Poison, Medicine, and Disease in Late Medieval and Early Modern Europe

Frederick W Gibbs

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9781472420398
• eBook ISBN: 9781317079323
• Edition: 1
• Topic: History
• Subtopic: World History
• Index: History

This book presents a uniquely broad and pioneering history of premodern toxicology by exploring how late medieval and early modern (c. 1200–1600) physicians discussed the relationship between poison, medicine, and disease. Drawing from a wide range of medical and natural philosophical texts—with an emphasis on treatises that focused on poison, pharmacotherapeutics, plague, and the nature of disease—this study brings to light premodern physicians' debates about the potential existence, nature, and properties of a category of substance theoretically harmful to the human body in even the smallest amount. Focusing on the category of poison ( venenum ) rather than on specific drugs reframes and remixes the standard histories of toxicology, pharmacology, and etiology, as well as shows how these aspects of medicine (although not yet formalized as independent disciplines) interacted with and shaped one another. Physicians argued, for instance, about what properties might distinguish poison from other substances, how poison injured the human body, the nature of poisonous bodies, and the role of poison in spreading, and to some extent defining, disease. The way physicians debated these questions shows that poison was far from an obvious and uncontested category of substance, and their effort to understand it sheds new light on the relationship between natural philosophy and medicine in the late medieval and early modern periods.

1 Classical authorities and traditions

When the Emperor Nero (r. 54-68 CE) realized that Locusta. his favorite poisoner, had failed in an attempt to dispatch a political rival (she merely made him ill), he chastised her for administering a medicine rather than a poison.¹ Nero's distinction between medicine and poison clearly hinged on the ultimate effect of the substance, and thus his admonishment faithfully echoed the Greco-Roman conception of drugs that encompassed a broad spectrum of effects upon the human body. That classical physicians rarely drew sharp distinctions between medicines and poisons—even though they obviously recognized and described the harmful potential of many drags—stands in sharp contrast to some late medieval physicians who labored to define, characterize, and understand the properties of poison as a substance categorically and ontologically distinct from medicine.

To understand the significance of how late medieval physicians re-conceptualized and reshaped the nature of toxicology, one must first understand the ways in which the concept of poison was employed and discussed by various Greek, Roman, Byzantine, and Arabic medical writers. This preliminary chapter, therefore. seeks to establish the nature of "classical" toxicology that was inherited by physicians of the Latin West. A few key questions guide the inquiry here: How did physicians write about poisons and unusually powerful drugs? To what extent did medical authorities attempt to differentiate poisons from other drugs? When a physician labeled something as a poison, what were his assumptions and understandings? How did theoretical understandings of poison develop and change over time? To address such questions, I examine some influential medical discussions about poison ranging from the earliest extant Greek text by Nicander (fl. 2nd c. BCE[?]) to a late Arabic treatise by Maimonides (1135-1204 CE). While highlighting the medical sources in which strong drugs, poisons, or venoms feature prominently, this chapter also provides a synthetic overview of classical toxicology that complements the many and variegated specialized studies on the subject.

The first section of this chapter highlights the inherent and multivalent ambiguity in both the Greek pharmakon and the Latin venenum with a cursory survey of the wide variety of ways these terms were employed in literary and medical contexts. The relative disinterest in crafting a distinction between medicines and poisons characterizes classical works such as Pliny's Naturalis historia (Natural History) and Dioscorides's De materia medica (On the Substances for Medicines), even as such authors helped to enumerate, systematize, and classify hundreds of poisonous plants, animals, and minerals. Their ambivalence about what was and was not especially dangerous or poisonous partially motivated later medieval physicians to craft more precise categorizations and distinctions between them.

The second section highlights how classical medical texts that significantly engaged with poison focused almost exclusively on the practical concerns of prevention, symptoms, and remedies for poison—that is, avoiding or dealing with an acute medical condition, whether from the ingestion of a deleterious substance, or from a bite or sting from a venomous animal. In contrast to later medieval physicians, classical physicians paid comparatively little theoretical attention either to how poison operated inside the body, or to the status of poison as a separate category of substance. Inquiries into the nature of poison, or any systematic attempt to craft a definition of poison, for example, are not an explicit feature of classical literature. For this reason. I suggest that medical writings on the subject of poison that comprise the classical tradition are more about being poisoned than about the substance of poison itself. Specific inquiries into the nature and properties of poison per se would become a key feature of late medieval Latin treatises on poison.

The last two sections outline some important theoretical developments with respect to distinguishing between poison and strong drags. In particular, I survey crucial works by Galen, Avicenna, and Averroës—each of whom was heavily cited in later literature on poison (and of course in medical texts generally)—and how they paid increasingly explicit attention to the operation of poison in the body. Their emphasis on the operation of poison by some kind of innate power—generally referred to as its "specific form" or "total substance"—proved foundational for subsequent medical literature on poison.

The ambiguity of pharmaka and venena

To describe the character of the Greek or Roman concept of pharmakon remains a daunting task for the English language. Of course it most closely mirrors the notion of drug, but often translators attempting to clarify the ambiguity of a particular context render pharmakon as either poison or medicine—thus unfortunately abandoning the spectrum of meanings inherent in the Greek word, which ranged from helpful medicine to deadly poison. Classical physicians did not draw definitive conceptual boundaries between substances that could help the body and those that could harm it. which ultimately created an unusually rich etymological interplay between various signifiers for poison, such as potion, drink, and gift.² I do not here attempt a comprehensive linguistic analysis of the way physicians used either term. Rather, I canvas some representative medical (and a few literary) examples to illustrate the wide range of uses and the inherent ambiguity that governed how physicians considered and discussed drugs, medicine, and poison. This ambiguity, in part, would give rise to medieval and early modern debates about the very nature of poison itself.

Beyond the particular meanings of drug and poison, literary examples illustrate the wide range of potential meanings, many of which have been examined through various social lenses.³ Perhaps the most provocative illustration of the ambiguity inherent in pharmakon comes from the contrast between how Euripides (5th c. BCE) had Palamedes describe his creation of writing as a pharmakon against forgetfulness. in the sense of a remedy, and how Plato (428/7-348/7 BCE) in his Phaedrus had the Egyptian king Thamous declare the pharmakon of writing to be not for memory, but for reminding, a more nefarious characterization that embraces the helpful and harmful duality.⁴ Not only was the idea of pharmakon employed to signal ambiguity itself, but it most fundamentally implied an element of change. In perhaps one of the earliest examples, as found in the Odyssey, Helen added to wine an Egyptian pharmakon (nepenthes) to ease the melancholy of Menelaus and Telemachus.⁵ In that same passage, the Odyssey goes on to suggest the range of effects possible from pharmakon, noting that "so cunning the drugs that Zeus's daughter [Helen] plied. . . many health itself when mixed in the wine, and many deadly poison."⁶ Affecting change upon the body could be more spectacular as well, such as when the mythological sorceress Circe employed a phar makon to change Odysseus's men to pigs and back again.⁷ Even the identity of Circe herself as a polypharmakos has led to a variety of translations, including "knowing many drugs." "skilled in spells," and "skilled in medicine."⁸ Creating change could of course mean inflicting injury as well, as when pharmakon referred to something into which arrows might be dipped with the aim of poisoning the enemy.⁹ Bearing in mind the notion of change and transformation, though rarely as dramatic in medical texts as in these literary examples, will prove essential to understanding later theoretical writing about poison that makes the nature of change inside the body a possible dividing line between food. drug, and poison.

Although pharmakon often referred to change, the term in many legal contexts referred more specifically to the process of harm. Plato's Leges, for example, described two kinds of poison, one of which occurs when "injury is done to bodies by bodies according to nature's laws." such as the employment of drugs and potions. The other type works upon the mind by the practice of "sorcery, incantations. or spells." convincing victims that they in fact are being injured.¹⁰ Bringing harm to the body, especially through the second case—and thus through processes that remained rather mysterious—encouraged an affinity between magic (as part of nature) and drugs. It is no surprise, then, to find that one Theoris (an alleged "witch" from Lemnos prosecuted in Athens before 338 BCE) was characterized in trial documents as a pharmakis (a woman who works with drugs), and also a member of "a recognized group of women who have specialized in providing magical services."¹¹ Crucially, we must note that in both of these cases (and in the medical cases that will be discussed shortly), any drug that could cause the body harm was thought to do so as a result of how it was used rather than through any particular property of the drug itself. For this reason, intent mattered for a legal defense, provided that the administrator of the pharmakon was considered inexpert. Physicians who caused a patient to die via some pharmakon "should be punished by death;" for a lay person, the court would decide "what he shall suffer or pay. Similarly, prophets or diviners using sorcery to injure victims could be executed for their crimes, but those ignorant of the prophetic arts would be less severely penalized.¹²

Trials for poisoning further demonstrate the inherent ambiguity between drug and poison, particularly how pharmakon frequently signified deadly poison, even if it were administered with the intention of being a beneficial drug. For instance, we see this in the case of Antiplion (c. 480-411 BCE), the Athenian orator and sophist, who wrote a defense for a choirmaster who was tried for poisoning when one of his choristers was benevolently administered a throat-clearing drug that inadvertently proved fatal.¹³ Similarly, Antiphon's only surviving speech from when he served (uniquely in his career) as a prosecutor for a murder trial in which poison was involved shows how he countered a defense that argued that the defendant had no intention of murder, but rather tried to provide a love-philtre instead.¹⁴ Similarly. Apuleius (c. 125-? CE) in his Apologia—a public defense against an accusation that he was a poisoner—cites hellebore, hemlock, and opium as examples of dangerous drags that would be perfectly beneficial if used properly.¹⁵ Tellingly. Antiphon glosses over the procurement of such strong drugs as if they were a common occurrence, and thus further underscores the spectrum of drug action in classical medicine rather than any pervasive dichotomy between medicine and poison.

Even though pharmakon (drag) embraced a wide range of effects on the body, the concept of a natural poison that was potentially (if not expectedly) deadly was well represented in the Greek lexicon: toxon was the word for "bow"; toxikon meant "pertaining to a bow"; the phrase toxikon pharmakon came to refer to a poison to be smeared on arrows. Later, the Greek toxikon becam...

Table of contents

• Cover
• Title
• Copyright
• Contents
• Acknowledgments
• Introduction
• 1 Classical authorities and traditions
• 2 Poison and venom in the Latin West before 1300
• 3 Toward a new toxicology
• 4 Plague, poison, and metaphor
• 5 Poisonous properties, bodies, and forms
• 6 Poison, putrefaction, and ontology of disease
• 7 Reframing toxicology
• Epilogue
• Bibliography
• Index