Galenic Pharmacy: An Introduction

The Four Qualities

Galenic medicine, named for the second-century physician Galen of Pergamon and built on the Hippocratic writings before him, judged every substance by four qualities in two pairs: hot or cold, and dry or moist. Each pairing answers to one of the four elements: fire is hot and dry, air hot and moist, water cold and moist, and earth cold and dry. Every entry in the database that has a recorded nature shows it as a small square of the four elements, with its quarter lit in gold.

The Four Degrees

A quality came in strengths, graded in four degrees. In the first degree its action is too slight for the senses, and known only by reason; in the second it is plainly felt; in the third it is vehement and does harm if misused; in the fourth it is extreme, burning or benumbing, and able to destroy. So rue was hot and dry in the third degree, garlic hot and dry in the fourth, opium cold in the fourth, which is why so small a dose could kill.

The Four Humors and the Complexions

The body held four humors, each with the qualities of an element: blood (hot and moist), yellow bile or choler (hot and dry), phlegm (cold and moist), and black bile or melancholy (cold and dry). Health was their right balance; each person’s natural mixture was their complexion, sanguine, choleric, phlegmatic, or melancholic. Disease was an excess or corruption of a humor, and the rule of cure was contraria contrariis, contraries by contraries: a hot illness was met with cooling remedies, a moist one with drying. This is why Canale, in his manual of healing the bewitched, prescribes differently for the choleric, the phlegmatic, and the melancholic.

Simples and Compounds

A simple was a single substance, an herb, a resin, a mineral, used as nature gave it. A compound was a made medicine of several simples, blended so that their qualities corrected and strengthened one another. The standard compounds were kept ready-made in the apothecary’s shop and set down in official books, from the medieval Antidotarium Nicolai to the Ricettario Fiorentino of 1498, the first official pharmacopoeia of a city, and the London Pharmacopoeia that Nicholas Culpeper put into English in 1649. The greatest of all compounds were the universal antidotes, mithridate and theriac, of sixty ingredients and more.

The Forms of Medicine

Decoction and infusion

Herbs boiled in water, or steeped in it without boiling.

Syrup and julep

A decoction or juice boiled with sugar or honey to keep; a julep is a thinner, sweet draught. See syrup of sorrel.

Electuary and confection

Powders worked into a soft paste with honey or sugar, taken from a spoon: the lenitive electuary, diacatholicon, the confection of hamech.

Conserve

Fresh flowers or leaves beaten with sugar, as roses and borage were.

Troche and pill

Powders bound and shaped into lozenges or small balls: troches of agaric, golden pills, cochia pills.

Species

A named powder of several aromatics, ready to be made up into other medicines: species pleris archonticon.

Oxymel and mulsa

Honey boiled with vinegar, or with water or wine: oxymel and oxymel of squill, honeyed wine.

Oil, ointment, and plaster

Herbs steeped in oil, or worked into wax and fat, for anointing and dressing the body.

Suffumigation

Smoke or vapor from substances burnt on coals, taken in through the nose or around the body. In the exorcists’ art the sweet smokes, frankincense and myrrh, honored God, and the foul ones, sulfur and asafoetida, tormented the spirit.

Amulet

A substance worn or hung, working by its hidden virtue rather than by being taken: peony root, red coral, the amulet herbs.

Preparing and Purging

Treatment followed an order. First came the preparatives, syrups and waters meant to ripen (concoct) the offending humor and make it ready to leave the body; then the purge, which drove it out, by stool with senna, rhubarb, and hellebore, or by vomit with the white hellebore and antimony; then the comforting remedies that restored the heart and brain. Canale’s manual follows exactly this course, chapter by chapter, before it turns to baths, fumigations, anointings, and amulets.

The Apothecaries’ Weights

Recipes also measure by the handful (manipulus, M.), the pinch (pugillus), and the equal part (ana, āā). Local pounds and ounces differed from city to city, so the modern figures are approximate.

After Galen

The system held for some fifteen centuries, reshaped by the Arabic physicians, above all Avicenna, and by the universities of Salerno, Montpellier, and Padua, until the chemical medicine of Paracelsus and his followers, and then modern physiology, displaced it. Its words survive: a galenical is still a medicine made from a plant or animal source by the old methods, and the complexions live on in English as sanguine, phlegmatic, choleric, and melancholy.