A Fantasy Pharmacy: The Arabic Pharmacopeia Arrives in the Latin West

How do you document a revolution? Not a coup d’état or anything political. No, a revolution in thinking, an alteration in practice. The adoption of a whole new way of doing things. Here’s one way.

In the British Library in London, there is a manuscript, Sloane 1621, a collection of medical recipes, that was owned in the Middle Ages by the Suffolk monastery of Bury St Edmunds. Yes, the same house that owned two of the manuscripts Winston Black talked about last month that helped introduce the medicine of Constantine the African to England. Sloane 1621 was almost certainly created elsewhere, somewhere on the Continent, and then it passed to Bury where it continued to collect new insertions. Michael Gullick, who has studied the manuscript most intensely, perceived the work of at least twenty-one different hands contributing over a half century between the mid-eleventh century and the early part of the twelfth. In those decades, we find traces of a revolution.

The Norman Conquest of England in 1066? Psshh. Okay, alright. Maybe that was a factor. But the revolution I’m talking about had its origins much further away than the English Channel.1 The revolution I’m talking about is the creation of a new “fantasy pharmacy”: substances whose medicinal powers were so unique that one simply must have them in one’s storehouse or infirmary, so that their marvelous properties could be drawn on in case of fever or incapacitating headaches or any of the other ills that normally befall the human body. This was a “fantasy pharmacy” because it likely was one that, at least initially, most individuals or institutions in Europe could have only imagined having, even a wealthy house like Bury.

What does our Sloane manuscript have to tell us about this revolution? Gullick describes two main hands that write out the opening 39 leaves of the volume, and then contribute various sections later on. Scribe A writes first, and then Scribe B copies up to the recto (front) side of leaf 38 (hereafter I’ll use “f.” for folio, “leaf”). He then leaves the rest of the quire (to f. 39 verso) blank. All the content copied by Scribes A and B were compound recipes, and all of them look quite typical for early medieval Latin medicine. The ingredients were all the same kinds of things that could be found in the Mediterranean area under the Romans. It is after Scribe B drops off that things get interesting.

In the blank lines that Scribe B left at the bottom of folio 38, Scribes d and then e take over. These two hands appear nowhere else in the manuscript. Gullick judges them both to date from around the middle of the eleventh century, and to show a Continental character, suggesting that the manuscript had not yet passed over to England. (I’m not convinced of this last point. As we know, not a few Continental “hands” went with their attached bodies across the Channel after the conquest.) Together, they copied out one very long recipe, taking up more than five pages all together. At the bottom of f. 39v, Scribe e switched from full lines of text to an itemized list: the ingredients, nearly 150 of them. Usefully, the list is alphabetized. Here are the ‘M’s:

London, British Library, MS Sloane 1621, f. 40v, part of the list of ingredients of a compound remedy.

Myrrh (mirra) and mastic were both resins that would have come from the Arabian peninsula and Mediterranean, respectively, and were as readily available in Antiquity as they likely were in the 11th century.2. Malabatron (a cinnamon-like plant) and mandrake (mandragora) would likewise have been known, even if not universally available, in the early Middle Ages. Even musk (muscatum) and myrobalans, substances imported from India or Tibet, were not completely new. But they were, likely, still extremely rare in any part of Europe in this period, and their inclusion in this one list is quite extraordinary.

In the ‘A’ section of the list, we similarly see ingredients that would have been familiar in the early medieval pharmacopeia. But we also begin to see something new. Ambergris (ambra, a secretion of sperm whales) and antimony (antimonium, the sulfide mineral stibnite) both appear here. The appearance of antimonium is especially intriguing, because Constantine is credited as having introduced that neologism into Latin.

London, British Library, MS Sloane 1621, f. 40v, some the ingredients beginning with the letter ‘A’ in a compound remedy. New here are ambra (ambergris, in the first line), and antimoniu (antimony) in the bottom line.

At the end of the list, come two additional clues that we’re dealing with something quite extraordinary:

London, British Library, MS Sloane 1621, f. 41r: the final lines of a list of pharmaceutics, ending with the newly imported substance, sugar (zaccara). In the second line from the top, the Arabic word uzifur (cinnabar) appears.

In the second line is uzifur, an Arabic word (perhaps originally from the Persian) for cinnabar, a kind of mercury sulfide. In the final row, the last item, zaccara, is sugar. A crop that originated in New Guinea, sugar had moved westwards over the course of the early medieval centuries and by the eleventh century was widely cultivated in various locales in and around the southern Mediterranean.3 Sugar would also appear in recipes as candi (rock sugar) and sciroppi (syrups) – and yes, now you know where those two words come from!

The recipe for which these items are the ingredients is a compound medicine called Antidotum Esdre maius. And it captures a moment of transition, of revolution. The record of pharmaceutics in early medieval medical manuscripts show that Latin medicine and Islamic medicine had gone quite separate ways in their development. As Brian Long has already told us, the Islamicate world expanded in the eighth, ninth, and tenth centuries, uniting a wide swath of the Old World from the Iberian peninsula to Central and Southeast Asia. So, too, did the pharmacopeia expand, bringing in substances that had already been adopted in local medical traditions. In the eleventh century, Europe finally began to participate in this larger network of medical trade.

It was, of course, a trade not simply in things (materia medica) but also knowledge. In fact, our Sloane manuscript suggests that the knowledge came first. The European adoption of the expanded Islamic pharmacopeia entailed three stages: first, the importation of recipes that used the new ingredients as part of compound medicines; second, the importation of the ingredients themselves, a process requiring a network of merchants skilled in trading the substance; and third, a growing lore of what each substance did individually and why it had a particular medicinal value. In other words, Europeans learned to desire a “fantasy pharmacy” before it ever existed in reality in Europe’s emporia.

The written recipe would have been the “advance advertising” for this new system of medicine, and that’s exactly the role our Sloane manuscript plays. We will recall that Scribes d and e, who copied out the Esdra recipe, appeared nowhere else in the manuscript. Sloane 1621 has a catch-as-catch-can character: most of the other scribes besides the main scribes A and B also wrote only a couple of recipes here and there. And we can prove, in fact, that Scribes d and e were copying an already set text (and not their own pharmaceutical creation), because the entire recipe appears word-for-word in two other manuscripts produced around the same time on the other side of the Alps.

One manuscript is Copenhagen, Det Kgl. Bibliotek, Gamle Kgl. Samling, MS 1653, most famous for its striking images of the fetus-in-utero from the treatise on women’s medicine by a late antique author, Muscio. It also has a second treatise on women’s medicine, this one associated with the Egyptian queen, Cleopatra. The latter half of Copenhagen 1653 is filled in with two long antidotaria, that is, collections of antidota, compound medicines. Similarly, Monte Cassino cod. 225 contains two long antidotaria. In both manuscripts, the Antidotum Esdre maius is the longest recipe. And both manuscripts were copied at the great Benedictine monastery of Monte Cassino, Constantine’s home for perhaps two decades after his arrival around 1076. Indeed, Monte Cassino 225 contains the first “polished” version of Constantine’s translation of Ḥunayn ibn Isḥāq’s Isagoge, the basic introduction to Galenic medicine as it was interpreted in the Islamic world.4

Although no explanation of the name is offered here, in other versions of the recipe it is said that “The Greater Esdra was composed when the prophet Esdra was sent into Babylon in exile.” In fact, recipes called Esdra were commonly found in early medieval compendia from the ninth century on. This Antidotum Esdre maius, however, is different from its early medieval predecessors in including all the new ingredients from the Islamicate world we flagged above.

The beginning of the list of ingredients in the recipe for Esdra in Copenhagen, Det Kgl. Bibliotek, Gamle Kgl. Samling, MS 1653, late 11th century, f. 159v. Note that in the left margin, a slightly later hand has written Confita nigra Constan[tini] (“Constantine’s black concoction”). Perhaps a reference to an alternate recipe that Constantine preferred?
The scenario I am imagining, therefore, is that our Sloane Scribes d and e, having been presented with a copy of an elaborate recipe—a veritable panacea that promised its efficacy against pains of the head and the belly, bites of both snakes and scorpions, leprosy and kidney stones—eagerly copied it down while they had the text in front of them. The only change the Sloane copyists made was in putting the ingredient list at the end of the recipe, whereas the Monte Cassino scribes put it in the middle.

Where did our Sloane scribes find an exemplar for this recipe? Did they travel all the way to Monte Cassino? Not necessarily. There’s no reason recipes like this couldn’t have circulated on scraps of parchment, passing by hand from one religious house or secular court to another. Did the Sloane scribes have access to all the ingredients? That seems unlikely. Did they even understand what all these ingredients were? I rather doubt it. The whole, rather chaotic volume of Sloane 1621 speaks of “for future reference” ambitions.

Maybe calling what we see in Sloane MS 1621 a “revolution” is too strong. Maybe this was a slow transition, a growing fascination for drugs whose smells, colors, tastes, effects, could only be imagined by those first hearing about them in northern Europe in the later eleventh century. The pages in Sloane 1621 with the Esdra recipe are still fairly clean, unmarked by later annotations or commentary. As Gullick notes, no additions at all were made in the manuscript after the early twelfth century; although preserved for centuries in the Bury library, the volume elicited no further interest. Perhaps it did just remain a fantasy pharmacy.

But we should note: it was into this same house that Constantine’s larger corpus of writings soon entered. And at Bury, as Winston Black has shown us, Constantine became a star! Constantine’s works at Bury not simply listed all these same drugs (and more!) but explained their properties. Although not documented there, it is possible that the Bury monks also had his treatise De gradibus—on the “degrees” (that is, the intensity) of different medicinal substances—which was one of his “bestsellers” throughout Europe.5 The De gradibus was used almost immediately after its composition for a medical poem written by someone in the Loire Valley styling himself “Macer” (after an ancient Roman poet), which was known as De viribus herbarum: “On the Properties of Herbs.”

“Macer” was, to be honest, not yet that adventurous in his pharmaceutical fantasizing. He focused on substances already familiar to Latin readers. He did, however, use the descriptions from the De gradibus to talk about the Indian imports zedoary and galangal, which had been known in the early medieval pharmacopeia but likely remained rare.6 It would be “Macer’s” successors, in the twelfth century, who more heartily incorporated into their medical practice the new luxury items of sugar, lapis lazuli, ambergris, musk compounds, and the several kinds of myrobalans. All these and more would appear in medical texts later, as a second wave of Arabic influence reached into Europe and as Europeans became better supplied by merchants and more daring to engage with what had first been only a fantasy world of new drugs.

Acknowledgements: My thanks to Arsenio Ferraces Rodríguez, who very kindly shared with me his transcription of the antidotaria in the Copenhagen manuscript, as well as his comprehensive list of earlier iterations of the Esdra recipe. Thanks also to Winston Black, for information on the pseudo-Macer herbal.

Further Reading:

  • Zohar Amar and Efraim Lev, Arabian Drugs in Early Medieval Mediterranean Medicine (Edinburgh: University of Edinburgh Press, 2017).
  • Debby Banham, “Medicine at Bury in the Time of Abbot Baldwin,” in Bury St Edmunds and the Norman Conquest (Woodbridge: Boydell Press, 2014), pp. 226-46.
  • Winston Black, “‘I Will Add What the Arab Once Taught’:  Constantine the African in Northern European Medical Verse,” in Herbs and Healers from the Ancient Mediterranean through the Medieval West, ed. Anne Van Arsdall and Timothy Graham (Aldershot: Ashgate, 2012), pp. 153-86.
  • Florence Eliza Glaze, “Salerno’s Lombard Prince: Johannes ‘Abbas de Curte’ as Medical Practitioner,” Early Science and Medicine 23, no. 3 (2018), 177–216.
  • Michael Gullick, “An Eleventh-Century Bury Medical Manuscript,” in Bury St Edmunds and the Norman Conquest, ed. Tom Licence (Cambridge, UK: Boydell & Brewer, 2014), pp. 190-225.
  • Anya H. King, Scent from the Garden of Paradise: Musk and the Medieval Islamic World, Islamic History and Civilization, 140 (Leiden: Brill, 2017).
  • Carmélia Opsomer, Index de la pharmacopée du Ier au Xe siècle, 2 vols. (Hildesheim, Zurich, and New York: Olms-Weidmann, 1989).
  • Nicholas Purcell, “Unnecessary Dependences: Illustrating Circulation in Pre-modern Large-scale History,” in: The Prospect of Global History, ed. James Belich, John Darwin, Margret Frenz, and Chris Wickham (Oxford: Oxford University Press, 2016), pp. 65-79.
  • Tsugitaka Sato, Sugar in the Social Life of Medieval Islam (Leiden: Brill, 2015).
  • Romney David Smith, “Calamity and Transition: Re-Imagining Italian Trade in the Eleventh-Century Mediterranean,” Past and Present, no. 228 (August 2015), 15-56.
  • Kathleen Walker-Meikle, “Antimony and Ambergris: ‘New’ Ingredients in the Antidotarium magnum,” 22 October 2015, https://recipes.hypotheses.org/6901.

1. That it was related to the other Norman Conquest—that of Sicily (ca. 1061-1091)—is very likely. Hopefully, that will be a topic we will return to in a future post.

2. Nicholas Purcell offers a fascinating survey of evidence for various types of incense in the ancient Roman world, though he omits medicinal uses.

3. Succarum is not documented in the Dictionary of Latin from British Sources until 1267, about 200 years after the Sloane manuscript. (Sugar compounds, such as zukarum Alexandrinum, zukarum rosatum, and zukarum violatum, show up somewhat earlier, in 1226.) This is an indication how much remains to be researched about the circulation of imported pharmaceutics in medieval Europe, since clearly our medical manuscripts document a much earlier knowledge of these substances.

4. An analysis of the two earliest copies of the Isagoge can be found in Francis Newton, “Constantine the African and Monte Cassino:  New Elements and the Text of the Isagoge,” in Constantine the African and ‘Alī ibn al-’Abbās al-Maǧūsī: The ‘Pantegni’ and Related Texts, ed. Charles Burnett and Danielle Jacquart, Studies in Ancient Medicine 10 (Leiden: Brill, 1994), pp. 16-47. Monte Cassino, Biblioteca della Badia, Cod. Casin. lat. 225, had not yet been digitized; a color reproduction of the stunning “colonnades” of the Antidotum Esdre maius recipe (on pp. 82-83), can be found in Peter Murray Jones, Medieval Medicine in Illuminated Manuscripts, rev. ed. (London: British Library [by] arrangement with Centro Tibaldi, 1998), fig. 51.

5. Monica H. Green, “Medical Books,” in The European Book in the Twelfth Century, ed. Erik Kwakkel and Rodney Thomson (Cambridge: Cambridge University Press, 2018), pp. 277-292, Table 1.

6. Black 2012, pp. 163-166.