Methods of the “Big Tent” Approach to the History of Pharmacy and Pharmaceuticals

In the previous issue of HoPP, the editors made a case for a “big tent” approach to the history of pharmacy and pharmaceuticals that celebrates its firm grounding in the profession of pharmacy and as a fully developed historical field, yet also one that ranges widely and recognizes the value of traditions and practices far removed from modern Western pharmacy. This current special issue on “Pre-Modern Pharmacology between Theory and Practice” continues along this path in a number of ways, in that it focuses on connections between pharmaceutical theory and practice, centers on ancient and medieval eras, and ranges far beyond the West. Indeed, its focus hinges on multi-dimensional connections among medical and nonmedical professions, practices, and sources; and recognizes multi-directional connections and exchanges between the Mediterranean and Indian Ocean worlds, and across Eurasia.

The contributors to the issue, further, represent a multidisciplinary and international group of scholars: guest editor (and contributing editor to HoPP) Petros Bouras-Vallianatos and Maximilian Haars hold degrees in pharmacy, and all are conducting advanced historical research, with specializations ranging from Hippocratic and Galenic pharmacology of the ancient Mediterranean to the Byzantine and Carolingian Empires, the Islamicate world, South Asia, and the Far East. Their various contributions trace influences among and between European, Mediterranean, South Asian, and Chinese traditions, taking into account pharmaceutical theory and evidence from learned texts, as well as the practicalities of pharmacy in daily life and the legacies left behind of the respective societies, including their material culture. Altogether, this special issue brings different practitioners, places, and times into the larger historical narrative, tracing connections and patterns of development that until recently have largely escaped historical coverage.

Maximilian Haars, for example, examines Galen’s pharmacology and empirical expertise using an unusual source—his Method of Medicine, which is usually associated more with his clinical practice. Haars is able to show Galen’s knowledge and use of materia medica as a kind of “field botanist” and in his daily medical practice through his mention of over 1,000 phytonyms in that work. These findings, moreover, serve to highlight the profound connections between Galen’s different texts and the ways in which the plants named follow—or sometimes diverge from—the patterns in his pharmacological works. Haars is able to trace and recognize these patterns using a statistical approach, as he has built an extensive database that catalogues phytonyms across the whole of Galen’s massive corpus.

In her contribution, Laurence Totelin presents a study of the relations among physicians, pharmacists and nonmedical craftspeople—painters and gem engravers—in Greco-Roman Antiquity who worked with some of the same materials. While recent literature has recognized a “medical marketplace” of a range of different medical practitioners and healers in a society, there has been comparatively little recognition of connections between medical professions and craft trades. Yet as Totelin has found, certain substances such as pigments and gemstones were widely utilized in the decorative arts as well as in pharmacy. Totelin presents a fine-grained study of that shared culture in medical texts as well as from artefacts, with both types of sources revealing evidence concerning the decorative and medical uses of stones—engraved stones, particularly gemstones, that were used as medical amulets, as well as engravings or stamps used to mark kollyria, medicinal pastes for afflictions of the eye.

Claire Burridge also foregrounds the material culture of medicine in her study of newly introduced materia medica in pharmaceutical recipes for compound remedies in the early medieval Carolingian Empire. Her innovative approach to the research involves the compilation of these recipes from medical as well as nonmedical texts of unpublished manuscripts and from additions over time to handwritten marginalia on these texts. By expanding significantly the type of source material consulted, Burridge is able to shed valuable light on pharmaceutical materials in use in the early Latin Middle Ages, a period that deserves further research in the history of pharmacy. Not only has she demonstrated that new materials from the East had entered the Latin West at this time, but she has also identified groupings among these materials—several that were incorporated, for example, into incense recipes—and patterns in which recipes evolved and developed.

Petros Bouras-Vallianatos’s article corroborates Burridge’s findings as well, examining the fraught question as to which Asian medicinal materials were known and used when in the Latin West and Greek East. He attempts to disrupt narratives that depict a linear, chronological influence of East to West. Rather, Bouras-Vallianatos shows that Asian materia medica traveled throughout the Mediterranean region at different places and times. His study presents another fine-grained examination of materia medica using a varied source base of medical texts, commercial records, archaeological data, and evidence from papyri that allows him to identify three key eras in the first centuries CE in which these materials entered, re-entered, and circulated in the Mediterranean world. The study also reveals the challenges of the source materials—the difficulties (also discussed by Haars) of establishing clear identifications between ancient and modern plant nomenclature, and the pitfalls of accepting textual evidence at face value given the vagaries of manuscript copying over the centuries as well as the lack of (much-needed) modern, critical editions of key sources.

And finally, Amanda Respess employs a critical approach in her study of early understanding of cane sugar across a wide swath of Eurasia, comparing depictions of its processing and use among Persian, Arabic, Indian, and Chinese society. Respess argues that sugar’s ontological nature and medical purpose was understood differently in these different societies—for some it represented heat as a warming agent whereas for others it was cooling—in a way that was closely correlated to understanding of its elemental make-up and the changes wrought during the refining process. Not only is her approach fundamentally global and comparative, but also highly innovative as it juxtaposes textual, archaeological, and linguistic evidence from Islamicate, Indian, and Chinese societies and medical traditions.

In sum, we editors of History of Pharmacy and Pharmaceuticals are delighted to help bring this collection of papers to our readers. The kind of painstaking, multidisciplinary work contained in the following pages breaks new ground in the field by employing innovative methodologies and tying together eras and areas of pre-modern pharmacy that have often remained separated. Each contribution in this special issue displays great skill and creativity in formulating careful and innovative arguments. As a start, each of these studies requires extensive knowledge of languages, in addition to modern vernaculars, of ancient Greek and medieval Latin as well as Persian, Arabic, and Chinese. Even more than that, they require intimate knowledge of historical contexts and of source material from the distant past: in addition to medical texts that may or may not be available in critical editions, the contributors utilize evidence from fragments on papyrus, archaeobotanical remains, unedited manuscripts, and marginalia.

We are proud to share this issue for other reasons, too. First, studies such as these add more precision to our understanding of the kinds of materials earlier societies utilized for health and healing, how those materials were understood, what techniques were used to process them (and who did so, with what instruments), and how and why the materials and the processing they underwent were thought to be effective. Their findings also demonstrate the value of going beyond the traditional corpus of textual materials, and of approaching that corpus with critical understanding. And second, the inclusive and comparative approach utilized in this issue contributes key knowledge and understanding to a larger, global narrative of pharmaceutical development over time. In these ways, among others, the contributors to this issue are holding up the “big tent” of the history of pharmacy with very able hands, and pushing our field in new directions.