Galen, On Simple Drugs
First of all, it is helpful to identify the boundaries that Galen explicitly draws in his medical practice. He is by no means the only physician to express disgust at certain remedies, and it may be worth asking to what extent such statements by physicians are merely rhetorical (see Santini-Scivoletto-Zurli 1990–98).
Two statements in Galen’s vast treatise On Simple Drugs (XI.379–XII.377 Kühn) are of particular interest: they appear in prefatory chapters or prologues at the beginning of book VI (introducing the section from book VI to VIII on plants) and book X (introducing the section on animal products, in the final two books the treatise). Book IX on stones, earth and mineral products is sandwiched between these two sections. It is worth noting that Galen wrote books IX–XI later in life than the rest of the work: he wrote books I–VIII before the death of Marcus Aurelius in 180 and books IX–XI after the great fire of 192, perhaps even after 193, under Severus. Much happened during this 15-year timespan. In 193, Galen was in his late sixties and was beginning to show signs of concern about the number of years he had left to complete his pharmacological oeuvre: indeed, two major works follow up his eleven books on simple drugs, namely, Compound Remedies according to Places and Compound Remedies according to Kinds. Both were written after 193, although the first two books of the latter work were written before the fire of 192 and were subsequently rewritten following their destruction in the event. Altogether, Galen’s three major contributions to pharmacology amount to just under three thousand pages in the standard edition (Kühn, vols. XI–XII–XIII). To these we must add the treatise On Antidotes, written in the same period.
Galen’s text is not without its problems; his argument is not straightforward, partly because of a pair of hapax legomena, namely ὀφιονικοῖς and κογχακόχλοις. The second term corresponds to a reading in a key manuscript (Urbinas gr. 67) and apparently is supported by the Latin and Syriac tradition; it contrasts sharply with the name of an obscure author, Conchlas or Conchlax, read by Renaissance scholars on the basis of some manuscripts and still found in Kühn (in fact, a vox nihili). What the manuscripts make clear here, however, is that Galen is describing imaginary substances, akin to the “eagle” mentioned earlier in the text. Are these alchemical remedies? Plants or animals? In any case, the alchemical tradition preserves evidence of such ambiguous, polyvalent names (a plant or a stone bearing the name of an animal and linked to a deity and/or a planet, then ascribed healing powers).
Galen addresses several problematic areas of ancient pharmacology. First and foremost, he is concerned with Dreckapotheke, the “dirty remedies” exemplified by the works of Xenocrates of Aphrodisias, a physician who lived in his grandfather’s lifetime, in the latter half of the 1st century AD. The remedies that Galen lists here as inappropriate (Galen says “perverted,” aselgē, a term with strong moral connotations) consist of several different kinds – one problem arises from consuming human flesh, blood and other body parts, another from ingesting or touching human bodily fluids and excrements. Clearly, cannibalism may have been taboo in Galen’s world. I have not found any evidence that the consumption of human flesh and blood was prohibited under the Roman Empire, but magical practices may be the underlying issue here: people who practiced black magic used human body parts and blood, usually snatched from corpses but sometimes even taken from living people (as part of underground human sacrifices). The lex Cornelia de sicariis et veneficis (81 BC) was intended to suppress such dangerous practices, although it also helped convict innocent people of black magic and divination (see Graf 1997). There are, however, some hints of the disgust that cannibalism evoked. A great declamation by Pseudo-Quintilian on ‘a city that feasted on its own dead’ demonstrates Roman revulsion toward cannibalistic practices (see Stramaglia 2002). On anthropophagy in ancient Rome, see Vandenberg 2014; Nagy 2000; id., 2009. On the persistence of cannibalism in a therapeutic context beyond Antiquity, see for example Noble 2011 (introduction: “The pharmacological corpse”); Sugg 2012 (see esp. chapter 1 on ancient and medieval evidence, with further literature).
Here he merely refers to Roman law and not to any such taboo; in fact, it would be fair to say that cannibalistic practices, though controversial among ancient physicians, were part of the landscape. Other ancient physicians who express disgust at the use of human blood in therapeutics include:
Celsus De medicina III.23,7 (I.338–339 Spencer), Caelius Aurelianus (Chron. I.118–120 and 130). Also, see Tertullian, Apol., IX.10. The horror may arise from the practice of drinking directly from a gladiator’s wound – thus applying lips to impure substances. Pliny the Elder’s discussion of human remedies (XXVIII.4–9) also expresses disgust, but he attributes the invention of such medical practices to Persian magus Ostanes, and their popularisation in the Roman world to Greek physicians
The consumption of human body parts and blood played a part in well-known therapies; for example, for epileptics. Alexander of Tralles discusses gladiator’s blood as a remedy for epileptics (I.565), a remedy previously mentioned by Celsus (III.3,7, cited above), Scribonius Largus (Compositiones 17, ed. Sconocchia), Pliny the Elder (Hist. nat. XXVIII.4–5), Aretaeus of Cappadocia (Chron. VII.4,7–8) and the anonymous Medicina Plinii (III.21). Caelius Aurelianus (cited note 14) also mentions this treatment with horror. These texts prescribe the use of human blood in various ways: directly from a wound, through an impregnated piece of cloth, from a gladiator’s wound or from that of an executed criminal and so on. On the history and origins of such magic-infused therapies, see Moog & Karenberg 2003, 137–143. I disagree with the authors’ suggestion that this practice probably did not exist in Greece. In addition to Aretaeus (whom they themselves mention), Galen here provides evidence about the use of many human body parts, including blood and the liver, in Xenocrates’ work.
We can reasonably infer that drinking human blood for epileptics was the kind of remedy mentioned in Xenocrates’ account, evoking horror from such readers as Galen. What is more “perverted” in Galen’s opinion is the impurity of the “disgusting” fluids and excrements that Xenocrates prescribes, either in the form of cataplasm or for ingestion. Galen even sarcastically describes the desperate state one would have to be in to use semen (not just male semen, but the semen that refluxes out of the vagina after intercourse) as a therapeutic remedy against chilblains (a condition for which many simple remedies exist). Indeed, it sounds as if anything is better than that. But this remedy was indisputably euporiston, easy to find and free: it must have had its appeal, just like urine used to help relieve insect bites. Eating faeces is the worst part for Galen. In an intriguing hierarchy of shame, Galen regards coprophagy as worse than sexual perversion, especially oral sex, and, among oral sex practices, cunnilingus: that is the closest thing, he says, to ingesting menstrual blood. It is thought that a religious notion of pollution accounts for revulsion at such banal (for us) sexual practices (See Parker 1983, 99 (oral sex); and about the pollution of menses in particular, pp. 100–103).
Galen Against Galen?
Apparently Galen contradicts himself a lot:
Amulets (περίαπτα)
See Galen, On Simple Drugs, XI.813,5; 842,1; 852,5; 859,11–14; 860,13; XII.207,4 and 14; 208,3; 295,13; 296,9; 297,4–5 K. Galen praises some amulets, here’s an example of an epileptic child who suffered seizures as soon as he let go of the amulet (Galen, On Simple Drugs X.10 (= XI.859–860 K.). In ancient times, children were a distinct category of patients insofar as many ailments that affected them were difficult to cure – in fact, magical remedies are recorded more often for children than for adults. It thus is not entirely surprising to read that Galen believes in the efficacy of this amulet. More importantly, Galen sets the entire story in a rationalising framework about the properties of drugs; after this brief story, he goes on to explain that the properties of drugs worn as amulets are somehow carried through the air and enter the body through respiration, which explains the efficacy of magical amulets hanging from a patient’s neck. Galen uses three examples, the juice of Cyrene (silphium), nigella seeds (melanthion), and amulets made from suffocated vipers, all of which have a heating and drying effect on account of their proximity to the chest and inhalation. Galen cuts this account short, saying he will say more later. But we should bear in mind that Galen is not giving in to iatromagic, but rather is rationalising the power of iatromagical remedies. As we will see below, this is a recurrent feature of Galen’s pharmacological discourse.
Making the Disgusting Acceptable
At On Simple Drugs, X.1, Galen voices his anger and disgust at the use of faeces in medicine, because (we may suspect) of its polluting nature. Galen in fact carefully qualifies the use of dung. One of the main reasons why dung is disgusting is because it stinks (4 Galen, On Simple Drugs, X.18). By drying it out and removing the smell, however, or by using naturally odourless dung (from animals such as doves or from children fed certain foods), then it becomes possible to use dung for the greatest benefit to the patient. Galen says that dung sometimes works best when worn as an amulet. Indeed, Dioscorides had also dedicated a chapter to the great powers of dung (Dioscorides, Mat. med. II.80). Galen’s stories give evidence of practical uses of dung, such as the case of a Roman aristocrat who begged him to cure her from spitting blood (Galen, Meth. med. V.13). After shaving her head, Galen spread a paste based on pigeon dung over her head for several days; this was followed by a drastic drying and heating treatment. Eventually the woman regained her health. The great value of pigeon dung is laid out in full at On Simple Drugs X.25 (= XII.302–303 K.): it is naturally odourless and has wonderful heating and drying properties. Thus Galen does not hesitate to using faeces and urine – but he frames his practice with clear qualifications. More over, Galen does not reject ingesting feces (Galen, On Simple Drugs, X.18)!
