Perspectives
The theriac in antiquity
Article Info
In
Greek mythology, Panacea, the goddess of healing, was said to have a
potion that healed every sickness. The search for the cure-all remedy
would continue throughout antiquity as physicians and healers tried out
various cures in the regular care of their patients, especially in
desperate situations. In the ancient world, poisonings were fairly
common and the pursuit of a compound that was capable of protecting a
person against any kind of toxin led to the popularity of what was
thought to be a universal antidote: the theriac.
The name theriac comes from the Greek term theria,
which refers to wild beasts, and it was given to a preparation that
served initially as an antidote and later as an all-purpose cure for a
range of illnesses. According to Pliny the Elder (23–79 AD) and Galen of
Pergamum (131–c.201 AD), one of the earliest formulations for a
theriac against the bites of venomous animals was inscribed on a stone
in the Temple of Asclepios on the island of Kos; it contained thyme,
opoponax (sweet myrrh), aniseed, fennel, and parsley. Another early
reference to theriacs can be found in the didactic poems Theriaca et Alexipharmaca,
from the second century BC, by the Greek grammatician, poet, and
physician Nicander of Colophon who described a variety of poisons from
animal bites and their antidotes.
The
idea of a theriac seems to have gained greater prominence during the
reign of Mithridates VI (132–63 BC), King of Pontus in Asia Minor.
Mithridates VI lived in a constant fear of being poisoned and not only
tested poisonous substances on criminals and slaves but also regularly
ingested poisons and their antidotes himself. His personal physician
Crateuas concocted an antidote known as Mithridatum, which contained
about 40 ingredients and was thought to protect against venom from
scorpions, vipers, sea-slugs, as well as other toxins. Mithridates
appears to have become so accustomed to various poisons that, when he
was captured by Pompey, he attempted suicide by self-poisoning. Yet as
Dio Cassius wrote “the poison, although deadly, did not prevail over
him, since he had inured his constitution to it, taking precautionary
antidotes in large doses every day”. Some histories describe that having
failed in this attempt, Mithridates ordered one of his soldiers to kill
him with a sword. Among the papers of the defeated king, Pompey found
the formula for Mithridatum and translated it into Latin.
Different
kinds of theriacs were subsequently produced in antiquity but the most
celebrated was perhaps that invented by Andromachus, physician to the
Roman Emperor Nero, in the first century AD. Andromachus came from the
island of Crete where “botanical men” in the service of the Emperor
collected herbs and placed them in knitted vases, which were sent not
only to Rome but also to other nations. Andromachus’ vast knowledge of
botany helped him “to provide the mankind with the necessary medicines”.
He claimed that his formula for his Galeni Theriaca (tranquillity
theriac) was an improvement on that of Mithridates because it contained
some 64 ingredients and was enriched with the flesh of viper and a much
greater quantity of opium. According to Andromachus, his theriac could
be used not just for poisonous animal bites, but also for such illnesses
as asthma, colic, dropsy, inflammation, and even the plague. Indeed,
the success of Andromachus’ theriac raised him to the dignity of
Archiatrus (chief-physician) and the preparation enjoyed a great
reputation for centuries.
In the next century, the Greek
physician Galen formulated a theriac that would, he intended, eclipse
all others in its popularity. Moreover, he experimented with his
theriac, intent on proving its therapeutic effect. Galen was a leading
figure of medicine in the Roman era. He wrote a great number of
treatises on medical and philosophical subjects and his doctrines
dominated medical thought until the 16th century. Born in Pergamum, part
of Asia Minor, Galen's father Nicon, a wealthy architect, oversaw his
education. Initially, Galen studied medicine in his home city, then in
Corinth, and finally in Alexandria. Returning to Pergamum, he was
appointed as a city physician to the School of Gladiators but gained
such a reputation that he soon became the court physician of the Roman
Emperors Marcus Aurelius and Lucius Verus. Following Hippocrates’
humoural theory, Galen believed that the four humours of the body
(phlegm, blood, black bile, and yellow bile) were responsible for health
or illness. Going further, he classified all personalities into four
types: phlegmatic, sanguine, choleric, and melancholic. Imbalances in
these humours would lead to the disease and could be corrected by adding
herbal extracts of similar origin but also other extracts with opposite
properties. Galen also believed more than one medicine should be
administered to have a therapeutical effect, and favoured mixing several
agents to optimise their absorption.
In the royal court, Galen prepared his theriac and wrote about various theriac compounds in his books De Antidotis I, De Antidotis II, and De Theriaca ad Pisonem.
The basic formula consisted of viper's flesh, opium, honey, wine,
cinnamon, and then more than 70 ingredients. The final product was
supposed to mature for years and was administrated orally as a potion or
topically in plasters. Galen claimed that his theriac drew out poisons
like a cupping glass and could divide the tissue of an abscess more
quickly than a scalpel. The preparation was taken daily by the Emperor
Marcus Aurelius to protect against poisons and to aid in ensuring good
general health.
But Galen did not just administer his theriac, he also experimented with it on animals. In De Theriaca ad Pisonem
he describes how he took roosters and divided them into two groups: in
one group he gave the theriac and in the other group he did not. Then he
brought both groups into contact with snakes; Galen observed that the
roosters who had not been given the theriac died immediately after being
bitten, whereas those who had been given the theriac survived.
Moreover, he points out that this experiment could be used in cases
where someone wants to make sure whether a theriac is in its natural
form or has been adulterated. Alongside this work, Galen wrote about the
effect of his theriac on individual patients. In one passage in De Theriaca ad Pisonem, his gives an illuminating account of using his theriac to treat jaundice caused by snake bite.
One
of the slaves of the Emperor whose duty it was to drive away snakes,
having been bitten, took for some time draughts of ordinary medicines,
but as his skin changed so as to assume the colour of a leek, he came to
me and narrated his accident; after having drunk theriac he recovered
quickly his natural colour. Physicians seek to find out if there are
signs peculiar to poisoning, because they often see, without the
administration of any deadly poison, that the body presents a corruption
of the humours similar to that which is produced by poisons; it is not
at all surprising, therefore, that there sometimes supervenes a change
in the humours, so that the whole body is affected with jaundice.
Galen
called his preparation Theriac of Andromachus and for as long as
Galenic medicine held sway, so did the appeal of the theriac—not just as
an antidote for snake bites but eventually as a universal cure-all.
Stored in ornate porcelain jars, often illustrated with scenes from the
life of Mithridates, it survived into medieval Europe in the trade that
developed in theriacs, most notably in Italy, where theriacs became
known as the Venice Treacle, an official preparation that carried the
republic's seal. Its legacy is even apparent in French and German
pharmacopoeias of the 19th century. Whether as a universal panacea or
just an addictive preparation thanks to opium, the theriac's influence
extended far beyond its origins in antiquity.
Further reading
Galen, 1965Galen. De Theriaca ad Pisonem. in: Kühn CG
(Ed.)
Opera omnia. Olms,
Hildesheim; 1965
Mattern, 2008Mattern, SP. Galen and the rhetoric of healing. Johns Hopkins University Press,
Baltimore; 2008
Porter and Teish, 1995Porter, R and Teish, M. Drugs and narcotics in history. Cambridge University Press,
Cambridge; 1995
Thompson, 1929Thompson, CJS. The mystery and art of the apothecary. John Lane/The Bodley Head,
London; 1929
Watson, 1966Watson, G. Theriac and Mithridatum: a study in therapeutics. Wellcome Historical Medical Library,
London; 1966
