Hiera Picra.
A medicine with this familiar name can be bought in any chemist’s shop in Europe or America to-day, just as it could in Damascus a thousand, or in Rome and Alexandria two thousand years ago. Probably it is the oldest pharmaceutical compound still in existence. Through all the centuries the hiera picra known to the public has been a preparation of aloes. The adjuncts have varied but aloes has always been the essential ingredient, with one celebrated exception.
The origin of this medicine is variously stated by medical historians. The common theory is that it first acquired fame as a remedy employed in one or other of the Æsculapian Temples. This may have been the case, but there is no evidence in support of the suggestion. It is possible that the name may have suggested the notion, and the drug vendors of Rome would certainly not discourage the fancy.
Before the time of Julius Cæsar there were no physicians in Rome. Greek practitioners of the minor arts of medicine, such as bath-keepers, corn-cutters, tooth-drawers, and herbalists crowded into the great city as it became rich, and opened shops which were known as “medicinas,” and it is likely that most of these brought with them a more or less famous “hiera,” claiming that it had been compounded from a genuine Temple formula.
Leclerc, an excellent authority on all matters concerning ancient medicine, attributes the first Hiera to Themison of Laodicea, who practised in Rome about 50 B.C., and who is reputed to have been the first physician to make use of leeches. The Hiera of Themison was composed of 100 drachms of aloes, with 1 oz. each of mastic, saffron, Indian nard, carpobalsamum, and asarum.
The Hiera of Galen, which was modified from that of Archigenes, was originally in the following form:—
Socotrine aloes, 100; cinnamon, spikenard, xylobalsamum, mastic, asarum, and saffron, of each 6; honey to make an electuary. In the P.L. this was ordered to be kept in the form of species, and was principally used to make a tincture which was called tinctura sacra. In the 1721 edition the mastic and the spikenard were omitted, cardamom seeds being substituted for the latter, and some cochineal was added with a view to colouring the tincture. In 1746 hiera picra became simply a mixture of aloes and canella, and as such it was retained in the following edition (1788), but under the title of Pulv. Aloeticus, which in the Index is given as “olim Hiera Picra.” This was the latest reference to Hiera Picra as such in the London Pharmacopœia. The P.L. of 1788 gave also a Pulv. Aloeticus c. Guaiaco, which consisted of 1½ oz. of Socotrine aloes, 1 oz. of powdered guaiacum, and ½ oz. of aromatic powder (afterwards called Pulv. Cinnamomi Co., and compounded of cinnamon, cardamoms, ginger, and long pepper). The canella mixture did not appear again, but that with guaiacum was repeated in all the subsequent London Pharmacopœias including the last in 1851, but was dropped from the British Pharmacopœias.
Pil. Rufi, our Myrrh and Aloes pill, was originally a Hiera invented by Rufus of Ephesus, who lived in the reign of the Emperor Trajan. The Hiera was made into pills by the Arabs, and were for a long time known as Pilulæ Pestilentiales, which was the name Avicenna gave them. In the early Edinburgh Pharmacopœias they were called Pilulæ Communes.
Scribonius Largus, physician to the Emperor Tiberius, relates (A.D. 52) that one of these noted hieras, the Hiera Pachii, was much sought after, and that large sums had been offered for the formula. When Pachius died at Antioch the Emperor had his library searched, and the true recipe for the famous medicine was there found in a book which Pachius had prepared and had dedicated to the Emperor. Tiberius handed the formula to Scribonius with instructions for its publication. The formula given by Scribonius, which it will be noted contained no aloes, was as follows:—Colocynth, agaric, germander, white horehound, Arabian stœches (a sort of lavender), of each ℥x; opoponax, sagapenum, parsley seeds, round birthwort root, white pepper, of each ℥v; spikenard, cinnamon, myrrh, and saffron, of each ℥iv; despumated honey, 3 lb. 3 oz. 5 drachms, to make an electuary.
It is not necessary to describe the other hieras devised by later authorities, but it may be noted that the Hiera Tralliani compounded by Alexander of Tralles (about 550 A.D.) contained scammony, and that he advises concerning it that the quantity of scammony shall not be increased, as it appears some were inclined to do, not knowing that thereby they make it useless. For he says it is not the intention that the medicine should be carried immediately through the system. It should be detained in the body and conveyed to the remote parts so as to correct the various humours, open the passages, remove the obstructions of the nerves, and make way for the motion of the spirits. This was the formula given in the P.L. 1721 under the name of Hiera Diacolocynthidis, but our present-day hiera picra has descended from the Hiera Simplex of Galen. The old dispensatories up to the eighteenth century give a liberal choice of Hieras, among which were the Hiera Simplex Galeni cum Agarice, Hiera Logadii, Hiera Antiochi, Hiera Archigenes, Hiera Tralliani, Hiera Rufi, Hiera Justi, Hiera Constantini, and others. Originally these were all electuaries made with honey. It became the practice, however, to keep them in the form of “species,” and ultimately electuaries went out of fashion altogether.