The Book of Theriac represents a history of theriac, from the first composition that consisted of only five drugs, including laurel leaves, believed to be effective against poisons, up to the famous theriac of Andromachus, transmitted by Galen, which was composed of about 70 drugs including viper’s flesh. The first pages show the portraits of the nine Greek doctors who, one after the other, took the theriac of their predecessor and enriched it with the introduction of new drugs and who thus widened the scope of therapeutic applications.

In chronological order, and respecting the vocalisation given by the scribe, they are: Andrūmakhūs al-Qadīm (or Andromachus the Elder), Abrāqilīdus (or Heraclides), Aflāghūris (or Philagrius), Afarqalis (or Proclus), Yūyāghūris (or Pythagoras), Mārīnūs (or Marinus), Maghnas al-Ḥimṣī (Magnus of Mesa), Andrūmakhūs al-Qarīb al-‘Ahd (or Andromachus the Younger), Jālīnūs (Galien) (Galen). Two of these scholars, Galen and Andromachus, are indeed known as having given a more significant contribution to the history of theriac. The Greek sources distinguish between an Andromachus the Elder and an Andromachus the Younger, that is between the father who invented the theriac based on viper flesh and described it in verse form and the son who put the father’s work into prose. However, this does not correspond to the distinction in question here, which is between an Andromachus the Elder whose existence is lost in the dim and distant past (on page 24/14 it is written that 1442 years passed between the first production of theriac by this Andromachus the Elder and the death of Galen…) and an Andromachus the Younger. Two more of these physicians are mentioned in Greek sources for having effectively composed a theriac. One is Heraclides of Taranto who lived at the end of the third century and beginning of the second century BC. Galen reports some of his recipes, one of which includes nine drugs, as in the Book of Theriac. The other is Magnus to whom Galen attributes the recipe for Hedychroum tablets, which is taken from the Arabic text. Philagrius, Proclus, Pythagoras and Marinus are also physicians mentioned in the Arabic biographical dictionaries concerning Antiquity. Their names are used in these cases to designate various preparations, however their effective role in the history of theriac remains to be confirmed.

The history of theriac, even when presented in a simplistic and partially mistaken manner, demonstrates that its composition is the result of trial and error rather than theory. It is based on the idea of constant progress, from the origins up to the period of Galen. Each doctor improved the theriac of his predecessor. Belief in the progress of medical knowledge, and in scientific knowledge in general, existed in the Arab world. Thus the physician and philosopher al-Rāzī (ninth century) claimed “to have understood, by persistent examination of the writings and books of the Ancients, truths that they had been unable to reach, so much is it true that research, examination and persistent effort perforce lead to increased knowledge”. However, this belief was not shared by all, since an adversary of his responded: “However, if he who comes after understands things that conflict with what has been said by those who have gone before, this will be negative and will represent a further step towards blindness. Therefore you will not be saved by those who come after you. They will overtake you and will reduce to nothing what you have established. There is no longer hope for truth”. Here the history of the progressive development of theriac stops with Galen, and therefore no significant improvement was made to theriac composition by the Arab physicians.

A compilation taken from Galen’s treatises
It is not known by whom, when, or in what language the Book of Theriac was originally written. In Greek, in Alexandria in the fifth or sixth century? In Syriac, in a city or convent of upper Mesopotamia in the sixth or seventh century? In Arabic, in Baghdad in the eighth or ninth century? These three hypotheses are plausible since these are significant moments and places for the transmission of Greek and Hellenistic medical knowledge to the Arab world. The environment of Alexandria is equally important for the assimilation of Galenism and the explicit reference to the work of compilation carried out by Yaḥya al-Naḥwī al-Iskandarānī suggests Alexandria as the place of origin. Yaḥya al-Naḥwī (the Arabic form of the name of John the Grammarian or John Philiponus) lived in the first half of the sixth century in Alexandria (here he is referred to as al-Iskandarānī, the Alexandrian). This great figure of the intellectual life of Late Antiquity was renowned for his comments on Aristotle, although the Syrian and Arabian authors consider him as the representative par excellence of ancient knowledge and apocryphally attribute to him a series of medical treatises.

However, it is not clearly stated whether Yaḥya al-Naḥwī was the author of the Book of Theriac or if a later compiler borrowed it from him. In any case, this work was composed, directly or indirectly, starting from Galen’s treatises, as indicated by the title given above and below the portraits of the nine physicians in a formula that is – to tell the truth – a little obscure: “In the name of God the Merciful and Compassionate. Compilation (in Arabic jawāmi‘, a word in the plural that refers to the dual idea of summing up and collecting) of the first treatise of Galen’s book on electuaries (ma‘jūnāt) in which he has dealt mainly with the theriac electuary, according to the interpretation give by Yaḥya al-Naḥwī al-Iskandarānī, in the manner of extracts (jawāmi‘), he has in fact eliminated all that was not useful in this book and has maintained the extracts (jawāmi‘) that were useful, making them the basis on which he has constructed his book”. The majority of Galen’s book was translated into Syriac, and from that language into Arabic. Ḥunayn ibn Isḥāq, the great Christian translator who lived in Baghdad in the ninth century, left a short work in which he describes the 129 books written by Galen that he knew of, and where he mentions the different versions made by his predecessors or himself.

The book De theriaca ad Pisonem was also translated into Syriac by Ayyūb al-Ruhāwī, then into Arabic by Yaḥyā ibn al-Bitrīq. The books on antidotes were also made into two versions: the first in Syriac by Yuḥannā ibn Bakhtīshū‘ with the assistance of Ḥunayn himself, the second in Arabic by ‘Īsā ibn Yaḥyā. All these translators came from the same milieu of Nestorian Christian scholars in Baghdad and worked during the ninth century. The Book of Theriac is not the translation of one of these works, nor of any of their passages. However the subjects, deas, anecdotes and recipes that are given are exactly the same as those that were already to be found in Galen’s books. Like De antidotis, it is organised in two parts: the first part, by far the more important, is dedicated to theriac, while the second deals with other electuaries.

The composition of the theriac of Andromachus, with about sixty ingredients, the scilla tablets, and those of viper flesh and Hedychroum, is identical except for some slight variants. The long passage on the different types of snake, on the preference to be given to the female viper, on how to catch it and prepare it, develops from the descriptions that can be found in various treatises by Galen. The more theoretic pages on the composition of theriac (classification of the ingredients into groups and definition of the weight of each of them), and its therapeutic action presented in the Book of Theriac as deriving from the Galen’s contribution, correspond to the ideas developed in the De theriaca ad Pisonem. To describe more precisely the parallels between the Book of Theriac and its Greek sources would involve lengthy and difficult research, especially since access to Galen’s work is not the same for its author as for us. He had the opportunity of knowing certain of Galen’s works that have been lost, and above all there is no evidence that he did not work directly from the original works; he might very well have used compilations like those that were drawn up precisely in Alexandria in Late Antiquity, notably Epitome medicae libri septem (Medical Compendium in Seven Books) by Paul of Aegina.

The three anecdotes that allowed Andromachus to discover the therapeutic interest of viper flesh offer a significant example of the difficulty to precisely identify the sources of the Book of Theriac. He first describes a farmer suffering from elephantiasis, a form of leprosy, who was healed after drinking wine from a jar in which there was a dead viper. As mentioned above, this identical story can be found in chapter XI of De Simplicium Medicamentorum Temperamentis ac Facultatibus. In the case of the second, which tells of the recovery of Andromachus’ brother, the Greek origin has not yet been discovered. The third, of a servant who was imprisoned and poisoned but who recovered thanks to a viper’s bite, is reported in the Book of Poisons probably edited at the end of the ninth century by Jæbir ibn Îayyæn with the name of Galen, but the passage is not found in the author’s treatises that are available to us, and this demonstrates that Galen’s texts, or those attributed to Galen, of which we know nothing, circulated in the Greek and Arab world. In the same passage Jābir ibn Ḥayyān reports another anecdote: a man bitten by a snake recovered by eating laurel berries, and Andromachus, who witnessed the scene, then had the idea of preparing a drug based on laurel berries.

Yet again, the reference to Galen on the part of the Arab author, remains to be confirmed by modern scholars. This story is also recounted in the Book of Theriac, but by a mysterious Andromachus the Elder, however, who was witness to this recovery and creator of the first theriac based on laurel. Regardless of these erudite reflections and the uncertainty surrounding the development of the texts, the Book of Theriac is undoubtedly a compilation founded, whether directly or indirectly, on Galen’s treatises. It brings nothing new to its Greek and Hellenistic heritage.

Text by Françoise Micheau with the assistance of Gérard Troupeau.

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