Chapter III: Antidotes to Poison in Ancient Times

Judging from the earliest laws on record, criminal poisoning does not appear to have been common amongst the ancient Egyptians or Hebrews.

The first recorded instance of a judicial trial for poisoning at Rome is stated by Livy to have been in the year 329 B.C. In the time of Justinian (A.D. 483–565) the aid of the physician was called in specially during the investigation of crime. According to the institutes or laws of that period, those who by odious arts, whether by poison or by “magical whispers” (incantations), took away the life of another, were punished with death. A contract for the sale of a poison was also held to be void “on the analogy of the contracts of partnership and agency which have no power to deal with improper matters.”

It seems appropriate that the first law to regulate the sale of poisons should have been enacted in Italy. Thus as early as 1365 a statute was passed in Siena rendering it illegal to sell red arsenic or corrosive sublimate to any slave, freed or otherwise, or to any servant or person under twenty years of age. These poisons could only be sold to an adult who was well known to the apothecary. There was also a law in Perugia in 1378 which enacted that a person could not obtain a poison without the express permission of a doctor, which permit should state the purpose for which it was intended to be used. The statutes of Genoa (1488) amongst other items demanded that in no medicament should substitution be allowed, or as the statute reads “Ponere quid pro quo” without the doctor’s express permission. The pharmacist was to be careful that honey was not substituted for sugar, nor that the latter should serve as a cover for the former, and that he should put neither rice nor starch in anything composed of sugar, in whole or in part.

In ancient times there is little doubt that many people died from the effects of poison without suspicion, although on the other hand many more succumbed to the sudden effects of latent and unrecognized diseases, such as aneurism, peritonitis and others of which practically nothing was known, whose deaths were wrongfully attributed to poison. Before the period of judicial post-mortem examination, the practice was to expose the bodies for inspection to those who were believed to be able to form a sufficiently accurate judgment for themselves as to the cause of death.

It was believed that poisonous substances had a peculiar action on the heart and were capable of altering its substance in such a manner that it resisted the action of a funeral pyre and remained unconsumed. When the heart resisted the pyre it was regarded as unmistakable evidence that the person had perished by poison. If, in addition, the body from any cause rapidly decomposed, such a sign was at once believed to be conclusive of death from poison. This belief prevailed to a greater or lesser extent down to the middle of the seventeenth century.

From the time man first discovered the effects of poisonous substances, he no doubt began to consider some means of preventing their action if taken internally by accident. He sought also to find protection against the bites of venomous animals, reptiles and mad dogs. Homer (900 B.C.) in the “Odyssey,” in the account of Ulysses’ men, alludes to a plant which Hermes recommended him to take when he set out to rescue his followers:—

“Then take the antidote the Gods provide
The plant I give through all the direful power
Shall guard thee and avert the evil hour.”

This is thought to refer to a herb called moli or molu which is often mentioned by ancient writers. It is alluded to by Theophrastus, Ovid, Pliny, Dioscorides and Galen and it was considered to be a species of Allium. It is described by some as a plant having an onion or squill-like odour, and was said to grow in Arcadia and Campania.

The Hindus, like other ancient peoples, also had an idea of a universal antidote against poisons, as expressed by the word “agada.”

Apparently the ambition of the early Greek physicians was to discover a universal antidote to all poisons, and many of them appear to have devoted years and spent a great part of their lives in attempting to find it. These antidotes were called by the Greeks Alexipharmics, or Theriacs, the former word being derived from the Greek “Alexipharmakos,” meaning that which keeps off a poison, and the noun “antipharmakon,” an antidote.

One of the earliest writers on the subject was Nicander of Colophon (185–135 B.C.), who was physician to Attalus, King of Bithynia, under whom he is said to have secured special facilities for studying poisons, being allowed to experiment upon condemned criminals. He was an hereditary priest of Apollo at Clarus. He wrote a work in about a thousand hexameters on

Theriaca, which deals with the bites of venomous animals and six
hundred hexameters on

Alexipharmica, which treats of poisonous substances when swallowed by
the mouth, and the use of emetics.

Theriaca became an actual substance and differed from the _Alexipharmica_, which was more a method of treatment. This division was afterwards adopted by all the subsequent early writers on the subject, including Dioscorides, Galen, Aetius, Paulus Aegineta, Avicenna and Rhazes.

From the first century theriaca was regarded as a very important compound, and in the endeavour to secure the most effective combination for the purpose, the most extraordinary formulæ containing a large number of ingredients, were devised by various physicians. The general treatment recommended by Nicander for the bites of all venomous animals was sucking the wound, applying cupping vessels to it, cauteries and leeches, and afterwards administering stimulant medicines.

Respecting the sucking of a wound, he gives an important injunction that the person who sucks the wound should not be fasting, from which it may be gathered that he was aware of the physiological fact that the vessels absorb more readily when in an empty state.

Nicander’s particular remedies were such drugs as birthwort, alkanet, and theriaca of vipers, which was prepared with a great many aromatic roots and fruits, including ginger, cinnamon, myrrh, iris and gentian. In his work he mentions twenty-two poisonous substances including:

Aconite (wolf’s bane), litharge (lead oxide), buprestis (a beetle resembling cantharides), ceruse (white lead), conium (hemlock), cantharides, hyoscyamus (henbane), ixias (probably a species of chameleon), coagulated milk, sea-hare, poppy (opium), pharicum (probably a composition of agaric), the red toad and marsh frog, the salamander, bull’s blood, taxus (yew), and toxicum (an unknown poison). As antidotes he recommends warm oil, warm water and mallow or linseed tea to excite vomiting.

From this list we have some idea of the knowledge of poisons at that period. Most of the substances enumerated are of vegetable or animal origin, few of the soluble mineral poisons being known at that time.

Galen noticed that opium dissolved in a small quantity of wine produced stronger effects than when given alone, and that when a larger draught of wine was given, it proved an antidote by counteracting the narcotic powers of the opium. He stated that he once cured a person reduced to the last stage of coma by the administration of strong wine.

Dioscorides also dealt very largely with this subject, and, like Nicander directs that “the person who sucks the poisoned wound be not fasting and that he shall keep some oil in his mouth.” The wound is then to be fomented with a sponge and scarified or cut out, a method on which there is no improvement at the present time. Cauterization with fire is another method which Dioscorides recommends, and for the bite of a venomous serpent known to be fatal, he advises immediate amputation to save life.

According to Pliny and Galen, the formula for the first theriaca against the bites of all venomous animals was inscribed in verse on a stone in the temple of Asklepios on the island of Cos. It contained wild thyme, opoponax, aniseed, fennel, parsley, meum and ammi. These were to be beaten up with meal of fitches (ervum ervilla), passed through a sieve, kneaded with wine, cut into lozenges of the weight of half a denarius (30 grammes), one to be placed in three cyathi (about five ounces) of wine and swallowed.

The next theriaca in antiquity is that originated by Antiochus the Third, King of Syria and Babylon, who flourished about 223 B.C. He is said to have devised a compound that was proof against the bites of all venomous animals and reptiles except the asp.

One of the most celebrated of the theriaca was that of Mithridates VI (120–63 B.C.), King of Pontus in Asia Minor. From the constant apprehension of being poisoned by his enemies, Mithridates is said to have rendered himself immune from their effects by taking small doses of poisonous substances daily in combination with the antidote he devised, and thus believed himself poison-proof. For many years he carried on warfare with the Romans, but was finally defeated by Pompey, and, not wishing to fall into the hands of his enemies, he put an end to his life. After the conquest Pompey is said to have captured the coveted formula among the secret papers of the King.

This compound contained fifty-four ingredients, which were prepared in the form of a conserve or electuary. Needless to say this elaborate remedy would be quite useless as an antidote to any poisonous substance, but judging from what Pliny tells us of some of the so-called poisons known to Mithridates, such as “the blood of a duck found in a certain district of Pontus” which was supposed to live on poisonous food, it is no wonder he had a belief in its efficacy. Curiously enough, Mithridates employed the duck’s blood as an ingredient in the later modifications of his theriaca, and he tells us that he did so because he observed that “these ducks fed on poisonous plants and suffered no harm.”

Another theriaca is attributed to Zopyros, a Greek physician of Alexandria, about 80 B.C. He named his formula “Ambrosia,” and it contained frankincense, galbanum, pepper and other aromatic substances, made into a conserve with boiled honey. A piece the size of an Egyptian bean was directed to be taken, washed down with a draught of wine.

Equally celebrated was the theriaca of Philon of Tarsus, who is said to have lived in the early part of the first century and recorded his formula in symbolic Greek verse. Galen mentions that it had a great reputation for a long time and was one of the most famous compounds of the kind. It contained such curious substances as “the red hair of a lad whose blood had been shed on the fields of Mercury,” which was possibly symbolic language for suffering, and certain drugs the names of which are disguised in mystic language. The whole of the mixture was to be made into a conserve with “the work of the Daughters of the Bull of Athens” which is supposed to mean Attic honey.

The Theriaca Philonium survived over 1,700 years and has an interesting history. It passed into many of the pharmacopœias of Europe, remaining in the _London Pharmacopœia_ until 1746, when it was composed of opium, pepper, ginger, caraway, syrup, honey and wine. Until 1746 it was called “Philonium Romanum,” but was then changed to “Philonium Londonense,” and syrup of poppies was substituted for the honey. It is probable that this mixture was originally intended as a remedy for a peculiar form of colic which became epidemic in Rome when Philon flourished there. Philon’s formula formed the basis of what was afterwards known as Confection of Opium and remained in the _London Pharmacopœia_ until 1867.

The Theriaca which eclipsed all others in fame and popularity was that originated by Andromachus, physician to Nero (A.D. 37–68). So much did the Emperor appreciate his physician’s efforts to devise a universal antidote that he raised him to the dignity of Archiatrus. The Theriaca of Andromachus was claimed to be an improvement on that of Mithridates, until then the greatest antidote in Roman pharmacy. He added vipers to the compound and called his theriaca “Galene.” Like other physicians of his time Andromachus wrote his formula and described its virtues in Greek verse, which he dedicated to Nero. He claimed that it would “counteract all poisons and bites of venomous animals and that it would also relieve all pain, weakness of the stomach, asthma, difficulty of breathing, phthisis, colic, jaundice, dropsy, weakness of sight, inflammation of the bladder and kidneys, and plague.” It was indeed a panacea for all complaints.

Galen states that he tested this antidote by giving it to a number of fowls to which he had first administered a poison. Those to which the theriaca had been given survived, but all the others died. He says that it resisted poison and venomous bites and cured a great many diseases. The original formula contained no less than seventy-three ingredients, including dried vipers. This remarkable preparation remained in popular use throughout the Middle Ages and is still made and sold in the drug bazaar of Constantinople and also in some parts of Italy.

About the year A.D. 50 the Theriaca of Democrates became famous. This was similar to the compound of Andromachus, the formula for which Democrates, a Greek physician then living in Rome, translated into verse. Other formulæ were originated by Nicolaus of Salerno, Amando, Arnauld and Abano, each of whom added something to the original formula. These preparations may be said to have reached their zenith in the sixteenth century when Pietro Andrea Matthiolus, the commentator of Dioscorides, published another formula which contained no less than two hundred and fifty separate substances, including dried vipers, pearls, red coral and emeralds. This formula in a modified form was included in the _London Pharmacopœia_ in 1618 and remained an official remedy until 1746.

Several cities became celebrated for the manufacture of Theriaca, including Cairo, Florence, Genoa, Bologna and Venice. The Theriaca of Venice or Treacle, as it was called, contained sixty-one ingredients, had a reputation throughout Europe and was included in the _London Pharmacopœia_ down to 1746. In Bologna the mixing of the Theriaca was carried out with great ceremony in the courtyard of the ancient Archiginnasio in the presence of the chief officials of the city. The ingredients were mixed under the supervision of the medical professors of the University to ensure of it being faithfully and properly compounded. From the fourteenth to the seventeenth century it was regarded as a remedy for plague and was used in great quantities. Evelyn, in his Diary, March 23, 1646, thus alludes to the Theriaca of Venice—

“Having packed up my purchases of books, pictures, casts, treacle, etc. (the making and extraordinary ceremony whereof I had been curious to observe, for it is extremely pompous and worth seeing) I departed from Venice.”

The great consumption of this medicament in the sixteenth century is evidenced by Morgan, Apothecary to Queen Elizabeth, who in a pamphlet insists that a product that he had made had been compared with other “theriacle” brought from Constantinople and Venice and had been commended.

“It is very lamentable to consider,” he writes “that straungers doe dayly send into England a false and naughty kinde of Mithridatium and Threacle in great barrelles more than a thousand weight in a year, and vtter ye same at a lowe price for 3_d._, and 4_d._ a pound, to ye great hurt of Her Majesties subjects and no small gaine to straungers purses.”

In 1612, it is recorded that the Master and Wardens of the Grocers’ Company of London marked that “a filthy and unwholesome baggage composition was being brought into this Realm as Tryacle of Genoa, made only of the rotten garble and refuse outcast of all kinds of spices and drugs, hand overhead with a little filthy molasses and tarre to worke it up withal.” This was communicated to the College of Physicians, and they set about not only to devise their own formula, but to superintend its manufacture, which was then entrusted to William Besse, an apothecary in the Poultry. Besse was made to take a “corporal oath” before the Lord Mayor, and every year when he made the confection had to show the ingredients and the product to the College of Physicians. His treacle was sold at not above 2_s._ 8_d._ per lb. or 2_d._ per ounce.

The use, however, of this medicament in Great Britain goes back to a much earlier period. It was recommended to Alfred the Great by Helia, the Patriarch of Jerusalem, according to an Anglo-Saxon MS. of the eleventh century. It is again mentioned by Foucher de Chartres in 1124, who states it was used in the first Crusade. It is recorded in a Close Roll of King John in 1208, and a “triacle box du pere apelle une Hakette garniz d’or” is mentioned amongst the precious effects of Henry V.

Prosper Alpinus, the physician of Padua, who travelled in Egypt in 1591, refers to the manufacture of Theriaca in Cairo and states that it was only allowed to be made in public, and that the ceremony was performed once a year in the Mosque of Morestan by the chief apothecary of the city in the presence of all the physicians. He states that at that time Italians, Germans, Poles, Flemings, Englishmen and Frenchmen came to Cairo to purchase this true Theriaca.

Much more might be written describing the making of this ancient and interesting medicament, which has a literature of its own, but it will be sufficient to quote one more account from the Regulations and Statutes of Montpellier, where the compounding was also carried out with great ceremony.

According to a report by Laurens Catelan, Master Apothecary in Ordinary to Monseigneur the Prince of Condé, it was required that the preparation should be made in public in the presence of the very illustrious professors of the famous Faculty of Medicine so that they might have the opportunity of censuring or approving the ingredients and that the public might therefore be sure of the virtue of these important medicines.

It may well be asked what was the rationale of administering these extraordinary compounds which survived for centuries. All that can be said is, that these complex mixtures of gums, balsams and aromatic substances would probably have some antiseptic action on the alimentary and internal organs. They were generally directed to be given with wine which would aid this effect and, at any rate, would have a reviving and stimulating effect on the individual, but no real antidotal properties can be ascribed to them.

The search for antidotes to poison was not confined entirely to the Old World, for according to the _Carolina Gazette_ of May 9, 1750, the General Assembly, the Governing Body of the Colony, authorized the publication of “Nigger Caeser’s cure for poison.” The General Assembly had purchased Nigger Caeser’s freedom, who was apparently a slave, and granted him £100 a year for life as the price of his formula, which consisted of roots of plantain and wild horehound, 3 oz. boiled together in 2 quarts of water down to 1 quart and strained. Of this, one-third was to be given every morning fasting for three consecutive mornings. Certain dieting was also required, and it is stated that if in the three days’ treatment no benefit had resulted, it was a sign that the patient had either not been poisoned at all or had been by such poisons as Caeser’s antidote would not remedy.