A Pharmaceutical Recipe From an Egyptian Temple

Years ago, I came across the directions to make a plaster or salve in a work by the Roman era doctor Galen. I might right a follow up blog on him soon. What caught my attention was that this prescription was that it was described as having come from the wall just outside the inner shrine of what he described as the Temple of Hephaestus in Memphis, Egypt. 

I looked into this and discovered that this was actually the Temple of Ptah, one of the oldest temple sites in Egypt. Ptah was identified with Hephaestus because he was the god of craftsmen, including metalworkers. I found the idea that a fully Greek trained physician copied a prescription which was recorded in this way. I'll admit, I was excited like the true history nerd I am. Then I found that there has been no English translation made of the prescription. Now, I am not strong at Greek translation, but I have decided that the idea of such inscriptions being preserved in texts is worthy of being discussed with students, so I made an attempt. I made myself feel better about my attempt by reminding myself that this is the best English translation made of the prescription to date. If you feel you can do better, please do, and um, maybe send me a copy?

Galen, Compound Drugs Arranged by Kind in 7 Books, book 5 chapter 2 (K13.778-80)
[Treatment] through dittany: The preparation of the dittany plaster/salve they call holy said to be found in this inscription on the Hephaesteion in Memphis. Everyone remembers it at least because of its proportions or being a little different. It will be enough to write about it with the text given by Heras.
From the Temple of Hephaistos in Memphis:
It is efficacious for staunching fresh wounds and discharge; for cut tendons, old sores and spreading ulcers, bruises, mortification [of the flesh], carbuncles, black spots, weeping sores, sores that are hard to cicatrise [i.e. heal by forming a scar], swollen parotid glands, chilblains, abscesses, scrofulous swellings, boils, indurations; the removal of arrows, thorns, and bones from the head; the strikes of wild/venomous animals and the stings of scorpions, bites of spiders and shrew-mice, and human bites. For all pain of the neck, shoulders, and joints instead of an emollient. It checks not only the recent fluxes of the eyes but also the long standing; and having been diluted with rose ointment it is efficacious for headache and, smeared over or used as a fumigant, for womb pain. The plaster/salve used as a fumigant banishes wild/venomous animals. It is:
Old oil, 2 cotyle
Litharge/lead monoxide, 100 drachmas
Verdigris, 8 drachmas
Scale [flakes of copper ore], 6 drachmas
Liquid Colophonian [resin]
Pine resin, 50 drachmas
Powdered/granulated frankincense, 12 drachmas
Ammoniac incense, 16 drachmas
Burnt copper, 8 drachmas
Pyrites, 6 drachmas
Gentian, 6 drachmas
Aloe, 8 drachmas
Galbanum, 12 drachmas
Propolis [bee glue], 8 drachmas
Wax, 25 drachmas
Birthwort/aristolochia, 10 drachmas
Cretan dittany, 10 drachmas
Boil litharge and oil in a large dish over coals so there are no impurities through all, or very little, then using an earthenware pot, mix verdigris and copper ore flakes and boil until there are no impurities at all, then again lifting, add sifted resin and ammoniac [incense], stirring until boiling has stopped, then setting it on [the heat] and leaving it for a little. Lifting, sprinkle [burnt] copper and pyrites, and boil it again until it is not impure. When the added ingredients relax, next lift and add wax and again boil until it becomes purified; this happens quickly. Then removing, add propolis and set on [the heat] again, leaving a little and removing it. Measure the aloe, powdered/granulated frankincense, dittany, birthwort/aristolochia, and gentian. With these are sufficiently cooled, and having ground extremely smooth each, sprinkle in and stir. If it is pure you will take it away, if not boil over a light fire.

This is what Heras wrote about the plaster/salve:
We compound it [plaster] sometimes separating the burnt copper from the pyrites, becoming a stronger drawing ointment for deeply imbedded material, more emollient, and more capable of promoting perspiration, but is not in the least suitable for hard to cicatrise sores. We made it [plaster] without dittany, but everything else and 6 drachmas of chrysocolla to thus become more therapeutic for malignant sores.

So, just a warning, a number of the ingredients in this plaster are poisonous. Lead monoxide obviously is and is no longer even used externally like this plaster, but aristolochia will actually mess up your kidneys if taken internally and I can't say anything about its topical application. 

So, some thoughts on this prescription. It appears Galen copied it from Heras, a Cappadocian medical writer who is described as plying his trade between 20 BCE and 20 CE in Rome. This pushes the date of this prescription back well over a century before Galen was rewriting this work after 192 (he lost his original copy in a fire at that time). We cannot be sure if Galen ever actually travelled to Memphis and saw this inscription for himself. The more I look at the text myself, the more I think he might have only known it from written texts.

So why and when might Heras have travelled to Egypt? We do not know much at all about Heras. Galen travelled to Alexandria prior to travelling to Rome. Might Heras have gone to Egypt prior to travelling to Rome? Did Heras actually copy the inscription himself, or did he like Galen might have, did he copy someone else's copy? If that were the case, we can push the date of the prescription back further. As for why someone interested in medicine might have visited, the "Enclosure of the Temple of Ptah" at Memphis included a temple to Imhotep, who in addition to being the deified architect of the Step Pyramid at Saqqara, he becomes identified with the Greek god Asclepius in the Ptolemaic period of Egypt. 

Now, as I have said, this is an extremely old temple site, even though modern excavations cannot go lower than the Ramesside period (from memory around 1200 BCE) because of the water-table. The age of the site makes me wonder about the nature of where this prescription was inscribed. Galen wrote a little before he quoted the prescription (K13.776-7):

...if you were to be at the Hephaesteion in Egypt you would discover writing outside the innermost sanctuary exactly like the dia tou diktamnou [treatment through dittany].

I cannot imagine that the walls of the antechamber before the room in which Ptah's cult statue was kept would have been available for a random Greek prescription inscribed upon it. I am seriously wondering whether this prescription was recorded in Egyptian hieroglyphics. 

An Egyptian family line continued to be the priests and caretakers for the temple without a break throughout the Ptolemaic period, coming to an end when Augustus took personal ownership of Egypt. The Ptolemies did enforce the use of Greek in temple decorations. We also see numerous examples in other Roman period temples where Roman emperors are shown in pharaonic dress and the use of hieroglyphics. 

All of this makes me seriously contemplate the idea that the plaster is Egyptian in its original writing, if not origin. This means that we have no real idea regarding just how old this prescription is. Ancient Egypt had a long and respected medical sciences history. If this was indeed written in Egyptian, someone translated this prescription and rendered it into Greek language and measurements.

Small Commentary on the text:

Anthrax: this is the skin infection of the disease which caused carbuncles and legions, that is most commonly associated with livestock.

Swollen parotid gland and Scrofulous swellings: the parotid problem is either a blocked salivary gland or an infection (including possibly tuberculosis), while scrofulous swellings relate to an infection in the neck's lymph glands. These diseases shared a lot of pharmacological treatments in the classical world. 

Abscesses and boils: these also shared a lot of treatments.

Toxicology: there were a lot of treatments which were meant to treat all kinds of venomous bites. The shrew-mouse is not venomous, but was widely believed to have been in antiquity; even Aristotle thought it was. The inclusion of human bites here is a recognition of the difficulty in treating human bites owing to the potential for infection. Curiously, Galen wrote about how he had no sympathy for people who struck slaves in the head and ended up with wounds from the slaves' teeth which did not heal easily as a result.

Pain in the neck, shoulders, and joints: The combination of muscular and joint conditions which could be treated by using this plaster as an emollient makes me think of modern products like Deep Heat and Tiger Balm.

Diluting in rose ointment: Rose oil was a common treatment in Greek and Latin headache remedies.

Eye conditions: These were common complaints in antiquity and given the sand of Egypt it was likely worse.

Fumigants: A fumigant is typically used by burning something to make smoke which is used. This might be a treatment for "wandering womb", a condition that Galen knew did not actually exist. Oddly, sweet smelling items were placed to draw the womb down to its proper position, but the use of this to also scare off venomous implies it smells bad. Another common fumigant against creatures is staghorn which stinks.

General thoughts on the plaster's usage: Up until the fumigant uses, this all read very similarly to other multipurpose treatments used within the Graeco-Roman world that I have come across. The use of a fumigant for both a womb and animals seems to be a distinct change.

Old oil: 2 cotyle if an Attic measurement would be 546 mls.

Litharge/lead monoxide: 100 Attic drachmas is 345 grams. This is a very heavy product, and would only amount to 7.24 metric teaspoons.

Verdigris: 8 Attic drachmas 27.6 grams. If this is the same as crystal verdigris, this is 2.94 metric teaspoons.

Flakes of copper ore: 6 Attic drachmas is 20.7 grams and would be .46 metric teaspoons.

Liquid Colophonian resin: it is odd that we have no amount. Galen wrote about how numbers could drop out of prescriptions. This might be an example of the same happening to him.

Pine Resin: 50 Attic drachmas is 172.5 grams.

Powdered frankincense (also known as manna): 12 Attic drachmas is 41.4 grams.

Ammoniac incense: 16 Attic drachmas is 55.2 grams. This is incense from the region of the Oasis Siwa in the desert west of Egypt and is named for the famous oracle of Zeus-Ammon there.

Burnt copper: 8 Attic drachmas is 27.6 grams. Oddly, Dioscorides' On Medical Material states that the best of this is processed at Memphis.

Pyrites: 6 Attic drachmas is 20.7 grams. Galen described collecting his own from a copper mind on Cyprus.

Gentian: 6 Attic drachmas is 20.7 grams. The root seems to have been the part used.

Aloe: 8 Attic drachmas is 27.6 grams. The finest quality was imported dried from India.

Galbanum: 12 Attic drachmas is 41.4 grams. This is the resinous juice of Ferula galbaniflua.

Propolis (bee glue): 8 Attic drachmas is 27.6 grams.

Wax: 25 Attic drachmas is 86.25 grams. This refers to bees wax.

Birthwort/aristolochia: 10 Attic drachmas is 34.5 grams. There were multiple kinds of aristolochia identified in Greek and Latin texts, but this prescription does not define which.

Cretan dittany: 10 Attic drachmas is 34.5 grams. This is the ingredient which the plaster is named after, but it is not the largest ingredient. With it being named last, might this reflect a prescription convention in which the active ingredient is listed last? If this is a much older prescription, this use of dittany from Crete is not unusual. There is evidence for contact between Crete and Egypt dating to the Minoan period in the Bronze Age, well before the Ramesside period of Memphis.

General thoughts: There is almost an entire kilogram of dry ingredients used in the preparation of this prescription. No wonder it says to use a large dish to make it.

Looking through my collection of materia medica, I only have a limited number of those used here: Bees wax, frankincense, Cretan dittany, galbanum (in the little pot at the front). The two stones are malachite (left) and chrysocolla (right) which are mentioned by Heras as being used replacing the dittany to make a plaster for malignant sores. I find that he removed the ingredient for which the plaster was named to make another medicament rather odd but might reflect his own experimentation in pharmacology.

In conclusion: Having written this blog, if I were more confident in my Greek translation, I would definitely be trying to write this for publication. Maybe I should call upon a friend to work together.

Addendum

The day after I first posted this, I ran a discussion session with students that I have mentioned previously on this blog, devoted to this passage. I would like to share some of the outcomes of that discussion that are interesting and insightful.

Given that the first ingredient is oil, a question was asked about the risk of oil fires. When looking at the method, this was at first prepared over coals. If additional heating was required, it is specified as a "light fire". On reflection, this suggests that the risk of oil fires might have been deliberately avoided when compounding drugs. It might be interesting to see if this is a trend when looking the directions for making other drugs with a large oil component.

While I questioned the order in which the ingredients were listed, a student pointed out that the list loosely followed the order in which they were added. I had not actually noticed that. Again, this might be worth some comparisons with other prescriptions.

In case it was not apparent, this is a prescription for a "batch mix". I doubt very much that almost a kilogram of this stuff was used per treatment, especially considering its use as a drawing ointment and an emollient for muscle and joint issues. Once this was made apparent, it was questioned about who might have originally made this plaster. Was this plaster originally made by the priests of the Ptah at the temple? If this was the case, why them? This made me consider whether like today, the making of drugs was a different specialty to being a doctor in Egypt. Was it perhaps a craft? If so, it being made in a temple devoted to craftsmen might make sense. The idea of the priests of a craftsman god, Ptah, making ingredients for use in the temples devoted to healing within the temple complex (at least that of Imhotep if not Sekhmet) appeals to my imagination. For publication, I would need to look into these possibilities.

So, as is often the case, discussing these things with students is always worthwhile. The conversations always lead you to address issues of assumed knowledge (e.g. how much of this stuff was used), to directing your thoughts in ways you might not have considered previously. While the numbers of students who attend these sessions are never huge, I always come away feeling appreciated and viewing the ancient world in a slightly different manner to before. And that is always a good thing!

Limited Bibliography:

Kuehn, C. 1827, Claudii Galeni Opera Omnia, volume 13, Leipzig.

Dioscorides, 2005. De materia medica, trans. Lily Beck, Hildesheim: Olms-Weidman.

Anthes, R. 1956, "A First Season of Excavating in Memphis." Museum Bulletin XX, no. 1, pp. 3-25. Accessed August 06, 2024. 

Keyser, P. T. and Irby-Massie, G. L. 2008, The Encyclopedia of Ancient Natural Scientists, Routledge: London.

Markovic, N. 2018, "Changes in Urban and Sacred Landscapes of Memphis in the Third to Fourth Centuries AD and the Eclipse of the Divine Apis Bulls," The Journal of Egyptian Archaeology, vol. 104, pp. 195-204.

Nutton, V. 1993, "Galen and Egypt," in Galen und das hellenistische erbe, Franz Steiner: Stuttgart, pp. 11-31.

Omran, W. 2016, "The Egyptian and the Hellenistic Characteristics of the Asklepieion," International Journal of Heritage, Tourism, and Hospitality, vol. 8, pp. 70-111.