PHARMACOLOGY

Ingredients, Recipes, and Guides

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Pharmacology was a cornerstone of medicine in the ancient world and an area of particular interest for Galen. It had been a part of his training in Pergamon from the very beginning. As a young student there, in addition to studying drugs with his physician-teachers, Galen also undertook a separate and expensive training with an unnamed expert—possibly a pharmacological counterfeiter—to learn how to prepare substitutes for exotic medications, “so that what I prepared was indistinguishable from the genuine item.” Over the course of his career, Galen collected and annotated recipes for compounding drugs and wrote voluminously on pharmacological theory. Although Galen lamented the loss of his most treasured drug compendia in the Great Fire of Rome, seventeen volumes of his work on pharmacology have come down through time. These texts are organized by type of drug (simple or compound), type of treatment (plasters, laxatives, etc.), or by the body part to be treated (from the head down). Galen’s commentaries reflect his clinical experience as well as the experience of others:

“I gave some of my writings also to my friends, when they asked for drugs like these; the drugs, tested by these very people, seem to have lived up to their promise.”

Physician preparing an elixir. From Dioscorides (1st century CE), De Materia Medica (Iraq or Northern Jazira, possibly Baghdad, 1224 CE). Metropolitan Museum of Art: Rogers Fund, 1913; 13.152.6. Photo: Metropolitan Museum of Art. Public domain.

Galen’s pharmacopeia (a written list of medications and their effects) was not the first of the ancient world: he built on a long-established tradition. Pliny the Elder (23 or 24–79 CE), writing in his Natural History, describes an herbal containing plant paintings along with descriptions of their medical properties from an earlier doctor and pharmacologist, Crateuas (who wrote in the first century BCE). Court physician to the emperor Claudius, Scribonius Largus (ca. 1–ca. 50 CE), also wrote a list of 271 prescriptions in the early first century CE. The most important herbal from antiquity, the five-volume De Materia Medica, was written by the physician and pharmacologist Pedanius Dioscorides (ca. 40 CE–ca. 90 CE).

Text describing the uses of medicinal plants with an illustration of European bramble. From Dioscorides (1st century CE), De materia medica (Vienna Dioscorides; Byzantine, ca. 515 CE), fol. 83r. Österreichische Nationalbibliothek: Codex Vindobonensis Med. gr. 1. Photo: © ÖNB Vienna.

Dioscorides is remembered as the central figure in the history of Roman pharmacology for attempting to write the most comprehensive compilation of medicinal substances ever assembled. He built on the work of earlier writers like Crateuas, but, instead of simply replicating earlier herbals, he sought to verify the findings of his predecessors and colleagues, both personally and through interviews. His was not a handbook of remedies for specific problems (as one finds in the writings of Scribonius Largus, for example), but an attempt to document the intrinsic medicinal properties of plants, animals, and minerals. He was exacting: even within these broad categories of substances, Dioscorides subdivides his organization of plants into roots, pot herbs, fruit, trees, and shrubs. De Materia Medica presents these active ingredients according to their effects on the body, and while comprehensive, its structure is a bit unwieldy from a practical standpoint. Later editions were sometimes rewritten with lists of substances arranged in alphabetical order to facilitate ease of reference. Galen noted that the original structure of the text was difficult to follow and, in some ways, unhelpful to a Hippocratic doctor, yet he praised Dioscorides’s accomplishment and precision—a feature of his work that continues to be celebrated by scholars today. 

Not only did Galen study the pharmacological writings of his predecessors and collect drug recipes and stories of their efficacy, he also gathered ingredients for the compounds themselves. He traveled extensively around the Mediterranean to assemble “a large enough quantity of [rare] drugs for my whole life.” Doctors often carried common treatments, and a wide variety of medications were easily available in urban centers, even if the ingredients were exotic.

Pill container and medication for the eye from a physician’s tomb. Roman, 1st century CE. Bronze and unknown substance. Tomb of the Physician, Este, Italy. Museo Nazionale Atestino di Este. Photo: Guido Petruccioli. © Institute for the Study of the Ancient World.

But when traveling around the countryside, where the supply chain was less robust, Galen took pride in prescribing what was readily available and notes that one can recognize a good doctor by the ability to do this. In one story, he recommended a patient urinate on his wounds, and, although Galen found it disgusting and would not prescribe such a treatment to one of his “urban and famous” patients, he knew it to be an effective remedy. (Today we understand that healthy human urine has antimicrobial properties, hence its effectiveness.)