Pharmacology (History of)

Summary

For most of human history, the line between food and medicine did not exist. Ancient Greek physicians thought of drugs and diet as a continuum — both could adjust the body’s internal balance. The first great systematic work on medicines was written by a Greek physician named Dioscorides around 65 CE. His De Materia Medica described roughly a thousand substances from plants, animals, and minerals, and organized them in a way that we can now recognize as grouping drugs by how they act on the body. Later, the physician Galen built a competing theory that ranked drugs by four qualities — hot, cold, wet, dry — and assigned each a degree of intensity from 1 to 4. Galen’s system was so persuasive, and fit so well with Christian and Islamic worldviews, that it dominated pharmacy for over a thousand years. Islamic physicians expanded the drug list and added distillation techniques. Medieval Europe inherited all of this through university medicine. Only with Paracelsus in the sixteenth century did a rival framework emerge: chemistry, not qualities, as the basis of drug action.

The Food-Drug Continuum

Ancient Greek pharmacology did not recognize the categorical distinction between food and drug that modern pharmacy takes for granted. Both food and medicine were understood as substances that could alter the body’s internal balance, and the physician’s task was to regulate that balance through diet first, then medicines if needed. The author of the Hippocratic treatise Regimen — part of the fifth-century Corpus — set this framework in place: dietetics was elevated alongside surgery and pharmacology as a core medical discipline, partly on the grounds that it worked both curatively and preventively.(Nutton, 2023)

This was not mere theoretical neatness. The expansion of dietetics into a full medical discipline came partly through the gymnastic trainer Herodicus of Selymbria in the mid-fifth century BCE, who extended its scope far beyond foodstuffs to encompass all aspects of lifestyle.(Nutton, 2023) The Hippocratic pharmacopoeia listed over 380 plant names but operated with broad functional categories — purgatives, caustics, emollients — that applied equally to substances a patient might eat daily.(Nutton, 2023) Gynaecological treatments in the Hippocratic Corpus illustrate how thinly the line between symbolic and pharmacological function could be drawn: plants used in ritual purification also served to fumigate the womb, and their therapeutic rationale rested on symbolic logic as much as observed efficacy.(Nutton, 2023) The formal distinction, when it was finally stated clearly, came from Avicenna in the Canon of Medicine: food is assimilated by the body, whereas medicine assimilates the body to itself. Yet even Avicenna noted that both food and medicine were complexionate and affected the patient’s complexion, so “in practice, not only spices but also various vegetables counted now as one and now as the other.”(Siraisi, 1990) The boundary was formally stated precisely because it kept collapsing.

The practical consequence was that the dispensary (iatreion) of a Hippocratic physician served simultaneously as consultation room, pharmacy, and minor surgical clinic.(Jouanna, 1999) The physician mixed, prepared, and dispensed medicines on site. There was no separate pharmaceutical profession in the classical period. What we would call pharmacy was inseparable from medical practice — the physician prescribed by adjusting diet first, moving toward stronger medicines only when the lesser intervention failed.

The continuum also had a theoretical foundation in Diocles of Carystus, one of the most important fourth-century physicians after Hippocrates. Diocles argued that the effects of foodstuffs cannot always be predicted from knowledge of their properties, and that experience is a better guide than theory in dietetics, with the whole nature of a substance — not any single quality — determining its action.(Nutton, 2023) He is also credited with introducing the notion that drugs worked through their properties or potentialities in the Aristotelian sense, a formulation that gave pharmacological reasoning a foothold within the dominant natural philosophy of the period.(Nutton, 2023) This emphasis on the whole substance rather than isolated properties would resurface, much later, as a recurring counterweight to Galenic reductionism.

Dioscorides and Empirical Classification

The most consequential pharmacological text of antiquity was De Materia Medica, written by Pedanius Dioscorides of Anazarbus in Roman Cilicia around 65 CE.(Riddle, 1985) Dioscorides dedicated the work to Areios of Tarsus, his teacher in pharmacology, and explained in his preface why he had been dissatisfied with all prior writers on the subject.(Riddle, 1985)

The core complaint was organizational. Predecessors like Sextius Niger had arranged drugs alphabetically, which Dioscorides called an approach that “splits off genera and properties from what most resembles them” and is “almost impossible to memorize as a unit.”(Riddle, 1985) Dioscorides announced a “new and superior” arrangement — but, as John Riddle’s 1985 study shows, he never stated what that arrangement was. Riddle argues, on the basis of detailed comparison with modern pharmacognosy and phytochemistry, that Dioscorides organized drugs by their physiological effects on the body: substances that act similarly on the body appear together, regardless of their botanical or mineral taxonomy.(Riddle, 1985) This method was decipherable only after the development of modern chemistry, which is why it was not recognized for nearly two millennia.

The organizational principle was matched by a rigorous empirical method. Dioscorides described his approach as researching prior writers, comparing accounts to determine consensus, and then confirming usages through “talking with people about their experiences with them.”(Riddle, 1985) Where sources carried magical or irrational content, he prefaced them with “It is reported that…” — a rhetorical device marking claims his reasoning could not fully accept.(Riddle, 1985) He explicitly criticized the Asclepiadean school for explaining drug action “by differences among particles” rather than experimental testing.(Riddle, 1985) The intellectual context for this stance was a live debate about what medical knowledge rested on. The Empiricist sect, founded by Philinus of Cos around 260 BCE, had rejected investigation into the hidden causes of disease altogether as unhelpful, insisting instead on treatment grounded in experience and accumulated case histories.(Nutton, 2023) Their epistemological method rested on what they called a tripod: accurate personal observation, collective memory of past cases, and reasoning from analogy with similar cases.(Nutton, 2023) Dioscorides worked in a tradition shaped by this empirical pressure even where he did not formally adopt Empiricist doctrine. His most favorably cited predecessor was Crateuas the Root-cutter, who had served Mithridates VI and produced an illustrated herbal; Crateuas was one of the few writers Dioscorides regarded as methodologically comparable.(Riddle, 1985)

Dioscorides drew on an unusually wide range of prior sources, combining observations from extensive travel with systematic research across earlier authorities — making him a critical synthesizer rather than a compiler who simply transcribed received knowledge.(Riddle, 1985) His contemporary Scribonius Largus, writing in the reign of Claudius, articulated what was at stake in this approach: medicine, he argued, was a unified profession bound by the Hippocratic ethic, in which surgery, dietetics, and pharmacology were inseparable parts of proper practice, not specialized trades to be parceled out separately.(Nutton, 2023)

The work covered five books — aromatics and resins, animal products and cereals, roots and herbs, additional herbs and roots, and wines and minerals — totaling just over a thousand substances, around 700 of them plants.(Riddle, 1985)(Nutton, 2023) The proportion of animal drugs (roughly 10%) and mineral drugs (roughly 10%) is close to the modern Western distribution of non-synthesized drugs, a correspondence that Riddle finds significant.(Riddle, 1985)

Within the mineral section, Dioscorides’ grouping of copper compounds came close to a chemical classification, not because he was reasoning chemically, but because his physiological grouping and a chemical grouping coincide for closely related substances.(Riddle, 1985) Similarly, his observation that burning shells of different sea animals all yield the same white powder with the same caustic and escharotic properties — what we now call calcium oxide — represents proto-chemical thinking across the animal-mineral boundary.(Riddle, 1985)

Dioscorides explicitly rejected the doctrine of similars. He prescribed hippopotamus testicles for snakebite rather than for conditions involving virility, which would have been the expected application under the older sympathetic principle that like cures like.(Riddle, 1985) Riddle treats this as a marker of the empirical turn in pharmacy: the criterion is what works, not what symbolic analogy suggests. The same pragmatism extended to toxicology — the Greek word pharmaka meant both drugs and poisons, and Dioscorides embodied this dual nature in his treatment of cantharidin (Spanish fly), noting that its wings and feet served as the antidote for those who had swallowed the main preparation.(Riddle, 1985)

Galen’s Theoretical Pharmacology

Galen of Pergamon (c. 129–c. 216 CE) praised Dioscorides’ De Materia Medica as “the most perfect of all treatises on materia medica” and cited it throughout his own writings.(Riddle, 1985) Yet Galen’s pharmacological framework effectively displaced the organizational contribution of Dioscorides, even while preserving the drug list.

Galen reduced all primary drug properties — what Dioscorides had called dynameis — to four: warm, cold, wet, and dry, tied to the four humors and the four elements of Aristotelian natural philosophy.(Riddle, 1985) Within this scheme, every drug could be assigned a pair of qualities and a degree of intensity: four main grades, each subdivided into three, yielding a twelve-degree system.(Nutton, 2023) A substance cooling at the first degree would produce an effect almost imperceptible to the senses; cooling at the fourth degree would be lethal.(Riddle, 1985) This quantitative framework gave Galenic pharmacy the appearance of precision.

The operational consequence was a shift from Dioscorides’ grouping by shared physiological effects to an analysis of individual drug properties. When Galen corrected Dioscorides’ classification of coriander as “cooling,” the debate that followed among later writers — Arab and Latin alike — concerned whether coriander was warming or cooling, not which other drugs shared coriander’s range of actions.(Riddle, 1985) The drug’s properties, not its affinities with other drugs, became the center of attention.

Galen personally acquired drugs through extensive travel, interviewing shippers at Alexandria, visiting mines in Cyprus, and on one visit to Lemnos purchasing 20,000 seals of Lemnian earth as a medicinal bulk purchase.(Nutton, 2023) His pharmacological commitment was genuine. Mattern’s biographical account fills in the texture of this acquisition work. Before settling in Rome, Galen traveled extensively for ingredients: “I sailed along the whole of Lycia in a small boat for the sake of inquiring into the things there. From Syria Koile [Palestine] I brought back many black crustaceous rocks and rocks which, when exposed to fire, emit a meager flame [i.e., asphalt], found in the eastern part of the highlands surrounding the so-called Dead Sea.”(Mattern, 2013) He also visited the copper mines of Cyprus, where slaves chained at the feet extracted mineral substances through brutal labor — a scene Mattern narrates in detail — to procure diphryges and cadmeia for his drug stocks.(Mattern, 2013) On Lemnos, “he would make two separate trips to the island… to procure signets of its famous earth prepared specially by the priestess of the cult of Philoctetes… These signets were compressed medallions stamped with an image of the goddess Artemis, to guarantee their authenticity, and were thought to have great medicinal value for healing abscessed wounds, snakebite, animal bites, rabies, and poison… Galen left Lemnos on this second occasion with 20,000 of the signets and knowledge only obtainable through exhausting and inconvenient travel.”(Mattern, 2013)

Galen also paid handsomely for expertise he could not acquire through travel alone: “He paid an exorbitant sum to an unnamed expert who taught him to prepare certain exotic drugs ‘so that what I prepared was indistinguishable from the genuine item’… Later in life he traveled widely around the eastern Mediterranean to obtain a lifetime supply of these ingredients: ‘for this reason I was zealous to travel to Lemnos and Cyprus and Palestinian Syria to acquire for myself a large enough quantity of each of these drugs for my whole life.’”(Mattern, 2013) The authenticating visit to Lemnos and the paid apprenticeship in preparation both reflect a systematic concern with adulteration — one of the central practical problems of ancient pharmacy.

The theriac tradition stretched back to Pergamum’s own rulers. Galen praised the pharmacological discoveries of the Attalid king Attalus III, “complaining that Attalus did not leave enough written records”; he called him “our king Attalus” and “our Attalus, ruler of the Pergamenes.”(Mattern, 2013) But the more consequential precedent was Mithridates VI of Pontus, whose “prowess in pharmacology was legendary, his recipe for theriac — an antidote of profound complexity — is cited not only in Galen but in several other ancient sources, and he remained famous for this through modern times… Galen adds what is also repeated in other sources, that after his defeat and exile by the Roman general Pompey, Mithridates tried twice to commit suicide by poisoning himself, but the antidote to which he had accustomed his body was so effective that he had to beg one of his officers to run him through with a sword instead.”(Mattern, 2013) This anecdote — circulated through Galen’s own account — became the most famous illustration of what compound antidotes could theoretically achieve, and it anchored the theriac tradition’s claims to efficacy.

But the theoretical architecture was decisive: Galenic pharmacology offered “a blend of the rational and the experiential” that embedded drug treatment within a comprehensive humoral cosmology compatible with both Christian and Islamic world views.(Temkin, 1973)(Riddle, 1985) Dioscorides’ method was, as Riddle puts it, “almost purely empirical.” Galen’s carried metaphysical scaffolding.

Temkin argues that Galenic pharmacology proved one of the most durable features of the entire Galenic system, outlasting Galenic anatomy (demolished by Vesalius in 1543 and Harvey in 1628): the therapeutic anarchy that followed its eventual destruction “made itself felt beyond the middle of the nineteenth century.”(Temkin, 1973)

The fate of Dioscorides’ organizational method was determined by manuscript transmission as well as by theory. Dioscorides’ emphasis on drug affinities over alphabetical arrangement was not always accepted by later users of the text; copyists rewrote the work alphabetically, though the De Materia Medica continued to function as the authoritative reference for medical botany from late antiquity through the seventeenth century.(Nutton, 2023) Between Galen’s death (c. after 210 CE) and Oribasius (c. 325–400 CE), copyists rearranged the De Materia Medica alphabetically.(Riddle, 1985) The oldest surviving illustrated manuscript, the Anicia Codex of c. 512 CE, presents herbs in alphabetical order.(Riddle, 1985) Riddle’s counterfactual point is explicit: had subsequent physicians concentrated on Dioscorides’ affinity groupings, “chemistry would have developed much faster” because the grouping directs attention toward what substances have in common internally, not just toward their properties in isolation.(Riddle, 1985)

Islamic Pharmacology

The expansion of Greek medical knowledge into the Islamic world from the eighth century onward substantially enlarged the materia medica. Alexander’s conquests had already demonstrated the link between trade routes and pharmacological knowledge — increased access to African and Indian herbs and spices in the Hellenistic period produced a “massive increase” in available pharmacological materials.(Nutton, 2023) Islamic physicians extended this process through systematic integration.

The two principal Greek pharmaceutical texts available in Arabic translation were Dioscorides’ On Medicinal Substances and Galen’s On the Powers of Simple Drugs. These were the two main sources of Islamic pharmacology: Dioscorides assigned to each substance — plant, mineral, and animal — attributes such as softening, warming, astringent, diuretic, and emetic, while Galen refined the quality of drugs in four different degrees from weakest to strongest.(Jackson (ed.), 2011) Pormann and Savage-Smith note that in these translations Galen departed from Dioscorides in two respects: he listed medicinal substances alphabetically, and he fine-tuned the classification system by assigning each substance a pair of primary qualities graded one to four.(Pormann, 2007) Islamic pharmacologists received both texts but worked primarily within Galen’s quality-grading framework, which the Arabic scholars elaborated into a system of cosmic numerology associated with Jabir ibn Hayyan — building, as Temkin observes, on “just that part of Galenic doctrine which was among the weakest as far as empirical evidence was concerned.”(Temkin, 1973) Physicians including ibn Masawaih, Sarabiyun, ibn Sina, and al-Kindi engaged with Dioscorides through this Galenic lens, debating the properties of individual drugs rather than applying Dioscorides’ original method of grouping substances by affinity.(Riddle, 1985)

Islamic physicians introduced new substances unknown to the Greeks: camphor, musk, senna, myrobalan, and sal ammoniac all entered the pharmacopoeia from non-Greek sources.(Pormann, 2007) Stapley notes that the trade infrastructure that made this possible ran through Arabia Felix — the Dhofar region of present-day Oman — where aromatic resins, spices, and medicinal plants from India and East Africa were collected and distributed; this route accounts for the Arabic introduction of senna, rhubarb, tamarind, musk, camphor, nutmeg, cloves, saffron, and liquorice into Mediterranean medicine.(Stapley, 2024) Distillation techniques were developed for essential oils and inorganic acids, and rose-water distillation became a significant industry. These were not merely additions to an existing list; they required new preparation techniques and new frameworks for understanding drug action.

The most influential Arabic materia medica was compiled by Ibn al-Baytar (d. 1248), originally from Malaga. His Comprehensive Book on Simple Drugs and Foodstuffs was an alphabetical guide to over 1,400 medicaments in 2,324 entries, drawn from his own observations and over 260 written sources.(Pormann, 2007) This represented the largest systematic pharmacological compilation since Dioscorides. Ibn al-Baytar produced a second major work, Kitab al-Mughni fi al-Adwiya al-Mufrada, in which he organized drugs not alphabetically but according to their therapeutic value across twenty chapters each treating diseases of a specific organ — head, ear, eye, and so on.(Saad Said, 2011) The combination gave Islamic pharmacology two complementary reference traditions: the alphabetical materia medica for identifying substances, and the organ-organized formulary for treatment lookup.

The broader institutionalization of pharmacy as an independent profession was a distinctive Islamic achievement. Independent pharmacy — the separation of drug dispensing from medical practice — first developed in Baghdad during the caliphate of al-Mamun (813–833 CE), with the first formal pharmacy shop probably established as early as 762 CE; it was there that medicines were first manufactured and commercially distributed in forms including ointments, pills, elixirs, confections, tinctures, suppositories, and inhalants.(Saad Said, 2011)(Saad Said, 2011) This professional separation preceded its European equivalent by roughly four centuries.(Saad Said, 2011) State-sponsored hospitals operated dispensaries attached to manufacturing laboratories where syrups, electuaries, ointments, and other preparations were made at scale.(Saad Said, 2011) Pharmacists were required to pass examinations, be licensed, and remain subject to ongoing state oversight.(Saad Said, 2011) A government official, the al-Muhtasib, and his aides periodically inspected pharmacists and their shops, checking weights, measures, purity, and adulteration of medicines.(Saad Said, 2011)

Arab–Islamic civilization substantially enlarged the pharmacopoeia by drawing on the geographical reach of the empire. The annual pilgrimage to Mecca brought together peoples from India, China, Spain, and Arabia, facilitating the exchange of both ideas and goods; this convergence introduced many new medicines into Islamic practice that Greek physicians had not known.(Saad Said, 2011) Senna, camphor, sandalwood, musk, myrrh, cassia, tamarind, nutmeg, cloves, aconite, ambergris, and mercury were among the new drugs introduced for clinical use.(Saad Said, 2011) Al-Dinawari (828–896), considered the founder of Arabic botany, described roughly 640 plants and their growth phases in his Book of Plants, providing a botanical foundation that supported the systematic expansion of the drug list.(Saad Said, 2011)

Al-Kindi (800–873) — the philosopher known as the “philosopher of the Arabs” — was the first to systematically determine doses for all drugs known in his time, resolving the conflicting views among physicians that had previously made prescription writing unreliable.(Saad Said, 2011) Shapur ibn Sahl (d. 869) composed what historians regard as the first Arabic pharmacopoeia, the al-Aqrabadhin, containing details of pharmaceutical recipes organized by dosage form — tablets, powders, ointments, electuaries, and syrups — along with methods and techniques of compounding and means of administration.(Saad Said, 2011) A formal code of ethics for pharmacists was also formulated in this period, calling on the practitioner to have deep religious convictions, consideration for others, a general sense of responsibility, and to be careful and God-fearing.(Saad Said, 2011)

Ibn Sina devoted the fifth volume of his Canon of Medicine entirely to compound drugs, attributing their necessity to the fact that diseases are usually complex and often develop from the combination of several pathological problems — a single simple drug is rarely adequate for a compound disorder.(Jackson (ed.), 2011) The Canon’s broader pharmacological classification offered a more structured framework for drug selection. The first book alone details 797 drugs, classifying each by its medicinal degrees — a four-point scale running from barely perceptible warming or cooling action through two intermediate grades to a fourth degree that was potentially lethal.(Stapley, 2024) The Canon also contains what Stapley identifies as a clinically useful pain taxonomy: Ibn Sina distinguished fourteen distinct types of pain — including boring, compressing, heavy, tearing, pricking, incisive, and irritant — and divided the therapeutic agents that address them into resolvents, narcotics, and analgesics that produce cold.(Stapley, 2024)

In practice, Islamic physicians’ actual drug use was more conservative than their theoretical pharmacopoeias. Al-Razi’s clinical notebooks, the Book of Experiences, preserve over 900 cases recorded by his students and show that his actual therapy relied on evacuation (phlebotomy, cupping, purgatives), dietary regimen, and a restricted range of simple remedies including rose-honey and barley-water, with surgery entirely absent.(Pormann, 2007) Al-Razi’s critical posture toward received authority extended to his pharmacological sources: having found clinical evidence that contradicted Galenic prescriptions, he wrote a treatise titled Doubts about Galen, and Stapley reports that he proposed testing new medicines on monkeys before administering them to patients — an early statement of the principle that new therapeutic agents should be tested in animals before human use.(Stapley, 2024) Analysis of Islamic formularies for coughs shows that the drugs used — fennel, hyssop, liquorice, and poppy — function as expectorants or cough suppressants in modern terms, though they were applied in complex compound recipes rather than as isolated agents.(Pormann, 2007)

The medieval Islamic tradition also inherited the problem of compound medicines. Mithridates VI of Pontus (132–63 BCE) had allegedly protected himself against poisoning by habituating himself to small doses — mithridatism — and gave his name to a compound drug claimed as a universal cure because it incorporated all known antidotes.(Nutton, 2023) Andromachus the Elder, Nero’s physician, updated this into the sixty-four-ingredient theriac Galene, replacing viper flesh for lizard and increasing the opiate content.(Nutton, 2023) Marcus Aurelius took a daily dose of theriac as a tonic, and when Septimius Severus asked Galen to prepare it, the emperors’ example helped turn this elaborate secret compound into a widely accessible remedy.(Nutton, 2023)

Medieval and Renaissance Pharmacopoeia

The Latin West received Galenic pharmacology through Byzantine and Arabic intermediaries — what Temkin calls a medical philosophy “twice removed” from Galen himself.(Temkin, 1973) The Articella curriculum, centering on Galen’s Ars medica and the Isagoge of Iohannicius, defined the formal framework. Within this framework, hygiene and therapeutics were both organized around the six non-naturals: surrounding air, food and drink, sleep and waking, exercise and rest, retention and evacuation, and the passions of the soul. The doctrine was taught “more or less under these headings” down to the early nineteenth century.(Temkin, 1973)

The actual practice of therapy in this period is illustrated by the case of Peter the Venerable in 1150–51, documented in surviving letters. His illness was understood as a complexional imbalance caused by retained phlegm from delayed bloodletting. Treatment included heating foods, steam inhalation, and herbal preparations: hyssop, cumin, licorice, and ginger in wine.(Siraisi, 1990) What is notable in Siraisi’s analysis of this case is that the patients — not the physicians — insisted on the most heroic applications of theory; the practitioners recommended “simple, soothing remedies that would bring some comfort and do no harm.”(Siraisi, 1990) Theory and practice diverged in favor of pragmatic conservatism.

Theriac occupied a special position in medieval pharmacy as the premier compound medicine: a universal antidote to poison and a remedy for diseases caused by excess of melancholy and phlegm.(Siraisi, 1990) The Montpellier masters of the late thirteenth century debated the theoretical principles of its action and the basis for determining dosage, using it as a vehicle for discussing compound pharmacology more generally. This debate was stimulated by Avicenna’s and Averroes’ descriptions of theriac.

The formal distinction between food and medicine, which Avicenna had articulated in the Canon, remained practically fluid throughout this period. Siraisi notes that “not only spices but also various vegetables counted now as one and now as the other,” and that preventive health regime was as much a part of a physician’s responsibility as treatment of active disease.(Siraisi, 1990) The physician was supposed to maintain health by regulating the non-naturals, tailoring diet, exercise, rest, environmental conditions, and psychological well-being to the patient’s individual complexion.

The Ebers Papyrus (c. 1600 BCE) had already shown that older pharmaceutical traditions were systematically drug-focused: it contained 876 prescriptions drawn from over 500 substances, including gentian, senna, castor oil, pomegranate, squill, and henbane, but mentioned neither diet nor venesection.(Ackerknecht, 1955) Ackerknecht notes that Dioscorides was the “father of our materia medica” in a direct genealogical sense: he described over 600 medicinal plants and his text became the canonical reference that medieval pharmacy cited, added to, and argued from.(Ackerknecht, 1955) The pharmacological legacy of Egyptian and Mesopotamian medicine fed into this tradition via Hellenistic trade and translation.

The Chemical Turn

Paracelsus (c. 1493–1541) mounted what Temkin calls “a frontal attack upon the established way of thinking” — combining religious conviction with a new philosophy of nature that rejected Galenic qualities altogether.(Temkin, 1973) Where Galen had assigned drug properties by reasoning from humoral theory, Paracelsus appealed to chemical analogy between macrocosm and microcosm and offered chemically prepared remedies, often containing metals, as an alternative therapeutic system.

The move to mineral and chemical medicines had been prepared, in part, by the empirical observation that metals worked in ways plant medicines could not. Dioscorides had already noted that burning sea-animal shells, lead vessels used in wine preparation, copper compounds, and mineral waters all had physiologically significant effects.(Riddle, 1985)(Riddle, 1985) The proto-chemical observation that different sources could yield the same active substance (quicklime from burned shells of diverse animals) pointed toward the internal constitution of substances rather than their surface properties or humoral qualities.(Riddle, 1985) Riddle’s argument is that had Dioscorides’ affinity grouping been followed, this line of thought would have advanced more quickly; Galen’s quality-theory redirected attention elsewhere.(Riddle, 1985)

Paracelsus made the internal chemical constitution of substances the basis of drug action — the same direction Riddle identifies in Dioscorides, but now combined with a mystical-religious framework and an explicit polemical rejection of university Galenism. His offer of a new theoretical approach to drug action was “combined with the offer of a new therapy by chemically prepared remedies often containing metals.”(Temkin, 1973) The spagyric medicines of the Paracelsian tradition — preparations involving distillation, extraction, and recombination — represented a new pharmaceutical technology as well as a new theory.

William Withering’s introduction of digitalis into orthodox medicine in 1775, following a folk informant’s use of foxglove for dropsy, marks the Enlightenment phase of this turn: the systematic assimilation of folk and empirical knowledge into a pharmacopoeia that was moving toward chemical isolation of active principles.(Ackerknecht, 1955) Ackerknecht notes that this “assimilation of folk remedies was a specialty of Enlightenment doctors,” exemplified also by Jenner (cowpox for smallpox immunity) and Fowler (arsenical solutions). The transition from compound medicines of many ingredients to single isolated active substances — the pharmaceutical model that has dominated since the nineteenth century — depended on chemistry, which depended in turn on abandoning the Galenic quality framework in favor of analyzing what substances actually contain.

Sources

Riddle, John M. Dioscorides on Pharmacy and Medicine. University of Texas Press, 1985. — Primary source for Dioscorides’ organizational method and the affinity argument.
Nutton, Vivian. Ancient Medicine. 3rd ed. Routledge, 2023. — Chapters 6, 8, 10, 12, 16, 17.
Pormann, Peter E., and Emilie Savage-Smith. Medieval Islamic Medicine. Edinburgh University Press, 2007. — Chapters 3, 5.
Siraisi, Nancy G. Medieval and Early Renaissance Medicine. University of Chicago Press, 1990. — Chapter 5.
Temkin, Owsei. Galenism: Rise and Decline of a Medical Philosophy. Cornell University Press, 1973. — Chapter 3.
Ackerknecht, Erwin H. A Short History of Medicine. Ronald Press, 1955. — Chapters 3, 4, 8, 12.
Saad, Bashar, and Omar Said. Greco-Arab and Islamic Herbal Medicine. Wiley-Blackwell, 2011. — Chapter 5.

(Saad Said, 2011): It is a historical fact that the development and the recognition of the independent, academically oriented status of pharmacy started in Baghdad during the time of Al-Mamun’s caliphate (813–833). (Saad Said, 2011): The first pharmacy shop was most likely founded in 762 in Baghdad. It was here that medicines were first manufactured and distributed commercially, and then dispensed by physicians and pharmacists in a variety of forms: ointments, pills, elixirs, confections, tinctures, suppositories, and inhalants. (Saad Said, 2011): Pharmacists were required both to pass examinations and be licensed and monitored by the state, resulting in significant developments in pharmacy. (Saad Said, 2011): A large number of new drugs were introduced for use in clinical practice, including senna, camphor, sandalwood, musk, myrrh, cassia, tamarind, nutmeg, cloves, aconite, ambergris, and mercury. (Saad Said, 2011): The early rise and development of the professional pharmacy in Baghdad took place over four centuries before such development took place in Europe. (Saad Said, 2011): The pharmacists and their shops were periodically inspected by a government appointed official al-Muhtasib and his aides. These officials were responsible for checking weights and measures, as well as the purity and adulteration of the medicines sold. (Saad Said, 2011): A code of ethics was formulated and accepted at this time, an important step in the development of any profession. The pharmacist was called to ‘have deep religious convictions, consideration for others, a general sense of responsibility, and be careful and God-fearing.’ (Saad Said, 2011): Kitab al-Jami fi al-Adwiya al-Mufrada, the major contribution of Ibn al-Baitar, is one of the greatest botanical compilations dealing with medicinal plants in Arabic… It comprises some 1400 different items, largely medicinal plants and vegetables, of which about 200 plants were not known earlier. The book refers to the work of some 150 authors, mostly of Arab origin, and it also quotes about 20 early Greek scientists. (Saad Said, 2011): Kitab al-Mlughni fi al-Adwiya al-Mufrada is an encyclopedia of medicine in which he lists the drugs in accordance with their therapeutic value. Thus, its 20 different chapters deal with the plants bearing significance to diseases of the head, ear, eye, and so on. (Saad Said, 2011): Al-Kindi was the first to systematically determine the doses to be administered of all the drugs known at his time. This resolved the conflicting views prevailing among physicians on the dosage that caused difficulties in writing recipes. (Saad Said, 2011): Al-Dinawari (828–896) is considered to be the founder of Arabic botany for his Book of Plants, in which he described about 640 plants and their growth phases. (Saad Said, 2011): Al-Aqrabadhin by Sabur ibn Sahl (died 869) represents one of the earliest pharmacopoeias in Arabic. It contains details of pharmaceutical recipes, including methods and techniques of compounding drugs, their actions, dosages, and means of administration. The recipes are organized in accordance with their administration form, for example, tablets, powders, ointments, electuaries, or syrups. (Saad Said, 2011): The vastness of the Arab empire and the fact that Arabs and Muslims from the farthest corners met each other while on pilgrimage to Mecca provided the exchange of both ideas and goods between people from India and China as well as from Spain. Thus, a lot of new medicines were introduced.

Jackson, Mark (ed.). Oxford Handbook of the History of Medicine. Oxford University Press, 2011. Chapter 10.

Summary

The Food-Drug Continuum

Dioscorides and Empirical Classification

Galen’s Theoretical Pharmacology

Islamic Pharmacology

Medieval and Renaissance Pharmacopoeia

The Chemical Turn

See Also

Sources

Sources