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The Alphabet of Galen: Pharmacy from Antiquity to the Middle Ages – A Critical Edition of the Latin Text with English Translation and Commentary

The Alphabet of Galen: Pharmacy from Antiquity to the Middle Ages – A Critical Edition of the Latin Text with English Translation and Commentary by Nicholas Everett. Toronto, Canada: University of Toronto Press; 2012. Softcover, 445 pages. ISBN: 978-0802098126. $95.00.

Galen (129–post 215 CE), also referred to as Galen of Pergamon (a Greek city-state in what is modern-day western Turkey), was a 2nd century naturalist philosopher and physician to the Roman emperors Marcus Aurelius and Commodus. Galen is credited with numerous writings as well as the development of alcohol (wine)-based botanical extracts (later known as “galenicals” in pharmacy), among many other accomplishments.

The Alphabet of Galen’s prologue claims to present “every medicine derived from minerals, as well as aromatics, and from every species of plants” — in all, some 220 plants, 61 minerals, and 19 animal drug products. This treatise is one of the more important pharmaceutical texts from the early Middle Ages, with surviving manuscripts from the 7th through 11th centuries. This important work has been little known until Nicholas Everett’s thorough, competent study and English translation. The earliest manuscript, Everett finds, is probably from the region of Ravenna, Italy. Manuscript copies vary considerably, but the critical text is thorough and skillfully presented.

First, even though the treatise was published in the Kühn edition of “complete works” by Galen (20 volumes in 22 parts; Leipzig, Germany, 1821-1833), the text is not by Galen. The sources that the unknown author employed are as mysterious as the author’s obscurity. Harnessing linguistics and the best tools available to modern scholars, Everett postulates that the author was learned in Greek as well as Latin and utilized sources that are now lost. The unknown author employed neither the Greek nor Latin works of the 1st century CE Greek physician and herbalist Dioscorides (an unexpected observation by Everett), nor closely followed any surviving classical texts. Everett also postulates (persuasively to this reviewer) that similarities to Dioscorides, Galen, and the Roman naturalist Pliny the Elder (23–79 CE) drew upon texts that probably included Sextius Niger’s lost work on pharmacy, which Dioscorides and Pliny used as well. Thus, this popular work in Late Antiquity and the early Latin Middle Ages preserves plant and drug lore from “the ancient and most popular authorities,” to quote from the epilogue (which itself may have been added to the text).

Most of the chapters’ formats on plants have the following: (1) a brief description, origin, or location (with India mentioned most frequently for more exotic plants); (2) a simple statement for most of the plants’ general “properties” or virtues (such as “sharp, heating, and loosening properties” for cardamom [Elettaria cardamomum, Zingiberaceae]); and (3) uses and other applications primarily for medical afflictions. The author avoided (but not completely) what we would call superstition or magic, even more so than rational classical authorities such as Dioscorides and Galen. To us, verdigris (a green pigment) might or might not be good as an eye-salve, but it is bizarre when “some” mix it with an infant boy’s urine, according to the text. Similarly, donkey dung mixed with vinegar “relives toothaches.” These examples withstanding, the Alphabet of Galen is notable in the absence of what appears to us as truly irrational uses.

The book’s alphabetical order served ease of use. Everett provides an excellent analysis of pharmacy in what he describes as “self-medicating in late Antiquity” and an implicit theory for associating properties with specific medicinal actions. For example, opium (derived from Papaver somniferum, Papaveraceae) has a “cooling” property that “alleviates earaches, reduces all types of fatigue in the body, and for this same reason it also induces sleep” (italics supplied). Similarly, licorice (Glycyrrhiza glabra, Fabaceae) has “moistening properties…therefore quenches thirst, and relieves pain in the kidneys and bladder.” The connection between properties and specific medicinal applications is inconsistent, thus, for example, a cooling action rarely points to a specific medicinal affliction. Many plants have no properties specified.

The opium account delivers an objective, succinct description about harvesting, preparation, and adulteration, but omits the assertion by Dioscorides that “when too much of it is drunk, it plunges into a coma and it is deadly.” “Uniquely,” Everett finds, the Alphabet of Galen claims the best opium comes from Spain. Many therapeutic uses “hold up remarkably well against the finds of modern science,” although some “seem to have no biological or physiological basis and remain puzzling,” he writes. An example of what to us is rational, mastic gum (Pistacia lentiscus, Anacardiaceae), according to this book, “is styptic…It is good for those coughing up blood,” whereas only recently have our laboratories proved it useful for peptic ulcer disease.

With an unknown author living in an unknown time and place and using many unknown sources, the Alphabet of Galen is an important, largely overlooked, and certainly unstudied treatise whose popularity mostly was confined to Late Antiquity and the early Latin Medieval West. Despite its title, it is not connected to Galen, which is a characteristic of the period’s contrivance to lend authority to the composition. The original treatise was written in Latin, using “simple, technical language;” Everett’s competent English translation achieves the same. The Latin and translation are on facing pages. Nicholas Everett’s study is important for two primary reasons: to elucidate an important Western medical work on pharmacy, and — especially for HerbalGram readers — to establish a significant young scholar who can provide technical and linguistic skills to help us understand early herbal medicine.

—John M. Riddle, PhD Professor Emeritus of History North Carolina State University Raleigh, NC