Erectogenic Drugs in Greek Medicine

Dioscorides of Anazarbus and Rufus of Ephesus

Writing in the second half of the first century AD, Dioscorides of Anazarbus produced one of the most influential works in medical history, the Materia Medica. As Dioscorides reported in the preface, his interest in materials of medicinal value began at a young age. After leading a so-called “military life” with extensive traveling, he committed his lifelong findings and observations to a five-book tome.⁶ Among the vast array of plants, animals, and minerals described throughout his work, Dioscorides included over twenty substances with sexually stimulative properties (see Appendix, page 22). None are specified outright as erectogenic,⁷ though a later body of material associated with Dioscorides’ name does present such details.

Sometime during the early sixth century a list of synonyms entered the alphabetical recension of the Materia Medica. There, in the alternative names for a type of orchid known as satyrion, we find that

some people call this satyrion the erythraikon, some the apple in the waters (mēlon to en hydasin), some entatikon, some priapiskon, some satyriskos, and some the orchid of Satyr (orchis Satyrou). The Romans call it rabbit’s testicle (testikouloum leporis).

Whatever the actual identification of the orchid in question, the name drew inspiration from its association with satyrs, the notoriously lecherous goat-human hybrids of Greek mythology, or else Priapus, the ithyphallic god punished with a permanent erection—perhaps because this orchid was perceived to bear physical resemblance to male genitalia.⁸ The fluidity of botanical nomenclature in antiquity comes out in this passage, especially for plants deemed to have sexual value. As we will see, however, not all of those plants were linked to sex by name or appearance.

For an earlier and more secure attestation of entatikos, one must turn to the fragmentary On Satyriasis and Gonorrhea written by Rufus of Ephesus (fl. AD 100). Our single manuscript of the work begins with a certain man, presumably a former patient of Rufus’, “whose penis was twitching.” Unfortunately, the text breaks there. When the fragment becomes intelligible again, Rufus assessed the causes of twitching in various areas of the body, and two conditions known as “satyriasis” (a perplexing state of painful arousal) and “gonorrhea” (involuntary release of semen). Rufus later moved to a discussion of treatment, in which he made one of the following recommendations:

Moderate excretions of the belly, apart from being helpful for the entire [affection, also] lighten [the area around the] loins, which one must take great caution to ensure neither becomes filled nor irritated. For, both [of these conditions] are exciting and arousing (kinētika kai entatika).

The underlying logic seemed to be that disturbance in the belly could quickly translate into disturbance in the nearby area of the loins. Remaining circumspect about one’s diet—particularly avoiding excessive intake—was thus an important precautionary measure.⁹

Galen and Pseudo-Galen

Dioscorides and Rufus were not the only ones to link food with the potential for arousal. Writing not long after them was Galen (AD 129–c. 216/217), a native of Pergamum in modern day Turkey whose meteoric rise to fame earned him one of the most prominent places in medical history. Galen received a broad training in medicine and related disciplines under noted authorities of the time, and he went on to serve as a physician for the gladiators in Pergamum, and later, as personal physician to the emperor Commodus.¹⁰ The massive corpus of Galen’s works contained discussions of erectogenic drugs in two places: On the Affected Places and On the Mixtures and Faculties of Simple Drugs. Towards the end of On the Affected Places, Galen proffered an explanation of the physiological mechanisms behind priapism, a devious condition that creates painful and involuntary erections. He appended the following observation:

And furthermore, drugs that create erection—both those that are imbibed and those that are applied around the perineum and the loins—are all hot and produce air (pneumatōdēs), just as, in turn, the drugs that do the opposite are not flatulence inducing (aphysos) and are cool rather than heating.

Though a link between flatulence and sex sounds odd to the modern reader, Galen here reflected a general theory in antiquity that a form of air (pneuma), rather than blood, filled the penis during tumescence. In Galen’s reckoning, heat dilated the appropriate arterial passages transporting that air. Thus, excessive amounts of heat could allow excessive amounts of air to pass through. Accordingly, in the case of priapism, patients should seek to do the opposite. As we shall see, Galen was one of many authors in antiquity to associate heating properties with sexual stimulation.¹¹

On the Mixtures and Faculties of Simple Drugs was one of Galen’s works on pharmacy. Like Dioscorides, Galen covered a broad range of plants, animals, and minerals. One of these substances was the skink—or, to be more precise, its insides:

The area around the kidneys of the skink is imbibed to produce erection and, furthermore, seems able of doing the opposite, especially when imbibed with lettuce seed (thridax) in water. Some people also say that drinking a decoction of lentils (phakos) with honey stops erections.

This passage echoes Dioscorides, who had already described the skink as stimulative and noted the opposite effect in combination with lentils and honey. Galen, though, linked it specifically with erectogenesis.¹² Lettuce was generally associated with cooling properties, and Galen even provided an anecdote in one of his works about his personal use of lettuce as a sleep-inducing cure for insomnia.¹³ More significantly, though, the passage above demonstrates one of the recurrent difficulties in studying erotic drugs in antiquity, and one that ancient readers would have surely faced as well: ambiguity. Textual evidence suggests that the skink had a widespread reputation as a stimulative substance—whether by generating sexual arousal, as Dioscorides had it, or by generating an erection, as Galen reported.

These two works by Galen said little about erectogenic drugs when compared to On Easily Procured Drugs, another work attributed to him. The authorship of On Easily Procured Drugs remains disputed, and the lack of any clear reference to it by ancient commentators makes dating difficult. If it was composed after Galen’s lifetime, the only terminus ante quem available is the thirteenth century, which is the date our earliest manuscript.¹⁴ The author specified that “the following things make the penis erect and are sexually stimulative,” thus combining the two strands of thought about sexually charged substances encountered above. He then listed a series of recipes, some of which are imbibed, others of which are anointed. These recipes were relatively straightforward with few ingredients, such as:

Anoint the penis with honey before sex.

Another: put arugula seed (euzōmon) in honey and drink.

Honey was used broadly in cuisine and certain wines, while arugula was famous for its pungent flavor, and so generally described to have a heating effect. Both appear frequently in erectogenic recipes, and the latter as a stimulative substance in its own right.¹⁵ Other recipes from the text involve additional spicy ingredients, along with more directions:

Take two ladles of arugula juice (euzōmon) along with a sufficient amount of white pepper (peperi leukon) for three days back to back; or, take one spoonful of arugula juice and white pepper on an empty stomach.

And other recipes involve animal products:

Whenever the bull urinates after sex, mix soil and the mud made by the urine into a plaster and anoint it on the penis.

Although this recommendation likely sounds unpalatable to modern readers, it is worth remembering the differences in perceptions of hygiene between agricultural and industrial societies. The ancients lived in close proximity to, and interacted daily with, domesticated animals. Animals were such a familiar aspect of daily life that ancient physicians often turned to them for inspiration—not only for producing anatomical knowledge through dissection, but also pharmacological experimentation.¹⁶

Aelius Promotus

Biographical details about our next author are scarce. Aelius Promotus (c. AD 140–190?) was probably a contemporary of Galen, and he wrote multiple works on pharmacy, the most relevant for our purposes being the Dynameron.¹⁷ Its 130 chapters covered conditions from hair loss to dysentery, and three were dedicated to erotic recipes. In language reminiscent of a sales pitch, chapter twenty-four promised:

an entatikon, unfailing from experience: after chopping up two ounces of arugula seed (euzōmon), one ounce of pepper (peperi), and a half ounce of celery seed (selinon), take one spoonful with seasoned wine mixed in hot water on an empty stomach after a bath for three days and you will be amazed.¹⁸

Note the appearance of arugula and pepper again, famous for their heating properties. Celery seed was thought to be diuretic, a property linked in some texts to sexual stimulation.¹⁹ There was also the implication that this recipe had been tried many times. Authors of pharmaceutical texts sometimes vouched for the efficacy of a recipe by describing their personal experience with it, though it is hard to tell whether they were actually repeating the experience of their sources.²⁰

Aelius followed with a chapter on drugs that prevent erections, listed under the antonym anentata:

1. After crushing up mountain mint (kalaminthē oreinē) with wine and milk, rub the member [i.e. penis] and it will not be made erect.

2. Place a twig or root of artemisia (artemisia) with mint (kalaminthē) under the bed.

3. Lay out thin-leaf fleabane (konuza leptophullon) [under the bed] or smear the member with the gallbladder of an electric ray and olive oil.²¹

The juxtaposition of drugs that produced and inhibited erections was an interesting one. In Galen’s case, the skink served both purposes when combined with different ingredients. Aelius, however, offered a glimpse into recipes as a means to prevent erections. Two operating principles were at work: either anointing the penis or placing certain herbs under one’s bed before sleep. The former was exactly like erectogenic drugs that were topically applied, except that the ingredients were intended to have the opposite effect. Use of the electric ray in the third recipe above was well suited in that regard, because electric rays were famous for their ability to numb predators and were used in various medical treatments.²² Placing plants under a bed probably reflected a notion present in the rituals of a festival known as the Thesmophoria, during part of which Greek women would abstain from food and sex by sleeping on mats made of, or placed atop, chaste tree—a plant widely reputed for its ability to curb sexual desire and to prevent nocturnal emission, among other things.²³

The third and final chapter devoted to erotic recipes causes some terminological confusion. Labeled hedonika (lit. “pleasurable things”), these eleven recipes are an eclectic mixture of ingredients, sometimes accompanied by incantations, with the apparent goal of creating pleasure. The most recent translator has labeled these “aphrodisiacs,” but their function seems more complex.²⁴ For example, at least one of these explicitly doubles as an erectogenic:

2. A hedonikon and entatikon: a whole pig’s gallbladder […], 23 grains of pepper (peperi), a sufficient amount of honey. Rub the penis [with this] while having sex.

An instruction appears to be missing from the manuscript here, but the essence remains: use pepper and honey, two of the favored ingredients for producing an erection, along with part of a pig. But was this recipe meant to induce an erection, or to help sustain one during sex? Moreover, who received the pleasure to be generated from this recipe? One might assume the male was the intended recipient for any hedonika applied to the penis, but a few were specifically targeted at women:

4. A hedonikon with the effect of making the woman become weak from pleasure: one drachma of myrrh (smyrna), one drachma of cloven alum, 24 grains of pepper (peperi). Triturate with Attic honey and apply by rubbing the glans.

10. An amazing hedonikon with the effect of making the woman howl and send out all kinds of noises from the pleasure: two drachmae of Cnidian grain (kokkos Knidios) without the skin, two drachmae of myrrh (smyrna), two drachmae of pepper (peperi), 16 berries of white ivy (kissos melas), two drachmae of staphis agria, two drachmae of the larva[?] that have tails and are found in bathhouses, and a sufficient amount of honey so that it can be rubbed on.²⁵

Interestingly, medical literature on hygiene usually warned that sex caused weakness and so cautioned moderation, but here, the point was to cause weakness!²⁶

In sum, Aelius’ description of hedonika implied the enhancement of sexual pleasure via a kind of supplement. Nevertheless, finding an accurate categorization for hedonika is not so straightforward. The term will appear again below, where the designation of “aphrodisiac” might arguably be justified. As for the way in which hedonika occurred in Aelius, however, “aphrodisiac” fails to capture the circumstances of each application. Ambiguity not only affected how erotic substances were supposed to work, but also how they were designated.

Medico-Magic and the Cyranides

In the case of Pseudo-Galen’s and Aelius Promotus’ recipes, erectogenic drugs could involve ingredients or processes that we today might broadly call “magical.” Yet, medical texts were not the only place to turn to for sexual medicine. A strong tradition of erotic magic existed throughout antiquity, offering recourse to a variety of romantic endeavors in and outside the bedroom.²⁷ Indeed, some of this material blurred any strict line between “magic” and “medicine,” especially as they related to recipes for erectogenesis. One such recipe from the Greek Magical Papyri fits in well with the material reviewed thus far:

To get an erection when you want: grind up a pepper (peperi) with some honey and coat your ‘thing.’²⁸

Both the familiar ingredients of pepper and honey and the method of topical application as an unguent were recurring features. There was also an expanded interest in the products of animals with certain associations deriving from their sexual behavior. The Cyranides (AD 50–200?), a pseudonymous compilation of the properties of various animals, plants, and stones, devoted several such chapters in its two books on tetrapods and birds. Goats were notoriously promiscuous, and their semen could be rubbed onto the human penis to create a “large and unconquerable” erection; sparrows were noted for their stamina when copulating in the spring, and mixing their droppings into wine could likewise produce an erection.²⁹

Yet, magical texts revealed more than similarities and differences between means of erectogenesis. They also provided details about the people who sought to use such drugs as well as their motives for doing so—information that does not always appear in the terse formulation of medical texts. A chapter of the Cyranides about ostriches and amulets, for example, provided various critical details:

The gizzard of ostriches pounded dry and given secretly as a love-potion is a hedonikon preparing the girl that drinks it for love. A stone from within the gizzard, broken off and given in drink or food along with a grain of man orchid (satyrion), creates a large erection, especially for those who are not able to have sex. […] In the sapphire an ostrich is engraved holding a sarpa in its bill; place under the stone a grain of man orchid (satyrion) and a bit of the stone found in the gizzard of the belly of the ostrich. Secure the amulet and wear it for good digestion. Also, erection is brought about and erotic affinities. Above all it produces an erection for those who are already old and want to have a lot of sex. It also makes the wearer charming.³⁰

Represented here are both the elderly, who seek to circumvent age-related sexual difficulties, and a group of people vaguely described as not being able to have sex. That the former “want to have a lot of sex” hints at the potential use (or overuse?) of erectogenic drugs for recreational purposes. As for the latter, the phraseology of sexual inability did not necessarily refer to men with what is labeled today as erectile dysfunction. The Cyranides sometimes described substances as causing an “erection” for both men and women, implying that the word also sometimes had the general meaning of “sexual arousal” in the text.³¹ It is important to repeat here that traces of motivation, whenever mentioned, should be taken as a serious component of the historical study of sexual medicine and pharmacy. While the intended outcome of a drug correlates with usage, it does not necessarily explain the factors contributing to usage in the first place.

Oribasius and the Medical Encyclopedists

Oribasius (c. AD 350–400), like Galen, was a native of Pergamum who served as the personal physician to an emperor. Charged with the task of assembling a massive encyclopedia of medical writings up until his time, Oribasius penned seventy books known as the Medical Compilations. Twenty-five of the individual books have survived in their entirety, and two shorter synopses dedicated to friends and family are also extant.³² After Oribasius’ age, medical encyclopedias rose to prominence as a means for condensing and transmitting knowledge.³³ Aetius of Amida (c. AD 500–550) and Paul of Aegina (c. AD 630–670?), for example, later expanded upon Oribasius’ project, using much of his material as sources for their own compilations. Altogether, these works preserved an abundance of material from texts that have become otherwise lost to time—including several recipes for erectogenesis. One recipe in Oribasius particularly built on several of the plant and animal ingredients encountered above:

Two drachmae of man orchid (satyrion), four drachmae of arugula seed (euzōmon), four drachmae of pellitory (pyrethron), three drachmae of roasted barley (kachrys), two drachmae of stag penis, two drachmae of skink urine, one drachma of spurge (euphorbion), one drachma of terebinth (terminthinē), four drachmae of beeswax, three sparrow eggs, three geckos, and [a sufficient amount] of pine or iris oil (elaion dadinon ē irinon). The geckos are steeped alive in vinegar until day forty, the container being placed in a dung heap and covered.³⁴

The method of application for this concoction was unclear, but the presence of oil as the final ingredient suggested that this drug would be topically applied. In addition to the standard components of orchid, arugula, and skink, the recipe also included animal products such as sparrow eggs and stag penis, another ingredient accorded sexual value in various texts.³⁵ Paul of Aegina repeated this recipe nearly verbatim and noted elsewhere that geckos had erectogenic properties. From the time of Dioscorides to Oribasius, then, recipes for erectogenic drugs continued to be created and expanded with different plant-based and animal-based products,³⁶ though not every author in Late Antiquity went on to be as expansive in their coverage. Alexander of Tralles (c. AD 525–605), for example, only devoted a few lines to the topic after a chapter on the treatment of “gonorrhea.”³⁷

Aside from new recipes, the later compilers also provided us with significant evidence for the use of erectogenic drugs in the context of treatment. One striking example occurred in a fragment of an unknown source that appeared in three parallel chapters. The earliest example could be from the Excerpts of Medicine, though this work derived from a single manuscript questionably attributed to Oribasius.³⁸ There, and in Paul of Aegina, the material appeared under a chapter entitled “concerning non-functioning members,” while Aetius of Amida used the title “concerning those who are not able to engage in sex.” All three mentioned individuals who wish to have sex but are hindered by penises that do not work, which, according to the Excerpts of Medicine and Aetius of Amida, caused them psychological distress. Paul of Aegina explicitly called this an “affection” (pathos) and recorded the cause as being “either paralysis of the member or a lack [or fault?] of semen,” suggesting in his case, at least, that erectile performance was predicated on tumescence and/or fertility.³⁹ Moreover, all three prescribed recipes—like those above—consisted of ingredients noted for their stimulative properties.