope that he would kiss her, and thus imbibe the poison with which her lips would be charged; but, fortunately, Aristotle saw her first, and recognised by her flaming eyes that she was filled with some sort of poison, and thus the Indian’s purpose was frustrated.

After another interval and some more music, the lecturer came to the third part of his subject, in which he expounded the special virtues of the drugs before him. These were grouped, and it was shown that some were good for the brain, others for the chest, for the stomach, for the kidneys, the heart, and other organs. Others, like the viper’s flesh, were directly sympathetic with poisons, and would go straight for them if they were inside the body, or would lie in wait for them, as it were, if they were only expected. When the subject was exhausted, it was announced that in consequence of the lateness of the hour the weighing of the ingredients would be postponed till the next day. That ceremony was duly performed on the 24th of September, and the drugs were passed on to a “pulveriser.” It was not until the 16th of November that the final mixing was undertaken.

KERMES.

Kermes as a pharmaceutical term reaches us through the Arabic, qirmis, red. But it was not a native Arabic word. It was adopted into that language from the Persian, and was of Sanskrit origin. The word Krimija in Sanskrit meant produced by a worm, and was itself from krimi, a worm; worm is the direct English descendant of krimi. Kermes is responsible in modern English for carmine and crimson, but it need hardly be said that it has no connection with the Flemish kermess though it looks so like it. Kermess is kerkmess, or, in English, church-mass.

The kermes of the Arabs was the kokkos of the Greeks, coccus of the Romans. It was found on a species of oak, now called the Quercus ilex, a low, shrubby, evergreen bush with prickly leaves like the holly. The tree, however, bears acorns. The ancients generally regarded these insects as the fruit of the trees, though they were aware that worms came from them. But these they thought were produced from the corruption of the fruit. The principal use they made of them was in dyeing, and for this purpose they were employed until the superior coccus cacti from Mexico superseded the coccus ilicis. In the middle ages kermes was retained as the medicinal name, but for dyeing the insects were called vermiculi, and the cloth dyed by them was known as vermiculata. From this came the French word vermeil, and from that vermilion was derived.

Medicinally the coccus was principally employed by the Greek and Latin physicians as an application to wounds and for inflamed eyes. It acquired a very high reputation among the Arab doctors as a cordial for internal administration, and the famous Confection of Alkermes, invented by Mesué the younger, who was contemporary with Avicenna, continued in popular favour up to the eighteenth century. Meanwhile, the external application of kermes lingered in the use of scarlet cloth in measles, erysipelas, and other red diseases.

The original Confection of Alkermes contained juice of rennet apples, rose water, silk, kermes, sugar, ambergris, amber, yellow santal, lapis lazuli, pearls, musk, and leaf gold. In the sixteenth and seventeenth centuries this compound was prepared publicly at Montpellier, and was supplied from that city to all Europe. It was described as good for all maladies proceeding from the melancholic humour, faintings, palpitations, heart weakness, and in slow convalescence. It fortified the stomach, rejoiced the heart, and engendered good spirits. The dose was 1 drachm, or it might be applied externally on a piece of scarlet cloth.

MEL ÆGYPTIACUM

is a very ancient compound used chiefly by veterinarians as an escharotic. Its name suggests Egyptian origin, but it has not been traced further back than to the “Grabadin” of John Mesué, the Arabian author, about the year 800. Scribonius Largus before him gives a similar formula under the name of Hygra. Mesué’s formula was to boil 1 oz. of vinegar with 1 oz. of honey to the consistence of honey and to add 2 drachms of verdigris. This formula was modified in various ways in the different pharmacopœias in which it was adopted; alum was added in some cases, cream of tartar in others. The chemical action varied with the process, but generally the result was to reduce a part of the verdigris to an oxide of copper, metallic copper, and a little basic acetate in different proportions. The compound appeared in the London Pharmacopœia of 1721 as Unguentum Ægyptiacum; in that of 1746 as Mel Ægyptiacum; as Oxymel Æruginis in that of 1788; and as Linimentum Æruginis in the P.L. 1851. In this last edition the formula given was to dissolve 1 oz. of verdigris in 7 oz. of vinegar, and boil this with 14 oz. of honey to a proper consistence. It was not adopted in the British Pharmacopœia. In old veterinary recipes it was often combined with tincture of myrrh to form a detergent liniment, and occasionally in a very diluted form was administered internally as a tonic. On the Continent, where its employment lingered longer than in this country, an Egyptiac of Solleysel, from which the vinegar was omitted, but litharge, sulphate of zinc, and arsenic in small proportions added, was frequently preferred to the original.

An Unguentum Ægyptiacum magis compositum, containing rock alum and sal ammoniac, in addition to the other ingredients mentioned, was included in the London Pharmacopœia 1721. In some foreign pharmacopœias camphor was prescribed as an ingredient, and in one old one theriaca is ordered.

TERRA SIGILLATA.

Various earths were celebrated as medicines in old times, that from the Island of Lemnos especially having been esteemed from the days of Herodotus among the Greeks, and this product retained its reputation in Western Europe down to the seventeenth century. It is still used by the Turks and neighbouring nations. The Lemnian earth is a greasy clay which is dug from a desolate hill in the island and consists of silica, alumina, chalk, and magnesia, with a little oxide of iron which gives it a red tint. It acquired the fame of being an antidote to all poisons, and was given in dysenteries, internal ulcers, and hæmorrhages; also in gonorrhœa, and in pestilential fevers. Externally it was applied to festering wounds. The characteristic of the best Lemnian earth was its greasy feel and freedom from grit.

A sufficient supply of this Lemnian earth is still, and has been certainly from the time of Galen, dug out of the hill only on one day of the year, with considerable ceremony and in the presence of the principal inhabitants of the island. At present the ceremony is largely a religious one, and the day fixed for it is the 6th of August, which in the Greek church calendar is the Fête of the Saviour. Formerly the ceremony was originally associated with the worship of Diana, and the date of the performance was the 6th of May. The particular earth may not be dug by any one on any other day of the year except that formally set apart for the operation. According to Dioscorides the earth was made up into a paste in his time with goats’ blood, but when Galen visited the place 150 years later he could find no evidence of this addition.

Lemnian earth was, and I presume still is, a monopoly of the Sultan of Turkey. Most of the produce of the day’s digging was sent to Constantinople and was made up into round tablets of about half an ounce in weight, which were stamped with designs similar to those shown in the accompanying sketches. At one time it is said the figure of Artemis (Diana) or the goat, which was one of her symbols appeared on the tablets, and it may be from this that the story of the goat’s blood originated.