Roman Pharmacopoea

Roman Pharmacopoea

ROMAN PHARMACOPOEA AND MODERN SCIENCES

Octobre 2012                    André J. Fabre            

Despite ever-present legacies from Greek culture, Roman pharmacopoeia spread out during four centuries with its own set of rules and traditions. The huge volume of this Ancient knowledge, its richness and biodiversity are beyond all attempts of analysis. However, in a previous study on Pliny the Elder and his De Naturalis Historiae , we tried to summarize some main features of the Roman pharmacopoeia through a computer analysis of 2141 quotations. Nearly 1700 therapeutic substances could thus be registered (1693, not including  a large choice of magic receipt) :

 •         plants and vegetal drugs : 1391, including 119 quotations of spices and diverse aromatic herbs

•         medications from animal origin : 218

•         mineral medications : 84

 We could also demonstrate in this study that the amazing size of this pharmacopoeia has two main causes : multi-drugs combination (a typical example is given by the "theriac" ) and the wide array of choices proposed at every step of medical decision. Thus, a total of 98 substances (including 52 spices or aromatic herbs) is available in case of snake bites and 66 indications are conferred to a single vegetal drug, the garden rue....

 In final, the "prescription profile" of medicinal spices could be confronted with the data given in a previous study on the pharmacopoeia proposed by of Pliny the Ancient in his De Naturalis Historiae. : the conclusions are summarized in the next figure showing the respective ratio of "prescriptions" in each field of therapeutics   :

 

DE NATURALIS HISTORIAE

MEDICINAL SPICES

symptoms

nb quotations

%

symptoms

nb quotations

%

dermatology  

 708/4448  / 708

15 /

pneumology

268

10

gastro-enterology

690

15

dermatology

257

10

toxicology   

425

9

ophtalmology

212

9

pneumology  

284

6

otorhinolaryngolgie

201

9

gynecology   

281

6

pharmacology

200

 

traumatology 

271

6

toxicology

160

6

nephrology   

265

6

gastro-enterology

138 

5

otorhinolaryngol.

235

5

rhumatology/ost.

131

5

general condition 

233

5

neurology

129

5

ophtalmology  

227

5

nephrology

117

4

rhumatology/ost..

216

5

traumatology

107

4

neurology   

183

4

gastro-enterology

107

4

stomatology  

137

3

abdominal pain

95

3.6

urology

90

2

hepatology

81

3.1

tumours

65

1.4

stomatology

69

2.6

psychiatry

62

1.4

general condition

65

2

parasitology

59

1.3

gynecology.

65

2

paediatrics

19

0.04

urology

54

2

cardiology 

18

0.04

tumour

41

1.5

hepatology

30

0.06

splenomegalies

33

 

 

 

 

obstetrics

27

 

 

 

 

psychiatry

22

 

 

 

 

parasitology

15

 

 

 

 

paediatrics

14

 

 

 

 

cardiology

7

 

total

4448

 

total

2615

 

 

Despite discordances between the two sets of data, the ratios of "prescription" remain quite comparable. Thus, the main object of our study is given  here : attempt an evaluation of the Roman pharmacopoeia through the analysis of a significant volume of data.

  Many comments could find place in this study of the "Roman pharmacopoeia of spices" :

 in first place, a discussion on the meaning, of such words, common in Ancient texts, as "phytotherapy", "aroma" and "qualities" :

 .1. The word "phytotherapy"

3Phytotherapy"should not be interpred as a reference to some marginal fashions but to healing traditions transmitted from generation to generation with their own assortment of rules and restraints :

. local administration of drugs was customary in a wide range of indications : respiratory tract disorders but, also, in other fields as dermatology, gynaecology and even proctology.

 Such facts are still open to discussion : could it be a  mere attempt to obtain better results or fear of dangers inherent to an oral administration of drugs ?

. polymedications mixing together several substances was of common practice in preparation of drugs : ultimate example is given by the "theriac" intended to give the highest possible level of protection against poisons.

. whole products : for obvious technical reasons, only whole products could be available to the Ancient pharmacists.

 In our modern pharmacopoeia drugs have to be calibrated with precision : such "isolates" are warranted to possess experimentally reproducible effects. There is little doubt that, in Antiquity, vegetal products could be largely variable in their composition and uncertain in their effects. However, a question remains unanswered : could the overall effect of a drug be something more than a sum of all the components?

 2. "Aroma" :

the word refers in Ancients texts to the concept of "odour particles" passing through ethmoid via the "lamina cribrosa" to reach the center of thoughts and emotions, the brain. However, in Ancient pharmacopoeia, all medicinal substances were not aromatic : sugar and salt had a status of medicinal drugs but the chain linking aromatic plants to aroma and aroma to aromates was credited of mighty powers, giving to spices a singular "merit" called "quality".

 3.        "Quality"

The word will seem, in our times, loaded with mysteries. In fact, the concept of "quality" marks an important milestone in History of Sciences : for the first time, was available, assigned to the detection of frauds orcounterfeits slurring the spice trade, a system of "scientific" appraisal of drugs. Pliny gives a great deal of details on the procedures to which spices were subjected prior to their delivery: weighing, tests for solubility, purity, inspection of post-combustion residuals and, in final, a "qualitative" analysis using nostrils and tongue buds, first example, without any doubt, of laboratory instrumentation.

 Later, the concept of "quality" will become a first attempt to propose some sort of pharmacological classification, indexing drugs into different categories all based on appreciation of taste or aroma with appellations as "warm", "acid" or "bitter" to only cite a few examples among a wide range of "qualities".

 From the start, the word "quality" had the most brilliant fate to become, after many centuries, heavily and wrongfully ridiculised. Can we ever forget the jokes from Molière on the "dormitive virtue of opium"... Actually, many arguments could bring us to admit that the system was based on better grounds than expected. Thus, in a previous study, we could demonstrate the rationality underlying behind the concept of "hot substances", particularly in the group of terpenic drugs as myrrh or incense.

 Any attempt to summarize twenty centuries in History of Sciences will seem hazardous. Perhaps  should we keep in mind that the Sciences of Antiquity were often based on a "qualitative" approach while our modern concepts are based on a "numerical" approach.

 Use of the therapeutic knowledge of antiquity

 Could it be some use, in our therapeutic researches of our times, for the pharmacopoeia of Antiquity, so close and so remote from us. Prior to any stand on this question, two facts should be taken in account :

 .1. The revival of phytotherapy

 The golden age of phytotherapy goes well beyond the four centuries of Roman Empire, in the Arab world then the Middle Age of Occident. Afterwards arrived the times of contempt for "old wife's remedies" and, later, times of oblivion as the triumphant "scientism" splattered the end of XIXème century.. Thus, Littre, famed French encyclopaedist , had only few words to comment the word "phytotherapie" in his Dictionnaire de Medecine

Meanwhile, the medical profession keeps unchanged opinions about "plant medicine" with the idea that a "quack science" not to say charlatanism has nothing to do with our modern medical knowledge. However, time has come to a change and nowadays, research on vegetal drugs has taken place at the most scientific level in "Nobelized" or "Nobelizables" scientific centers

.2. the current development of ethno-pharmacology

 The first step in History of ethno-pharmacology was the discovery, at the beginning of the Fifties, of potent hypotensive action in a tree from the tropical forests of sub-Himalayan India, Rauwolfia serpentina. Since that time, many works have been dedicated to investigation of the traditional medicines of South America, Africa, Israel or South-East Asia. At present, China and, to a lesser extent India have started a program of systematic investigations of their Ancient medicinal texts.

 Emergence of a new discipline :"archeo-pharmacology"

 A new field of therapeutic research appears, which could be called, in place of any other name available, "archeo-pharmacology". A large number of publications have shown a growing interest from the scientific world in this area. Previously, in the seventies, an experimental study of Sulllivan had given evidence that the assertions of Soranos and Serenus Sammonicus on the abortive action of silphium and pennyroyal were based on solid grounds. In 1985, Riddle, in a reference study, confronted the texts of Dioscorides with the pharmacological knowledge of our time. More recently, Holland brought new arguments to promote and develop drug researches based on archeo-pharmacology

 Many concordances between yesterday and today have to be taken in account, many of them are since a very long time known. Among many examples :

•         opium poppy was, in Antiquity, the basic drug for pain and, most likely, surgical anaesthesia. Few things have changed here, outside the availability of purified products. The question is still open : are we better than the Ancients to understand the reasons why the poppy has been given a "dormitive virtue"?...

•         Ginger was widely used in  all sorts of digestive affections, specially when vomiting or nausea were associated. Several publications have confirmed recently that ginger could be an efficient treatment of gravidic nauseas and the diverse gastro-intestinal side-effects of chemotherapy. We should also note that ginger as ant scorbutic agent was known in Asia prior to Europe : Chinese junks were supplied with broad reserves of ginger kept in porcelain earthenware

•         ferula : the Ancients made their delight of this garlic tasting Umbellifer. From this passion came the first ecological disaster of History  Libyan fields of ferulas were turned in deserts. Ferula was also, as we mentioned earlier, a major element of the Antique pharmacopoeia, known, among others for its abortive effects : Catulle in one of its epigrams maliciously comments this type of indications. Ferula, is the subject now, in India, of investigations on its contraceptive actions..

We can only briefly comment some other fields of concordance :

•         henna : "prescription" of henna  in Antiquity as a cure for various dermatological diseases is well documented. A plausible interpretation could refer to the multiple antimicrobial properties of henna, among which antimycobacterial action which has been demonstrated recently.

•         ammi : exposure to the sun followed with skin application of diverse ointments containing ammi was a common procedure to treat various dyschromic affections, such as vitelligo. There is ample documentation on the subject in the paper from J Cheymol on therapeutic photosensitization of psoralenes.

•         yew : many observations from the Ancient authors on the toxicity of yew are still relevant, knowing that yew and its derivatives (taxotere and taxol) are major agents in our times for the treatment of malignant tumours. There is ample mentions in Pliny , Dioscorides and even Virgile of the mysterious and noxious effects of the yew : the mortal danger to sleep in the shade of these trees or drinking wine contained in barrels made of yew.

 Also :

•          aloe : drastic laxative

•          bdellium and cardamon : anti-inflammatory properties used in the treatment of diverse rhumatologic affections.

•          benzoin : symptomatic treatment for respiratory tract affections

•          cardamomum : anti-inflammatory action

•          cinnamon : used as treatment of Helicobacter pylori infections

•          cloves : analgesic use in dentistry

•          cyperus : anti-malaria

•          ferulas : contraceptive

•          frankincense : colitis

•          ginger : antiemetic

•          myrrh : local anaesthetic and antibacterial action

•          opium poppy : major analgesic action.

•          turmeric : gastro-intestinal tract diseases

 As a conclusion should be kept in mind the fact that, in medical Treaties of Antiquity, diagnosis and therapeutic have gone dramatically different routes. On every questions of diagnosis, the most contradictory "theories" abound to explain nature and mechanism of diseases. On the opposite, as soon as there is mention of drugs, appears evidence of a great coherence, displayed in Ancient texts, since the most remote times.

 There is no question to accept without close investigations the legacy inherited from our Mediterranean Antiquity but, why not give the pharmacopoeia of the Ancients the same interest that we rightly give to medicinal traditions of Africa, Asia or South America?

Many efforts will be necessary, lengthy and expensive but we can expect, from now, a great future for a systematic exploration of the Past.

 

a.fabre.fl@gmail.com

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