On luxurious preparations of drugs for nerve damage.

It would not be useless to know about these kinds of drugs as well. While perhaps not as frequently as budget drugs, there is sometimes a need for them. For wherever there is a man who is an amateur pharmacist or doctor, even if he does not have more than five hundred thousand denarii, the man would not consider it worth his while to use any of the budget drugs. All the more if one is rich or especially a king—they would want the drug to be fragrant and prepared along with a great deal of silver.

There once was a rich man, the same one I told a story about in the first book of On Prognosis by Pulses, whose name I did not mention then and will not mention now, but you will get a sense of the kind of man he was from this pair of stories about his conduct. He once tried to treat a slave’s malignant ulcers. When he was unsuccessful, he entrusted the person to me, and when he saw that I had cured him, he asked me for the prescription for the drug. He was not aware that there are many different kinds of malignant ulcers and many different kinds of drugs but thought that one drug would be able to cure everything. Yet, even though the one administering the drug does not need to have any skill to use it, when he heard what the drug was made of and that all its ingredients were inexpensive, he exclaimed, “Keep this one for your beggars and teach me about the more luxurious ones.”

Another time, there was a young child who had a chronic ear condition and the man had no success in curing him (since even though he used drugs many times, he used them without a method). And so he ordered the child to be brought to me for treatment. Later, when he had learned that I had treated the child with what was available, he considered it not to be worth his while to acquire the prescription for the drug. So, having witnessed for himself many cases of nerve damage—fingers cut off and gone septic, some even leading to death or permanent injury—and recognizing that none of the patients I treated were in danger but had all quickly become healthy, he still thought what was important was to get a drug from me that was soothing and luxurious and which he could also use to treat nerve damage at the same time.

I had already often given many rough and ready prescriptions to colleagues and amateur doctors following the method we wrote about earlier, so that the theory behind their composition had been confirmed by their results. I would not give to poor people the kind of luxurious drug that this man wants, since I consider it better when cures are prepared with what is readily available. But since the rich man considered it important to get a recipe for a soothing and luxurious drug, I gave him several prescriptions that I produced according to the method I mentioned before. He was eager to have them tested and ordered both freedmen and slaves to find him patients with nerve damage. When the drugs worked beyond all expectations, first he praised me for generously sharing my recipes with him, and then he honoured me with gifts, for he was also prepared for such things. The recipes for the drugs I gave to him are as follows.

Cinnamon, Cretan dittany and maron [1], each in the amount of 40 drachmas. For these also have a pleasant aroma and are composed of fine parts. As for marjoram, since it does not have a pleasant aroma, I did not intend to mix it in at all. And yet, since it was difficult to get in Rome, as was maron, and I noticed that things that were difficult to get made him happy, just like the luxurious ones did, I added one small portion of it to the recipe, a fourth or fifth, I believe. After chopping and sifting them with a fine sieve, I ordered them to be mixed into a cerate prepared with the finest balsam sap and Tyrrhenian wax. I figured the right balance was to make it with eight parts wax and ten parts balsam sap.

To prevent the drug from being brittle but to make it rather somewhat cohesive, I mixed in one part terebinth resin, which itself has a pleasant aroma when it is of excellent quality. Additionally, I said, if you wish to make the drug more potent, do not add only one part of each of the herbs we mentioned, but a bit more, about one and a half parts. This drug has been tested by experience.

In addition to it, a second was composed with the same cerate and the juice of Cyrene, the mixture produced with the same proportion of spurge; and another, third, composed from both; and in addition to them a fourth, once I had gotten hold of stacte myrrh. For those patients whose nerve was exposed, I prepared the cerate from what’s called perfumer’s wax and from the ointments called spicatum and foliatum by the Romans. I mixed into it a twelfth part of pompholyx, washed, either using the masculine (peplumenos) or feminine (peplumenēs) form of the word; for whichever you choose, you will not do the drug either any good or harm [2].

And there is another way you can prepare it with Tyrrhenian wax: it is also possible to make it without the perfumes previously mentioned, by melting the Tyrrhenian wax with good nard in, naturally, a double vessel, since this is common for all perfumes. Once the wax has been scraped, you mix it with spikenard, amomum, malabathrum leaf, and washed pompholux in equal amounts. As we mentioned, in the case of stabbings, one needs more acrid drugs, which always protect the open wound. For exposed wounds, one should administer moderate styptics that have a dispersing capacity without any sting. Among styptics, one is amomum, but better are spikenard and malabathrum leaf.

Περὶ τῶν πολυτελῶν σκευασιῶν τῶν πρὸς τοὺς νευροτρώτους φαρμάκων.

Οὐκ ἄχρηστον ἂν εἴη καὶ τὰ τοιαῦτα ἐπίστασθαι φάρμακα. χρεία γὰρ αὐτῶν ποτε γίγνεται σπανιώτερον, ὥσπερ τῶν εὐτελῶν πολλάκις. ὅπου γάρ τις οὐ πλείους ἔχων πεντακοσίων μυριάδων ἀνὴρ φιλοφάρμακός τε καὶ φιλίατρος οὐδενὶ τῶν εὐτελῶν ἠξίου χρῆσθαι, πολὺ μᾶλλον ἤτοι πλούσιός τις ἢ καὶ μόναρχος, εὐῶδές τε ἅμα καὶ πολλοῦ σκευαζόμενον ἀργυρίου βουληθήσεται τοιοῦτον ἔχειν φάρμακον.

τοῦ δὲ ἱστορηθέντος μοι πλουσίου κατὰ τὸ πρῶτον τῶν περὶ τῆς διὰ τῶν σφυγμῶν προγνώσεως μέμνημαι χωρὶς ὀνόματος, ὥσπερ καὶ νῦν, ὁποῖός τις ἦν, ἐκ δυοῖν αὐτοῦ τοιῶνδε μαθήσῃ πράξεων. ἕλκος οἰκέτου κακόηθες ἐπειρᾶτο θεραπεύειν αὐτός. ὡς δὲ οὐδὲν ἤνυσεν, ἐνεχείρισεν ἐμοὶ τὸν ἄνθρωπον, ἰδών τε θεραπευθέντα τοῦ φαρμάκου τὴν γραφὴν ᾔτει μὴ γιγνώσκων πολλὰς μὲν εἶναι διαφορὰς τῶν κακοήθων ἑλκῶν, πολλὰς δὲ τῶν φαρμάκων, ἀλλ' οἰόμενος ἓν φάρμακον δύνασθαι θεραπεύειν ἅπαντα. μὴ γοῦν μήτε τεχνικῶς αὐτῷ χρωμένου τοῦ προσφέροντος, ὡς ἤκουσεν ἐκ τίνων συνέκειτο, καὶ ἦν ἅπαντα εὔωνα, τοῦτο μὲν, ἔφη, τοῖς προσαίταις φύλαττε, τῶν πολυτελεστέρων δέ τι δίδαξόν με.

καὶ μέντοι καὶ παιδαρίου χρονίαν ἐν ὠσὶ διάθεσιν ἔχοντος, ὡς αὐτὸς ἐπὶ πολλοῖς οἷς ἐχρήσατο φαρμάκοις ἄνευ μεθόδου μηδὲν ὤνησεν, ἐμοὶ κᾀκεῖνο τὸ παιδάριον ἐκέλευσε προσαχθῆναι θεραπευθησόμενον. ὕστερόν τε γνοὺς αὐτὸ διά τινος τῶν ἐπιτυχόντων θεραπευθὲν, οὐκ ἠξίωσε λαβεῖν τοῦ φαρμάκου τὴν γραφήν. οὗτος τοίνυν αὐτὸς ἑωρακὼς πολλὰς τῶν νευροτρώτων, ἀποκοπέντας τε δακτύλους καὶ σαπέντας, ἐνίους δὲ καὶ τελευτήσαντας ἢ κυλλωθέντας, εἶτα γνοὺς ὅτι μηδεὶς ἐκινδύνευσε τῶν ὑπ' ἐμοῦ θεραπευθέντων, ἅπαντες δὲ διὰ ταχέων ὑγιεῖς ἐγένοντο, φάρμακον ἠξίου τι παρ' ἐμοῦ λαβεῖν εὔπνουν τε ἅμα καὶ πολυτελὲς, ᾧ τοὺς νευροτρώτους δυνήσεται θεραπεύειν.

ἐγὼ δὲ πολλὰς ἤδη πολλάκις ἐδεδώκειν ἑταίροις τε καὶ φίλοις ἰατροῖς γραφὰς αὐτοσχεδίους κατὰ τὴν προγεγραμμένην μέθοδον, ὅπως ὑπὸ τῶν ἐκβάσεων ὁ τῆς συνθέσεως αὐτῶν λόγος βεβαιῶται. πολυτελὲς δ', οἷον ἐκεῖνος ἐβούλετο, πένησιν ἀνθρώποις οὐκ ἂν ἔδωκα νομίζων ἄμεινον εἶναι διὰ τῶν εὐπορίστων γίγνεσθαι τὰς ἰάσεις. ὡς οὖν ὁ πλούσιος ἠξίωσεν εὔπνου τε καὶ πολυτελοῦς φαρμάκου λαβεῖν τινα σύνθεσιν, ἔδωκα πλείους αὐτῷ γραφὰς κατὰ τὴν προειρημένην μέθοδον ποιήσας, ὧν πειραθῆναι σπεύδων ἐκεῖνος ἐκέλευσε τοῖς ἐλευθέροις τε καὶ δούλοις ἀναζητεῖν αὐτῷ νευροτρώτους. ἐνεργησάντων δὲ τῶν φαρμάκων ὑπὲρ ἅπασαν ἐλπίδα, πρῶτον μὲν ἐπῄνεσεν ὡς ἀφθόνως αὐτῷ κοινωνήσαντά με τῶν γραφῶν, εἶτα καὶ δώροις ἐτίμησε, καὶ γὰρ ἦν ἕτοιμος καὶ εἰς τὰ τοιαῦτα. τῶν δοθέντων δ' αὐτῷ φαρμάκων ἡ σύνθεσις ἦν τοιάδε.

♃ κινναμώμου, δικτάμνου καὶ μάρου ἀνὰ ἑκάστου δραχμὰς μʹ. καὶ γὰρ εὐώδη καὶ λεπτομερῆ ταῦτ' ἔστι. τὸ δὲ ἀμάρακον ὡς οὐκ εὐῶδες ἐνενόησα μηδ' ὅλως μιγνύειν. εἶτ' ἐπεὶ δυσπόριστον ἦν ἐν Ῥώμῃ, καθάπερ καὶ τὸ μάρον, ἑώρων δὲ ἐκεῖνον χαίροντα τοῖς δυσπορίστοις ὥσπερ γε καὶ τοῖς πολυτελέσι, προσέθηκα τῇ γραφῇ κᾀκείνου βραχύ τι μέρους ἑνὸς, ὡς οἶμαι τέταρτον ἢ πέμπτον. ταῦτα κοπέντα καὶ σηθέντα λεπτοτρήτῳ κοσκίνῳ μιγνύειν ἐκέλευσα κηρωτῇ δι' ὀποβαλσάμου τοῦ ἀρίστου καὶ κηροῦ Τυῤῥηνικοῦ. σύμμετρον δ' ἐστοχασάμην εἶναι τοῦ κηροῦ μὲν ὀκτὼ ποιήσασθαι μέρη, τοῦ δὲ ὀποβαλσάμου δέκα.

χάριν δὲ τοῦ μὴ ψαθυρὸν εἶναι τὸ φάρμακον, ἀλλ' ἡνωμένον πως ἑαυτῷ, καὶ τῆς τερμινθίνης ῥητίνης ἔμιξα μέρος ἓν οὔσης καὶ αὐτῆς εὐώδους, ὅταν ᾖ καλλίστη. γενναιότερον δ', ὡς ἔφην, εἰ βούλοιο ποιῆσαι τὸ φάρμακον, οὐχ ἓν μέρος ἑκάστης τῶν εἰρημένων βοτανῶν ἐμβάλλῃς, ἀλλὰ πλέον, ὡς ἓν καὶ ἥμισυ γενέσθαι. τοῦτ' οὖν ὑπὸ τῆς πείρας ἐμαρτυρήθη τὸ φάρμακον. ἕτερον δὲ δεύτερον ἐπ' αὐτῷ διὰ τῆς αὐτῆς κηρωτῆς καὶ ὀποῦ τοῦ Κυρηναίου συντεθὲν, κατὰ τὴν αὐτὴν ἀναλογίαν τῷ εὐφορβίῳ τῆς μίξεως γενομένης, ἄλλο τε τρίτον ἐκ τῆς μίξεως ἀμφοῖν συντεθὲν καὶ τὸ τέταρτον ἐπ' αὐτοῖς τῆς στακτῆς σμύρνης προσλαβόν. ἐφ' ὧν δὲ γυμνόν ἐστι τὸ νεῦρον, ἐπὶ τούτων τὴν μὲν κηρωτὴν ἐκ κηροῦ τοῦ καλουμένου μυρεψικοῦ καὶ μύρων τῶν παρὰ Ῥωμαίοις ὀνομαζομένων σπικάτου καὶ φουλιάτου συνέθηκα. δωδέκατον δ' αὐτῇ μέρος ἔμιξα πομφόλυγος, εἴτε πεπλυμένου λέγειν ἐθέλοις ἀῤῥενικῶς, εἴτε πεπλυμένης θηλυκῶς· οὐδὲν γὰρ ὁπωτέρως ἂν εἴποις οὔτ' ὠφελήσεις οὔτε βλάψεις τὸ φάρμακον.

ἔστι δέ σοι καὶ διὰ τοῦ Τυῤῥηνικοῦ κηροῦ σκευάζειν αὐτό. πάρεστι δὲ καὶ χωρὶς τῶν εἰρημένων μύρων τὸν μὲν Τυῤῥηνικὸν κηρὸν τῆξαι διὰ νάρδου καλῆς ἐπὶ διπλοῦ δηλονότι σκεύους, κοινὸν γὰρ τοῦτο ἐπὶ πάντων τῶν μύρων. ξυσθείσῃ δὲ τῇ κηρωτῇ μίξεις νάρδου στάχυος καὶ ἀμώμου καὶ φύλλου μαλαβάθρου καὶ πομφόλυγος πεπλυμένου τὸ ἴσον ἑκάστου. ἐπὶ μὲν γὰρ τῶν νύξεων, ὡς εἴρηται, δριμυτέρων ἐστὶ χρεία φαρμάκων ἀνεῳγμένον ἀεὶ φυλαττόντων τὸ τραῦμα. τοῖς γεγυμνωμένοις δὲ τὰ μετρίαν στύψιν ἔχοντα μετὰ διαφορητικῆς ἀδήκτου δυνάμεως προσφέρεσθαι χρή. στύψεως δὲ μέτεστι μέν τι καὶ τῷ ἀμώμῳ, μᾶλλον δ' αὐτοῦ τῷ τε τῆς νάρδου στάχυι καὶ τῷ τοῦ μαλαβάθρου φύλλῳ.

Galen, Compound Drugs by Place 3.8, 13.635–640 K.

[1] Lots of opinions, not much certainty about what μάρον / marum is. Nice note from Bostock’s Pliny (relying on Fée) available via this link.

[2] Suggesting some debate over the gender of the word, pompholyx, πομφόλυξ.