Felipe Fernandez del Castillo
Massachusetts, United States
We don’t know much about Scribonius Largus. The first century Roman physician has been overshadowed by more famous medical authors like Celsus, Pliny, and Galen. Dismissed by one scholar as “second rate”,1 Scribonius has lurked for centuries in the footnotes of history textbooks and journal articles, and the bulk of his only work is as yet untranslated into English.
It is easy to see why. The Compositiones Medicamentorum is a distinctly “low yield” book. Written in tortured Latin, the book contains about 300 medication recipes: lists of ingredients and instructions for turning them into remedies. Few anecdotes relieve the monotony, and though some of Scribonius’ remedies are intriguing, and fewer are plausible, most are either useless or harmful.
Yet Scribonius is a unique voice among ancient medical authors. Far less polished than any of his contemporaries (“if the Latin of Celsus is . . . a glass of sparkling wine, that of Scribonius is not far from dishwater.”1), there is a refreshingly folksy, down to earth quality to his writing. Though his work teems with references to the titans of ancient medicine, he is also happy to cite “a certain good woman who lives in Rome,” and he applauds the efforts of folk healers who are “eager to assist the sick in any way possible.”
Furthermore, Scribonius is a model physician in his dedication to his patients. We see this particularly in his Preface, where he argues that physicians should be motivated by kindness (humanitas) rather than materialistic aims.2,3 We also see it in the number of references to other books and other physicians in his text. Though sometimes Scribonius’ reliance on the limited scientific tradition of his time leads him spectacularly astray (see his recommendations on tourniquets below), it is clear that he regards his profession as a privilege and feels compelled to muster all the resources he can to the service of his patients. On these grounds alone, modern clinicians will feel a kinship with their 2000-year-old colleague.
I present below a selection of original translations from Scribonius’ work.
A live stingray placed on that part [of the head] which is in pain until the pain stops and the part goes numb immediately relieves and perpetually cures headache, however chronic and intolerable. As soon as [the patient] senses numbness, let the fish be removed, otherwise that part of the head will be numb forever. Many electric rays of this type should be obtained, since occasionally a cure (that is numbness, which is a proof of cure) appears after two or three [applications of the treatment].i
14, 16, 17—EPILEPSY
(14) It is established among many that a victoriatus2 of crocodile testicles taken with three cups of water for thirty days has cured many [from epilepsy].
(16) I know a certain good woman in Rome who has cured many of epilepsy by this medication:
1 small measure of ivory filings
1 pound of Attic honey
These are mixed together.
Afterwards, if it is a boy who suffers, the following ingredients are added:
The blood of a male turtle, a male dove, and the blood of any recently captured wild beast: as much blood as flows out while each animal is still alive.
But if it is a girl who suffers then the animals should be of the female sex, captured in the same way.
Let these animals be killed by bloodletting. It is important that a sharp nail of Cyprian bronze be stuck into the jugular vein of the turtle, and to incise the veins of the dove, which are beneath the wings, with sharp bronze. . . . There are even those who will drink blood from their own veins, or who will drink three spoonfuls of blood from a dead man for thirty days.
(17) Likewise let them consume a part from the liver of a slain gladiator nine times. Whatever remedies of this sort exist fall outside the profession of medicine, however much they seem to be of benefit to other people.
I add opium to this mixture and to all salves, and my patients respond better. However, make sure to use that which comes from the pulp of the wild poppy flower, not from the leaves, like what the peddlers of unguents make for the sake of profit. The former is wrought with great labor in small quantities; the other is ground up without bother and [found] abundantly.
[This is] a toothpaste which makes teeth shine brightly and makes them stronger: sprinkle a sextarius of barley with vinegar mixed with honey, and knead it thoroughly. Then divide [the mixture] into six globules. This done, a measure of salt dug up from the ground is mixed in. Cook this in an oven until it is rendered into charcoal. It will then be necessary to mix in nard however much seems like enough.
It is imperative that the person seeing the wound place a sponge recently taken from water or harsh vinegar over it and to change [the sponge] frequently lest it harm the wound by becoming too warm. It is also important to prevent the limb from being bound up, which many doctors do, not realizing that bleeding is aggravated by compression of the muscles. This is because all forms of compression in any part [of something] will cause more of the underlying material to spurt out. Just as is the case with a bag, if someone tightly ties the middle of the bag with a string, he will notice that the underlying material will move to another part. And if by chance there is a hole over [that part of the bag], whatever is inside it will be ejected with rapidity. For this same reason when blood is spurting [from limbs] those who cinch [them], compressing the limbs with great force, cause more blood in the veins to be lost through the wound. The evidence for this assertion is that if someone punctures a vein above a tourniquet in the limb of an animal, he will notice that blood is lost equally from that part as from a lower place when the vein is punctured. And if physicians do no not see this plainly they deserve to be blamed . . . since blood loss is aggravated by their ignorance. And, O God, these are the very ones who blame their failures on medicines, as if these weren’t good for anything.
Fenugreek, sent up through the anus, also works well for this disease. It is important to cook the fenugreek well in water and then to administer a measure. Likewise, it is important to cook rue in household oil and add to this a measure of the warm water I mentioned earlier. Into these you should mix in a smaller amount of saltpeter, and send it up warm through a syringe.
I myself once healed the slave of a certain merchant who sold perfumes by means of this medicine. He was already vomiting feces, so he otherwise would have died. Ileus is a very deadly disease indeed, and therefore is accounted among the most serious. For this reason, we should certainly not approach this kind of disease with a lot of confidence.
This medicine is of benefit for patients with dropsy. . . . Take:
20 parts of white bryony
4 parts of cooked mezereon
10 parts of scilla bulb cooked with the exterior part having been peeled off ii
8 parts of myrrh
. . . It is important during treatment to give the patient simple, rustic meat, or poultry, for food, with austere and simple wine.
When drunk, opium (which some call meconium) is recognized by its heavy odor, a property which it takes from the green poppy, of which it is the juice. It causes heaviness of the head, bruising and stiffness of the joints, and causes cold sweat to flow. It impedes respiration, fogs the mind, and makes one unconscious. Those who drink it . . . should be made to vomit frequently with either a feather or lorumvomitorium. . . . Mustard and harsh vinegar, rubbed on the feet and calves are also useful here, as they prevent sleep for a time, lest the patient becomes unconscious.
199—ACCIDENTAL LEECH INGESTION
When leeches, which some call blood suckers, have been eaten and are clinging to the upper throat, a great bother to that part of the body, and something most ticklish, then it is important to remove them with vinegar, as much as can be drunk. . . . Lumps of snow will also do the same thing, if taken in great quantities.
Honey, either by itself, or dry iris ground up with honey, cleans dirty wounds in all parts of the body (by dirty I mean when they become white, or become covered with a white crust).iii
- Electrotherapy for chronic migraine has been studied and reviewed.4
- Plants in the Scilla family contain cardiac glycosides, and have been implicated in at least one case of fatal toxicity.5
- Honey is an excellent antimicrobial and is still used in some settings.6
- Majno G. The Healing Hand: Man and Wound in the Ancient World. Cambridge, MA: Harvard University Press; 1991.
- Pellegrino E, Pellegrino A. Humanism and ethics in Roman medicine: translation and commentary on a text of Scribonius Largus. Literature and Medicine. 1988; 7 (22-38).
- Hamilton JS. Scribonius Largus on the medical profession. Bulletin of the History of Medicine. 1986; 60 (209-16).
- Silberstein SD, Dodick DW, Saper J, et al. Safety and efficacy of peripheral nerve stimulation of the occipital nerves for the management of chronic migraine: Results from a randomized, multicenter, double-blinded, controlled study. Cephalalgia. 2012;0(0):1-15. doi:10.1177/0333102412462642.
- Tuncok Y, Kozan O, Cavdar C, Guven H, Fowler J. Urgineamaritima (squill) toxicity. J ToxicolClinToxicol. 1995;33(1):83-86. http://www.ncbi.nlm.nih.gov/pubmed/7837318.
- Jull AB, Rodgers A, Walker N. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2008;(4):CD005083. doi:10.1002/14651858.CD005083 .pub2.
FELIPE FERNANDEZ DEL CASTILLO is a 4th year medical student at the University of Massachusetts. He lives in Central Massachusetts with his wife and daughter.