Theriac-the “cure” for the disease
We are all bound thither; we are hastening to the same common goal. Black death calls all things under the sway of its laws.
-Ovid
*Disclaimer-this is about a historical preventative and curative medicine that did not work, but was nonetheless widely popular for thousands of years.
The Recipe
Why write an article about a cure that does not work? With the continued spread of COVID around the world, I thought it would be timely to take a step back and look at the plague (the Black Death), another widespread pandemic. We now know that the Black Death was caused by the bacterium Yersinia pestis or Y. pestis. It caused painfully swollen lymph nodes that form pus-filled boils (buboes) as well as fever, chills, headaches, shortness of breath, hemorrhaging, bloody sputum, vomiting, and delirium. In the worst cases, the plague killed about 50 percent of the people who contracted it. Want to know more? I highly recommend the plague episodes on This Podcast Will Kill You.
Outbreaking in waves for over 700 years (the peak was in 1347 to 1351 CE), the plague resulted in the deaths of up to 200 million people (though a wide range of estimates exists). The ramifications of the plague went far beyond death, resulting in religious, social, and economic upheavals in its wake. In short, the plague was catastrophic. So, how did people deal with the plague? Not well. But one of the ways was through partaking in a range curatives; from the reasonable (rest and basic hygiene practices) to the absurd (like rubbing a chopped up snake or dead pigeon on the plague boils).
A common curative was a syrup known as theriac. Said to cure the plague and marketed as medicine, theriac was composed first and foremost, of vinegar. This was because vinegar was thought to be the remedy for “bad humors,” caused by an imbalance of the four bodily humors (blood, phlegm, black bile, and yellow bile). The ideas of humors relating to disease can be traced back to Greece (or perhaps even as far back as Mesopotamia). Essentially, the idea is that when your bodily humors get out of a balance, action had to be taken to restore your health, such as bloodletting to get rid of your extra blood (you didn’t have extra, that is not a thing, oh old-timey science). Often, the imbalance was ascribed to bad air, an idea that would stick in medicine far longer than you might imagine.
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Emperor Mithridates VI Eupator ![]()
Pliny the Elder
The origins of this cure (theriac) can be traced back to another medicine called mithridate. Mithridate, named for its supposed inventor, Emperor Mithridates VI Eupator of the Pontic Empire (it was in Anatolia, I had to look it up), who ruled in the first century BCE. Mithdridate, the preventative, was thought to be an antidote to poison. This was apparently something Mithridates was overly concerned about as he took it every day in order to render his body safe against poison. While actual evidence for this supposed preventative is limited to non-existent; later writings go on to describe mithridate as containing numerous ingredients, such as:
“costmary 1.66 grams, sweet flag 20 grams, hypericum, gum, sagapenum, acacia juice, Illyrian iris, cardamon, 8 grams each, anise 12 grams, Gallic nard, gentian root and dried rose-leaves, 16 grams each, poppy-tears and parsley, 17 grams each, casia, saxifrage, darnel, long pepper, 20.66 grams each, storax 21 grams, castoreum, frankincense, hypocistis juice, myrrh and opopanax, 24 grams each, malabathrum leaves 24 grams, flower of round rush, turpentine-resin, galbanum, Cretan carrot seeds, 24.66 grams each, nard and opobalsam, 25 grams each, shepherd’s purse 25 grams, rhubarb root 28 grams, saffron, ginger, cinnamon, 29 grams each. These are pounded and taken up in honey. Against poisoning, a piece the size of an almond is given in wine. In other affections an amount corresponding in size to an Egyptian bean is sufficient.”
Celsus, De Medicina (V.23.3)
While there are ingredients in that list that do have health benefits, such as reducing inflammation, not everyone bought into its ability to prevent and heal poisoning. For example, Pliny the Elder’s Natural History, stated, in 79 CE, that
“the Mithridatic antidote is composed of fifty-four ingredients, no two of them having the same weight, while of some is prescribed one-sixtieth part of one denarius. Which of the gods, in the name of Truth, fixed these absurd proportions? No human brain could have been sharp enough. It is plainly a showy parade of the art, and a colossal boast of science.”
-Pliny NH
The later preventative and curative Theriac more or less evolved from Mithridate. The name theriac comes from the Greek term theria, which translates to beasts; perhaps due to the belief that it could cure the bites from wild animals. The popularity of theriac as a cure-all is evident; versions of theriac were used from approximately first century BCE up until the nineteenth century CE, with the medicinal concoction becoming widely adopted throughout the ancient Old World (spreading from Greece to as far away as Persia, China and India via the Silk Road).
One of the earliest formulations for theriac was used to cure bites from venomous animals. The recipe for this concoction was inscribed on a stone in the Temple of Asclepios on the island of Kos, off mainland Greece. The recipe called for thyme, opoponax (a gum resin), anise, fennel, and parsley.
Theriac quickly became more than just a cure for poison. Andromachus, physician to the Roman Emperor Nero, in the first century CE, claimed that “his formula for his Galeni Theriaca (tranquillity theriac) was an improvement on that of Mithridates because it contained some 64 ingredients and was enriched with the flesh of viper and a much greater quantity of opium.”
Viper? Yes, snakes, scorpions, flesh from animals, were all included in versions of theriac throughout history. Even more unusual, Mummy powder (from real Egyptian mummies) was also sometimes added to theriac. In fact, up to eighty different ingredients could be included in theriac; with expensive or rare ingredients limited to the upper classes and common substitutes used among the poor.
As theriac grew in popularity, it was sold in apothecaries and pharmacopeias throughout the countryside. Commonly, tonics included cinnamon, saffron, rhubarb, pepper, ginger, and opium, then mixed with wine/vinegar and honey (mixed together this is known as an electuary-or medicinal syrup).
Another common version includes a recipe by Gentile of Foligno, an Italian professor and doctor of medicine. His fourteenth-century remedy included ‘garden herbs’ such as pear garlic, radish, nuts, rapeseed (mustard), and rue (a herb) cooked and drunk with wine, vinegar, or water.
In Gervaise Markham’s The English Housewife (1615), there is a recipe for theriac which used rue and other herbs. Another similar recipe from this time, published in the British Jewel (1769) used rosemary, sage, rue, other herbs, and flowers, fermented in white wine.
When the plague starting surging in Europe in the 14th century, theriac (sometimes also known as Venice Treacle) quickly became a popular preventative and cure. As Gentile of Foligno boldly stated, those who drank theriac “may walk in airs infected every hour” and not get sick. Even Aristotle, in the Book of Heaven, proclaimed that who drank theriac did not die of the plague.
Theriacs popularity likely stems from multiple factors; its wide availability, the oral history of its effectiveness dating back centuries, the (poor) understanding of disease and illness at that time, and the general fear triggered by the mass death and hysteria associated with the plague. Moreover, the ability of theriac to cross-cut social classes, through modifications to the ingredients, only furthered its popularity and subsequent belief in its potency. Theriac maintained popularity well into the seventeenth- and eighteenth centuries, though the recipe was modified through time. Snakes and scorpions became less common and other, more widely available ingredients, such as sugar, took prevalence.
Was theriac a miraculous cure-all and preventative medicine? Could it prevent and heal disease, heal bites from rabid and poisonous animals, and prevent poisoning? Of course not. In fact, many people, going back centuries (such as Pliny the Elder in the first century CE) had questioned its efficacy. In Europe, advances in science and medicine, starting in the seventeenth century, began to refute earlier medical texts and cures. Eventually, theriac fell out of favor, with pharmacists stopping its production and sale in the 1800s.
But the power of such medicines does not necessarily lay in their ability to cure, but in their ability to ease fear and anxiety in uncertain times; to provide action for those who otherwise do not have the ability, or knowledge, to act. For people living through the Black Death, concocting and consuming theriac must have provided momentary relief from the realities of the world around them. At that moment, the Black Death was not as frightening and as uncontrollable as it seemed. At that moment, people may have felt that they prevented their death and the death of those they cared about, and that alone, was powerful.
Further Reading
Emma-Louise Groucutt, Dining with death: An Exploration of Food Culture During theLong Black Death (1348-1771). Masters thesis, University of Sydney, 2014.
Adamson, Melitta Weiss. Food in medieval times. Greenwood Publishing Group, 2004.
