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Medieval Drugs, Part 2: The Drugstore in Paradise

Updated: Aug 30, 2023

Welcome to the second instalment on Winston Black’s excellent Points series on medieval drugs. To read the first post in this series, check out ‘Turning Herbs Into Drugs in the Middle Ages‘.

Where do quality and health come from? Apparently only from jungles and primitive tribes.

One of the favorite advertising gambits of the alternative medicine industry is to promote the exotic nature of a cure. This is done with images of rain forests or Tibetan monasteries, hard-to-pronounce names (ylang-ylang or acai berry), or by dressing up a homely remedy (cornflower becames echinacea). This industry plays on fears of or hostility to modern, chemical pharmaceuticals, and popular beliefs that a plant sourced from an unsullied, non-Western locale, and preferably used by “primitives” must necessarily be better than our local weeds.

Such beliefs about exotic, natural remedies (whether genuinely believed or used deceptively) are not new. The favorite drugs of the High Middle Ages were advertised as coming from far away, in the lands of Arabs and Indians, or from Paradise itself. Our modern paradises tend to be jungles or hidden valleys, the farther from Europe or America, the better. Medieval people didn’t need new paradises; they had the real thing in the Garden of Eden, never seen by sinful humanity but firmly believed in. Everyone knew it was the best place on Earth, and most agreed it lay far to the East. (Want to know more? Try Jean Delumeau’s History of Paradise).

Exotic materia medica laid out neatly on a shelf, including sapphires, coral, mercury, a squid, and mumia, a secretion of the spinal column in Egyptian mummies. From Robinet Testard’s lavishly illuminated edition of the Livre des Simples Médecines, a French adaptation of Matthaeus Platearius’ Circa instans.

In last week’s post, I put forward the idea—as a historical exercise—that drugs were an invention of High Medieval culture. This applies not to the contents of the drugs, but how they were understood, sourced, packaged, and sold—drugs as a cultural construct, representing new attitudes toward medical practice and herbs that had been used for centuries. The transition from herbs to drugs included a change in where philosophers and pharmacists thought the best drugs came from, or at least in where they claimed they had come from. Ideas about the nature of Paradise were central to this change: even if we can’t enter Paradise any more, so the argument ran, we can still obtain its healing plants and craft the very best drugs. But like modern websites, which can deliver health secrets from the deepest jungle to your door by UPS, exotic medieval drugs also had to be made accessible (if only to the wealthy) through pharmaceutical manuals and urban apothecaries.

One of the main aspects of Paradise was abundant spices, valuable in commerce, cuisine, and medicine. Clear lines were drawn between “spices” and “herbs”, even if we now find all of them on the spice rack. In the seventh century St. Isidore, archbishop of Seville, made the distinction: “Spices are whatever India or Arabia or other regions produce that have a fragrant scent”. The herbals of Macer Floridus and Henry of Huntingdon both have separate sections for herbs and spices. Macer’s twelve spices were pepper, pellitory, ginger, cumin, galangal, zedoary, cloves, cinnamon, costus root, spikenard, frankincense, and aloe. Henry added several dozen more spices, but both authors were right: these spices did come from central and east Asia. As European knowledge of Asia grew, the spices moved farther away. In the fourteenth century the travel writer John Mandeville claimed that farther east than Eden itself is the land of Java where “there grow all manner of spices more abundantly than anywhere else, such as ginger, cinnamon, nutmegs, cedar and mace”. (For more on medieval spices, I recommend Paul Freedman’s 2008 book, Out of the East

How to collect aloeswood from the rivers flowing out of Paradise. Also from a 15th-century copy of the Livre des Simples Médecines.

The efficacy of Eastern spices in medicine is an idea frequently repeated by medieval authors, as much those of theology as of medicine. Inspired by descriptions of Eden in Genesis (2:8-17) and the “enclosed garden” in the Song of Songs (4:12-14), medieval philosophers believed that some plants (often spikenard, saffron, sweet flag, balsam, cinnamon, myrrh, and aloe) came from in or near Eden and shared the virtues of Paradise: freedom from disease, a balanced temperament, long life, and even immortality. Belief in such virtues goes a long toward explaining the popularity of spices in the Middle Ages. The more scientifically inclined physicians also embraced these ideas. Take for example Matthaeus Platearius of Salerno, in southern Italy. In the middle of the twelfth century wrote a pharmaceutical treatise known as Circa instans in which he described aloes lignum, aloeswood, the resinous heartwood of a southeast Asian evergreen: “Aloeswood is hot and dry in the second degree, and is found in the great river of Upper Babylon, to which is joined the river of Paradise. For this reason some say that it is carried down by the force of the river from the trees of the Earthly Paradise. No one is said to have seen the location of this tree. Others also say that this wood grows on the peaks of mountains in the wild places situated around the aforesaid place, or that by the force of the wind or the passage of time it falls into the river.”

Despite the skepticism implied by the phrase “some say”, the origin of aloeswood in Eden is presented as a fact within a rational pharmaceutical manual. Aloeswood may be a product of Paradise, but it can still be analyzed in terms of the latest pharmacology. (More on this next week.) Being hot and dry, aloeswood is effective in treating diseases coming from cold and moist humors, the most dangerous combination, which could result in an excess of black bile, called melancholy. Platearius was not alone. In the twelfth century, a broad group of writers, theologians, poets, and physicians joined Biblical legend with the latest natural philosophy to explain the origin and medicinal virtues of spices, focusing on their ability to transfer their own temperies (elemental balance) to a patient. They shared the belief that spices, by virtue of their source in the East, in or near Paradise, are more “natural” and share temperies, the proper mixture or concord of Aristotle’s elemental qualities (hot, wet, cold, dry) that was the rule in the Garden of Eden, but is rarely or never found outside of it, because of Adam and Eve’s fall from grace.

Henry of Huntingdon makes temperies a defining aspect of certain spices in his twelfth-century herbal Anglicanus ortus. He treats forty different “eastern spices” in the sixth book of the herbal. He calls them “heavenly gifts” and remarks on “how much the beautiful spices surpass the herbs.” Spices with temperies cannot be judged particularly hot, cold, wet, or dry, and is therefore best suited for encouraging one’s humors back to homeostasis. Temperies is a valuable attribute of a plant, the medieval equivalent of a universal blood donor, and one found only in spices of the East.

Not every spice possesses this temperies, since it was still necessary to practitioners of the latest Galenic medicine to have ingredients that are more hot, cold, wet, or dry than others in order to compound medicines for a specific patient and disease. (See my post from last week for more on this idea). The value of temperies was that it made a spice useful for every temperament, every humoral complexion: in the case of Sweet Sedge, which Henry knows comes from India, the temperies makes it more valuable and more useful than other types of sedge:

It comes from Indians and Persians, but this Sedge Which fragrant India delivers has a greater value. By a great moderation [temperies] it agrees with every nature And this moderation heats and dries in the second place.

In other instances, Henry attributes temperies to Nature, God’s allegorical assistant in the arrangement of the universe. In the case of cassia, which was often singled out by as one of the spices of Eden, Henry attributes knowledge of its marvelous balance and moderation to the great Galen himself:

Galen says that Cassia fruit stands between Both degrees. He does not judge it hot, Nor cooling, nor moistening, nor dry – Nature grants that it is effective by such moderation [temperies].

Liquorice is also considered marvelous for its elemental balance and flavor:

The power of Liquorice cannot be considered small, Nor can it be surpassed by any spice in sweetness. Nature bestows on it such temperies that, Scarcely heating and scarcely cooling, it cannot be considered Even of the first degree. Good for all and harmful to none, It therefore splendidly medicates mankind in this way.

No, this isn’t a party. We’re taking our drugs, cinnamon and cloves.

For natural philosophers in the twelfth century, the discovery of dozens of new and desirable spices from the Far East was not a challenge to their science, but an opportunity to explain how the drugs of Paradise worked according to their modern science. Next week, for my third and final post, I will look at how later medieval philosophers completed the invention of drugs, subjecting herbs and spices to a rational, mathematical pharmacology.


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